We may also use it after using a stress diary, when we see that we are frequently experiencing bad moods of a particular type or in particular circumstances.
To use the tool, go through the following steps:
- Write down the situation that
triggered the negative thoughts:
Make a brief note of the situation in the first column of the worksheet.
- Identify the moods that you
felt in the situation:
In the second column, enter the moods that you feel in the situation. Moods here are the deep feelings that we have about the situation. They are not thoughts about it.
“Mind over Mood” offers an easy trick to help tell moods from thoughts: It is usually possible to express moods in one word, while thoughts are more complex. Keep in mind, you may well feel several different moods at the same time. These reflect different aspects of the situation. For example, “he is trashing my suggestion in front of my co-workers,” would be a thought, while the associated moods might be “humiliated”, “frustrated”, “angry” and “insecure”.
- Write down the Automatic Thoughts
that you experienced when you felt the
mood:
In the third column, write down the thoughts that came into your mind when you felt the mood. Identify the most distressing of these.
In the example above, thoughts might be:- Maybe my analysis skills aren’t good enough…
- Have I failed to consider these things?
- He hasn’t liked me since…
- How rude and arrogant of him!
- Everyone will think badly of me
- But my argument is good and sound…
- This is undermining my future with this company
In this case, the person in this example might consider that the most distressing thoughts (the “Hot Thoughts”) are “maybe my analysis skills aren’t good enough,” and everyone will think badly of me”.
- Identify the evidence that
supports these Hot Thoughts:
In the fourth column of the worksheet, write down the objective evidence that you can find that supports the Hot Thoughts. Developing this example, the evidence written down might have been:- The meeting moved on and decisions were taken with no account being taken of my suggestion
- He did identify a flaw in one of
the arguments in my paper on the subject
- Identify the evidence that
does not support the Hot Thoughts:
In the next column, write down the objective evidence that contradicts the Hot Thoughts.
Evidence contradicting the Hot Thought in the example might be:- The flaw was minor and did not alter the conclusions
- The analysis was objectively sound, and the suggestion was realistic and well founded
- When I trained in the analysis method, I usually came close to the top of my class
- My clients respect my analysis and
my opinion
- Now, identify fair, balanced
thoughts about the situation:
By this stage, you will have looked at both sides of the situation as far as you can. This should have clarified the situation. You may now have all the information you need to take a fair, balanced view of the situation.
Alternatively, you may find that there are still substantial points of uncertainty. If this is the case, then you may need to clarify this uncertainty, perhaps by discussing the situation with other people who have a view or by testing the question in some other way. Obviously, the amount of effort you put in does depend on the importance of the situation.
Do what is needed to come to a balanced view and write the balanced thoughts down in the sixth column of the worksheet.
The balanced thoughts in this example might now be:- I am good at this sort of analysis. Other people respect my abilities.
- My analysis was reasonable, but not perfect
- There was an error, however it did not affect the validity of the conclusions.
- The way he handled the situation was not correct.
- People were surprised and a little shocked by the way he handled my suggestion (this comment would have followed a conversation with other people at the meeting).
- Finally, observe your mood now
and think about what you are going to
do:
You should now have a clearer view of the situation.
Look at your mood now. You will probably find that it has changed and (hopefully!) improved. Write this in the final column.
The next step is to think about what you could do about the situation. You may conclude that no action is appropriate. By looking at the situation in a balanced way, it may cease to be important.
Alternatively, you may choose to do something about the situation. If you do, you may find that some of the techniques explained elsewhere on this site are useful. The Assertiveness tool is most likely to be particularly useful in dealing with problems with other people!
Make a note of these actions in the final column, but also put them on your To Do List so that you act on them.
Finally, think through positive affirmations that you can use to counter any future negative thoughts of this type, and see if you can spot any opportunities coming out of the situation.
Concluding the example above:- Mood: Compared with the moods felt at the start of the example, the mood experienced by the person completing the worksheet will have changed. Instead of feeling humiliation, frustration, anger and insecurity, this person is most likely to feel only anger.
- Actions: A first action will be to use relaxation techniques to calm the anger. Having done this, this person may take away two actions: First, to check his or her work more thoroughly and second, to arrange a meeting to discuss the situation in an assertive manner.
- Positive Thoughts: This
person could also create, and use,
the following positive thought in
a similar situation: “My
opinions are sound and are respected
by fair-minded colleagues and clients.
I will rise above rudeness.”
Awareness Is The First Step
Become aware of your cognitive distortions of choice. The first step in loosening the grip of cognitive distortions is to become aware of them. Take a look at this list and see which ones sound familiar. If you have a name for them, and some examples of how they work, they become much easier to recognize -- or harder to ignore! Once you become aware of your patterns of faulty thinking, you can begin to challenge these thoughts more and more: look for exceptions if you’re an all-or-nothing thinker; make it a point to look for evidence and try to find alternate conclusions if you find yourself jumping to conclusions or practicing emotional reasoning. With time and practice, this type of cognitive restructuring will become second nature to challenge your negative thinking patterns, and replacing them with more positive thoughts and views will become easy.
Recognize Your Power
Studies on burnout show that people tend to get more stressed when they feel that they don’t have a choice in what happens to them. In some situations, such as within the context of a job, there is very little choice. However, we can also create a choice-less reality in our minds when we fail to recognize when choices exist. Pay attention to your self talk: do you tend to say you ‘have to’ or ‘can’t’ do things a lot? The statement, “I can’t work out because I have to volunteer at the kids’ school again,” ignores the reality that both activities are choices. Just because one choice isn’t chosen doesn’t mean it wasn’t a choice to begin with. Changing your ‘have to’s and ‘can’t’s’ into ‘choose to’ and ‘choose not to’ (or some smoother-sounding approximations) can actually remind you that you do have choice in a situation, and help you feel less stressed. “I’d like to work out, but I choose to volunteer at the kids’ school instead,” feels less confined, and sounds more fun, doesn’t it? (For more on recognizing choices in your reality, see this resource on locus of control.)
Cut Down On The ‘Shoulds’
As I was studying to become a therapist, I once heard a colleague tell a client, "Stop ‘shoulding’ all over yourself." It was a cute way of helping the client notice how often she said the word ‘should’ when making plans. What’s the problem with the word ‘should’, you may ask? It’s another confining word that implies that there’s one way that things need to be done, and usually it’s a way mandated by someone else that doesn’t necessarily fit for your situation. The truth is, we do things because we want to (usually, but not always, because we have valid reasons for wanting to), and if our self talk reflects this, it usually feels much nicer. “I should call my friend” sounds and feels better as, “I’d like to call my friend”. And if this is not a true statement, you might reconsider the action.
Actively Focus on the Positive
Often people place an inordinate level of focus on the negative, discount the positive, or fail to see the positive altogether. This leads to a world view that can seem overwhelming, and problems that feel insurmountable. When you place a focus on the positive aspects of a situation, and make peace with the negative, the situation becomes less stressful. If people are rude to you done day, go out of your way to notice the people who are neutral or polite. If things just seem to be going wrong one after another, make an effort to notice and appreciate what does go smoothly. Along these lines, many people find that keeping a gratitude journal -- a daily log of things for which they are grateful -- is immensely helpful in that it not only supplies a list of blessings to look over, but it trains the mind to notice these blessings throughout the day, and it affects their whole experience of stress.
Stay In The Here And Now
When dealing with a problem, try focusing on what’s happening right now, without projecting into the future or dredging up the past; it keeps you dealing with what’s going on now. For example, interpersonal conflicts are often complicated by past grievances, and when people focus on not only what’s happening now, but on all the previous times they’ve been angry at each other, and project into the future that things will never change, their anger and frustration sharply escalates. Try to stay in the present, the specific problem, and finding a solution that works. This can effectively help you deal with a variety of stressors without becoming as overwhelmed. (For more, also see this article on communication skills.)
Again, if you’re dealing with a more severe form of stress or a clinical disorder, you’ll see the best results with a trained therapist. However, these techniques for cognitive restructuring can be helpful in changing negative thought patterns to relieve daily stress; with practice, you may see a significantly positive change in outlook, and a decrease in your experience of stress.
Sources:
Burns, David, M.D. Feeling Good: The New Mood Therapy. Avon Books:New York, NY, 1992.
Fava GA, Ruini C, Rafanelli C, Finos L, Conti S, Grandi S. Six-Year Outcome of Cognitive Behavior Therapy for Prevention of Recurrent Depression. American Journal of Psychiatry. October 2004.
CBT techniques, part 1: Cognitive restructuring
Introduction
This is the first in a
series of three articles describing the primary techniques of Cognitive
Behavioral Therapy (CBT). Prior to reading this article, please read my
Introduction to CBT and my disclaimer regarding information provided on this website.
This article focuses on a
set of techniques called “cognitive restructuring,” which help to to
promote more accurate and useful thinking. It is very helpful in
treating depression, anxiety, and other problems.
An overview of cognitive restructuring
CBT holds that most of our
emotions and behaviors are the result of what we think or believe about
ourselves, other people, and the world. These cognitions shape how we
interpret and evaluate what happens to us, influence how we feel about
it, and provide a guide to how we should respond. Unfortunately,
sometimes our interpretations, evaluations, and underlying beliefs
thoughts contain distortions, errors, or biases, or are not very useful
or helpful. This results in unnecessary suffering and often causes us
to react in ways that are not in our best interest.
Cognitive restructuring is a
set of techniques for becoming more aware of our thoughts and for
modifying them when they are distorted or are not useful. This approach
does not involve distorting reality in a positive direction or
attempting to believe the unbelievable. Rather, it uses reason and
evidence to replace distorted thought patterns with more accurate,
believable, and functional ones.
An illustration
To illustrate the role of thoughts in influencing emotions and behavior, consider the following vignette1:
Suppose you are at a party and have been introduced to Alex (you can
imagine Alex as a male or as a female). As you talk, Alex never looks
at you; in fact, throughout your brief conversation s/he looks over
your shoulder across the room. What are you thinking and feeling, and
how would you respond?
This is deliberately an
ambiguous situation that can be interpreted in many ways, because much
of life is like this. We often have to make sense of what is happening
to us based upon limited information. Let’s consider how three
different people interpreted and reacted to this scenario:
Person A thought “Alex is
rude. S/he is insulting me by ignoring me.” As a result, they felt
annoyed and they terminated the conversation and avoided Alex at future
parties. Person B thought “Alex doesn’t find me interesting. I bore
everybody.” As a result, they felt ashamed and depressed, and they left
the party and became more likely to decline invitations to parties in
the future. Person C thought “Alex seems shy. S/he’s probably to
uncomfortable to look at me.” As a result, they felt sympathetic and
attempted to engage Alex in a conversation about how Alex knew the host
of the party.
This vignette illustrates
that given the same situation, people can have very different
interpretations and reactions. Often these are indicative of recurrent
patterns of thought and underlying beliefs. CBT holds that when we are
experiencing problems in our lives, it can be very helpful to become
aware of these patterns and beliefs and to be curious about how accurate
and useful they are.
The cognitive (ABC) model
Albert Ellis,
one of the pioneers of CBT, illustrated how our emotions and behaviors
are often the result of what we think or believe with his “ABC model.”
In the model, “A” stands for the event or situation that triggers a
cognitive, emotional, and behavioral reaction. “B” stands for our
underlying beliefs about ourselves, other people, and the world and the
resulting interpretations and evaluations we make of the event or
situation. “C” stands for the consequence of our interpretations and
evaluations which can include both an emotional reaction and a
behavioral response. To show how the model works, I have used the
experience of Person B from the vignette above.
Cognitive distortions
The term “cognitive
distortion” refers to errors in thinking or patterns of thought that are
biased in some way. They may include: (A) interpretations that are
not very accurate and which selectively filter the available evidence,
(B) evaluations that are harsh and unfair, and/or (C) expectations for
oneself and for others that are rigid and unreasonable. The more a
person’s thinking is characterized by these distortions, the more they
are likely to experience disturbing emotions and to engage in
maladaptive behavior. A number of common patterns2 of cognitive distortions have been identified, including:
1. All-or-nothing
thinking: Looking at things in absolute, black-and-white categories,
instead of on a continuum. For example, if something is less than
perfect, one sees it as a total failure.
2. Overgeneralization:
Viewing a negative event as a part of a never-ending pattern of
negativity while ignoring evidence to the contrary. You can often tell
if you’re overgeneralizing if you use words such as never, always, all,
every, none, no one, nobody, or everyone.
3. Mental filter:
Focusing on a single negative detail and dwelling it on it exclusively
until one’s vision of reality becomes darkened.
4. Magnification or
minimization (e.g., magnifying the negative and minimizing the
positive): Exaggerating the importance of one’s problems and
shortcomings. A form of this is called “catastrophizing” in which one
tells oneself that an undesirable situation is unbearable, when it is
really just uncomfortable or inconvenient.
5. Discounting the
positive: Telling oneself that one’s positive experiences, deeds, or
personal qualities don’t count in order to maintain a negative belief
about oneself. Or doing this to someone else.
6. Mind reading:
Concluding what someone is thinking without any evidence, not
considering other possibilities, and making no effort to check it out.
7. Fortune telling:
Anticipating that things will turn out badly, and feeling convinced that
the prediction is an already established fact. It often involves: (A)
overestimating the probability of danger, (B) exaggerating the severity
of the consequences should the feared event occur, and (C)
underestimating one’s ability to cope should the event occur. B and C
are also examples of catastrophizing.
8. Emotional reasoning:
Assuming that one’s negative emotions necessarily reflect the way things
really are (e.g., “Because I feel it, it must be true.” “I feel stupid,
therefore I am stupid”).
9. Rigid rules
(perfectionism). Having a precise, fixed idea of how oneself or others
should behave, and overestimating how bad it is when these expectations
are not met. Often phrased as "should" or “must” statements.
10. Unfair judgments:
Holding oneself personally responsible for events that aren't (or aren’t
entirely) under one’s control, or blaming other people and overlooking
ways in which one might have also contributed to the problem.
11. Name-calling: Putting
an extremely negative and emotionally-loaded label on oneself or
others. It is an extreme form of magnification and minimization, and
also represents a gross overgeneralization.
In addition to the above list which is largely influenced by Aaron Beck’s version of cognitive therapy, Albert Ellis produced a similar list that highlights what he called irrational beliefs (which consist of faulty assumptions and unreasonable rules about life).
The origin and function of cognitive distortions
Where do these distortions
come from, and what purpose do they serve? Frequently, cognitive
distortions develop in childhood as the result of unfortunate and
difficult life experiences and/or being taught to use them by
significant others (e.g., parents and peers). We also become more prone
to cognitive distortions when under stress, because under pressure we
are apt to take more “cognitive shortcuts” resulting in less accurate
and more extreme interpretations and reactions. Cognitive distortions
can also serve the function of trying to protect us from harm. For
example, when a depressed or anxious person thinks, “I can’t do it,” it
justifies inaction and protects the person from possible failure. Of
course, this strategy is ultimately self-limiting and defeating, and
keeps people stuck in old patterns that don’t work very well.
How CBT views emotions
CBT is not saying that all
negative or painful emotions are bad and that we should always “think
positively.” Emotions such as fear, anger, and sadness can be very
appropriate and even useful. Fear can tell us there is danger, and
motivate us to protect ourselves. Anger can inform us that our rights
are being violated, and we need to take action to assert our rights.
Sadness can be the result of losing something or someone important to
us, and can indicate that we need to take the time to grieve.
What is important is not
whether an emotion is positive or negative, but whether it is adaptive
or maladaptive. Negative and painful emotions can be adaptive if they
are based on accurate thinking and guide an appropriate response.
Maladaptive emotions are driven by distorted thinking and cause
unnecessary suffering and inappropriate responses. One way of defining
mental health might be the extent to which one can recognize the
difference between adaptive or maladaptive emotions.
The process of cognitive restructuring
Cognitive restructuring
refers to the process of replacing cognitive distortions with thoughts
that are more accurate and useful. Cognitive restructuring has two
basic steps: (1) Identifying the thoughts or beliefs that are
influencing the disturbing emotion; (2) Evaluating them for their
accuracy and usefulness using logic and evidence, and if warranted,
modifying or replacing the thoughts with ones that are more accurate and
useful.
In CBT, the therapist
guides the client through the process of becoming more aware of what
they are telling themselves and helps them to evaluate, and when
appropriate, to modify their own thinking. In essence, the therapist
teaches the client a process that will help them distinguish distorted
thinking from more accurate and useful thinking. CBT emphasizes that
this is best done as a collaborative process in which the client is
assisted in taking the lead as much as possible. The therapist refrains
from assuming that the client’s thoughts are distorted and instead
attempts to guide the client with questions that encourage the client to
make their own discoveries. Clients are also encouraged to engage in
his process on their own during their time between sessions by using a
written format, described below.
The Cognitive Restructuring Worksheet
When learning Cognitive
Restructuring, it is very helpful to use a worksheet designed to guide
the process. I encourage you to download the Cognitive Restructuring Worksheet
(which is in Microsoft Word format) to have available as you read the
next section. Having it in this format allows you to print multiple
copies, or to type directly onto it. The table below depicts the main
headings of the worksheet.
The following are
instructions regarding how to use this worksheet. Below these
instructions is an example of a completed Cognitive Restructuring
Worksheet.
Part I: Identifying emotion-causing thoughts
Instructions: When you are experiencing a negative emotion use the following procedures to identify the emotion-causing thoughts.
1. Situation: Briefly describe the situation that led to the emotions.
2. Emotions / ratings:
Identify the emotions you are experiencing and any physical
sensations. Emotions can be described by single words, such as sad,
nervous, afraid, angry, guilty, or ashamed. For more examples of
emotion words, click here. Then, rate the intensity of your emotions using the scale below.
3. Automatic thoughts / ratings:
Identify the thoughts or images connected to the emotions and record
them in brief simple declarative sentences or statements. For examples,
see the completed worksheet below. (These thoughts are called
“automatic” because they tend to occur automatically or habitually).
Questions3 that may help you to identify thoughts are:
-
What is going through my mind as I am feeling this emotion?
-
What am I telling myself about this situation?
-
What am I afraid might happen?
Once you identify a
thought, you can further explore the meaning of the thought to you and
record these thoughts. Questions that may be helpful are:
-
If this thought is true, what does this say about me as a person?
-
What does it say about my life, and my future?
-
What is the worst thing that could happen if it is true?
-
What does this mean about how other people think about me?
-
What does this mean about how I think of other people?
-
What images or memories do I have in this situation?
Once you have identified a
number of thoughts, put a star by one or two of the thoughts that seem
to be producing the most emotion (“hot thoughts”). Then, rate your
degree of belief that each hot thought is true (0-100%).
Part II: Evaluating and modifying thoughts
The second part of
cognitive restructuring involves evaluating your automatic thoughts and
perhaps developing a new perspective that is more accurate and useful.
Instructions: Choose one or more “hot thoughts” to work on. It is best to focus on only one or two of these thoughts at a time.
1. Identify any cognitive distortions: Identify if the thought contains any cognitive distortions (refer to the list of common cognitive distortions).
2. Evaluate and modify:
Evaluate the accuracy and usefulness of the thoughts, and if warranted,
modify the thoughts in a more accurate and useful direction.
Some questions3 can help you evaluate the accuracy of a thought:
-
What is the evidence that supports or contradicts this thought?
-
Is there an alternative explanation? Is there another way of looking at it?
-
Am I overestimating the probability of the negative event occurring? What is the worst that could happen? What is most realistic?
-
Am I overestimating the severity of the consequences of the event (should it occur)? Is it really a terrible catastrophe if X happens? Could I cope with it?
-
Does X have to = Y (e.g., “Does not having a dating partner = being a loser?”)
-
If a friend had this thought, what would I tell them?
Some questions can help you evaluate the usefulness of a thought:
-
What are the advantages of telling myself this? And what are the disadvantages?
-
What might be a more useful or helpful way of thinking about this?
-
To the degree that this belief is true, what should I do about it?
-
-
Be sure to record any data that contradicts the thought, and the more rational thoughts you may have composed.
3. Summarize your new perspective: Summarize or highlight the key points you discovered as a result of the work you have done.
4. Go back and re-rate your
degree of belief in the hot thoughts and the intensity of your original
emotions. Note whether there has been a change in your emotions.
Example of a completed Cognitive Restructuring Worksheet
The following is an example of a worksheet completed by a semi-fictional 20 year-old male college student.4
He has come to counseling to get help with his depression, low
self-esteem, and social anxiety (e.g., fear of being judged negatively
by others). In particular, he is unhappy because he has never had a
girlfriend. This is largely because he has never initiated
relationships with females because he sees himself as undesirable and
likely to be rejected. The thought of initiating a relationship makes
him very anxious. In actuality, he is handsome, smart, personable, and
caring toward others. However, like many people with low self-esteem
and depression, he cannot see these positive characteristics in
himself. In this example, I selected two of his upsetting thoughts,
identified some of the his primary emotions, and then evaluated and
modified his thoughts using the procedures described above.
Comments: His original
automatic thoughts were marked by cognitive distortions that selectively
filtered the evidence (e.g., ignoring evidence contrary to the idea
that he is undesirable) and faulty reasoning (e.g., not having a
girlfriend must necessarily mean that he is undesirable). It was
distorted thinking like this that produced his social anxiety in the
first place earlier in his teens. In turn, the anxiety inhibited him
from pursuing relationships with females. As a result, he felt even
more unwanted and undesirable. Notice how a self-reinforcing vicious
cycle tends to develop between negative distorted thoughts and avoidance
behaviors. This cycle is what is behind many people’s problems with
depression and anxiety.
Troubleshooting cognitive restructuring
Frequently, people say that
they have completed the cognitive restructuring process and they know
that their thinking is distorted but they still feel that it is true.
When this occurs, they may be tempted to conclude that cognitive
restructuring isn’t very helpful. However, there are a number of
reasons that this might occur:
1. Failing to fully
identify the thoughts driving the emotions (including interpretations,
evaluations, and underlying expectations). It can be helpful to
explicitly answer all of relevant questions in Part I in writing.
2. Failing to fully
challenge and modify the thoughts. Often people stop once they see their
thoughts are distorted, but do not specifically identify what makes
them distorted or come up with alternative ways of thinking. It can be
helpful to explicitly answer all of relevant questions in Part II in
writing, and then to write out a summary of the alternative way of
thinking.
3. The distorted thoughts
serve a purpose, and people can be reluctant to let this go. Remember
that distorted thoughts often are an attempt to protect a person from
negative consequences. It can be helpful to ask, “What are the
advantages and disadvantages of believing this thought?” Often, there
are some advantages, but they are frequently outweighed by the
disadvantages.
4. Often cognitive
restructuring is not enough on its own, and a person needs new learning
experiences to convince them of what is true at a deeper level. This
means engaging in new behaviors, often of the type that the person has
been avoiding due to pessimism or anxiety. This can be where CBT
techniques such as behavioral activation (for depression) and exposure (for anxiety) can be very helpful.
5. Finally, it is helpful
to remember that it may have taken a lifetime to develop these patterns
of thought, and takes time and hard work to change them.
More about Cognitive Behavioral Therapy (CBT)
CBT techniques part 1: Cognitive restructuring (you are on this page)
CBT techniques part 2: Behavioral activation
CBT techniques part 3: Exposure therapy
Notes
1. This vignette was adapted from: Mind over mood- Change how you feel by changing the way you think, by Dennis Greenberger & Christine Padesky.
2. This list of cognitive distortions was partially adapted from: The feeling good handbook, by David Burns. Plume, 1999.
3. These lists of questions were adapted from: Cognitive therapy: Basics & beyond, by Judith Beck.
4. This semi-fictional male college student is a representative composite of several clients I have worked with over the years.
Cognitive Restructuring: Challenging Your Thinking
By Diane LaChapelle PhD LPsyc
What is cognitive therapy?
Cognitive therapy is a psychotherapeutic approach that focuses on how your thinking influences your feelings and behaviours. The idea is that it is your thoughts about things that happen - not the events themselves - that cause you to feel or behave in a certain way. This will be easy to understand if we look at an example.For this example, recall a time when you failed a test at school. If you have never failed a test, try to imagine what it might be like. How did you feel? Sad? Angry? Disappointed? Ashamed? How is it possible that so many different feelings could be associated with the same objective event? The answer is that different people give themselves different messages about the event.
| Possible thought | Resulting emotion |
|---|---|
| I am so stupid. Why can’t I understand such simple stuff? | Shame, depression |
| That teacher is useless. He/she cannot teach! Plus, he/she asks questions about things that were not even taught. | Anger |
| That was harder than I expected it would be. I guess I should have studied harder. | Disappointment |
| Wow, I am not good at calculus! I should get some extra help before the next test. It is a good thing I do not need to be a math whiz to major in history. | Neutral. Probably a bit disappointed for a short time but not feeling bad about oneself |
Whether you are reacting to failing a test, winning a lottery, or living with chronic pain, the process is the same. Consider the following example of Paul, who is dealing with the fifth snowstorm of the season. Due to a back injury several years ago, he is not able to shovel his driveway. How might he feel in this situation? Let's see how having different thoughts leads to having different emotional reactions to the event.
| A: Activating event | B: Possible thought | C: Emotional consequence |
|---|---|---|
| Unable to shovel | I am so useless. I am the man of the house and my wife is out there shovelling the snow! | Shame, depression |
| Great, more snow. Just what we need. Now I have to pay to have the driveway plowed. | Anger towards self, the snow, perhaps his employer if he was injured on the job | |
| My wife must be so mad that I cannot help her shovel. I’m sure she will end up leaving me when she realizes how useless I am. | Fear, anxiety | |
| More snow! I’ll call to have it ploughed so that I can enjoy the afternoon with my wife and kids rather than having to recuperate from shovelling. | Neutral, relief, happy |
Changing the way you think
The great news is that you can learn to change the way you think, and in doing so change the way you feel. This is not simply about "thinking positive." Rather, it is about evaluating the evidence for your thoughts and then challenging the truthfulness of the thought.The first step in challenging your thinking is self-monitoring. You need to become aware of the messages you routinely give yourself. This can be a little more difficult than it might first appear. The negative messages tend to be so automatic and routine that we not even be aware of them. Usually, you can quickly identify the activating event and the emotional consequence - you know what has happened and how you feel - but identifying the thoughts and beliefs that lead to the emotional consequence can be more challenging.
To identify the thoughts, you have to actually stop and examine them. So the next time something happens and you have a strong emotional reaction, take a few minutes to stop and record your thoughts. Simply ask your self the question "What am I thinking right now that is making me feel (angry, frustrated, sad, ashamed)?" Take out a piece of paper or keep a notebook handy and write down the event (A) and how you feel (C). Next, take a few minutes to write down all the thoughts you are having about the event (B).
The second step is to dispute your thoughts with more rational ones. You can download a useful worksheet here.
For example, consider the case of Angela who suffers from fibromyalgia. She wakes up Tuesday morning in a considerable amount of pain (A). She thinks, oh no, here I am again. This pain is awful, I can't go to work and I have so much to do. My boss is going to fire me this time. I just cannot deal with this anymore (B). As a result of these thoughts, she feels hopeless and depressed (C).
Having learned how to challenge her thoughts, however, she has an internal dialogue with herself. She replaces these thoughts with more adaptive thoughts. She tells herself the following: The pain is bad this morning but I know from past experience that it always improves after a hot bath and some stretching. I will call into work and let them know that I'll try to make it in this afternoon. My boss has always been understanding. He knows I'll do a good job this afternoon. It is going to be hard to catch up on the work, but I always manage.
After giving herself these messages, Angela feels more relaxed and better able to handle the pain and her work. She feels motivated to start her day with a hot bath.
Learning to dispute your irrational thoughts and replace them with more adaptive thoughts takes practice and effort. But if you stick with it and repeat the process for multiple events and emotions, you will get the hang of it and will see improvements in your mood. Soon you will be able to do it quickly and without the aid of pen and paper.
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