Cognitive-Behavioral Therapy Workshop
Step #3: Responding to Your Automatic Thoughts
Now you are getting to the heart of learning how to modify problematic Automatic Thoughts and improving your mood. The Strategies for Balanced Thinking as described below are powerful CBT strategies for modifying thoughts that cause us distress. Take a few minutes to read over them. You can also download your own copy as a .pdf file. We will be demonstrating some of them as Helen responds to her first Automatic Thought, "He is angry with me."
When you use your own Automatic Thought Record and try out these strategies, you should refrain from trying to move through them too quickly. It is best to sit with each strategy for several minutes until you truly exhaust all possibilities. It can be useful if you have someone who can help you brainstorm responses to your thoughts using these strategies.
Strategies for Balanced Thinking
What is the evidence for your thought? Against it? (Rate % of each = 100%)
This is where you need to put on your scientist's "cap" and really look objectively at the evidence you have that your Automatic Thought is both true and not true. Don't worry about how valid or ridiculous your evidence might seem at first, just write it down. Then, rate each group of evidence that supports your thought as true, and then not true. The two ratings should total 100 percent. Don't rate the two sides purely on how many statements you have for and against. Each item will likely have different weights for you based on their importance or validity. Just make a judgment call based on how valid you think each side is.
Would others agree that your thought is true?
Try to step outside of yourself as you answer this question. It can be very tempting to quickly answer, "Of course others would agree!" But would they really? Think of several family members or friends who, if they were right there with you, could give their opinions about whether your thought is true. Why might they disagree with you? Be careful about letting your thoughts be influenced by your emotions, or using only pieces of evidence to support your arguments.
What are some alternative explanations for your thought?
Again, with the scientist's "cap" on, let yourself come up with a list of probable or even not so probable alternative explanations to your thought. The longer you sit with this list, the more alternatives you are likely to generate.
What's the worst thing that could possibly happen? The best? Most realistic?
Also add, "Can I live with the worst outcome?" Sometimes we can become very distressed by events when we don't consider them in context with other things that could possibly happen. Our distress can seem like it's the worst thing we have ever felt, but when we compare it with something like experiencing nuclear holocaust, or death, the intensity of our feelings can diminish in comparison. So, to ask yourself, "Can I live with it?" the answer is yes!
If a friend in this situation had this thought, how would you respond?
Allow yourself to step outside of the situation for a moment by imagining your friend has come to you with the very same situation, thoughts, and feelings. As a compassionate friend, what would you tell him or her? Would you make the same conclusions and tell your friend he/she should feel distressed? What keeps you from being compassionate with yourself?
What are the benefits of this thought? The costs? (Rate % of each = 100%)
Here you are looking at the pros and cons. How beneficial is it to believe the thought versus not to believe the thought? Rate each side with both totaling 100 percent. Again, they shouldn't be rated by how many items you have for each side, but how much weight each holds for you.
Set up an experiment.
In the spirit of trying to gather evidence to test the validity of your thoughts, you can arrange an "experiment" to gather data and evaluate the outcome. For instance, if you believe, "I never do anything right," then for several days in a row you can record all the things you do right. Such things could include, "got the kids off to school," "drove safely to the store," "was nice to the clerk," "called to check on a friend," "took a walk to get some fresh air," "helped kids with homework," and "went to bed at a reasonable hour."
Define your terms.
When you label yourself or other people as "failure," or "loser," or something else, take a moment to define exactly what those labels mean as if it were a dictionary entry. You'll likely find that no one really meets such definitions.
Examine the logic.
Do your Automatic Thoughts have you jumping to conclusions that don't logically follow from the situation? Examples might include "I'm a terrible artist" because your painting didn't win first place in a competition. Determine what would be a more logical thought to have based upon the situation. For instance, "I'm a good artist. Not winning this contest doesn't mean I'm bad. I may place higher in a different competition."
Recognize limited information.
Do your Automatic Thoughts have you jumping to conclusions without enough information to back them up? You might find you are only looking for evidence that backs up your thought rather than evidence that doesn't support it, or even refutes it.
Examine shades of gray.
Instead of thinking about events in extreme terms, consider putting them on a scale from 0 to 100. What really is a 0 and what should be a 100? Where does your thought fit in? What other situations would also be on this scale? Rather than think about your experience as a total failure, let yourself acknowledge that it is a partial success. This technique is useful for modifying an "All-Or-Nothing" Thinking Style.
Examine your language.
Listen to how you speak to yourself, and/or examine the language of your Automatic Thoughts. Try using words that are less dramatic and emotionally laden. For instance, if you say or think to yourself, "I must get 'As' on all my tests," you might substitute, "I would like to do well in my classes. I will do the best I can." This technique is useful for modifying "Shoulds/Musts."
Examine your attributions.
Instead of blaming yourself for things that don't work out well, consider all the outside factors that have contributed to the situation. Rather than focusing on self-blame and guilt, let yourself work on solving the problem. This technique is useful for modifying a "Blaming" Thinking Style.
Take a poll.
Ask other people their opinions on an issue reflected by your thought. See if the evidence supports or refutes your thought. For instance, if you believe it is shameful and strange to feel shy or embarrassed in groups of people you don't know, ask a handful of your friends and family if they have ever felt shy when meeting new people.
Distinguish between people and behaviors.
Be careful about taking one behavior, situation, or feeling and letting that determine who you believe you are as a person. For instance, losing a competition doesn't make you a "loser" as a person.
Acknowledging variability in mood, thoughts, and behaviors.
Particularly with depression, it is important to accept that you will have variability in your behaviors, thoughts, and feelings. To expect strict consistency is unrealistic and sets you up for discouragement. If you see variability on your Automatic Thought records, be patient with yourself and determine whether this is expected and "normal" for depression.
Be your own "defense lawyer."
Pretend that you have hired yourself to defend yourself (e.g., make a positive case for yourself), and write down the strongest case you can think of in your own favor. It doesn't matter whether you believe it or not.
You can download your own copy of Strategies for Balanced Thinking as a .pdf file.