DQ Eee kk ~ in A D4 pec In syerh tealtae 12 CBT ts doct leu Byrtalioapy, Val helps pele te wre ong luence ove ete, Mrougda = Ore, are 7 1, hob. |- Rome Jerealty ave nal pretlenabe, tl ou. reoobion th ai ! 7 ral Cause Pratlea’ COGNITIVE Ky |AVIOR THERAPY eo ‘aluation Of Negative Automatic Thoughts Or ‘Thought Challenging’ “For There Is Nothing Either Good Or Bad, But Thinking Makes I(S0" "Wiliam Shakespeare, Maret Automatic Thoughts (ATs) * The term ‘automatic thought" was coined by the Ibert Ellis used a similar termed called '$elfalk” Psychologists also use the term for Ais as well ‘ good analogy is that ATs are like reflexes that occur quickly and spontaneously to an event. Automatic thoughts develop fom repeated experiences: For example, if someone were 4 constantly criticized by their parents, they might have the thought “I can’t do anything right” cvery time they made even the slightest mistake. This could develop into an automatic thought every time they are faced with a similar situation because repeated experiences have ‘led to the same result, that of being criticized. ‘The thought also becomes automatic because our minds can only hold so much information at a time. Our mind develops pattems or short cus to interpret our individual reality that become automatic reactions to events. Challenging Negative Automatic Thoughts © |NATS [com Without any efTortandautGmately, tha’s why they are known as negative automatic thoughts. The one become, the more of these types of negative thoughts he/she have, and the more he believes them, © This type of thinking is called a/VieiGUS\Gifeley The best way to help reduce these depressed feelings, is to break this Vicious circle. Overcoming the Problem CBT Practioner aims to help their clients I they are thinking negatively, to look for more positive and realist experiences, and then to test these out in action learn to recognize when ic ways of viewing their Ay & Scanned with OKEN ScannerIk by taking & © CBT Practioner teach clients to challenge their negative thoughts and self-tall a ep back and ¥ such as that from a friend and by “~~ >) f f Challenging NAT eee eee Frtosnal worry Y~ Step 1: Becoming aware of negative thoughts. dist ist of all, clients need to become aware of what negative thoughts are, an rece v9) te She wt what NOUCE them. fotice when mood changes, and think abou Novice was running through the mind at that moment. By doing this one can become more aware of changes in the way they are feeling ange to jdentify the thoughts that are underlying these a clients find it \ oe | a The best way to do this is to Usually Trestle down there negative thoughts, because they 1 OF “might be frightened, or even think they’are stupid. If they are feeling very upset while filling your NATS, they have to wait until calmed down before looking for some ways to answer thoughts back. (Step 2: Answering Negative Thoughts. Once client learn to become aware of his negative thoughts, the next stage is to try and answer the thoughts back and find more realistic and helpful alternatives. © 1. What is the evidence for your thought? «© Do the facts of the situation back up what you think? | 2 U2. What alternative reasons could there be for what has happened? °° Try and think of as many alternative explanations as can be and look at the evidence for and against them. |” 3. What is the effect of thinking in the way one do? US 4, What are the thinking errors clients are making? . |, and they end up and & Scanned with OKEN ScannerSPALG 24 Restle Reappraie? - Lele anus AAU Vy a Rest, Reap anid a | pe \Fefent managed to answer his negative thoughts in a more positive way, hs belie? in the negative thought definitely decrease etait Rabionalter * HOWTO CHANGE NEGATIVE THINKING — MPiU 59D » all “In CBT, thease be asrestiic and ekjestvews pM changing negative thinking i called, ‘examples: + I'm a loser, an idiot, a failure. + eg MII never be able to do it. + I'm losing control. + I {feel like dying. + People always put me -« that down, + Helshe doesn’t {care orlove-me. + They'll laugh at me, 2. Pick out the t cater -feally make you feel the emotion the most. Consider this th (s). 3 a “Negative thought(s). Write down the in you see the situation differently? Remember that we all make yr fall into thinking {raps sometimes. It might be helpful to identify which one you have made. Look at all the aos Now rte how you, feel. Did any other positive emotion come, such as relief, as a result of changing your negative thinking? Be aware of. Teach clients to be aware of "should, musts, butS).” and challenge these thoughts in the same way. Don’t expect your beliefs in the negative thoughts to disappear completely in one go. Vamibexpect your beliefs in the * Learn to answer your negative thoughts well, you will need to take time and practice regularly. * Don’t forget, don't put yourself down, and don't set yourself perfectionist standards, as this will only make answering your thoughts back harder. 20 Questions to identify NATs__ 2 1.Am I confusing a thought with a fact? ns? v2. Am | jumping to conclusi -® 3. Am I assuming my view of things is the only one possible? © 4, Do negative thoughts help or hinder me? “® 5. What are the advantages and disadvantages of thinking this way? * 6. Am I asking questions that have no answers? & Scanned with OKEN Scanner7. Am I thinking in all or nothing terms? 8. Am L using ultimatum words in my thinking? 9.Am [telling myself I'm a bad person because of things that have happened recently? '0.Am concentrating on my weaknesses and forgelting my strengths? 20 Ques ms to identify NAT '1-Am [blaming myself for something that isnot really my fault? 12, Am 1 taking things personally? 13. Am L expecting myself to be perfect? 14. Am Lusing a double standard? 7 Am I only paying attention to the black side of things? 16. Am | overestimating the chance of disaster? 17. Am | exaggerating the importance of events? 18. Am worrying about the wa 'y the way things ought to be rather than dealing with them as they are? 19. Am L assuming I can do nothing to change my situation? * 20. Am I predicting the future? Clients need to do things to help them prove that their negative thoughts are wrong. The best way to do this is to act on rational answers to prove to whether negative thou ights are true or false. Actions will help to break old habits inthe way one thinks and strengthen their neve positive way of thinking. Testing Out clients Predictions * © People are like scientists they make predictions, and then act on them (e, rain I'll get cold and wet"; “IF I press the bell, the bus will stop”), They use information from thet experiences to citer confiim predictions, , rather than using it to prove or change predictions, 8. “IfT stand in the ° ‘orto change them, — Many of negative thoughts take the form of predictions (eg. “I won't be able to cope”; “Everyone wit hee 1 & Scanned with OKEN Scannerme": “IF say what 1 think everyone will reject me”.) While questioning these thoughts or Predictions, review the evidence for and against them, look for alternatives and take action to test them out, teach your clients that they are like scientists running an experiment to examine anew theory. ‘ing Out clients Predictions. ‘The following points are the steps you need to take to test out your predictions: ‘State Your prediction or negative thought clearly. 2. Review the existing evideniée for and a 7 —_ ae will help you test the truth of your prediction, like doing an ‘4. Write the results down: a) If your prediction or negative thought is shown to be false. then n has shown you a positive alternative what you were originally thinking. b) If your prediction or negative thought is shown to be true, do not wor also valuable information, and you can think about what you were doing to bring about that result. You can then try and work out a way of acting or thinking differently in the future to try and bring about a more positive result. Once you have done this, set up another experiment to challenge your prediction or negative thought. Aebus “q 5. Think about what G6RGIURTBRBSou ean draw from your results Example: Yasir, A Level Student In class yasir never asks questions, because he is frightened he will look stupid. 1. Prediction “If I ask questions people will think I am stupid” 2. Review of the evidence If | was stupid, 1 wouldn’t be inthis class in the first place. Ignorance is not the same as stupidity, at this stage in the course there are bound to be many things I don't yet know. I don’t think other people are stupid because they ask questions. 1 have no evidence that other people think I'm stupid, infact the teacher encourages questions, Asking questions is a good way to learn, 3. Experiment | Over the next weeks, observe what questions are asked and what reactions they get form people. Results Lots of questions asked and no bad reactions that | could sce. Several questions led to stimulating discussions, Teacher actually said that one question was good, and I wes thinking ofthat question. If only | had the nerve to ask it. Jim asked a couple of questions \with obvious answers, but it wasn't a disaster, everyone laughed ineluding him & Scanned with OKEN Scanner5. Conclusion On the evidence, no-one is likely to think me stupid for asking questions. Even ifa question was stupid, it need not be a disaster - It does not mean that | am stupid. $ Experiment 2 Ask « question in class next week. Prepare for it by reviewing what | have done here, Cognitive Restructuring, ‘The term cognitive restructuring refers to the process of efiallenging, and changing, negati and irrational thoughts sone technique to encourage this process. Therapists use Socratic questioning verbally by asking probing questions about their clients’ irrational thoughts, * As clients improve their awareness of negative and irrational thoughts, they can begin to. consciously question their own thoughts * Putting Thoughts on Trial is a CBT activity focused on the examination of negative thoughts. Client will act as a defense attorney, prosecutor, and judge, as they compare evidence for and against a single thought. Like in a real court of law, only verifiable facts are admissible as evidence. Opinions, assumptions, and conjecture are not allowed Cognitive errors and falling into thinking traps Thinking traps are ‘how we think’ about a situation, which results in ‘what we think’ or automatic thoughts. The end result is an associated emotion and behaviour. © Clients frequently fall into what are called *Gognitive errors or ‘cognitive traps". When clients became able to identity the common negative thought wraps they can then challenge these by applying a more rational, balanced approach to their thinking, (One of the first things people do when they ae experiencing a lot of negative thoughts isto try and not think about them, or push them out of their mind. However, this doesn't always work. In fact the more they try not to think about something the more it can intrude into their minds © Psychoeducate clients rather than continually asking why ie. Why don’t | feel any beter it is more helpful for people to ask themselves what i.e, What am I going to do to make myself feel better?". Worrying People tend to worry when they feel anxious about the future ‘Set Worry Time & Scanned with OKEN ScannerSet worny time __7® Psychoeducate clients to help manage their worry it can be useful to set yourself some Vv = * This involves Setting’a'Specific 10 minute’slot when you will sit with a pen and paper and write down all your worties, ° yw (0 0 teh, ‘You then 5 “Is there anything 1 can do about this worry right now?”. 4 © Ifthe answer is yes, then ag ahead problem-solve and come up with a plan of action: ° . Hoveyer if your answer is no, then ask yourself: “ean I/deal with later?”, and if the answer is still NO, then try to Tet your worry go and focus on something else such as another activity or relaxation. Fox fit Time of worry - Itis important that if you find yourself worrying outwith your allocated worry time, that you [defer Your worry until then: For example if your worry time is 7pm and you worry at 10am, you say ‘I will deal with this worry during my allotted worry time so will dismiss it just now and focus on what I was doing instead’. What people have found who have used this technique is that they often forget some of thei 8, of realise that they are unnecessary and unrealistic. * Perfectionism © There are 3 ways in which we can be perfectioni s, we can believe that: 1. we have high 's and become critical when we do not meet these expectations 2. we i and become critical of them when we feel that they do not meet them id can lead us to feel rejected, ashamed or angry if we think that we have not achieved what is expected of us. Thinking this | way can lead to low mood and anger. This is because weno longer get‘any enjoyment out of> “ what'we'do’becauserwe are too busy worrying about the outcome. If our standards are not met we can become critical of ourselves and other people. When this criticism is directed at ourselves it leaves us fecling down. If our anger is targeted at other people this ean lead us to feeling guilty and damage our relationships. Ulimately this can leave us wi h low self esteem. Challenging Perfectionism & Scanned with OKEN Scanner[ challenging Persectionism / 1" is common to think that if we do not hold high expectations of oursel we wi and others then iH ot be successful in life. However, success is about being able to fail. Afterall if we then we are more likely to try again, Consequently, By a€e=ptine without damaging our ships. Quick Questions to help challenge unhelpful thinking It takes time to learn thought challenging. It ean be useful then to have some handy and quick questions that you can ask yourself when ever your thinking is negative. It can be good idea to write these down ‘tne ‘or keep them on your mobile so that you can read them to cope with fai ‘ded. . ; . 1). Is ithelpful to think in this way? Ifnot, Why not? ew er? 2). What are the consequences of continuing to think in this way? -feel worse, bett 3). What would you say to a friend who was being so critical of him/herself”? - Would you agree with them? - If not, why not? * Another way of challengiag NATs is called Cost-Benefit Analysis. This really means looking at both theladvantages and disadvantages of continuing to hold a particular thought or belief. t © Firstly Sélect a thoughtor belief which client wish to work on. “© © Then try to think of the advantages of holding that thought, Put them in the Benefits column) in the table below. * Following this, list the costs that holding the thought has on life. Make an effort to fist more ‘E coms (disadvantages) than benefits (advantages). Thought: “I should always strive to get others approval” Benefits of Thought Cost of Thought It means I try hard tw get people's | approval and not let this slip. I's exhausting and means I'm always striving, 11 stop tying | people might not like me as much, Trying hard all the time actually makes me feel worse! It puts me off meeting people, Lowers my mood, Makes me fee! more anxious around people. © This is a useful exercise for clients to think actually Gosts more than they realize: & Scanned with OKEN Scanner