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Old 07-28-2007, 12:06 AM
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Morning Glory
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Pin-pointing Nasty Cognitions

PIN-POINTING NASTY COGNITIONS

Robert W. Westermeyer, Ph.D.

Albert Ellis was a pioneer in the area of cognitive therapy (e.g. Ellis, 1961; Ellis and Grieger, 1977). Back in the 60s he developed what he called the A-B-C model. This model, according to Ellis, describes the sequence of events that ultimately lead to our experienced feelings. He recommends that people break down their experience into these three areas in order to discover if distortions or "irrational beliefs" are present. "A" refers to Activating Event. Activating events are the experiences we encounter. These events are described in objective terms and all views or opinions about the event are not considered. "B" refers to Belief. Here what the event means to you is listed. In other words, what do you believe to be true about the event "A?" The difference between an activating event and the associated belief is that "A" will be the same for all, yet the way the event is construed will vary from person to person. "C" refers to Consequent Emotion, the resulting feelings experienced as a result of our interpretation of the event. Ellis contends that people differ with regard to their feelings associated with events solely due to the fact that they have different interpretations.

For example, imagine two people are intimidated in a bar and only one resorts to becoming angry and punching the antagonist. If our emotions are a product of experience only, then why did only one get angry enough to punch the guy? If emotions were caused solely by events then both would have resorted to violence. Ellis would contend that the two people appraised the provocation in different ways. Consider four possible emotional outcomes of the same event:



What this illustration suggests is that our emotions are largely dependent on how we evaluate ourselves, events that befall us, our actions and the actions of others. Each of us establish in the course of our lives a basic understanding of ourselves and the world around us.

Therefore people are going to differ with regard to the styles of thinking they engage in on a regular basis. Some people make very dismal and hopeless interpretations of everything. Consequently, these people tend to be down more often. Others seem to see provocation in just about everything, and they are therefore angry a good deal of the time. Some people, on the other hand, seem to be able to assess most situations in a manner that rarely makes them experience the extremes of negative emotions. They just seem to be "balanced" emotionally most of the time. The last example in the ABC illustration represents a much more balanced (and probably more accurate) interpretation of the bar patron's insulting behavior.

In cognitive therapy, people learn how to pay attention to automatic thoughts and recognize those which are distorted. There are a number of techniques which can be easily implemented when distorted thoughts are identified so that more balanced, realistic interpretations can be discovered.

Cognitive therapy techniques are simple in theory but require constant practice. Remember, by paying attention to your thoughts and altering them, you are going up against a powerful process; stream of consciousness thinking. We are constantly thinking, and most of the time we don't put a great deal of effort into addressing the logic of our thoughts, we just trust them to be sound and reliable. In order for cognitive techniques to work for you, you have to practice them every day. Every time you identify a distorted thought and modify it, you have strengthened a new way of thinking, which can eventually become automatic. Each time you miss out, or ignore a distorted thought, you strengthen old ways. This does not mean that you will be forced to scrutinize every thought which enters your mind for the rest of your life--this would make anyone crazy! The key is to implement most where the distortions lie. Few think erroneously all the time. The more effort you put into practicing cognitive techniques in high risk situations, the less risky they will become.

The first step in tackling negative thoughts is to learn how to "tease" them out of your every day experience. Aaron Beck, who developed cognitive therapy of depression(Beck et. al.,1979), recommends monitoring your thoughts throughout the day. This way you gain "proof" of the inordinate amount of negative thinking which occurs when depression is present. Your self monitoring form should look something like the one below.





Below are explanations as to how to fill out the first three columns accurately.



EVENT: What is happening right now. The event should be listed in very objective terms, like "playing cards with my sister." as opposed to "Sister acting like a total bitch while playing cards." Any interpretation of the event will be listed under Automatic thoughts.

EMOTIONS: How do you feel? Some people confuse feelings for thoughts. They may say, I feel ripped off! In actuality, "ripped off" is not a feeling, it is a belief. How do you feel about being ripped off? Angry? Sad? Then rate your emotion on a scale of 0-100% (0=no negative emotion, 100=the most intense this negative emotion can be experienced). It is useful to create your own mood ruler by thinking about events in your past which have been associated with different percentages of the negative mood and compare current mood states to these events for accurate gauging. For example, 0% depression might be likened to a honeymoon, 25% to normal hassles of the day, like waiting in line, 50% to an extreme argument with a close friend, 75% with losing, 100% with the dissolution of a marriage.

AUTOMATIC THOUGHTS: What did you say to yourself in response to the event? What went through your mind? Your automatic thoughts are the beliefs attached and meaning assigned to events. For example the automatic thoughts associated with the event, "calling old girlfriend and being hung up on." might be, "I'm a loser...I completely ruined any potential for a relationship." It is important to pinpoint the automatic thought which is causing you to feel badly. This is often difficult, as there are always many thoughts occuring. Do a quality check on the automatic thought you have identified. If "I hope the grocery isn't crowded" is the automatic thought you have associated with 75% depression, you have not identified the true culprit cognition. Because, in and of itself, this automatic thought would not lead to this severity of depression. Knowing the COGNITIVE THEMES OF NEGATIVE EMOTIONS can be helpful in identifying the cognitions most related to the negative mood state:

1. DEPRESSION

A. COMMON THEMES: HOPELESSNESS, WORTHLESSNESS, HELPLESSNESS

B. COMMON AUTOMATIC THOUGHTS: "I'M WORTHLESS", IT'S HOPELESS", "I CAN'T DO ANYTHING", "I'M UNLOVABLE", "NO ONE LOVES ME", "NOTHING GOOD EVER HAPPENS TO ME", I'LL NEVER AMOUNT TO ANYTHING", "MY FUTURE HOLDS NO PROMISE", "THERE IS NOTHING I CAN DO TO CHANGE THINGS".



2. ANXIETY

A. COMMON THEMES: DANGER, VULNERABILITY

B.COMMON AUTOMATIC THOUGHTS: "IT WILL BE TERRIBLE", "I WILL CERTAINLY FAIL", "I WILL NOT BE ABLE TO COPE", "PEOPLE WILL THINK I'M AN IDIOT", "NO ONE WILL LIKE ME", "I'LL NEVER RECOVER".



3. ANGER

A.COMMON THEMES: BEING TREATED UNFAIRLY, DELIBERATE PROVOCATION, UNREASONABLE OBSTACLES

B.COMMON AUTOMATIC THOUGHTS: "SHE IS DELIBERATELY TRYING TO ANGER ME", "THIS IS NOT FAIR", "I SHOULD NOT HAVE TO TOLERATE THIS", "THERE IS NO REASON FOR HIS BEHAVIOR", "SHE SHOULD KNOW BETTER", "THE ONLY REASON FOR HIM DOING THAT IS STUPIDITY".



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So when you have identified an emotion, refer to the above discription of cognitive themes. Ask yourself, "If I'm this anxious, I must be feelign vulnerable to something? How would I word that?" or "If I'm this depressed, I must be feeling some degree of hopelessness, helplessness and/or worthlessness. How would I word that?" This technique will make your thought records efficient.

Here are some examples of self-monitoring lists which were filled out accurately:



The best time to monitor automatic thoughts is when you are feeling badly. The more monitoring the better, as this is the data for scientific scrutiny, which comes next.

DAZZLING YOURSELF WITH REASON

After monitoring your experience and breaking it down into these specific components, it is time to examine the cognition--it must be determined whether the thoughts listed could benefit from some re-constructive surgery.

The forth column is labeled, "Balanced Comebacks." It is in this space that you subject your beliefs to the rules of science. Scientists are particularly interested in experimental control and evidence. They are always conducting experiments to determine whether their hypotheses are supported. Therefore, in cognitive therapy, your automatic thoughts and beliefs are hypotheses to be tested. One way to modify biased thoughts is to know how thoughts become distorted.

Below are the six common distortions:

1. THE MENTAL FILTER: You take the negative details and magnify them while filtering out all positive aspects of a situation.

2. DICHOTOMOUS THINKING: There is no middle ground. Things are either/or, black /white, good o/bad. You're beautiful or hideous, perfect or a complete failure.

3. MIND READING: You can suddenly read minds. Without their saying so, you know exactly what people are thinking, and especially with regard to you.

4. CATASTROPHIC EXAGGERATION: The worst case scenario is going to occur, and it will be intolerable.

5. BLAMING: You hold other people solely responsible for your anguish.

6. CONTROL BELIEFS:

A. I AM CONTROLLED: You feel completely at the mercy of external forces. You are helpless.

B. I MUST CONTROL: You feel that any ease on the reins control in your life will result in a fall so disastrous you will never regain control.

Beck and his colleagues recommend several questions, which you can ask yourself when you suspect distorted thinking. To determine whether your belief is completely accurate ask yourself, "What evidence I have to support the belief?" and "What evidence you have which refutes it?" These questions are useful in identifying thoughts which are biased in that they do not consider all available information. Beliefs like, "I've made a complete fool of myself" and "no one loves me" are almost always distorted to some degree. You can divide a piece of paper and put the data which supports the automatic thought on the left side, and the data which refutes it on the right side. If you have any data whatsoever on the right side (usually there will be at least a little bit) then the automatic thought is necessarily biased, or missing data.

Consider the third example from the above self-monitoring: Where is the evidence that you are worthless? Worthless is a pretty strong word. Perhaps you believe that the break up of a relationship which you valued more than any other is evidence enough. Well than approach it from another angle: Where is the evidence that you are not worthless? Do you have any relationships which are not tainted? If yes, does this relationship then make the general belief that I am worthless inaccurate? Do completely worthless people morn lost relationships? Certainly not. The fact that you are concerned about what happened is a sign of worth. Did you put any effort into the relationship what so ever? Yes? Does that make you worthless? Probably not. More likely it makes you someone who either needs to pursue relationships with people who are accepting of this aspect of you or use the information and work toward modifying this quality. Either way it is a sign of growth, not worthlessness!

So, after such empirical rigor, it is hard to resist the second investigative question to ask yourself. "Is there another way of wording the automatic thought?" If the above question resulted in the identification of a distortion, then what would be a more realistic way of thinking? What modifications to the belief would make it more balanced? In the above example, it is apparent that the automatic thoughts were a bit skewed, to say the least. A much more realistic interpretation would be something like, "The break up with Greg is no doubt a bummer. I miss him terribly. However, we just didn't click. I thought we did, but I guess there were certain qualities that he didn't like. I'm not willing to give up who I am, and I really think I put an effort into trying to make it work. I learned from this relationship and hopefully it will benefit me in my future relationships."

Other questions which can be helpful in disputing biased cognitions are:

* What would my spouse, best friend, sibling (or anyone whom you admire greatly) say to themselves in this situation?

Sometimes distancing oneself from the situation at hand is enough to help see it in perspective. Imagining that our beliefs are being experienced by people we know to think realistically is often helpful in bringing a distortion into focus. Almost everyone knows at least someone who seems to be able to view things in a way which doesn't make them feel bad. How would they handle what you are grappling with?

* What would I say to my spouse, best friend, sibling if they were thinking the same thing I am?

Another distancing technique which many find helpful is to imagine someone you care deeply about voicing the same belief. Almost everyone is better at picking up on an exaggeration of distortion in others than ourselves. Furthermore, we all are better therapists of others than of ourselves!

* How could I look at this situation so I would feel less depressed. Is this view as reasonable as my first choice?

Brainstorming is a proven effective method for unlocking good ideas. Essentially, you must try to allow all ideas to come to mind uninhibited. When disputing a potentially distorted thought, brainstorm all potential alternatives. You might come across one or two which are much more appropriate, and make you feel better to boot.

It is important to capitalize on every opportunity to counter depressive thoughts. In time, if you keep at it, you will notice that reasonable examination of automatic thoughts will become second nature. This skill will enable you to manage negative mood throughout the day and make you much more robust to the emergence of clinical levels of negative mood.

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