Our thoughts and our moods (Part 2)

CHANGING OUR RESPONSES

When we take the time to become aware of what we’re thinking - which we can train ourselves to do more and more quickly when we notice a change in our mood or distorted thoughts emerging - something else important happens: we aren’t automatically swept along in the tide of our thoughts and feelings, feeling overwhelmed and helpless and at the mercy of the world. There may or may not be much we can do about the situation, but there is everything in the world we can do about our response to events.

Just the mere fact of stopping and wondering what’s going through my mind when I notice I’ve become upset is doing things differently from how I might have done it in the past, and helps to slow the thinking process down before it gets a head of steam and I become overly upset at what is occurring, often without knowing how I got there. In a very real sense we disturb ourselves, without being aware of it, but if we practice these ideas and use these tools, we may begin to see the process for the first time as to how my moods are created, which in turn begins to allow us to do something about it.

Often at this point, a client may ask, “But my Grandmother died last year, shouldn’t I be upset about that?” Absolutely, grief is an appropriate response to that event. There is no cognitive distortion in the thought, “I am sad because my Grandmother died.” However, if you are still constantly depressed and grieving a year or two later, we might look for a cognitive distortion, such as, for example, “not only am I sad at my Grandmothers’ death, but that means I’ll always be alone now.” We can investigate the last part of this statement in particular and see if there is a distortion, and if there is, which seems quite possible on the face of it, we might determine that the extended grieving is due not so much to the death itself as to this interpretation of it - that “I will always be alone”. Then we can begin to dispute this ‘all or nothing’ interpretation to see if it is realistic.

NB Beware of the words “always” and “never” in our thinking, they’re rarely absolutely applicable to real life though we use them all the time, especially in our relationships: e.g. “You always act that way”, or “You’ll never change.”

THE ABC’S

Cognitive Psychologists have created many exercises that we can utilize to help us become aware of our thoughts and to challenge them, and I can’t stress enough how important it is, especially at the beginning of this work, that you take the time to write out and dispute your thoughts. This helps us to learn these lessons in a more thorough way. This is important because CBT is in many ways a ‘do it yourself’ therapy. YOU are the world’s expert on exactly that is going on between your two ears, so the more you slow down and begin to notice in detail how your moods are generated, the more successful you will be in the this work. And yes, it takes practice, the more you do, the better you will become at this work, and the more control you will have over your moods, it’s as simple as that. Of course I don’t want to fall into the trap of ‘all or nothing thinking’ myself, and say that all your problems will be solved if you do this work, but I can tell you that many scientific studies have shown that the majority of people show distinct improvement across a wide variety of emotional disorders and problems after having commenced and stuck with a course of CBT, particularly anxiety, though addictions as well.

There are various written exercises that different writers and researchers have come up with to assist the learning and disputing process, but one of the simplest and most effective that I have come across is the A-B-C method of Dr. Albert Ellis, one of the pioneers of CBT. We can also go through it mentally when we are having a problem, but it is even better to write it down in this format either around the time it is happening, or later on.

A = Activating event - the stimulus that seemed to set off the particular mood I find myself in right now; i.e., when did these feelings start?

B = Beliefs - my beliefs and (automatic) thoughts and mental images about A

C = Consequence - How I felt (or behaved) after A occurred

D = Disputation – challenging the thoughts, beliefs and conclusions I find at B, to see if B contains distorted, exaggerated or unrealistic thoughts and beliefs (and where we apply our list of Cognitive Distortions from page 8/9)

E = Energization – A positive message, commitment or action I can make to myself after having been through this process and been able to take a different perspective on the original event.

Here is an example of a person in a relationship with her boyfriend who complained of feeling down after she tried to be affectionate with him.

This is how she wrote an A-B-C on this event (NB See below for worksheet on this topic):

A = I tried to kiss my boyfriend David and he seemed cold and distant (This is the ‘activating event’ when I noticed my negative feelings began)

B = He didn’t seem interested in me at all. Maybe I’m too fat and he’s lost interest. I did see him talking to that new girl after the lecture, Mary. How could he do this to me anyway, I’ve been a good girlfriend, this really upsets me, its not right. (We’re not going to remember every single thought we may have had even if we’re doing this exercise right after the event, or even during it. However, we can usually get a pretty good sense of what we’re saying to ourselves. Here’s a hint: look for the hot thought. There’s usually something about the interaction that bothers us the most. In this case, it’s “maybe I’m too fat”, so zero in on this in particular and see how true this is.)

C = I felt rejected, inadequate, unattractive, a bit depressed and angry and so I went out and bought myself a pint of ice cream, even though I was supposed to be on a diet (notice that consequences include not just feelings, but behaviors as well!)

D = Well, I have gained a few pounds this year, and I would like to lose it, but is this really why he seemed cold and distant? (Mind reading) David has never commented on my weight, and actually said recently that he liked me the way I was. I’m not all that overweight anyway, so maybe I’m being a bit hard on myself (All or nothing thinking). Now that I think about it, David has been kind of stressed recently about his finals, because he wants to go to law school, so maybe he was just distracted and worried and that’s why he seemed so cold. And Mary is applying to grad school herself, so maybe that’s all they were talking about, and not that they’re romantically interested in each other (Catastrophizing).”

E = I don’t know for sure what’s going through David’s mind, but as far as I can tell it seems more likely that he’s worried about other things than me, so I will resolve not to let this bother me, and get on with enjoying my life and not letting this get me down, there’s no real reason to let it. (This is the place for more positive affirmations, but notice that these are based on the realistic work of disputing and challenging our thoughts in D. For E to be effective, we must first respond to our exaggerated automatic thoughts in a rational way. A realistic example of a positive affirmation that could be introduced here is that “I am attractive”).

This ABC exercise can be used any time anywhere, either by writing it down, or doing it mentally (if we’re not able to write it down). It’s also important to note that there may be significant overlap in the various distortions; you may see any number of other categories of distortion in just this small example. The point in general is to notice what we are thinking and see if it is in any exaggerated or unrealistic when we slow down a bit and compare our thoughts a bit more objectively with the facts.

As I said previously, the more we practice these skills, the better we get at managing our responses and our moods. We are not trying to directly control our moods here by, say, consciously denying or suppressing them. This work is more subtle than that. We notice that what we are thinking has a direct affect on what we are feeling, so by becoming aware of what we are thinking in the moment, and the connection with what we are feeling, we can begin to dispute the thoughts, and then our moods will begin to change by themselves, as what we believe about the situation changes. If the situation is truly not as awful as we thought, its impossible for us not to feel a bit better than when we were convinced that something awful was absolutely bound to happen.

We can train ourselves to initiate the procedure outlined in this chapter whenever we notice our moods have changed for the worse. Then we can ask ourselves, “When did this begin, and what has been going through my mind since then?” Usually, depending on how disturbed we feel, we can identify some exaggerated or distorted thoughts, which we can immediately begin to challenge with the actual evidence, and therefore begin to diffuse.

It can also be very helpful to set this down in a schematic form. As I mentioned above, we can do the exercises mentally as disturbing events are occurring, but when we are early in this process we learn most effectively by slowing down and writing down our thoughts later on (though sometimes it is possible to write them down as the events are occurring too, but not always). This may take a bit of time but remember; it has typically taken a few decades of thinking a certain way to get you to where you are today. This is not likely to be reversed overnight, and will take a level of persistence and effort on your part. However if you make this commitment to yourself it will pay off handsomely!

DYSFUNCTIONAL THOUGHTS RECORD

A Activating Event	B Beliefs Automatic Thoughts Mental images	C Consequences Feelings, behaviours	D Disputation Challenging the thoughts and beliefs in B Cognitive distortions	E Energization
I tried to kiss my boyfriend David and he seemed cold and distant	-He didn’t seem interested in me at all. -Maybe I’m too fat and he’s lost interest. I did see him talking to that new girl after the lecture, Mary. -How could he do this to me anyway, I’ve been a good girlfriend, this really upsets me, its not right.	I felt rejected, inadequate, unattractive, a bit depressed and angry and so I went out and bought myself a pint of ice cream, even though I was supposed to be on a diet	-Well, I have gained a few pounds this year, and I would like to lose it, but is this really why he seemed cold and distant? (Mind reading) -David has never commented on my weight, and actually said recently that he liked me the way I was. -I’m not all that overweight anyway, so maybe I’m being a bit hard on myself (All or nothing thinking). -Now that I think about it David has been kind of stressed recently about his finals, because he wants to go to law school, so maybe he was just distracted and worried and that’s why he seemed so cold.	I don’t know for sure what’s going through David’s mind, but as far as I can tell it seems more likely that he’s worried about other things than me, so I will resolve not to let this bother me, and get on with enjoying my life and not letting this get me down, there’s no real reason to let it!

SUMMARY

To recap, what we have been saying here is that a good deal of how we’re feeling and our moods (maybe most, sometimes), is due not so much to what is happening in our world, but what and how we are thinking about it, and that the way we are thinking about it may be making things worse by exaggerating and distorting our judgment, usually without us being aware of it. Instead we tend to believe everything we are telling ourselves to be the truth. We end up scaring ourselves and upsetting ourselves unnecessarily, but we can begin to become aware of what is going through our minds when we notice our mood has changed, and see what role we may be playing in adding to the discomfort and disturbance. We can see if any of our beliefs and thoughts are distorted, and we can challenge them and make them more realistic. The problem may not necessarily thereby always be “solved” but usually we can at least moderate our responses and begin to feel a bit more in control and a little less overwhelmed.

Further Reading: A CBT Classic

Dr. Albert Ellis