Introduction to CBT - Automatic Thoughts

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23 Terms

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Automatic Thoughts - Characteristics

  • Often appear in shorthand

  • They are specific messages

  • Not unconscious thoughts because they can be readily accessed. 

  • Almost always believed

    • These thoughts have the same believable quality as direct sense impressions.

  • Plausible because they are hardly noticed, let alone questioned or challenged.

  • Often couched in terms of "should," "ought," “can’t” or "must."

    • People torture themselves with “should”

  • Tend to “awfulize”

    • Predict catastrophe, see danger in everything, and always expect the worst

    • Awfulizers are the major source of anxiety

  • Hard to turn off

  • Reflexive

  • Weaving through the fabric of your internal dialogue.

  • Come and go with a “will of their own”

  • They tend to act as cues for each other

  • They are learned

    • Examples: family, friends, media

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Clients and Automatic Thoughts

  • Many patients will be unaware of their thinking processes

  • They will often be much more aware of the emotions than of what precipitated the emotions.

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Ways to Help Client Notice Automatic Thoughts

  • Work back wards from affective increases

  • Take a reasonable guess

    • What might someone else think in this situation that could lead to the emotion I’m experiencing?

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Common Unhelpful Thoughts (Cognitive Distortions) Clusters

  • Self-centered

    • Thinking in extremes

  • Minimization and mislabeling

    • These distortions involve giving less weight to positive things and more weight to negative things.

  • Assuming the worst

    • Can lead to depression

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Cognitive Distortions - Self Centered Distortions

  • All-or-nothing thinking

  • Mind reading

  • Should and must statements 

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All-or-Nothing Thinking

You view a situation in only two categories instead of on a continuum.

  • Also called black-and-white, polarized, or dichotomous thinking

  • Example: “If I’m not a total success, I’m a failure.”

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Mind Reading

You believe you know what others are thinking, failing to consider other, more likely possibilities.

  • Example: “He thinks that I don’t know the first thing about this project.”

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Should and Must Statements

You have a precise, fixed idea of how you or others should behave, and you overestimate how bad it is that these expectations are not met.

  • Also called imperatives

  • Example: “It’s terrible that I made a mistake. I should always do my best.”

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Cognitive Distortions - Minimization and Mislabeling Distortions

  • Magnification/minimization

  • Labeling/mislabeling

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Magnification/Minimization

When you evaluate yourself, another person, or a situation, you unreasonably magnify the negative and/or minimize the positive.

  • Example: “Getting a mediocre evaluation proves how inadequate I am. Getting high marks doesn’t mean I’m smart.”

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Labeling/Mislabeling

You put a fixed, global label on yourself or others without considering that the evidence might more reasonably lead to a less disastrous conclusion.

  • Example: “I’m a loser. He’s no good.”

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Cognitive Distortions - Assuming the Worst Distortions

  • Overgeneralization

  • Emotional reasoning

  • Mental filter

  • Disqualifying or discounting the positive

  • Personalization

  • Catastrophizing

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Overgeneralization

You make a sweeping negative conclusion that goes far beyond the current situation.

  • Example: “[Because I felt uncomfortable at the meeting] I don’t have what it takes to make friends.”

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Emotional Reasoning

You think something must be true because you “feel” (actually believe) it so strongly, ignoring or discounting evidence to the contrary.

  • Example: “I know I do a lot of things okay at work, but I still feel like I’m a failure.”

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Mental Filter

You pay undue attention to one negative detail instead of seeing the whole picture.

  • Also called selective abstraction

  • Example: “Because I got one low rating on my evaluation [which also contained several high ratings] it means I’m doing a lousy job.”

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Disqualifying or Discounting the Positive

You unreasonably tell yourself that positive experiences, deeds, or qualities do not count.

  • Example: “I did that project well, but that doesn’t mean I’m competent; I just got lucky.”

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Personalization

You believe others are behaving negatively because of you, without considering more plausible explanations for their behavior.

  • Example: “The repairman was curt to me because I did something wrong.”

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Catastrophizing

This prompts people to jump to the worst possible conclusions

  • Example:: “I’ll be so upset, I won’t be able to function at all.”

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Ways to Elicit Automatic Thoughts

  • Ask them how they are/were feeling and where in their body they experienced the emotion.

  • Elicit a detailed description of the problematic situation.

  • Request that the patient visualize the distressing situation

  • Suggest that the patient role-play the specific interaction with you (if the distressing situation was interpersonal).

  • Elicit an image

  • Supply thoughts similar or opposite to the ones you hypothesize actually went through their minds

  • Ask for the meaning of the situation

  • Phrase the question differently

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Do You Need to Label the Cognitive Distortions?

In short, no, just need to recognize that just because you have a thought does not mean it is true or adaptive.

  • However:

    • Knowing what cognitive distortions to look out for can help us recognize when and what types of thoughts may not be true or adaptive.

    • Can serve as a cue for when to do restructuring work

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Evaluating Automatic Thoughts

  • Examine the validity of the automatic thought.

  • Explore the possibility of other interpretations or viewpoints.

  • De-catastrophize the problematic situations

  • Recognize the impact of believing the automatic thought.

  • Gain distance from the thought.

  • Take steps to solve the problem

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Evaluating Automatic Thoughts - Sample Questions

  • What is the evidence that supports this idea?

    • What is the evidence against this idea?

  • Is there an alternative explanation or viewpoint?

  • What is the worst that could happen (if I’m not already thinking the worst)? If it happened, how could I cope?

    • What is the best that could happen?

    • What is the most realistic outcome?

  • What is the effect of my believing the automatic thought?

    • What could be the effect of changing my thinking?

  • What would I tell____________[a specific friend or family member] if he or she were in the same situation?

  • What should I do?

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