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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
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.
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?
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
Cognitive Distortions - Self Centered Distortions
All-or-nothing thinking
Mind reading
Should and must statements
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.”
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.”
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.”
Cognitive Distortions - Minimization and Mislabeling Distortions
Magnification/minimization
Labeling/mislabeling
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.”
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.”
Cognitive Distortions - Assuming the Worst Distortions
Overgeneralization
Emotional reasoning
Mental filter
Disqualifying or discounting the positive
Personalization
Catastrophizing
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.”
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.”
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.”
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.”
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.”
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.”
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
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
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
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?