Steps in Cognitive Therapy
The first step is to recognise your own AUTOMATIC THOUGHTS whenever you feel anxious. In order to help you recognise them, keep these characteristics in mind. These thoughts just seem to come out of nowhere, and flash through your mind without you really being aware of them.They seem very plausible and believable to you at the time you are experiencing them. In fact you tend to accept them as perfectly reasonable way of thinking in the circumstances, just as you might readily accept the truth of a realistic thought like "The phone is ringing, I must answer it". These thoughts are however, quite unreasonable and irrational as you will realise when you learn to challenge them with reason and facts. Automatic thoughts are the kind of thoughts that most people would find depressing or anxiety-provoking if they believed them.
The second step is to learn how to challenge automatic thoughts with mason and fact about how the world really is. A good way of doing this is to consider all the various thoughts that you might have had instead of the automatic ones. When you do this you will begin to realise that the way you thought about the situation was only one of a number of different interpretations. (IT IS VERY IMPORTANT TO REMEMBER THAT THERE ARE ALWAYS LOTS OF DIFFERENT WAYS OF LOOKING AT THE SAME SITUATION) Once you do this you will start to see that the automatic thoughts that caused you to be anxious or upset contained THINKING ERRORS. These errors tend to fall into the following categories:-
a. ALL OR NOTHING THINKING: Seeing things in black or white rather than in shades of grey (e.g. you're either a total success or a total failure).
b. OVER GENERALISING: Imagining that one bad experience in a situation means that you will always have a bad experience in such situations; leg, thinking that you will always be anxious in social situations just because you were extremely anxious at a party you went to recently)
c. CATASTROPHISING: Assuming that the worst possible thing is bound to happen in a situation you find difficult leg, after an argument with your boss, assuming that you will lose your job, have to sell your house, and won't ever be able work again)
d. EXAGGERATING: Blowing things up out of all proportion. Reacting to a situation that is difficult, embarrasing or humiliating, as if it was major disaster leg, being extremely upset when a neighbour you know slightly criticises the behaviour of a friend of yours)
c. IGNORING THE POSITIVE: Overlooking positive experiences and positive aspects of a situation because they'don't count' for some reason. Dwelling exclusively on the negative qualities and personal failings after you have been turned down for a job.
d. JUMPING TO CONCLUSIONS: Coming to a quite arbitrary conclusion about something in the absence of any definite facts to justify this, leg, deciding that your new neighbour doesn't like you just because she turned down your invitation to go to the supermarket with her)
g. 'SHOULD' STATEMENTS: This refers to automatic thoughts that cause excessive anxiety or guilt because they inappropriately contain the words 'should' or 'must' or 'always' or 'never'. People generally have such thoughts when they try to live by personal rules and standards that may in fact be excessively rigid and over demanding and have no real application to normal, everyday life, leg, I must always look my best or people won't like me)
Once you have learnt to identify your automatic thoughts and the thinking errors they contain, the third step to practice is substituting RATIONAL RESPONSES for the automatic thoughts. Thus, instead of automatically responding to situations with a series of negative, anxiety-provoking thoughts, you will gradually' learn to respond to situations in a more reasonable way. For example, you will begin to realise that the experience of acute anxiety is always limited in time and that you can learn to control anxiety by not over reacting to symptoms. You will also learn to test out your anxious thoughts and beliefs about what might happen to you in certain situations, by conducting PERSONAL EXPERIMENTS. It very often happens that pople are not as anxious as they imagined they would be in certain situations. Remember that in nearly all anxiety-provoking situations, there are what we call RESCUE FACTORS, these are things that make the feared consequences of being anxious tolerable, unlikely to happen, limited in time, etc. When you have practised going through the first three steps and learnt how to control your anxiety symptoms in your everyday life, the fourth step is to modify any UNDERLYING ASSUMPTIONS you may have that make you vulnerable to being anxious.. These are a little more difficult to explain than automatic thoughts; they refer to the characteristic ways in which you tend to look at the world and think about yourself. For example, anxious people very often have excessive needs for love and approval from other people or beliefs that always being very successful at work is of vital importance to being a worthwhile person. They may have expectations of life that are very unlikely to be satisfied or perhaps excessive feelings of responsibility for other people. As therapy progresses you will begin to learn about the kind of beliefs and assumptions that you have that make you vulnerable to further episodes of anxiety in the future. Once these are identified you can work with your therapist to try and change them so that you are less likely to experience any recurrence of anxious thoughts and feelings.
The following statements are examples of maladaptive underlying assumptions:
a. In order to be happy I have to be successful in everything I do
b. I must be liked by people at all times
c. If I make a mistake it means I am incompetent
d. I can't live without being loved
e. If somebody disagrees with me it means he doesn't like me
f. My value as a person mainly depends on what others think of me.
