Overcoming Negative Thoughts: Secrets of CBT

A recorded continuing-education webinar by Dr. Dawn-Elise Snipes introducing cognitive behavioral therapy principles for addressing negative/unhelpful thoughts. The lecture explains how thinking errors and cognitive distortions (automatic thoughts, core beliefs, cognitive biases) affect emotions, behavior, sleep and health, and offers practical CBT-based strategies (distress tolerance, perspective shifts, behavioral experiments, mindfulness) and client exercises to interrupt negative reciprocal cycles.
Chapters
This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs register@allce.com counselortoolbox and I'd like to welcome everybody today to Cognitive Behavioral Addressing Negative Thoughts. Now, a lot of us took courses in cognitive behavioral therapy. We've worked with CBT for many, many years. So some of this is just going to be a refresher and others, you know, you may pick up a few new tips or tools as we go along. So we're going to define cognitive behavioral therapy and its basic practice principles. Just get a really basic refresher on what was that original CBT about? We'll identify factors impacting people's choice of behaviors because you know, they always have a choice. We'll explore causes and the impact of thinking errors. Whether you call them cognitive distortions, irrational thoughts, or when I work with my clients, I try to call them unhelpful beliefs or unhelpful thoughts because distortions and irrational seems sort of pejorative to me. So I try to avoid those words as much as possible and help clients see them as not incorrect necessarily, but unhelpful. And then we'll identify some common thinking errors and their relationship to cognitive distortions and some of our just very basic fears. Why do we care? Well, because cognitive distortions or irrational thoughts or unhelpful thoughts, whatever you want to say, really impacts people on a physical level, a mental level, and an emotional level. A person who perceives the world as hostile, unsafe and unpredictable will tend to be more hyper vigilant until they exhaust the stress response system. So think about, you know, a battleship and you've got a bunch of new people on this battleship and all the sailors, every time there's the least little thing, they send off the all hands on deck. So a big bird flies over and I mean literally a bird, and they freak out, sound the all hands on deck. And this goes on for a week or two or six months. You know, let's think about our clients. They don't usually come in right away where everything is sets off that startle response, everything sets off that fight or flight response. The staff starts to get exhausted. All the rest of the sailors that have to drop everything and run to their battle stations, after a little while they're like, really? No, no, we just, we can't even do this. And it also reminds me of the boy who cried wolf. Anyhow, I digress. Sticking with the battleship metaphor. So eventually the captain says, you Know what? Let's retrain on what is worth setting off the all hands on deck. Because everybody here is exhausted and nobody's even really responding anymore. When they come to their battle stations, they're just kind of dragging their butts in like whatever is probably another false alarm. The same sort of thing is true with us. When we're on high alert for too long, our brain says, you know what, we got to conserve some energy in case some really, really big threat comes along. So it turns down what I call the stress response system. It turns down the sensitivity. So you don't get alerted for every little thing that would cause you stress, but you also don't get alerted for those little things that would cause you happiness either. Anything that would cause the excitatory neurotransmitters to be secreted. You're just not getting those anymore, which a lot of people kind of refer to as depression. It's just kind of like, yeah, whatever. And only the biggest, most notable things actually cause an emotional effect. We don't want people to get to that point. That's no way to live. So we need to help them learn how to sort of retrain their spotters to figure out what is actually stressful. A person who perceives the world as generally good and believe they have the ability to deal with challenges as they arise, will be able to allow their stress response system to function normally. There are going to be times you have all hands on deck, whether it's a real emergency or whether it's just a drill, but it will happen. And they can go, they can do what they're going to do. They have that adrenaline rush, they have the energy and the focus to, to do their jobs. And when it's over, they can go back to their quarters, they can relax, refresh, you know, just kind of chill for a while, and then there's a lull where their body rebalances before the next one. And this is kind of what we want in life. I mean, ideally we wouldn't have super high peaks very often, but we want to make sure we give our body time to rebalance after there's a stressor and not have to stand on edge, not be hyper vigilant constantly just waiting for the next one to come along. So what is the impact of these thinking errors? Well, whenever we have that stress response system activated, the body is saying, we either need to fight or we need to flee. So you're just dumping all kinds of adrenaline and other neurochemicals. So there's anxiety. There can be stress. When people start having this reaction, you know, they start having muscle tension, sweating, heart rate increases, breathing increases. People will call that anxiety. Some will label that as anger. Either way, they're both sides of the same coin. They need to do something. But if it lasts too long, then we start moving into depression and they just, they don't have the get up and go anymore. There's just not any excitatory neurotransmitters really left. They need some time to rest and rebalance behaviorally. Think about it, if you go somewhere and you are just constantly on guard, are you going to keep going there or are you going to withdraw? So people who have a lot of thinking errors, unhelpful thoughts, tend to withdraw more. They may turn to addictions to kind of numb or blunt some of the input sleep problems and changes. When you are hypervigilant, when you have this stress response going, even if it's not at full bore, if it's still there somewhat, if you're stressed out, you're not going to sleep as well. You're going to maintain higher levels of cortisol. So you're not going to get that restful rejuvenating sleep. You may kind of doze on and off. Eating changes, you know, depending on the person. Some people eat to self soothe, some people can't eat at all. But we do see that the hormones ghrelin and leptin get all out of whack. Not under stress, but also when sleep gets out of whack, when your circadian rhythms get out of whack. So we're starting to see the cascade effect where it's emotional and behavioral, physical, you've got stress related illnesses that start coming up. If you're on that much, you've got muscle tension for that long, it starts to hurt. I mean, you start to get migraines, your back starts to hurt. Wherever you store your stress, so to speak, it starts to come out. And most people, when they're under a lot of stress for an extended period, you know, a day is not a big deal for most people, but for an extended period become more susceptible to illnesses, they start getting sick easier, headaches, GI distress, You know, some people store their stress right in their gut socially. Think about the last time you were stressed. Were you patient and tolerant and just a pleasure to be around? You may have tried to be, but you're more prone to irritability and impatience and again wanting to withdraw. All of these effects contribute to fatigue and a sense of hopelessness and helplessness. Which often intensifies thinking errors. So you'll see this negative reciprocal interaction. If somebody feels stressed out and overwhelmed and they withdraw, then they may start feeling like they have no support and they don't and they lose all their social buffers to the stress, so they feel even more stressed, so they want to withdraw even more. So we're going to talk about how to prevent that. Now, I like this little diagram. Maybe because it's got a heart in the center, I don't know. But behavior, feelings and thoughts, this is the outside of the circle. All three of these impact each other. When you do something, it often impacts your feelings and your thoughts about a situation. When you're thinking, if you think positively, you're probably going to choose more positive behaviors and have more positive feelings. If you're thinking negatively, obviously you may choose more of an escape behavior or a protection behavior and may have more feelings of anger, anxiety, depression, etc. So these things are going on and they're all interacting. The one really cool thing is if you break this chain somewhere or this circuit, then you can stop that reciprocal negative downward spiral. So cognitive behavioral helps people who are willing to show up or who are willing to address their thoughts. Not everybody is willing to start addressing their thoughts right away. Maybe they want to start addressing their sleep problems and their eating problems or, or something that's more physical. Okay, that's fine. Because anywhere we interrupt this circuit is going to have positive effects. Assuming the intervention is positive is going to have positive effects on the other ones. So what about the triangle? Well, yourself. So your feelings, thoughts and behavior impact you. It impacts how you feel. And you're like, well, yeah, okay, just stay with me. But the way you feel, think and act impacts your future and it also impacts how you interact with others. So you know, that kind of affects things because remember, social support is a big buffer for us. Now, core beliefs, and you can do this inward to outward or outward to inward. But either way it comes down to core beliefs. If you have positive thoughts, positive feelings, and you generally engage in positive behaviors to keep that cycle going, you will probably feel pretty good about yourself, have good relationships, have a somewhat optimistic feeling about the future. And your core beliefs may be more like, people are generally good, I can do this, you know, very self affirming and other affirming, positive core beliefs about yourself in the world. Now if your thoughts or feelings are negative, then you have this negative outer circle. You don't feel so good, you start questioning the goodness and trustability and dependability of other People, you have more of a bleak look in the future. So what do you think is going to happen to the core beliefs? The core beliefs may change to if someone doesn't love me, I am completely unlovable. They may change to being more extreme, more negative and more difficult to rectify. If you want to have somebody who's happy, I mean, you're not going to have somebody who's happy, who thinks the world is an unkind, unpredictable, scary place going. It's just wonderful roses today. So we have to help people try to adjust. Eventually start adjusting those core beliefs. And when we get into cognitive behavioral, remember the ABCs, your automatic thought. Wow. Your automatic thought, then your and beliefs are what happen as soon as that event occurs and those you don't think about. That's why they're called automatic. So when you have the ABCs, these core beliefs are those things that pop up that we need to address. So what factors affect this? And whoops. You know, there's a lot of stuff right here in dbt, they call them vulnerabilities. You know, we're just going to talk about in general different factors that affect the choices our clients make in terms of behaviors. So negative emotions, if they are not, if they're feeling angry, if they're feeling anxious, if they're feeling depressed, they're probably not going to be really motivated to get up and engage in a whole lot of self affirming activities. They're not, probably not going to be having a lot of positive, self affirming thoughts. They're going to be focused on whatever is causing that distress and maybe escaping from that physically pain and illness. When you don't feel well, it's harder to be Susie Sunshine. I don't think many of us are just a barrel of monkeys when we don't feel well. So if our clients have pain, this is one of those, if you want to put it in behaviors, behavioral areas, physical areas, we can address and have them go see their physician, have them go see their physical therapist and get recommendations so they aren't feeling physically painful, physically in distress all the time. Because physical distress and emotional distress both mess with sleep. Unfortunately, sleep is the first thing to usually go. And I'm not talking about quantity. I know a lot of clients who when they get depressed, they're in bed for days. They'll get up, they'll maybe shower and go back to bed and they're sleeping a lot. But it doesn't mean it's quality sleep. So what we need to look at is what Is the quality of their sleep. Are they getting that rejuvenation, the time for their brain and neurochemicals to rebalance so they can feel happy, so they can have that nice balance of all the neurotransmitters they need to feel happy. Poor nutrition. Well, no matter how much sleep they get, if they don't have the building blocks to make the neurotransmitters and the hormones that are needed to prompt the feelings, the physiological sensations that we've labeled happiness or excitement or you know, even depression and anxiety, those are all caused by different neurotransmitters being secreted in different combinations. If your body doesn't have the building blocks to make those, then it doesn't matter how much sleep you get, you're not going to get any benefit from it. And intoxication, and this can be uppers, downers, anything that is psychoactive, if you are messing with that neurotransmitter balance, you're going to get it out of whack. And you may either use up too much of the excitatory or cause a flood of it, or you may use up too much of the depressant. Either way, there's usually a rebound effect which we call withdrawal. So you're not going to be in a good space either during the intoxication Sometimes, but definitely when you're sobering up, there's a period where there's going to be negative emotions, negative feelings, environmentally. Yeah. Your environment can even make you grumpy. Introduction of a new or unique situation. Some people love new challenges, love going to new places. Other people, not so much. Depending on the person, taking on going somewhere new may be really stressful for them. So if they've already got this stress going on because of having to go to this new situation, then their thoughts may be a little bit more on the anxious side about a lot of things. And they may have less patience and tolerance to deal with other stuff that comes their way because they're already kind of on edge and exposure to unpreferable situations, you know, going places that you just really don't want to go. Maybe one of the places I used to work, we had this meeting once a month and it was literally an eight hour meeting. And we would all sit in there for eight hours and one person at a time would get up and give their staff reports or whatever. But it tended to be a relatively dreadful sort of environment or eight hours. And we all knew we had to be there and that was fine. But it was an unpreferable situation. So most people getting ready to go to this meeting were grumbling on the way in. They were getting their coffee and going, well, I better do this because I'm not getting out for another eight hours. We need to help our clients assess what is it in your environment, if anything, that is making you already feel grumpy or not as happy. And likewise, what can you put in your environment to make you feel happier? You know, I keep pictures of my kids and my animals on my phone. That way, if I'm having a moment or not, sometimes I just like looking at them. I can take a look at it. It makes me smile and I'm like, okay, life is good. You know, this moment may not be so wonderful, but it's just this moment. Then we move on to stress of a social nature. Peers or family who convey irrational thoughts as necessary standards for social acceptance. Nobody wants to associate with those people or nobody's going to like you when you're like this or you really, if you really want to be successful, then you need to change. Fill in the blank. It's always a something needs to change. You are not okay for who you are, how you are, and a lack of supportive peers to buffer stress because we all have negative people in our life. It happens. But if you have negative supportive peers that you can call afterwards and go, yeah, I just had to meet with so and so for an hour and it was just dreadful. And that person can go, I'm sorry, or just be there, make you laugh for whatever they do, it helps buffer the stress. If you don't have those positive social supports, then you're left walking out of it. You're kind of feeling shell shocked. And then you also at the same time have to figure out for yourself, alright, what do I do next? Now, it doesn't mean you can't do it. You know, people do it all the time. But it is good, it is awesome to have supportive peers to buffer your stress. So in cognitive therapy, clients learn to distinguish between thoughts and feelings, realizing that thoughts will trigger feelings, but they don't have to cause continual feelings and behaviors. And feelings can cause certain thoughts, but they don't have to. You can unhook from them and you can just say, this is how I'm feeling right now. Now, where am I going to go from here? And we talked about that on Tuesday with unhooking from unhooking from your thoughts and stepping back and going, what is the next logical action to get me to where I want to go? Become Aware of the ways in which the thoughts can influence feelings, ways that are sometimes not helpful. Being critical, being jealous, envious. Maybe you just don't like somebody. And you know there's a whole lot of reasons for that, but you don't like everybody. Most people don't like everybody. And so, you know, that's okay. But recognize how that affects your interactions with that person and your thoughts about that person. Learn how thoughts that seem to occur automatically affect emotions. So recognize, start getting down to what are these core beliefs that happen every time there's a negative incident that make me feel angry or anxious? Constructively evaluate whether these automatic thoughts and assumptions are accurate or perhaps biased. Evaluate whether the current reactions are helpful and a good use of energy. Unhelpful and a waste of energy that could be used to move toward those people and things important to the person. So again, back kind of to that act sort of thing. Is this a good use of your energy to help you achieve your goals and be the person you want to be and develop the skills to notice, interrupt, and correct these biased thoughts independently? Like I said, you don't always have to call somebody. You can do it on your own. But sometimes it's nice to have that buffer in that middle moment. So what causes these thinking errors? How can we even start helping people address their thoughts until we start thinking about, well, what caused them? Information processing shortcuts. As we grow up, we learn things. You know, when you were knee high to a grasshopper, you didn't have a lot of experience, so you learned things. But things you learned when you were a kid, unfortunately because you were cognitively a child, are either are dichotomous. They're all or nothing. It's either this way or no way at all. So things that you have, things that you learned back when you were a child may not have been challenged. If you heard something from your parent, maybe your parents said, you're a bad girl or you're a bad boy, it's all or nothing. Well, I am a bad girl, so I guess that means I'm not okay. And if I'm not okay right now, I'm never okay. That can stick with a person. So these outdated dichotomous schemas can really trip somebody up. Once the person gets into, you know, middle schoolish, the thoughts aren't nearly as dichotomous. There's a lot more formal operational thought, if you will. But up until then, I mean, you've got a child who's experiencing a lot of stuff and taking in like A sponge. Everything they hear, and it gets sorted into a yes or a no pile. There's. There's no kind of middle pile, that there's no yes. And so what we want to do is help people look at those thoughts now and say, okay, if they're all or nothing, is there a way to find both? And so, for example, we'll take that scenario I gave you earlier. If a child hears you're a bad girl when they're young, they take that to mean always, everything about me is bad. I'm unlovable. So what is the both and compromise as an adult, we can look back and go, you know, I'm a good person. I may make poor choices sometimes, I may make bad choices, but I'm a good person. So there's that both. And, you know, I'm not perfect, but I'm good. It's not all or nothing. And I encourage my clients to really always look for that middle ground. How can it be both? Or does it have to even be be that negative one? But most of the time, there's a little bit of something on both sides. The brain's limited information processing capacity and limited responses. When children are young, you know, they hear something. You know, mom comes in and says, you're a bad girl. And child hears, I'm totally unlovable. And it just crushes the child. They don't have experiences to go, well, mom's having a bad day. She kind of tends to say things she doesn't mean when she's having a bad day. It's just, it's devastating to that child. When you're older, if somebody says something that's not necessarily tactful, you know, you can look at it and go, yeah, that really wasn't nice. But that person probably did not intend to be hurtful. They may have something else going on. Children have fewer experiences. So what was devastating or overwhelming as a child may not still have. Have to feel that way. When you were a child, if your best friend moved away, oh, that was devastating. It was the end of the world. Now, as an adult, you can go visit them, you can call them, and with the Internet and everything, you can email them. You can still stay in touch. So there are ways to do it. Yeah, you can't go out and swing, swing on swings together all the time. But it doesn't have to mean the end of the end of time. Things will change. And there's a little process of grieving that has to go along with that. But to an adult, a friend moving away is less devastating than say, to a six year old, your parent being angry with you. If you grew up in an alcoholic or addicted household, you learned, don't talk, don't trust, don't feel. When the parent came in, if the parent was angry with you, you could have been in a lot of hurt. You know, there could have been some actual danger to your physical or emotional person. So it was scary as a 26 year old or however old your client is, is it that threatening? You know, if your parent gets angry with you, you don't depend on them for food and shelter anymore. You don't have to be in their household if they were violent towards you. So is it as terrifying when your parent gets angry? Yes. There's lots of issues with wanting acceptance from your parents. That's over here. That's a whole nother issue. But when your parent is angry, do you have to have that person's approval? When we're in crisis, we don't process much. When you're in crisis, your body is worried about surviving. If you've been in a car wreck, if somebody has gone to the hospital, whatever the case is, you're not processing all of the data in order to make an informed decision. You're processing what's right in front of you. Because when we're in crisis, we generally have tunnel vision and really crappy memory. So if something happened when someone was in crisis that hurt their feelings, made them angry, you know, fill in the blank, some sort of dysphoric emotion, we want to say, well, let's look back at that and see if there's a both and let's look back at that and see if there was something that you missed that might help you understand why this person reacted that way. But understanding that in crisis, we just generally don't make the most informed decisions. So emotional reasoning, helping clients understand that feeling are not facts and helping them learn to identify feelings and separate them from facts. So if they say, I am terrified. All right, so you're terrified. Got that. About what are you terrified? You know, tell me, what are these things that make you feel like the world is such a scary place? And let's list them on the whiteboard or a flip chart. What is the evidence that those are present dangers right now, that they're actually impending threats? So tell me about what the evidence is. In what ways is this similar to other situations where you felt terrified and how did you deal with those situations? I have a friend who actually went this morning on an airplane flight and she hates Flying totally terrified of it. So what is the evidence that this plane is going to crash? You know, what is the evidence that it is likely that this plane will crash? And they're really. She's flying on an American based commercial airliner. There really isn't any. When you look at the proportions. So, okay, there's. There have been a couple of crashes over the past 20 years and in a couple of those there were some fatalities. No doubt. But looking at the proportions and running the numbers, what's the likelihood, in what ways this is similar to other situations that you have felt terrified. You know, maybe there haven't been any other situations where she's flown and gotten through it and been like, score, I did that. But what other situations have you had to get through that you were terrified? And how did you deal with those? Help people develop distress tolerance skills. One of the things I told her was when you're sitting on the airplane and you know the airplane starts up, don't wait till you start getting really stressed necessarily. But when we were little on the car, when we were in the car, we used to find things on the drive, find something that starts with A and everybody would find something that started with A and then find something that starts with B and, you know, so on. And if you couldn't find something that started with that letter, you were out. So I mean, she's going on this trip with her kids and I'm like, why don't you try doing that? Because there are some letters that you're going to have to work really hard. And it's kind of like the game apples to apples. You end up finding something really inane in order to get that letter. And you laugh and you're so busy focusing on that, you're not focusing on all of the things that could possibly maybe go wrong. Other distress tolerance skills, you know, you can go through the whole DBT curriculum and learn some of those. The biggest thing is if you have to face the terror, if you have to go through it, figure out a way to not have to focus on it and fight it and go, I shouldn't be afraid. I shouldn't be. Because that doesn't work. If it worked, we wouldn't be talking about it. And develop emotional regulation skills. So prevent those vulnerabilities. Set yourself up so you are as prepared as you can to not feel stressed, to not feel anxious. She has her spouse with her who can help diffuse some of it. She's got her kids with her, she downloaded some movies. She's prepared to Endure the distress. She's, you know, trying to go into it with a positive mindset as much as possible and focusing on the destination, which you know is ultimately the reason she's getting on the plane. Social causes of stress and thinking errors. Everybody's doing it. Well, that's not true. There's very little that everybody does. So correcting misinformation, have the client gather objective information about, you know, if they say, well, everybody else that I know has succeeded, okay, well let's gather objective information about that. Who do you know and tell me if they've succeeded. If I want to be liked, I must do it. This need for approval or low self esteem can cause a lot of problems in thinking errors and fears of rejection. So we say, okay, so let's look at developing some self esteem so you don't need to worry about if somebody likes you. What would it be like if you woke up in the morning and you didn't care if so and so liked you? I mean, we all want to have friends. Don't get me wrong, I'm not saying you want to be a hermit living out in the woods, but if we're talking about a particular so and so, what would it be like in the morning to get up and go? You know, what if that person messages me today or calls me today, that's great. If not, I'm okay with that. How liberating would that be to get your power back and help people develop social supports that share their same values and goals, at least mostly or at least can respect yours. So for example, when I work with people with co occurring disorders and they don't drink and they don't use drugs, so they may be around people, family, friends who drink. If you're going to be in that situation, do you have to drink and can you be around? Do you have social supports that can be supportive of your choice to not drink? Doesn't necessarily mean they're not going to not going to not drink in front of you, but at least they're not trying to get you to drink. So the social causes of irrational thoughts. If I want to be liked, I must do this. Why can't you be liked for who you are? Cognitive bias, negativity, mental filter, focus on the negatives and worry about the future. Most of us know some people like that. Most of us have had a moment where we felt like this. We've just gotten ourselves in a tizzy and spun out of control. But you can bring it back. So you want to ask yourself or have your Clients ask themselves what. What's the benefit to focusing on the negative? If you know that this is going to go south really fast, what's the benefit to just focusing on that? Could you focus on alternatives or Plan Bs? What are the positives to the situation? Most people who have mood issues who present to us in counseling don't focus on both sides. Yes, every side, you know, has a little bit of negative to it if you really want to look hard enough. But every side also has a silver lining if you really want to look hard enough. So we need to balance the positives and the negatives. So encourage people to look for the positives in the situation. Yeah, this really sucked. But. And what are all the facts? What are all the things going into it? Sometimes people will go to work and not know or wonder if they're going to get laid off because, you know, you're not necessarily always guaranteed a job anywhere. There can be layoffs. But if somebody is going to work every day worried about this focusing on the negative, oh, yep, I'm definitely going to be the one that's going to get the pink slip. And they go to their mailbox each time looking for that pink slip, except expecting it to be there, how's that going to affect their mood as opposed to, alright, there may be layoffs coming. What can I do to make myself really valuable or. And what are my options if I do get laid off? Let's make a plan B and C so I don't just feel like the rug was pulled out from under me. Coin toss activity. If somebody tends to be stuck in negativity, have them flip a coin every morning. If it lands on heads, they can just be their normal selves to their heart's content. If it lands on tails, they need to act as if they are a happy, positive, optimistic, maybe even obnoxiously optimistic person for the entire day. You know, we want them to be farting rainbows. And when I say that, they usually look at me and laugh. But that's okay. I'm like, every time you start having a negative thought, I want you to see a unicorn farting rainbows and take it from there and then have them process how they felt at the end of the day. If they weren't constantly focused on negativity and worrying and only seeing the bad stuff, disqualifying or minimizing the positive. If something happens and somebody says, well, I just got that promotion because they didn't have anybody else to give it to. Okay, if your best friend just got A promotion. Would you say that to them? What is scary about accepting the positive, about accepting the fact that maybe you got the promotion because you're awesome? Sometimes we disqualify the positive because it fails to meet someone else's standards. So might that be true here? You know, maybe you got this promotion and you're actually deep down inside, kind of proud of it, but you know that your mother had always wanted you to be this over here, and you're never going to meet that expectation, so you minimize it. That way, nobody else can say, well, you know, it's better than nothing, and take away your thunder. Egocentrism. My perspective is the only perspective. Take different perspectives. I always say three. If something happens and, you know, maybe somebody was rude to you and you. They were rude to me. Okay, they were rude to you. What are three reasons? What are some alternate perspectives why that person might have been rude? Maybe what you did something that triggered them, maybe they were having a bad day and it's got nothing at all to do with you. You know, there are options that we can look at. Personalization and mind reading. What are some alternate explanations for the event that didn't involve you? If you think, well, that person just really doesn't like me, and, you know, I've got to work with them every day and they hate me, my question to my client would be, what's the evidence for that? And what are some alternate explanations for why that person may be behaving that way? I had a staff member that a lot of my other staff members had difficulty getting along with. And ultimately, you know, we had to sit down and look when I had some different staff meetings with people and say, you know, what gives you the idea that she doesn't like you? What gives you the idea that it's about you? And, you know, they cited all kinds of behaviors. And I had to come back to, well, what are some alternate reasons why somebody, anybody, not just her, might be expressing those behaviors? Could it be something besides you? And of course, they came back to, yeah, availability heuristic. Remembering what's prominent in your mind. If somebody was. If you're a supervisor, for example, and you're doing a evaluation for the year, what are you really remembering when you're doing that evaluation the whole year or the last three months? And that's the availability heuristic. So when you're talking to somebody about their relationship with their best friend or their spouse or their kids, and if somebody says, well, that that child has always been a problem, okay, let's look at that. You know, the child is 18 and you've had a lot of problems with him lately, but what about three years ago? So was he always a problem? Or is this something that's relatively new, that something might have changed? Magnification. People getting stuck on fearing the absolute worst. So you want to ask them, is this a high probability or a low probability outcome? If they're magnifying something that happened, like, oh my gosh, that is the worst thing in the world, is this going to matter six months from now? Maybe you totaled your car and yeah, that is a huge bummer and you're safe in six months. Is this really going to matter that much? You know, there are going to be some bills and everything. But the big scheme of things, is it the end of the world? What have you done in the past to tolerate events like these when something really, really unpleasant has happened? And then if they're looking at dichotomous ways of thinking, which a lot of our clients still do, they're like, so and so always does this or never does this. Have them look at the differences between love versus hate, perfection versus failure, and all good intentions versus all bad intentions. Because a lot of our dichotomies fall in one of these three categories. This person always does this or never, or does it intentionally or, you know, just doesn't care. Belief in a just world. The fallacy of fairness. Encourage people to look for four good people they know that have had bad things happen. Attributional errors are labeling yourself, not a behavior, such as saying, I am stupid instead of I don't have good math skills. I am is difficult to get rid of. I can't get rid of stupidity if it's part of me. But if it's a thought or a skill, I can either get rid of it or improve it. Stable I am means I am right now, and I probably always will be. Stupid versus I can change this thought or skill. I can learn math. Internal attributions mean it's about me as a person versus about a skill or a skill deficit or something completely unrelated. So when somebody makes a global internal negative statement, we want to help them challenge that. Global internal positive statements I'm all about, but the negative ones, I want to say, let's take a look at that. Is that true that this is about you all of the time and it means that there's something wrong with you? So we want to ask them, how are these thoughts? How are these ways of thinking impacting your emotions, health, relationships, and perceptions of the World. We want to increase motivation to start looking at these thinking errors. Because it's a lot of work to start changing the way you automatically think. Because you've got to stop, you've got to become mindful, and then you've got to decide, well, what are the alternative thoughts? Because this is what I thought for so long. How may this thought have been helpful in the past? Most of the time, thoughts we have came from somewhere and whether it was a thought we had when we were a child, something we learned when we were a child, that is dichotomous and not quite applicable anymore. It may have been helpful in the past to help you navigate situations. Doesn't mean it was wrong, it means it's not helpful in the present. Asking them to always ask themselves, is this thought or feeling bringing you, the client, closer to those people and things that are important to you is hanging on to this negativity bringing you closer? And I like the energy philosophy, if you will. When you are unhappy, you are letting this person have your power, you are letting this person make you angry. When you decide you are not going to give them your power, then you may start feeling happier. And I don't always use that with clients, but sometimes the power metaphor helps. When we talk about thinking errors, ask them, are there examples of this not being true? And. Or how can the statement be made less global, stable, and internal? Is it about you or is it about what you do at work? Is it about you or is it about your relationship with this particular person? So the last couple of slides, focusing on some of the irrational thoughts or unhelpful beliefs, our basic fears are rejection and isolation, failure, loss of control, the unknown, and death. Generally, the things that cause people to have this fight or flight reaction fall into one of those categories. So some of the unhelpful beliefs that we hear a lot coming up when we do the ABCs is that mistakes are never acceptable. So if I make one, I am incompetent. So we've got dichotomous thinking and we've got a lot of internal global labeling here. Rejection and isolation. When somebody disagrees with me, it's a personal attack against me. Well, sometimes it is, but does that mean it's about you? We're helping them address their rejection and isolation fears. We want to ask them, you know, if they disagree with you, were they attacking you and saying you were stupid? Or were they attack attacking, if you want to use that word, or were they attacking the thought and saying they disagreed with the thought? There's a Little bit of a difference. It's somewhat semantic, but it's a difference because they may have a lot of respect for you, but they may disagree with what you just said. If someone criticizes or rejects me, there must be something wrong with me. Again, that's one of those internal, global negative statements. To feel good about myself, others must approve of me. We want to make sure our clients can self validate and they don't rely on external validation because they're setting themselves up for a world to hurt if they are not their own best friend. To be content in life, I must be liked by all people. Now think for a second. Are you liked by everybody? I know I'm not liked by everybody. So does that mean that I should not be content in life? And what does it say to give people that power to say, if you don't like me, then I can't be content because I've got to be liked by everybody? Sometimes with clients, I'll help them look at what may be going on with the other person, why that person might like them. Because a lot of times other people's reactions towards you are more about their stuff than about you. And helping them see how that might be true. My true value as an individual depends on what others think of me. So these other unhelpful beliefs pertain to those thoughts of failure and loss of control. None of us likes to fail. Don't get me wrong, it's not pleasant, but it happens. And there is a saying out there that says if you haven't failed, you haven't tried. Which means we need to get beyond our safety envelope. We need to push ourselves beyond our boundaries. And when we do, sometimes we're going to stumble and fall. We pick ourselves up and we learn from it. But to expect to never fail at anything is not realistic. So nothing ever turns out the way you want it to. How many times have you heard that from your clients? I won't try anything new unless I know I'll be good at it. I'm in total control and anything bad that happens is my fault. So let's look at this locus of control thing here. You're in total control, so you can make it rain. You know, it was unpleasant today because I had to come to work and it was raining outside. So that was bad and it happened. Was it your fault? Pointing out and depending on your relationship for your client, you're probably going to be more or less snarky when you present some of these. But a lot of times I have a semi joking Relationship, if you will, with my clients. And they're like, yeah, I see your point. That kind of didn't make a lot of sense. Other times, you know, if they're more serious, I'll ask them to identify things that happened that were bad that they had nothing to do with. If I feel happy about life, something will go wrong. Or I'm always waiting for the other shoe to drop. Helping people stay focused in the moment with mindfulness. Something's going to go wrong down the road somewhere, sometime. Yeah, it's true. It's going to happen. Let's enjoy what we've got for right now. The past always repeats itself. If it was true then, it's true now. So what was true when you were 10 is true now that you're 40? Always. Is that true? It's not my fault my life didn't go the way I wanted. Everybody conspired against me, and there's no gray area. So for people who feel the need to hold on to control, it's dichotomous. It is or it isn't. It's got to be that way. There's no gray area. And it can make life seem very uncomfortable because they've got to put things in one of two buckets, and sometimes things don't fit nicely in buckets. What happens if we add a third bucket? That both and bucket. So a quick note about irrationality. The origins of most beliefs were rational and helpful, given the information the person had at the time and their ability to process that information because of their cognitive development. So things that we identify as unhelpful or automatic beliefs now came from somewhere and they made perfect sense whenever they were formed. They may not be healthy or helpful now, which is why we want to look at them and either adjust them or just throw them out the door. But when they were formed, they were on point. Irrationality, or unhelpfulness of thoughts comes when those beliefs are perpetuated without examination. So again, we need to look at them continually. Look at what you're telling yourself, and go, is this still accurate? And continue to be held despite causing harm to the person. Sometimes you're going to look at a thought, an automatic thought, and you're going to go, yeah, that is still spot on. Now, is holding on to this helping me achieve my goals, you know? Yet the world right now is kind of a scary place. Is holding on to this fear and terror helping me be a happy, productive, yada, yada, whatever kind of person you want to be. Or is it causing me to Feel anxious and angry and scared. Sometimes it's more productive for clients to think of thoughts as unhelpful instead of irrational. Because, like I said, I feel like irrationality and distortions seem very pejorative to a lot of clients. So questions clients can ask themselves when they are faced with a situation. What are the facts for and against this belief? Is this belief based on facts or feelings? Just because you feel scared, is it a scary situation? Does the belief focus on just one aspect or the whole situation? Does the belief seem to use any of those thinking errors we talked about? And if so, you know, what do I need to do about it? What are some alternate explanations for this belief? What else could have caused this to happen besides whatever I'm afraid of? What would you tell your child or your best friend if they had this belief? What would you want someone to tell you about this belief? If you could have somebody tell you something that would make you feel okay, what would you want them to tell you? And how is this belief moving you toward what and who is important to you? Remembering that beliefs are a combination of thought and fact and personal interpretation of those thoughts and facts. I tend to, when I talk, you know, you see me, I kind of am all over the place with my arms. I am a animated talker now. If you are seeing me from a hundred feet away and you were seeing me talk, you might think I was angry because I make a lot of really big gestures. Because if you had grown up in a situation where there was domestic violence or something, but if you had grown up in a. In a household like I did, where you had a first generation Italian. First generations Italian. Italian Americans talk big. They talk real big with lots of gestures and sometimes loud. And that doesn't necessarily mean any anger. A lot of times it's just pure excitement. So understanding that there's thoughts and facts, you know, you see this going on, but your personal interpretation can really affect what you get out of it or what you perceive that situation to be. So we need to look at how is your personal interpretation maybe adding a negative bias, and what do we do about that? It may be 100% accurate. What do we do about it so it doesn't keep you miserable? Thoughts impact behaviors and emotional and physical reactions. Emotional and physical reactions impact thoughts and your interpretation of events. Irrational or unhelpful thinking patterns are often caused by cognitive distortions. My two favorite words in that same sentence. Cognitive distortions are schemas or shortcut ideas or memories, if you will, which were formed based on faulty inaccurate or immature knowledge or understanding of the event. You know, little kids may not have quite understood what was going on. They just understood that Mommy and Daddy were screaming. Identifying the thoughts the hecklers, I call them, those negative voices inside your head that are maintaining unhappiness helps people choose whether to accept the thoughts. Say, yeah, you know, that's right. I really am not good at that. Or whatever the negative thought is and change it or let the thought go. Are there any questions? Thank you, Ms. Pencen. Well, thank you all. If you come up with any questions, you know, you're mulling it over later and you think, you know, that I worked with a client and was something similar and I did this, or, you know, you have a question about something I said, feel free to email me. The easiest one to remember is supportlce.com there's only two of us in the office, so either my husband gets it or I do. So it'll get to me and I guess that's it. So I will see you all on Tuesday. If you have any types of courses that you want to see added to the list, please let me know. I'm always interested in doing what you want to learn about. Not necessarily just what I pull out of my rabbit hat. Yes, you can print the slides in the Golly, golly, golly. When you go into the class, there's a link that has a PDF of the slides that you can print. If you want to go ahead and print those out. The video version of this will be up on YouTube by tomorrow morning. Maybe later this afternoon. Okay everybody, have an absolutely amazing rest of your day and weekend. If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube. You can attend and participate in our live webinars with Dr. Snipes by subscribing@allce.com Counselor Toolbox this episode has been brought to you in part by allce.com providing 24.7 multimedia continuing education and pre certification training to counselors, therapists and nurses since 2006. Use coupon code counselortoolbox to get a 20% discount off your order this month.










