“What causes depression and anxiety?”
“How am I coping with this depression?”
“What am I even thinking about?”
One of the cornerstones of cognitive behavioral therapy to treat anxiety and depression is the idea that thoughts can influence our feelings. Therefore, if we know what we are thinking about, then we can do something to change it! A classic example I often use in session involves knocking over some object (usually an old cigar box I use as a card holder or a box of tissues). If three different people saw that, then those three people would likely have three completely different thoughts, even though they all saw the same thing. One person might think “Oh, that guy is so clumsy!” Another person might think “Hmm, I bet he’s ready to tell a story!” A third person might say “Oh, he’s probably tired. That’s why he knocked it off. Is he tired because he is bored? He’s bored because of me!”
Clearly, these three thoughts would probably lead to three very different feelings.
Once we figure out something about the thought, then we can stand to change it. When I do this exercise, I’m really looking for a couple of different kinds of thoughts. How do I know it is a thought? It’s typically a phrase or a sentence. If it is only one word, then it might be a feeling or a mood instead (“I want to get out of here!” Versus “scared”).
Automatic Thoughts
The automatic thought is what is listed above. It’s the first thoughts we have ‘automatically’ when we perceive a situation. Usually 5 - 7 of these are generated in this exercise. Some of the thoughts ‘hit harder’ than others and those are the ones I usually go after. It’s also not unusual for two thoughts to point to a similar concept.
Rarely is the surface automatic thought at the core of the feeling that comes from it. Instead, I use a technique to get to something called the ‘hot thought’.
Hot Thoughts
So, what makes these different? Well, there’s something about these thoughts that are ‘hot’. In other words, something about them makes them especially active when we think about them. It’s almost as if we feel we’ve touched a live wire or a hot stove top when we think these thoughts. It makes us want to recoil away or react strongly to the thought. Usually, these are leading more directly to the feeling or mood that the person wants to change.
The Core Belief
This is sort of a like a supercharged hot thought or group of thoughts. How do I know this might be in play? This is something that tends to manifest time and again across situations and contexts. For instance, if someone had a core belief that no one can be trusted, then this thought exercise would usually result in some hot thought that implies or infers that the person or situation can’t be trusted or that the world can’t be trusted.
What Do We Do About This?
Ok, so we know all about the thoughts that lead to the original feeling. So, what do we do about this? Well, we need to create a different thought. By really looking at the evidence, we can generate something called the ‘alternative thought’ or ‘alternative hypothesis’. This is a way we generate to think about the situation we experienced differently (and, thus, lead us to a different feeling or mood).
In terms of the above example where I knocked over the cigar box; perhaps I was just tired or ‘everyone makes mistakes’ or ‘it probably had nothing to do with me’. These sound easy as I type them out, but in the course of depression or anxiety these can sometimes be very difficult to pull out.
If we have an exceptionally difficult time creating one, then I usually ask the person to write something down EVEN if they don’t fully believe it. I really think just the cognitive exercise of generating the thought and writing it down is therapeutic in and of itself.
Finding alternative thoughts to cope with depression and anxiety can be easier with the counseling at Gentle Beacon located in Lafayette, Indiana.
Where Can I Learn More?
Much of this process is captured in something called the “Thought Record” which can be found in a book called “Mind over Mood” by Dennis Greenberger and Christine Padesky. The book was a part of my training and I think it is written in such a way that it could be used as a workbook if one wished. Check it out here.
In thought,
Chris