Cognitive Behavioural Therapy For Dummies

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Has he given you any reason to think this before? Look for evidence that contradicts your catastrophic assumption. For example, have you had more enjoyable times together than not? Engaging in a few more social encounters can help you put your party faux pas behind you. You can repair a damaged relationship — or find another. Even an injury following an accident can be fixed with medical care. Finding Somewhere in Between All-or-nothing or black-or-white thinking see Figure is extreme thinking that can lead to extreme emotions and behaviours.

People either love you or hate you, right? Unfortunately, humans fall into the all-or-nothing trap all too easily: All-or-nothing thinking may lead you to conclude that your plan is in ruins and then to go on to eat the other 11 doughnuts in the pack. All-or-nothing thinking makes you decide that the whole endeavour is pointless. Consider the humble thermometer as your guide to overcoming the tendency of all-or-nothing thinking.

Think like a thermometer — in degrees, not extremes. You can use the following pointers to help you change your thinking: Remind yourself of your goal, forgive yourself for the minor slip, and resume your diet. An alternative to all-or-nothing thinking is both—and reasoning.

You need to mentally allow two seeming opposites to exist together. You can both succeed in your overall educational goals and fail a test or two. Life is not a case of being either a success or a failure. Spotting Errors in Your Thinking All-or-nothing thinking can sabotage goal-directed behaviour. Neither people nor life situations are often that cut and dry. Predictions are the problem here. And yet, you may try to predict future events. Unfortunately, the predictions you make may be negative: The food will unpalatable, the music will be irksome, and the other guests are sure to find you boring.

So, you opt to stay in and bemoan the state of your social life. Put the dustcover back on the crystal ball and leave the tarot cards alone, and try the following strategies instead: You really never know how much fun you might have at a party until you get there — and the food could be amazing. To find out more about testing out your predictions, have a read through Chapter 4.

Learning to live experimentally and taking calculated risks is a recipe for keeping life interesting. Typically, fortune-telling stops you from taking action. It can also become a bit of a self-fulfilling prophecy. Same goes for meeting new people and trying new things. So, put on your party gear, ask him out for dinner, and book yourself in for some hang-gliding.

Taking Your Guesses with a Pinch of Salt So, you think you know what other people are thinking, do you? With mindreading see Figure , the tendency is often to assume that others are thinking negative things about you or have negative motives and intentions. Here are some examples of mind-reading tendencies: You think that he must be annoyed with you about your dog howling at the last full moon and is making plans to report you to environmental health. Stand back and take a look at all the evidence to hand.

Take control of your tendency to mind-read by trying the following: Do you have enough information or hard evidence to conclude that your boss thinks your work is substandard? Ask your neighbour whether your dog kept him up all night, and think of some ways to muffle your pet next time the moon waxes. You tend to mind-read what you fear most.

Cognitive Behavioural Therapy For Dummies, 2nd Edition

Mind-reading is a bit like putting a slide in a slide projector. Surely your feelings are real hard evidence of the way things are? Often, relying too heavily on your feelings as a guide leads you off the reality path. Here are some examples of emotional reasoning: You feel jealous and suspicious of your partner. When you feel emotional reasoning taking over your thoughts, take a step back and try the following: Take notice of your thoughts.

Look to see if there is any concrete evidence to support your interpretation of your feelings. For example, is there really any hard evidence that something bad is going to happen? Give yourself time to allow your feelings to subside. The problem with viewing your feelings as factual is that you stop looking for contradictory information — or for any additional information at all.

Balance your emotional reasoning with a little more looking at the facts that support and contradict your views, as we show in Figure Spotting Errors in Your Thinking reason Figure Take a look at Figure Here, our stick man sees one black sheep in a flock and instantly assumes the whole flock of sheep is black. However, his overgeneralisation is inaccurate because the rest of the flock are white sheep.

Rather than overgeneralising, consider the following: How true is the thought that nothing ever goes right for you? How many other people in the world may be having car trouble at this precise moment? When you judge all people as stupid, including the poor creature waiting in line for the train, you make yourself more outraged and are less able to deal effectively with a relatively minor hiccup. Would you be a totally rotten parent for losing patience with your child? Can you legitimately conclude that one incident of poor parenting cancels out all the good things you do for your little one?

Perhaps your impatience is simply an area you need to target for improvement. Shouting at your child in a moment of stress no more makes you a rotten parent than singing him a great lullaby makes you a perfect parent. Condemning yourself on the basis of making a mistake does nothing to solve the problem, so be specific and steer clear of global conclusions. Giving Up the Rating Game Labels, and the process of labelling people and events, are everywhere.

The following are examples of labelling: The article activates your belief that you live in a thoroughly dangerous place, which contributes to you feeling anxious about going out. You start to feel low and label yourself as a failure. You label the other driver as a total loser for his bad driving. Strive to avoid labelling yourself, other people, and the world around you. All human beings — yourself included — are unique, multifaceted, and ever-changing. To label yourself as a failure on the strength of one failing is an extreme form of overgeneralising.

Likewise, other people are just as complex and unique as you. Introducing CBT Basics When you label a person or aspect of the world in a global way, you exclude potential for change and improvement. Accepting yourself as you are is a powerful first step towards self-improvement. Thinking Flexibly Albert Ellis, founder of rational emotive behaviour therapy, one of the first cognitive-behavioural therapies, places demands at the very heart of emotional problems.

Consider these possible examples: Because your demand is not realistic — sadly, other people are governed Chapter 2: Spotting Errors in Your Thinking by their own priorities — you often feel hurt about your friends not acting the way you do yourself. Therefore, you rarely put your own welfare first. Holding flexible preferences about yourself, other people, and the world in general is the healthy alternative to inflexible rules and demands. Rather than making demands on yourself, the world, and others, try the following techniques: In fact, other people tend to have their own rulebooks.

So, no matter how much you value considerate behaviour, your friends may not give it the same value. So keep acting consistently with how you would like things to be rather than becoming depressed or irate about things not being the way you believe they must be. Keeping an Open Mind Mental filtering is a bias in the way you process information, in which you acknowledge only information that fits with a belief you hold.

The process is much like a filter on a camera lens that allows in only certain kinds of light. At the end of the week, you often feel disappointed about your lack of achievement — but this is probably largely the result of you not paying attention to your successes. To combat mental filtering, look more closely at situations you feel down about. Deliberately collecting evidence that contradicts your negative thoughts can help you to correct your information-processing bias.

If so, then only failure-related information gets through. What evidence do you cite? If you only ever take in information that fits with the way you think, you can very easily end up thinking the same way. Keeping the Baby When Throwing Out the Bathwater Disqualifying the positive see Figure is related to the biased way that people can process information. Disqualifying the positive is a mental action that transforms a positive event into a neutral or negative event in your mind.

The following are examples of disqualifying the positive: Instead of feeling pleased, you feel quite disappointed. I really am pathetic. You can try the following strategies to improve your skills: Practice acknowledging and accepting positive feedback and acknowledging good points about yourself, others, and the world. Introducing CBT Basics got the promotion. You can even consider that the promotion may well have been a result of your hard work.

Rejecting a sincerely delivered compliment is rather like turning down a gift. Steer your thinking towards taking in positive experiences. When others point out attributes you have, start deliberately making a note of those good points. If you frequently disqualify or distort your positive attributes or experiences, you can easily sustain a negative belief about yourself, even in the face of overwhelming positive evidence.

Spotting Errors in Your Thinking The following are examples of low frustration tolerance: Unfortunately, waiting until the last moment means that you can rarely put as much time and effort into your coursework as you need to in order to reach your potential. The best way to overcome low frustration tolerance is to foster an alternative attitude of high frustration tolerance.

You can achieve this way of thinking by trying the following: To combat a fear of travel, you can remind yourself that feeling anxious is really unpleasant, but you can stand it. Second, it leads you to underestimate your ability to cope with discomfort. Removing Yourself from the Centre of the Universe Personalising involves interpreting events as being related to you personally and overlooking other factors.

This can lead to emotional difficulties, such as feeling hurt easily or feeling unnecessarily guilty see Figure Here are some examples of personalising: I must have offended him somehow. Think about the following examples: Your friend may have lost his job or be suffering from depression. Despite your best efforts to cheer him up, these factors are outside your control. For example, your friend may be having a difficult day or be in a big hurry — he may even feel sorry for not stopping to talk to you.

Spotting Errors in Your Thinking Getting intimate with your thinking Figuring out which thinking errors you tend to make the most can be a useful way of making your CBT self-help more efficient and effective. The simplest way of doing this is to jot down your thoughts whenever you feel upset and note what was happening at the time.

When you feel bad, put your thoughts on the pad! See Chapter 3 for more on managing unhelpful thoughts by writing them down. You can then review your thoughts against the list of thinking errors in this chapter and write down next to each unhelpful thought which thinking error you may be making. You can then choose which alternative thinking styles to develop.

You may also become aware of patterns or themes in the kinds of situations or events that trigger your negative thoughts. These can also help you to focus on the areas in which your thoughts, beliefs, and attitudes need most work. CBT therapists can sometimes use similar tools to the ABC form we offer in this chapter, all of which help patients to identify and replace negative thoughts. Different therapists may refer to these forms as thought records, thought diaries, daily records of dysfunctional thoughts, or dysfunctional thought records DTRs. Fret not — in general, all of these forms are simply different ways of saying largely the same thing: Your thinking impacts on your feelings and actions.

The way you think affects the way you feel. Therefore, changing your unhelpful thoughts is a key to feeling better. In this chapter, we give you two versions of the ABC form: The first step is to fill out the first three columns Activating event, Beliefs and thoughts, Consequences of the form, which you can find further on in this chapter ABC Form I. This gives you a chance to focus on catching your negative automatic thoughts NATs on paper and to see the connection between your thoughts and emotions. You can always transfer your thoughts to a form later. Making the thought—feeling link A crucial step in CBT is to make the thought—feeling link or B-to-C connection; that is, seeing clearly for yourself the connection between what goes through your mind and your resulting emotions.

When you see this connection, it can help you to make much more sense of why to challenge and change your thoughts. Becoming more objective about your thoughts One of the biggest advantages of writing down your thoughts is that the process can help you to regard these thoughts simply as hunches, theories, and ideas — rather than as absolute facts. See how easily you can get caught in a vicious circle? Just one of the reasons to take your negative thoughts with a bucket of salt! The basic process for completing the ABC form is as follows: Emotions and behaviour are consequences C of the interaction between the activating event or trigger A and the beliefs or meanings B in the ABC model of emotion.

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We give you more information on how to help you understand and identify emotions in Chapter 6. Write down how your behaviour changed when you felt your uncomfortable emotion. Examples of the behaviour that people often identify in this box include: As we discuss in Chapter 1, the A in ABC stands for activating event or trigger, which are the things that triggered your unhelpful thoughts and feelings.

Activating events or triggers to put in this box can include: Use your feelings — rather than whether you think the event is important — as a guide to when you should fill out a form. They may be extreme, distorted, and unhelpful — but they may seem like facts to you. Some examples of these NATs include: Thoughts are what count, so think of yourself as a detective and set out to capture suspect thoughts.

We think not only in words but also in pictures. People who are feeling anxious frequently describe that they see catastrophic images going through their mind. For example, if you fear fainting in a restaurant, you may get an image of yourself on the restaurant floor with staff fussing over you. One of the key ways to become more objective about your thoughts is to identify the thinking errors that may exist in the thoughts you list in this box. Have a look at Chapter 2 for more details on common thinking errors.

Identify the thinking error for each thought: Write down the thoughts and beliefs that went through your mind: Write down what triggered your feelings: Write down your actions: Write down your emotion: Tackling Toxic Thoughts 43 44 Part I: Introducing CBT Basics Questions that you might ask yourself in order to identify your thinking errors include: Low frustration tolerance Creating Constructive Alternatives: This second form helps you question your unhelpful thoughts in order to reduce their intensity, generate and rate the effects of alternative thoughts, and focus on acting differently.

Then come five more steps. Examine your negative thoughts more closely. Ask yourself the following questions in order to examine and weaken your unhelpful thoughts: Consider long and hard your negative or unhelpful thoughts in the light of the preceding questions. Instead, think things through and perhaps write down your challenges to your unhelpful thoughts in column D.

See the list of questions and prompters at the bottom of the ABC form II, which can help you further with this. Generate alternatives for each of your unhelpful thoughts, attitudes, and beliefs. In column D, write down a flexible, non-extreme, realistic, and helpful alternative for each thought, attitude, or belief that appears in column B. The following questions may help you to generate some alternatives: Wrestling with NATs for a while before they weaken is typical and appropriate. Think of yourself as training your mind to think more flexibly and constructively over a period of time.

Some intrusive thoughts, images, and doubts can be made worse if you engage with them. If you have obsessive-compulsive disorder OCD , health anxiety, body dysmorphic disorder BDD , worry, or a jealousy problem, be sure to develop the capability to live with doubt, and allow catastrophic thoughts to pass through your mind rather than challenging them. We explain this in more depth in Chapter 5, Chapter 9, and Chapter So if you think you need to learn to live with doubt, or to tolerate upsetting, intrusive thoughts in general, we suggest steering clear of using ABC forms for these problems.

In column E, rate the effects of your alternatives on your feelings. Rate your original feelings 0— per cent. Also note whether you experience any alternative healthier emotions such as: Develop a plan to move forward. Your plan may be to conduct a behavioural experiment to help you gather more information about whether your thoughts are true or realistic, or to behave differently in a specific situation.

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  • Refer to Chapter 3 and Chapter 4 for more ideas. Write down what went through your mind, or what A meant to you. B's can be about you, others, the world, the past, or the future. Things will have changed and I won't know what to do Fortune Telling. People will ask me awkward questions about why I've been off sick and I won't know what to say Catastrophising. Briefly write down what triggered your emotions.

    Running over in my mind what I'll say to everyone. Depression, guilt, hurt, anger, shame, jealousy, envy, anxiety. Write down what emotion you felt and how you acted when you felt this emotion. Even if they have I've coped with changes many times before. I'm sure my colleagues will help. Possibly one or two people will ask, and I can just keep my answers short. Mostly everyone will be glad to have me back.

    I've no reason to think they'll think I'm crazy. When Peter was off with stress people were mostly supportive and understanding. When Helen called last week she seemed to treat me just the same as normal. Write an alternative for each B, using supporting arguments and evidence. The questions at the bottom of the form will help you with this. Dispute question and Wait and deal with things when I get there, and stop trying to work it out in advance.

    Alternative Behaviour or Experiment e. List any healthy alternative emotion e. Write down how you feel and wish to act as consequence of your alternatives at D. Mind Reading, Catastrophising, Labelling, Demands etc. Consider whether someone whose opinions you respect would totally agree with your conclusions. Evaluate the helpfulness of each B. Write down what you think might be a more helpful, balanced and flexible way of looking at A.

    Consider what you would advise a friend to think, what a role model of yours might think, or how you might look at A if you were feeling OK. Add evidence and arguments that support your alternative thoughts, attitudes and beliefs. Write as if you were trying to persuade someone you cared about. Beliefs, thoughts, and Activating Date March 18th Chapter 3: Tackling Toxic Thoughts 47 48 Part I: If you want to master any skill, remember these three words: You may not need to fill out an ABC form everyday.

    Other days, you may need to complete more than one form. The point is, that practising ABC forms regularly is worthwhile because: Set yourself some homework. Such repetitions may suggest that you need to add some other CBT techniques in order to overcome certain emotions or behaviours, for example: Keeping your old ABC forms can be a rewarding record of your progress, and a useful reminder of how to fill them in if you need to use one again in the future.

    Many of our clients look back over their ABC forms after they feel better and tell us: Behavioural experiments are particularly good examples of the common-sense side of CBT. If you want to know whether your hunch about reality is accurate, or your way of looking at something is helpful, put it to a test in reality. This chapter is an introduction to behavioural experiments, a key CBT strategy. We include in this chapter an overview of several behavioural experiments that you can try out for yourself. We also give you examples of these experiments in action. As with the other examples we use in this book, try to look for anything useful you can draw from them.

    Try not to home in too much on how the examples differ from your specific problem. Instead, focus on what you have in common with the examples and work from there to apply the techniques to your own problems. Beck emphasises that testing your thoughts in reality, rather than simply talking about them, underpins effective therapy.

    Reasons for Doing Behavioural Experiments The proof of the pudding is in the eating. The same can be said of your assumptions, behaviours, beliefs, and predictions about yourself and the world around you. Use experiments to test out the truth about your beliefs and to assess the usefulness of your behaviours.

    Cognitive Behavioural Therapy For Dummies

    You can use behavioural experiments in the following ways: You can also easily stick to familiar ways of behaving because you think that they keep you safe from feared events, or that they help you to achieve certain goals. An example of this may be holding a belief that other people are out to find fault with you — with this thought in mind, you then work hard to hide your mistakes and shortcomings. The trick is to prepare yourself to try out new strategies and to give them a chance before returning to your former ways.

    Find out what works best for you and your particular situation. Testing Out Predictions When testing out your predictions, strive to get unambiguous disconfirmation, in so far as you can. An example of unambiguous disconfirmation Chapter 4: Go through the following four steps to devise a behavioural experiment: Write down the nature of your problem and include your safety behaviours things you do to try to prevent your feared catastrophe — head to Chapter 7 for loads more on safety behaviour.

    Phrase the problem in your own words and make a note of how the problem negatively affects your life. Decide what you think will happen if you try out a new way of thinking or behaving in real life. Think of a way of putting a new belief or behaviour to the test in a reallife situation. Try to devise more than one way to test out your prediction. Look to see whether your prediction came true. You can rate the degree to which you believe a prediction will come true on a percentage between 0 and at the start of your experiment.

    For example, consider the following experiment, which Nadine initiates to examine her fear of rejection and social anxiety: In social situations, Nadine monitors her body language and censors what she says, taking great care not to cause offence. Nadine discovers that no one took exception to her saying more. In fact, two friends commented that it was nice to hear more about what she thought about things. Nadine re-rates her conviction in her original prediction as 40 per cent. This result gives Nadine the opportunity to change her behaviour according to the results of her experiment; therefore, to speak up more often.

    It also helps to reduce how much she believes the original prediction. Nadine can now adjust her thinking based on evidence gathered through the experiment. Since self-isolating and disengaging from previously enjoyed activities promotes depression, Nigel really needs to understand the benefits of becoming more active. Nigel worked through an experiment as follows: As we note in Chapter 10, selfisolation is one of the key ways in which depression is maintained. Nigel plans to structure his week and to schedule two occasions to see friends.

    He also plans to spend two half-hour sessions riding his bike, which he used to enjoy. He rates each day over the next seven days in terms of his mood and of how much he enjoys his activities. Nigel notices that he does get some enjoyment from seeing his friends, although less than he usually would.

    He re-rates his conviction in his original prediction as 40 per cent, and decides to conduct further experiments to see whether his mood and energy levels improve over the next two weeks if he continues to be more active. Noting these results can help Nigel to stick to a schedule of activity and ultimately help him to overcome his depression.

    Whichever theory explains a phenomenon most simply is the one a scientist adopts. When you want to test out a theory or idea you hold about yourself, others, or the world, developing an alternative theory is a good idea. This gives you the chance to disprove your original theory and to endorse the healthier alternative. In such cases, you may be better off developing some competing theories about what the problem actually is. You then devise experiments to gather more evidence and see which theory reflects reality most accurately. You develop the following two theories: A theory is just an idea or assumption that you hold, which to your mind, explains why something happens — a technical word for a simple concept.

    Often, developing one additional theory to compete with your original theory is enough. Introducing CBT Basics Developing competing theories can be particularly helpful in the followings situations: With these kinds of catastrophic thoughts, you need to design experiments to help you gather evidence to support the theory that you have a worry or anxiety problem, rather than a damnation problem or terminal illness.

    Similarly, if you have jealous thoughts that your partner desires someone else, but he reassures you otherwise, you may remain uncertain of his true feelings. For both of these situations, you can employ the theory A or theory B strategy: Following is an example of how Alex used the competing theories approach to get a better understanding of his physical sensations.

    Originally, Alex assumed his theory that uncomfortable bodily sensations signalled the onset of a heart attack was correct. By testing this in practice, Alex was able to consider that an alternative theory — uncomfortable bodily sensations are a byproduct of anxiety — may be more accurate. Alex suffers from panic attacks.

    He feels hot and his heart races, sometimes out of the blue. Alex sits down to try to reduce the strain on his heart an example of a safety behaviour. He goes out of his way to avoid situations in which he has experienced these symptoms.

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    Alex devises two theories about his raised heart rate: Alex decides to deliberately confront situations that tend to trigger off his raised heart rate and to stay in them, without sitting down, until his anxiety reduces. He predicts that if theory B is correct, then his heart rate will reduce after his anxiety subsides and he can leave the situation without having come to any harm. Alex finds that his heart rate does indeed reduce when he stays with his anxiety. He concludes that he can reasonably have about 70 per cent confidence in his new theory that his raised heart rate is a benign consequence of anxiety.

    However, you can experiment to see whether certain emotional states, and mental or behavioural activities, have a beneficial or detrimental effect on the kinds of thoughts that play on your mind. Conducting Surveys You can use the clipboard and pen of the survey-taker in your endeavours to tackle your problems, by designing and conducting your own survey.

    Surveys can be especially helpful in terms of getting more information about what the average person thinks, feels, or does. We suggest you have more than one type of behavioural experiment in your repertoire. Surveys are very useful if you believe that your thoughts, physical sensations, or behaviours are out of the ordinary.

    Use surveys to see whether other people have the same thoughts and urges. You may also discover that the symptoms you experience are actually less of a problem than the way you currently deal with them. His particular obsessional problem is related to frequent intrusive images of harm coming to his family. He tests his theory about his abnormality by conducting the following survey: He rates his strength of belief as 70 per cent. Henry tests his perception that his images are abnormal by devising a checklist of intrusive thoughts and asking his friends and family members to tick any that they experience.

    He re-rates his conviction in his original prediction as 15 per cent. Charlotte worries a lot about her health and the possibility of developing a life-threatening illness. Sometimes, Charlotte notices funny sensations in her body and instantly interprets them as signs of an undiagnosed disease.

    Charlotte assumes that no one else gets unusual bodily sensations from time to time. Charlotte worries that the bodily sensations she experiences are a sign of disease. Charlotte makes the following prediction: Charlotte devises a list of physical sensations, including many of those that she worries about herself. She asks ten people to fill out her questionnaire. Her strength of belief in her original prediction reduces to 30 per cent.

    Making Observations Observations can be an easier way of getting started with doing experiments to test out the validity of your thoughts. Observations usually involve collecting evidence related to a specific thought by watching other people in action. You may assume, for example, that no one in their right mind would admit to not understanding an important point about a work procedure. Test this assumption by observing what other people actually do. Behave like a scientist and gather evidence of others admitting lack of understanding, asking for clarification, or owning up to mistakes.

    Making observations to gather evidence both for and against your assumptions is another way of behaving like a scientist. Ensuring Successful Behavioural Experiments To get the highest level of benefit when designing and carrying out behavioural experiments, keep the following in mind: Make your experiments challenging enough for you to gain a sense of accomplishment from conducting them. For example, how do you respond assertively if someone is actually critical of you? Safety behaviours can affect the results of your experiment or determine how confident you feel about the outcome — for example, thinking that you avoided collapsing by concentrating hard, rather than discovering conclusively that your feelings of dizziness are a result of anxiety, not imminent fainting.

    For example, should you repeat the experiment, devise a new experiment, change your daily activities, or some other action? Treating your negative and unhelpful thoughts with scepticism is a key to reducing their emotional impact. Experiments can help you to realise that many of your negative thoughts and predictions are not accurate in reality. Therefore, we suggest you take many of your negative thoughts with a pinch or more of salt.

    Think about therapy as an experiment, rather than a lifelong commitment, especially at the beginning. By thinking in this manner, you can feel less under pressure and more able to approach therapy with an open mind. Keeping Records of Your Experiments All good scientists keep records of their experiments. If you do the same, you can look back over your results in order to: To help you keep records of your experiments, photocopy Figure , and use it as often as you like, following the instructions in the figure.

    Photocopy and fill in your own Behavioural Experiment Record Sheet. Experiment Plan what you will do including where, when, how, with whom , being as specific as you can. Results Record what actually happened including relevant thoughts, emotions, physical sensations, and other people's behaviour.

    Guidance on carrying out a behavioural experiment: Be clear and specific about the negative and alternative predictions you are testing. Rate your strength of conviction in the prediction or theory you are testing or evaluating. Record the results of your experiment, emphasizing clear, observable outcomes. Evaluate the results of your experiment.

    Write down what these results suggest in terms of the accuracy of your predictions, or which theory the evidence supports. Consider whether a further behavioural experiment might be helpful. Prediction or Theory Outline the thought, belief, or theory you are testing. Behaving like a Scientist 59 60 Part I: However, loads of scientific evidence shows that CBT is more effective than all other psychotherapies. So, CBT may well work for you, but how can you tell? The answer is to consider applying a specific tool or technique for a period of time as an experiment to see how the technique works for you.

    Depending on the outcome, you can then choose to do more, modify your approach, or try something different. Try to have a no-lose perspective on your experiments. If you do one experiment and it goes well, then great! However, if you plan an experiment but ultimately avoid doing it, you can at least identify the thoughts that blocked you. The point is, you can always gather information that you can make into a useful experience. Chapter 5 Pay Attention! However, modern CBT has begun to incorporate another area of human psychology — how we focus our attention.

    This chapter does not discuss what you think, but does discuss how you manage your thoughts and attention. We introduce task concentration training and mindfulness, two techniques for managing problematic thoughts and exerting some power over your attention. This chapter has two main messages: Rather, the importance or meaning you attach to those thoughts is what causes you the problem.

    You can also tend to overfocus on particular aspects of these unhelpful meanings. Fortunately, you can develop the ability to steer your attention towards, and away from, any features of your experience you choose, which can help improve your mood and reduce anxiety. Introducing CBT Basics Training in Task Concentration Becoming adept at redirecting your attention away from yourself this includes your bodily sensations, thoughts, and mental images , in certain situations, is the essence of task concentration.

    Task concentration can be particularly useful in situations that trigger anxiety. Task concentration can help you to counterbalance your tendency to focus on threats and on yourself when you feel anxious. As you begin to practise task concentration, break down the process into two rehearsal arenas — just as when learning to drive you begin on quiet roads and eventually advance on to busier roads. The two rehearsal arenas are as follows: Here, you typically experience little or no anxiety. For example, if you have social phobia, you may feel little anxiety walking through a park, travelling on a very quiet train, or socialising with family members and close friends.

    Here, you tend to experience moderate to severe anxiety. More challenging situations may include shopping in a busy grocery store, travelling on a train during rush hour, or attending a party with many guests whom you do not know. Typically, you gradually progress from moderately threatening situations to more challenging situations as you practise and develop greater skill. First, practise redirecting your attention in situations you regard as relatively non-threatening, then you can move on to using the techniques in increasingly challenging situations.

    Choosing to concentrate The point of task-concentration exercises is not to lessen your overall concentration, but to concentrate harder on different aspects of the external environment. Some tasks require you to focus your attention on certain Chapter 5: Refocusing and Retraining Your Awareness behaviours — such as listening to what another person is saying during a conversation, or attempting to balance a tray of drinks as you walk through a crowded room.

    In such a situation, for example, while sitting in a crowded waiting room, you can direct your attention to your surroundings, noticing other people, the features of the room, sounds, and smells. With practice, you can be both task- and environment-focused rather than self-focused, even in situations that you regard as highly threatening. The following exercises aim to increase your understanding of how paying attention to sensations and images limits your ability to process information around you.

    The exercises will also help you realise that you can attend to external task-related behaviours. In other words, you can master choosing what you pay attention to in situations when your anxiety is triggered. Intentionally directing your attention away from yourself does not mean distracting yourself from your physical sensations or suppressing your thoughts.

    Sometimes, people try to use thought suppression as a means of alleviating uncomfortable sensations and anxiety. However, suppression usually works only briefly, if at all. Listening For this exercise, sit back-to-back with someone else, perhaps a friend or your therapist. Ask the person to tell you a story for about two minutes. Concentrate on the story. Then, summarise the story: Note how much of your attention you directed towards the task of listening to the other person, towards yourself, and towards your environment during the exercise — try using percentages to do this.

    Your partner can give you feedback on your summary to give you some idea of how accurate your summary is. Now do the exercise again, but this time round sit face-to-face with the storyteller and make eye contact. Ask the person to tell you a story, but on this occasion deliberately distract yourself by focusing on your thoughts and sensations, and then redirect your attention towards the storyteller. Summarise the story, and note using percentages again how you divided your attention between yourself, listening to the other person, and your environment.

    Repeat the storytelling activities, sitting back-to-back and thenface-to-face, several times until you become readily able to redirect your attention to the task of listening after deliberate distraction through self-focusing. Doing so helps you to develop your ability to control where you focus your attention. Speaking Follow the same steps for this speaking exercise as you do for the listening exercise, as we describe in the preceding section. Starting with your back to the back of the other person, tell a two-minute story, focusing your attention on making your story clear to the listener.

    Next, position yourself face-to-face with the listener, making eye contact. Deliberately distract yourself from the task of storytelling by focusing on your feelings, sensations, and thoughts. Again, using percentages, monitor how you divide your attention among yourself, the task, and your environment. Graded practice For this exercise, prepare two lists of situations. - Cognitive Behavioural Therapy For Dummies - Rhena Branch - Livres

    For your first list, write down five or so examples of situations you find non-threatening. Practise distracting yourself by focusing on your internal sensations and thoughts and then refocus your attention onto external things in these non-threatening situations. For your second list, write down ten or so examples of situations you find threatening. Arrange the situations in a hierarchy, starting from the least anxiety-provoking and graduating up to the most anxiety-provoking. Now work through your hierarchy by deliberately entering situations, while practising task concentration until you reach the top of your list.

    This means you start to practice mastering your anxiety in real-life situations. Taking a walk For this exercise, walk through a park, paying attention to what you hear, see, feel, and smell. Focus your attention for a few minutes on different aspects of the world around you. First, focus your attention mainly on what you can hear. Then shift your attention to focus on smells, and then on to the feel of your feet on the ground, and so on.

    You can move your attention around to different sensations, which can help you tune your attention into the outside world. Try to do this for at least 20 minutes. Really let yourself drink in the detail of your surroundings. Discover what hooks your attention. You may be drawn to water Chapter 5: Refocusing and Retraining Your Awareness or have a keen interest in birds, plants, or perhaps even woodland smells.

    Notice how you feel much more relaxed and less self-conscious as you train your attention on the world around you. Luckily, you can change your attention bias and overcome much of your anxiety. You can also use your re-training attention to help prevent yourself from engaging with the stream of negative thoughts that accompanies depression, which will in turn help you lift your mood. Harold was particularly worried that people would notice that he blushed and sweated in social situations.

    He believed that people would think he was odd or a nervous wreck. Harold constantly self-monitored for blushing and sweating and tried very hard to mask these symptoms of his anxiety. Harold used the principles of task concentration to increase his ability to focus deliberately on chosen external factors in non-threatening situations.

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    • When Harold was at the pub with his mates, he focused his attention on what his friends were saying, other people in the pub, the music, and the general surroundings. Harold also deliberately distracted himself by focusing on whether he was blushing and sweating, and then he refocused his attention again. Harold then used the same techniques in more-threatening situations. In the grocery store, Harold found that the more he focused on his blushing and sweating, the more anxious he felt and the less able he was to pack up his shopping. Harold worked diligently through his hierarchy of feared situations and now feels much more confident and relaxed in social situations.

      For a few minutes, try to take in as much information as you can about the environment and the people around you. Tackling the task concentration record sheet You can keep an account of your task-concentration practice, and note the results, by using the task-concentration record sheet in Table The brief instructions at the top of the sheet are there to remind you how to do your concentration exercises. You can find a blank copy of the form in Appendix B.

      What were you doing? Note what you focused on most. Remember to focus on your task or environment. Note what you did. Record anything you learned from the exercise. Note how the situation turned out, changes in your anxiety level, and your ability to complete the task. Took my time to eat rather than rushing. My anxiety lessened as I ate. No one seemed to think I was odd for eating alone. I felt less awkward than I expected to feel. It took a lot of effort at first to keep my attention on the task of eating but it got easier.

      Introducing CBT Basics Becoming More Mindful Mindfulness meditation, commonly associated with Zen Buddhism, has become popular in the past few years as a technique for dealing with depression, and managing stress and chronic pain. Evidence shows that mindfulness meditation can help reduce the chance of problems such as depression returning, and adds another weapon into your armoury against emotional problems.

      Being present in the moment Mindfulness is the art of being present in the moment, without passing judgement about your experience. The mindfulness process is so simple — and yet so challenging. Mindfulness literature talks about the way your mind almost mechanically forms judgements about each of your experiences, labelling them as good, bad, or neutral depending on how you value them. Things that generate good and bad feelings within you get most of your attention, but you may ignore neutral things or deem them to be boring.

      Mindfulness meditation encourages awareness of the present moment with an uncultured mind, observing even the seemingly mundane without judgement. The whole experience is a bit like looking at the world for the first time. When you meet someone you know, try to see her through fresh eyes. Suspend your prior knowledge, thoughts, experiences, and opinions about her.

      You can try this with acquaintances or people you know very well, such as family members and close friends. Whether the surroundings are familiar to you or not, try to see the details of the world around you through fresh eyes. Letting your thoughts pass by You can develop your mindfulness skills and use them to help you deal with unpleasant thoughts or physical symptoms.

      If you have social anxiety for Chapter 5: Refocusing and Retraining Your Awareness example, you can develop the ability to focus away from your anxious thoughts. Watching the train pass by Imagine a train passing through a station. Each carriage may represent one or more specific thoughts or feelings. Visualise yourself watching the train pass by without hopping onto any carriage. Accept your fears about what other people may be thinking about you without trying to suppress them or engaging with them. Simply watch them pass by like a train through a station.

      Each passing vehicle represents your thoughts and sensations. Just watch the cars go by. Observe and accept them passing. Being mindful means learning to experience your thoughts without passing judgement as to whether they are true or not. Becoming more familiar with the thoughts that tend to pop into your head when you feel down, anxious, or guilty makes it easier for you to recognise them as thoughts and let them come and go, rather than treating them as facts.

      This familiarity gives you another skill to help manage your negative thoughts in addition to challenging or testing them out in reality. Introducing CBT Basics Incorporating mindful daily tasks Becoming more mindful about little everyday tasks can help you to strengthen your attention muscles. Essentially, everything you do throughout the day can be done with increased awareness. For example, think about the following: Notice the smell of the washing-up liquid, the temperature of the water, and the movement of your hands.

      Slow down the speed you eat, and pay attention to the texture of the food, the subtlety of the flavours, and the appearance of the dish. Part II Charting the Course: In this part you discover what you want to change in your life, and realise how some of your current solutions to problems may not be benefiting you in the long run.

      We also offer alternatives to current solutions that may not actually be working for you! You may be asking: Not a lot of people come to us looking for a way to overcome their relentless feelings of contentment. The emotions that give people trouble typically include guilt, anger, depression, and shame. Healthy negative emotions are generally less profoundly uncomfortable and less problematic than their unhealthy counterparts.

      For example, feeling intensely sad a healthy negative emotion is less uncomfortable than feeling intensely depressed an unhealthy emotion. Defining Problems and Setting Goals Fortunately, you can think what to feel, to a greater or lesser extent, which can reduce your emotional discomfort.

      The main point is to be able to analyse your thoughts and behaviours, and to take notice of where your attention is focused CBT refers to this as attention focus. This took me a long time to get through, because I like to read in a linear fashion rather than the dip-in-and-out style recommended by this book a behavioural quirk that's probably part of the reason I need such a book in the first place.

      There's lots of useful and helpful information here, in a chatty, informal style that didn't feel patronising. Now I've made myself happy by reading the whole thing from start to finish, I can go back and cherrypick what I need, when I need it Mar 19, Oceans rated it really liked it Shelves: This is a great introduction and walk-through the CBT. Lots of practical guides and examples and I think I'll be going back to some again until I internalize them. Jun 25, Lance rated it liked it Shelves: If we had to define the purpose of therapy, its purpose would not be to make you a straighter-thinking, more rational person.

      Rather, the purpose of therapy is to help you achieve your goals. The contents are very broad, and emphasise the concreteness of a systematic approach to the convolutions of If we had to define the purpose of therapy, its purpose would not be to make you a straighter-thinking, more rational person. The contents are very broad, and emphasise the concreteness of a systematic approach to the convolutions of unhealthy thoughts and feelings.

      One of the biggest advantages of writing down your thoughts is that the process can help you to regard these thoughts simply as hunches, theories and ideas - rather than as absolute facts. The formulae are very useful for simplifying a morass of thoughts and creating a sense of control.

      There were many exercises I had not seen before in specialist targeted CBT books, such as listing 10 different emotional reactions in response to the same situation, and formalising rebuttals to doubts about putting a healthier belief into practice. There are many insightful, if cheesy, metaphors to help put the surreal world of emotions into a functional context. Think like a thermometer - in degrees, not extremes. The assertion about behavioural experiments was particularly encouraging as the writers suggest that it encourages clients to become more like scientists.

      I was aware of trying to treat oneself the way one would a friend in need, but I felt greater compassion for myself when I was encouraged to Ask yourself what types of belief you'd teach a child. I found the advice non-intrusive. The writers are skilful in drawing the reader through their conclusions logically and at the pace of the reader's developing thinking. Many of the messages will apply profoundly to the full range of mental health conditions.

      Self-acceptance means deciding to resist labelling yourself at all and rather to entertain the idea that ratings are inappropriate to the human condition. At times I found the writing style patronising, but I believe this is a characteristic of the For Dummies franchise as opposed to their self-help books specifically. Especially when the tone was maintained as light and the diagrams often childish despite the seriousness of the content. But perhaps I am just overgeneralising. Rigid thinking is a reliable indicator that you're having an unhealthy feeling. Despite the flippancy of the narrative, the sheer breadth of this book is a strong redeeming factor and I would recommend it as a trove of potential new exercises for anyone who has benefitted from CBT in the past.

      However, the meanings you attach to certain types of negative events may not be wholly accurate, realistic, or helpful. Sometimes, your thinking may lead you to assign extreme meanings to events, leaving you feeling disturbed. May 12, David rated it it was amazing.

      They also share a similar tone of voice. The kind of calm, patient and pleasant tone you might adopt when talking about something that interests you, but wont really affect your privileged life in any real, practical, deep way. The same way that Jacob Rees-Moog talks about politics. I don't mean that as a criticism of either CBT or Anglicanism. I believed, in my ignorant way, that it was a mechanistic, soul-less model of therapy.

      That it subscribed to an essentially capitalistic notion that the best human beings can aspire to is being independent, self-sufficent, free-floating, positive, goal-directed, productive units. I realise after reading the book that none of my preconceptions held any truth, but it is true to say that CBT is partly a therapeutic model, and partly a way of selling that model. They want you to know this is a practical, common-sense method that works. As opposed to a cliched definition of an endless, navel-gazing, self-indulgent, broadly Freudian approach. In this way CBT is a kind of atheism, but unlike atheism it offers an alternative to the idea it is disproving.

      Baggini looks at how language and rhetoric can be used to undermine rational argument. CBT also looks at the way language is used to create negative patterns of thought. I was also reminded of Marcus Aurelius, although he has a fuller, broader sense of the tragic flavour of life, But I kept thinking about a favourite Aurelius quote, I forget it exactly, but it's about how we have a choice to believe in either a meaningless universe or a universe with meaning. Neither position can be proved or disproved, he says, so we should subscribe to the position that most helps us to endure.

      It's that idea that we should choose the approach that is most practical and helpful. It's a voice that seeks to underplay my overly dramatic, possibly pompous view of the world. It reminded me of my mum calming me down with a cup of tea, and an understanding, but realistic reassessment of some upsetting thing. And, most importantly, CBT wants me to be happy. CBT wants us all to be happy.

      Oct 20, Richard Schwindt rated it it was amazing. Books on CBT as a rule are well done. I suspect that CBT therapists, running the risk of their subject matter being too boring, have to be amusing communicators. That particularly true when CBT therapists are relegated to treatment compounds where they force depressed people to do every damn bit of homework.

      Frankly, once understood, CBT is the most flexible of day to day tools. People find their own ways of making it work for them. It can even be used effectively on people in a hypnotic trance. This book is straightforward, well written and full of useable information. Almost everyone will walk away with something they can think about or try. It is up there with "Mind over Mood" and David Burn's work on my recommended reading list for clients. May 04, Mahmoud Mostafa rated it it was amazing.

      One of the best i've ever read.. Great introduction to CBT packed full of interesting information and practical exercises. Oct 21, Fee rated it really liked it. I do think, however, that it's best to work with a coach or therapist. I need a stick behind the door and someone to guide me through it all. I got this book because I was unhappy with my general state of being emotionally wise.

      I looked around trying to find various self-help books to help me sort myself out, and while there was a huge range on offer the number of options available to me was hindering my ability to choose. So in the end I went for the one that looked the simplest to wrap my head around and could be quite enjoyable to read. Thankfully I think I made the right choice.

      Written by two experts of cognitive behavioural ther I got this book because I was unhappy with my general state of being emotionally wise. Written by two experts of cognitive behavioural therapy, this books tells in plain black and white English, as though reading the manuscript of a conversation between friends, divide up into simple clear chapters, helpful ways in which we can all learn to change something about ourselves that may be destructive to ourselves or those closest to us.

      Everything from depression, addictions, social anxiety, anger, impatience and many others can all be tackled or dealt with in one way or another thanks to this book. Complete with exercises and clear instructions on how to use those exercises it is more than helpful for a range of people who may feel that traditional therapy of sitting on a sofa and someone asking them "How does that make you feel? For me personally it has been a big help and I can confidently say that my anger, impatience, anxieties and depression have dropped significantly. On more than one occasion have i called upon what I've learned from the book and put those exercises to good use.

      Now am I saying I am free from all negative thoughts and feelings and am thus a perfect human? I am at the end of the day a fallible human being. But that's fine, we all, at some point or another will get angry or upset and it'll be justified. But after reading this you'll know when to drop it, or when to just leave things be. It has inspired me to change my outlook on life and has given me the push I needed to go out and help others like myself, so I shall continue to explore C.

      T and see if I can apply it to my drama-therapy workshops when working with others who may suffer from mental illnesses like myself. The only down side I can say of this book would that at times they do tend to repeat what's already been said, but as a result of this method the information is retained quicker and easier.

      So perhaps, like making yourself go out to confront your social anxiety, it's a small pain worth suffering through to see the bigger better picture at the end. Sep 28, Tony rated it did not like it. It's packed with well-meaning advice - the likes of which you might expect to find in a Reader's Digest, or from a well-meaning friend.

      It claims a scientific basis for Cognitive Behavioural Therapy but in this massive book its very hard to determine which bits have been tested with success in a clinical environment, and which bits are Dec 29, Ben Love rated it really liked it. To go down a side path: There is zero consistency in their quality from title to title. Then there are many others that confuse and feel more like an assembly of bits of information rather than a coherent guide.

      CBT for Dummies is a mix of the two. In part pieces of information, but threaded together in a sensible, gradually predictable and well paced manner. It was also a relief to hear that CBT is being used more frequently instead of medicine to cure psychological issues. An intelligent book on a complex topic. Requires a re-read at some point. Cannot decide if this is a gross oversimplification of CBT, tries to do too much with a chapter for just about every disorder under the sun, OR if it is the sort of thing a general reader like myself would find helpful, accessible and relatively painless to use.

      And, no, I did not do the exercises. Which would probably have solved this conundrum. However, since it was borrowed I was afraid I'd get stuck halfway through and then have to return it. Apropos of nothin Requires a re-read at some point. I'm something of a fan of the whole " For Dummies" books and their ilk, but this business of having separate workbooks bothers me. But that's a rant for another time.

      Apr 03, AmoRead rated it really liked it Shelves: As advertised, it's pretty simple and straight-forward presentation. Includes actual CBT interventions as well as theoretical guidelines. I appreciate how it's intended as a self-help book, but the author spends time near the end addressing when it might be appropriate for a reader to seek professional advice from a physician or a professionally trained therapist.

      May 17, Lukerik rated it liked it. One day I was too honest about myself while in conversation with a friend. The next day she lent me this book.

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      An excellent introduction to the subject from a practical point of view. It gives you everything you need to get started. I will not be practicing CBT as I like my flaws. Oct 12, Kimberly Lloyd marked it as to-read. This will be helpful on the psychiatric floor.

      Can also help with improving fitness and speed during racing. Can't wait to start this. Although, such a deep 'lable' really, it's just keeping your thoughts positive. Jan 11, Simone Cox rated it it was amazing. I've been in therapy for 3 months and this book has helped me so much. Ik zal proberen het langzaam in praktijk om te zetten. Maar daar is nog wat werk aan: Apr 16, Grant rated it it was amazing. It was very helpful and I continue to refer to it. A very useful insightful and easy read self help book. Written in plain English and easily accessible this is a book that can dipped into time and time again when needed.

      Oct 29, Nissa rated it liked it. I keep hearing this therapy referenced in other books so I wanted to get an idea of what it entails. This book achieved that for me. Jun 04, Suzanne Copping rated it really liked it. Really--some useful perspectives and helpful tools regardless of how much CBT you think you need.

      Apr 14, Lynda rated it really liked it. Have used a lot of the described exercised within my group therapy programme and by and large they have worked really well. Aug 10, Tazeen rated it it was amazing. Its a well laid out, well thought out book. Very easy to follow and very helpful. Jul 02, Raymond rated it really liked it.

      Sep 02, Sarah rated it really liked it. For anyone who ever has thoughts which act against rather than for them!

      Cognitive Behavioural Therapy For Dummies Cognitive Behavioural Therapy For Dummies
      Cognitive Behavioural Therapy For Dummies Cognitive Behavioural Therapy For Dummies
      Cognitive Behavioural Therapy For Dummies Cognitive Behavioural Therapy For Dummies
      Cognitive Behavioural Therapy For Dummies Cognitive Behavioural Therapy For Dummies
      Cognitive Behavioural Therapy For Dummies Cognitive Behavioural Therapy For Dummies
      Cognitive Behavioural Therapy For Dummies Cognitive Behavioural Therapy For Dummies
      Cognitive Behavioural Therapy For Dummies Cognitive Behavioural Therapy For Dummies
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