Recognizing and Dealing with Negative Automatic Thoughts

[Shmi]

Inspired by this post, which is point 3 on the list below, but I can’t comment there, so a separate post it is. Copied from here. Basically, this is cognitive-behavioral therapy (CBT) in a nutshell.

Recognizing Negative Automatic Thoughts

1. Overgeneralization: making a general conclusion based on one piece of evidence.
   Daniel gets a high glucose reading and thinks “I will never get my numbers under control.”

2. Filtering: Focusing on negative events, and ignoring positive events, or information that contradicts the negative outlook.
   Jo has done really well at following her diet plan all week, but at a work party, she eats more dessert than she should. Later, she reflects on her dessert choices and thinks, “I always fail at sticking to my plan, this is pretty hopeless.”

3. All or nothing thinking: Thinking that there are only two extremes, with no middle ground.
   Daniel is in a rush in the morning and doesn’t eat breakfast, so his numbers are off throughout the day. He thinks “Well, I’ve already screwed up, no point in continuing to try at this point.”

4. Personalizing: Taking responsibility for something that is not your fault.
   Jo is at her doctor’s appointment, but because the office is behind schedule, she does not get answers to all of her questions. When she leaves, she thinks, “Wow, I can’t even ask questions correctly. I don’t do any of this right.”

5. Catastrophizing: Expecting that the worst will happen.
   Daniel is preparing for vacation with his family. He decides not to make a plan to manage his diabetes while on the trip, because, “It’s not like I’ll stick to it at all anyway, because there won’t be any healthy food on the trip.”

6. Emotional reasoning: Mistaking how you feel about a situation with how the situation really is.
   Jo weighs herself after a couple weeks of working out daily, only to find that her weight has not changed. She feels like nothing she’s doing is working and thinks, “I shouldn’t keep trying, because nothing is changing.”

7. Mind reading: Thinking you know how another person thinks or feels about you without checking evidence from their actions.
   Daniel’s doctor is very rushed during his next appointment. Daniel thinks, “She must not like me because I’m not doing good enough at managing my diabetes.

8. Fortune Telling Error: Anticipating negative outcomes and then thinking your anticipation is fact.
   Right after Jo was diagnosed with diabetes, her thoughts were often along the lines of “There’s no point in trying to get this under control because I’m going to fail.”

9. Should statements: Using the words “should” or “must” can set up unrealistic expectations and difficult rules to stick to.
   Right after Daniel was diagnosed he thought, “I should never eat desserts again.”

10. Magnification/​Minimization: Emphasizing the impact of negative events, while downplaying the importance of positive events
    Jo overemphasizes the times that her numbers are too high and ignores the more frequent times that she is able to keep her numbers under control.

Reframing Automatic Negative Thoughts

1. Challenge your thoughts. Remember: thinking something does not make it true.
   Daniel starts thinking that there’s no reason to come up with a plan for managing diabetes on his vacation, because he knows there will be no healthy food options available on the trip. He thinks it will be too difficult to try to stick to his diet while eating out as often as he will on vacation. However, he soon realizes this is a negative thought. He realizes it is not helpful to think about the vacation or his management goals in this way.
   Can you come up with another challenge to this thought?

2. Next, look for evidence. Acknowledge any evidence in favor of your thoughts, but then ask yourself if you’re ignoring evidence that contradicts your thoughts. Be sure you have considered all the facts.
   Daniel takes a step back and looks more closely at his vacation plans. He realizes that he is focusing on the fact that he will be eating out more often, rather than learning what restaurants will have options that help him stick to his diet plan.

3. Then, search for alternatives. Try to look at the situation from another perspective. Ask yourself if your thinking is becoming too inflexible.
   Daniel decides to make a list of possible outcomes besides just eating out anywhere on vacation. First, he considers only choosing restaurants that offer salad entrees or salad bars. Then, he considers the possibility of bringing food and having picnics on the road. Finally, he considers making meals in his hotel.
   Can you come up with another alternative?

4. After considering alternatives, make sure to put the whole thing in perspective. Consider what the worst possible outcome could be.
   Daniel decides to develop a strong plan for while on vacation. However, he also decides to acknowledge that the worst outcome would be a week off of his plan. He recognizes that even if he didn’t choose good restaurants during the week, one week off his plan at home does not mean he can’t get back in his good habits when he returns home.

5. Finally, consider what a more helpful thought would be. Ask yourself what a more helpful way to look at the situation would look like.
   Daniel sits back and considers that in the future he should start by considering how he can continue to manage his diabetes in new situations, rather than assuming that he will not be able to do so.
   Can you come up with another more helpful thought?

[romeostevensit]

Treating negative thoughts as adversarial and illogical only works temporarily IME and something like coherence therapy, core transformation, focusing, et al are needed to investigate the motivation stack and world view of the aversive thoughts to discover their original positive intentions.

[Rene de Visser]

Yes, the postive reframing step from TEAM (version of CBT) /​ Feeling great by Dr David Burns is missing from the above, as is the “Magic Dial” step.

A bit odd, as I would have guessed that the above lists or taken directly from “Feeling Great”, or from his web site.

[Shmi]

The attribution is in the link.

[Alexander Gietelink Oldenziel]

Could you say more? What’s wrong with CBT?

[romeostevensit]

I dont think the fault lies with CBT, rather the implementation of CBT varies a lot. My opinion is that implementations that don’t include crucial moves, moves that are centerpieces of Focusing and Coherence Therapy, are unlikely to work well.

Second the quote from Kaj as well.

[dxu]

From Kaj Sotala’s review of Unlocking the Emotional Brain:

Something that the authors emphasize is that when the target schema is activated, there should be no attempt to explicitly argue against it or disprove it, as this risks pushing it down. Rather, the belief update happens when one experiences their old schema as vividly true, while also experiencing an entirely opposite belief as vividly true. It is the juxtaposition of believing X and not-X at the same time, which triggers an inbuilt contradiction-detection mechanism in the brain and forces a restructuring of one’s belief system to eliminate the inconsistency.

The book notes that this distinguishes Coherence Therapy from approaches such as Cognitive Behavioral Therapy, which is premised on treating some beliefs as intrinsically irrational and then seeking to disprove them. While UtEB does not go further into the comparison, I note that this is a common complaint that I have heard of CBT: that by defaulting to negative emotions being caused by belief distortions, CBT risks belittling those negative emotions which are actually produced by correct evaluations of the world.

I would personally add that not only does treating all of your beliefs—including emotional ones—as provisionally valid seem to be a requirement for actually updating them, this approach is also good rationality practice. After all, you can only seek evidence to test a theory, not confirm it.

If you notice different parts of your mind having conflicting models of how the world works, the correct epistemic stance should be that you are trying to figure out which one is true—not privileging one of them as “more rational” and trying to disprove the other. Otherwise it will be unavoidable that your preconception will cause you to dismiss as false beliefs which are actually true. (Of course, you can still reasonably anticipate the belief update going a particular way—but you need to take seriously at least the possibility that you will be shown wrong.)

This can actually be a relief. Trying to stack the deck towards receiving favorable evidence would just also sabotage the brain’s belief update process. So you might as well give up trying to do so, relax, and just let the evidence come in.

I speculate that this limitation might also be in place in part to help avoid the error where you decide which one of two models is more correct, and then discard the other model entirely. Simultaneously running two contradictory schemas at the same time allows both of them to be properly evaluated and merged rather than one of them being thrown away outright.

[abramdemski]

I appreciated the summary, but dislike the term “negative thought”. The term has connotations of the positive thinking industry, and it’s unclear from the term exactly what makes a thought negative. I think many people will interpret it as “thoughts involving negative emotions or negative judgements”, which I think isn’t right.

“Unproductive thought” or even “harmful thought” might be better? Although I feel this only clarifies things a little. What makes these thoughts unproductive or harmful?

[Shmi]

If a thought leads to an action that makes the situation worse, I’d call it harmful. Maybe “negative” is not the best term, I didn’t come up with it, just used the existing one.

[Cédric]

A failure mode for this is that when someone is faced with strong negative emotion, they are unable to think about the problem rationally. Their brain gets hijacked by negative emotion with no capacity to actually go through the correct steps.

A potential solution to that is putting things into the broadest perspective by asking yourself whether this is even a big deal at all (will it matter in a week? two weeks? a year?). Most problems don’t. But it can be hard to do even that. So you must change your entire mindset to recognise most problems as being not a big deal. You could go through past situations when faced with problems which you had a strong negative reaction to and recognise with the benefit of hindsight that they weren’t such a big deal after all. Then, when faced with a new problem, you can wedge in the broadest perspective trick before spiralling into negative emotion and that perspective will have strong prior evidence of being true which increases the likelihood of it working.

I think the broader point I am trying to make is that whatever rational technique you use for dealing with negative emotion is going to be out of reach when actually faced with strong negative emotion. So one has to, by whatever means, eliminate/​attenuate the negative emotions enough to get the neocortex back online such that one can then go on to use the right techniques. The best elimination/​attenuation techniques ideally would engender a mindset change such that the frequency and severity of strong negative emotions is reduced.

[Shmi]

A failure mode for this is that when someone is faced with strong negative emotion, they are unable to think about the problem rationally. Their brain gets hijacked by negative emotion with no capacity to actually go through the correct steps.

No logic is helpful in the moment, for sure. The idea is to practice it enough outside the stressful moment that the automatic negative thinking is overwritten by a similarly automatic productive thinking. The best one can usually do while in the moment is notice the unhelpful thought, but rarely resist acting on it.