Cognitive restructuring: How to become aware of and respond to negative automatic thoughts

Cognitive restructuring is a useful strategy for helping people evaluate and change automatic reactions that are rooted in distorted or unhelpful beliefs and ideas. To overcome depression and anxiety and other psychological problems we may have to change some of the basic meanings we give to events. Many depressed and anxious people latch on to one idea or meaning and don’t look for other ways of thinking about the situation. The fact is that any one situation can be looked at in a variety of different ways. Some of those ways will lead to strong and painful negative feelings while others will not. We can not only learn to see alternative ways of viewing situations but can discover we have the power to choose. No thinking pattern is absolute. We can learn to think in ways that are neutral or positive rather than destructive and negative.

Working with habitual automatic thoughts can be a major step in improving self-awareness and dealing more effectively with emotional problems. Use this guide to train yourself to work with automatic thoughts on a systematic and regular basis. Become aware of your own private meanings by noticing your automatic thoughts, especially at times when you feel emotionally upset. Regularly record them in a notebook and work with them as described below using the Worksheet on negative thoughts or the
Identifying and working with my patterns of negative thinking worksheet. The Child version of this worksheet can be used by children and adolescents.

Step 1: Identify times when they feel unhappy or distressed
There may be several types of situation where you feel distressed in some way. Even if you feel distressed all the time you, if you monitor your mood from hour to hour, you may notice that there are significant variations. If you monitor situations where you feel bad you will most likely find that the same types of situation recur. For the purpose of this analysis choose one particular incident.

Step 2: Identify and quantify (0-10) the specific emotions you experienced in that situation
People are not always accurate in labelling their emotions. They sometimes use vague words like ‘upset’, or ‘bad’ or ‘stressed’. However they are usually feeling one or more specific emotions such as sadness, anxiety, guilt, disappointment, anger etc. So pay attention to the particular emotions you feel at the time. (Some people require training in this, and most people improve with practice). Quantification does not have to be very accurate. Use your own subjective scale where 0 is a time you did not feel the emotion at all, and 10 is the strongest you have ever felt it or could imagine feeling it in a very difficult situation.

Step 3: Thought collection
The aim is to collect thoughts that you have at the same time as you feel emotionally distressed. There are several ways of doing this, and here are the main ones:

  1. Retrospectively you can recall the event and then become aware of specific automatic thoughts you had at the time. Write them down.
  2. Retrospectively reconstruct the event in imagination. Visualise what happened as clearly as possible. Try to enter again into the whole feeling of being there. Now pay attention to automatic thoughts provoked by this exercise and write them down (or work with a partner and have him/her write them down for you).
  3. Carry a notebook with you and monitor thoughts as they occur in the day. Pay attention at times when you notice you are experiencing unpleasant emotions (anxiety, depression, guilt, shame, sadness etc.). Record them in the notebook.

Note: some thoughts are very clear strings of words that you can easily identify. Others are much more subtle and sink into the background. These are not easy to identify, but this improves with practice.

Steps 4-9 should then be carried out for each thought

Step 4: Rate how much you believe thought (0-10)
If your belief level is very low (<30%) you may not need to bother with further analysis.

Step 5: Check for cognitive distortion in the thought
Does the thought represent one of the distortions described in the next section on Cognitive distortions – Look out for them and correct them?

Step 6: Generate a rational re-evaluation of the thought
This is a very important step because it will reduce the power of the thought to cause you to feel unpleasant emotions. You can begin by simply asking “Is this thought rational or realistic?” You could also ask some of the 27 Questions to put to negative thoughts and help correct distortions. A third way is to get new perspectives on the thought by discussing it with another person, such as your therapist or a friend.

Step 7: Rate your belief in your rational response (0-10)
This is important. If you don’t believe your rational response, then you have either done the analysis superficially, or there are other automatic thoughts and beliefs that have not yet been dealt with and which you will need to identify.

Step 8: Re-rate your belief in the original automatic thought
If you have correctly identified and corrected the cognitive distortion in and achieved a rational perspective on it, your belief in the irrational thought should have reduced considerably. If not, then most likely you do not believe your re-evaluation, and you need to take a deeper look.

Step 9: Name and quantify (0-10) the emotions you now feel
If your belief in the original thought has changed, then the emotion will probably have changed too. If it has not, you have missed something important.

Conduct a behavioural experiment
This is another way of challenging dysfunctional thoughts and cognitive distortions. Read more about this at Conducting behavioural experiments.

Next – Cognitive distortions

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