Tuesday, 29 July 2014
Throughout the last month, my CBT sessions have focused on challenging the negative thoughts that I have, and coming up with alternative, fairer thoughts to ease my negativity.
I've always tried to challenge my negative thoughts. I know that they're there, how overwhelmingly negative they are, and that they are adding to my low mood. So when my therapist said we need to start challenging my negative thoughts, I thought it was going to be a futile exercise because I was already doing that and it wasn't working.
First of all, we recognised some common thinking errors that might be causing my low mood (all of which can be found here). I've found that over the years I've developed many of these unhelpful thinking habits, most commonly thoughts that come under the critical self, compare and despair, shoulds and musts, and mind reading categories.
Once I had recognised the negative habits in my thinking, it was time to challenge them. My therapist gave me a 7 column thought record sheet, in which I had to record the unhelpful thoughts, the trigger and the emotion I felt. Then I had to provide facts that support and oppose my thoughts (facts being evidence that would stand up in a court of law!), then alternative, balanced perspectives to replace my negative thoughts with, and finally I would have to re-rate the intensity of the emotion my negative thoughts originally made me feel.
At first I found this really hard. Having recorded the unhelpful thoughts, and the facts that support the unhelpful thoughts, I looked at the blank 'against' column and didn't know what to put. 'Of course people think I'm fat, my BMI was over the healthy weight category' is what I thought. I filled in a couple of points in the against category; 'too self critical', 'people might not be as mean as I am about myself' etc. And then into the alternative perspective category I put 'I should not worry about what people think of me'.
I didn't feel any better about myself. This wasn't going to work.
I returned to CBT with my thought record sheets and went through them with my therapist. She noticed that I wasn't really challenging my negative thought processes, instead actually adding to them and making myself feel worse! She noted that while yes, my BMI might have been over the healthy range, a BMI score was no evidence that people thought I was fat, which was my original unhelpful thought. She also pointed out that my alternative perception was itself a thinking error; the 'I should not' bit shows that I am setting an unrealistic target for myself. She said that being aware of what other people think is not always a bad thing, and it is common for people to worry about it. Telling myself 'I should not worry what others think' is an unrealistic target and one of the unhelpful thinking habits that we recognised earlier on.
My therapist and I revisted my notes on the thought record sheet, focusing on each negative thought and pulling it apart. As it turned out, I had no evidence that would be accepted in a court of law to support the thought 'People think I'm fat'. Soon enough, the evidence against column was overflowing onto another page; 'Doctors are not concerned about my weight', 'I would not think of friends my size at fat', 'People's perceptions of fat vary' etc. My new, alternative perspective was amended to 'Most people probably don't think I'm fat'.
I felt so much better. My feelings of shame, that I had originally rated at an intensity of 80% (hide-under-the-duvet-&-cry level of intensity) had been reduced to about 10% (slightly-ashamed-but-not-letting-it-get-in-my-way intensity).
I've been challenging my thoughts in this way for a few weeks now and it has made a huge difference. Being able to break down each negative thought methodically instead of challenging it in my head has been so effective. Before, I was thinking I was an 'idiot' for being so negative, and for now clear reasons that did not help in overcoming my negative thoughts. Who'd have thought a little worksheet with some columns on would be so helpful?!