Super Simple CBT

1. Thoughts Cause Feelings: Understand the ABC Model of Emotions

Two simple insights form the heart of CBT. The first is this: Thoughts cause feelings.

The ABC Model. The ABC model of emotions explains how our thoughts influence our feelings. A stands for Activating event, B for Belief or thought, and C for Consequence or feeling. For example:

• A: Your car won't start
• B: "Oh no! My battery's dead. This is awful! I'm stuck, and I'll be late."
• C: You feel depressed and anxious

Changing thoughts changes feelings. By altering your thoughts about a situation, you can change your emotional response. For instance, if you think, "I'll have an extra cup of coffee, relax, and wait for a jump from the tow truck," you might feel only mild annoyance instead of anxiety.

Feedback loops. In real life, emotional reactions often form feedback loops, where the ending feeling from one sequence becomes the starting event for another. This can lead to escalating negative emotions if left unchecked. Recognizing these loops is crucial for breaking the cycle and regaining emotional control.

2. Identify and Challenge Limited Thinking Patterns

To control worry, you need to approach it on all these levels.

Common patterns. Limited thinking patterns are habitual ways of interpreting events that can lead to emotional distress. Some common patterns include:

• Filtering: Focusing on negative details while ignoring positives
• Polarized thinking: Seeing things in black-and-white terms
• Overgeneralization: Drawing broad conclusions from single incidents
• Mind reading: Assuming you know what others are thinking
• Catastrophizing: Expecting the worst possible outcome
• Personalization: Relating external events to yourself inappropriately

Challenge and reframe. To combat these patterns, practice identifying them in your thoughts and then challenging them with more balanced alternatives. For example, instead of overgeneralizing, look for specific evidence and exceptions to your conclusion. Replace absolute statements with more nuanced language using words like "sometimes" or "often" instead of "always" or "never."

Thought journaling. Keep a Thought Journal to record automatic thoughts that precede painful emotions. Analyze these thoughts to identify which limited thinking patterns you habitually employ. Then, compose balanced alternative self-statements that are more realistic and less emotionally charged.

3. Uncover and Analyze Hot Thoughts with Evidence

Hot thoughts are the thoughts that trigger emotion.

Evidence gathering. To challenge hot thoughts, gather evidence both for and against them. Use a Thought and Evidence Journal to record:

1. The hot thought
2. Evidence supporting the thought
3. Evidence contradicting the thought
4. A balanced alternative thought based on all evidence

Key questions. When searching for evidence against your hot thought, consider these questions:

• Is there an alternative interpretation?
• Is the thought an overgeneralization?
• Are there exceptions to the generalization?
• What are the more probable consequences?
• What are the real odds of your fear occurring?

Synthesize and practice. After gathering evidence, create a new, balanced thought that incorporates insights from both sides. Rate your belief in this new thought and your emotional state after the exercise. Practice these balanced thoughts regularly to reinforce them.

4. Practice Relaxation Techniques for Emotional Regulation

Deep relaxation and anxiety are physiological opposites.

Physiological benefits. Relaxation techniques can induce the relaxation response, which counters the body's stress reactions. Benefits include:

• Decreased heart rate, breath rate, and blood pressure
• Reduced muscle tension and metabolic rate
• Increased alpha brain-wave frequency associated with calm

Key techniques. Practice these relaxation methods regularly:

1. Abdominal breathing: Focus on deep, slow breaths that expand your abdomen
2. Progressive Muscle Relaxation (PMR): Systematically tense and relax muscle groups
3. Visualization: Create a vivid, peaceful mental scene using all senses
4. Cue-controlled relaxation: Pair a relaxation cue word with deep breathing

Regular practice. Dedicate time daily to relaxation exercises, even when you don't feel stressed. This builds the skill of relaxation, making it easier to access in high-stress situations. Aim for at least one full PMR session daily and several brief cue-controlled relaxation moments throughout the day.

5. Control Worry Through Risk Assessment and Exposure

Worry isn't just a mental process. When you worry, you enter into a cyclical pattern that involves your thoughts, body, and behavior.

Risk assessment. Learn to accurately assess risks to counter the tendency to overestimate danger:

1. Estimate probability: Recognize how personal experiences and beliefs influence risk perception
2. Predict outcomes: Consider realistic consequences rather than catastrophic scenarios
3. Use a Risk Assessment Worksheet to systematically evaluate worries

Worry exposure. Schedule dedicated worry time to make worrying less distressing and more productive:

1. List and rank your worries from least to most anxiety-provoking
2. Spend 30 minutes daily visualizing the worst-case scenario for one worry
3. After 25 minutes, allow 5 minutes for less stressful alternative outcomes
4. Rate anxiety levels before and after the exercise

Behavior prevention. Identify and gradually eliminate counterproductive worry behaviors:

1. Record avoidance or ritual behaviors related to your worries
2. Choose the easiest behavior to stop and predict consequences
3. Stop the behavior or replace it with a new one
4. Assess anxiety levels before and after the change
5. Repeat with increasingly challenging behaviors

6. Combat Depression by Increasing Pleasurable Activities

The less you do, the more depressed you feel, and the more depressed you feel, the less you do. It's a downward spiral that maintains withdrawal from life and prolongs depression.

Break the cycle. Depression often leads to reduced activity, which in turn deepens depression. To break this cycle, push yourself to engage in more activities, even when you don't feel like it.

Focus on pleasure and mastery. Add two types of activities to your schedule:

1. Pleasurable activities: Things you enjoy or used to enjoy
2. Mastery activities: Tasks that give you a sense of accomplishment

Overcome resistance. Remember that depression may make activities seem uninteresting or burdensome. Push through this resistance, as engaging in these activities will ultimately improve your mood, even if they don't seem appealing at first.

7. Implement Activity Scheduling for Mastery and Enjoyment

Activity scheduling can reenergize you and offer significant help in overcoming depression.

Weekly Activity Schedule. Use a Weekly Activity Schedule to:

1. Record and rate current activities for pleasure and mastery
2. Identify times for new activities
3. Select and schedule new pleasure and mastery activities
4. Predict and compare actual pleasure/mastery levels

Diverse activities. Include a mix of activities such as:

• Pleasure: socializing, hobbies, relaxation, entertainment
• Mastery: self-care, household tasks, work-related accomplishments

Gradual implementation. Start by adding 5-7 new activities per week. Be patient with yourself and recognize that even small accomplishments are significant when dealing with depression. Regularly review and adjust your schedule to maintain balance and continue challenging yourself.

Last updated: November 20, 2024