Robin I. Ellis, Psy.D.

Cognitive Behavioral Therapy (CBT)

Find yourself again...

Peace is often found after darkness.
Sometimes, all you need is a helping hand.
It's time...

Someone to listen but never judge.
Someone to guide but never demand.
Someone to be there.
Someone to listen but never judge. 
Someone to guide but never demand.
Someone to be there.

What is Cognitive Behavioral Therapy (CBT)?

It may sound complicated, but it's a simple idea.  The way we think and act effects how we feel.  Often we believe that our thoughts are out of our control, but, actually, it's like any habit we have learned, and therefore can be changed.  It can be difficult to change long held perceptions and beliefs.  The role of the therapist is to help you with that process.

Read the section below for more information: 

Self-Talk: How We Upset Ourselves:

Most people have an almost constant stream of inner self-talk.  It is usually so automatic and subtle that we don’t notice it or the effect it has on our moods and feelings.

Negative self-talk can often be irrational, but almost always, sounds like the truth.  It can trigger a panic attack and keep it going, cause a depressive episode, lead us to feel stressed, and cause conflict in relationships.  By learning how to change these thinking patterns you can begin to feel better.

Remember that just because you think it, doesn’t mean it’s true.

Your style of self-talk usually starts in childhood and soon becomes a habit, just like biting fingernails.  We often take on the beliefs and habits of those who influence us the most in our early years such as parents, teachers, peers, and the media.  For example, if I had a parent who told me I was lazy, I might view myself that same way, even if it was my own discouragement, not laziness that’s the problem.  We also learn these habits based on early experiences we’ve had, for instance, if I had a learning disability as a child and had difficulty doing well in school, I might think “I’m stupid,” even if I’m actually very smart overall.

Luckily, like any other habit, self-talk can be changed. 

Changing this habit is not about replacing negative thoughts for positive, as in positive affirmations.  While this may work on a surface level, at our core, we will reject it, because we don’t really believe it.  Instead, it’s learning to figure out where our thinking is distorted or irrational and how to think more objectively and logically.  For example, if I’m upset about my weight and my doctor has told me I’m obese, than the thought: “I’m overweight” is not illogical, but “I’m a fat cow” is.  The first statement is accurate, according to the facts and will prompt me to take positive action, the latter is simply mean name calling and will only depress and discourage me.

The first step is to become mindful of the patterns of self-talk that trigger bad feelings.  The next step is learning how to evaluate how logical or illogical your statements and beliefs are.   This is where a mental health professional trained in Cognitive Behavioral Therapy can help.   While it can take time to change long held belief systems and thinking patterns, the research has demonstrated a very good success rate once you begin the process.

Psychologists have discovered some common irrational thinking patterns that contribute to feeling bad.  Sometimes, just being able to catch yourself using one of these patterns can be enough to disrupt it.

 

Irrational Thinking Patterns

All or Nothing (or Black and White) Thinking: Thinking in extremes with no middle ground.  Everything is either wonderful or awful.  You are a complete success or failure.  You use words like “always” and “never.”  “Either/or” thinking.

Over Generalization:  A single bad event becomes a pattern of defeat.  A job interview that does not lead to an offer arouses fear of life-long unemployment or rejection.

Mental Filter:  You pick out and zoom in on only the negative details in a situation, seeing the whole situation as negative.  You have a fun day with the family at Disneyland, but the kids become cranky on the way home.  The whole day is ruined.

Ignoring the Positive: You transform neutral or positive experiences into negative ones.  You get all A’s and one B on your report card, and all you notice is the B and beat yourself up for not doing better.

Mind Reading:  You assume that people are reacting to you in a negative way, but you don’t check it out.  You leave a message for a friend and when she doesn’t call back right away, you assume she doesn’t want to talk to you.

Fortune Telling:  You predict that things will turn out badly no matter how good things are going.  You’re dating someone new and things are great, but you know he/she will hurt you eventually.

Magnification (or Catastrophising):  You blow things out of proportion.  If you have a setback it is a total disaster.  You maximize the bad.  A job layoff means you and your family will end up homeless and loose everything.

Minimizing:  You shrink the importance of things, discounting the positive. Someone compliments you and you think: “they are just saying that to be nice.”

Emotional Reasoning: You view your feelings as evidence of the truth.  “I feel inadequate so I must be worthless.”

Unrealistically High Expectation:  You criticize and judge yourself and others with “shoulds”, “oughts”, “musts”, and “have tos”, or “if…thans.”  When you don’t match your expectation you feel guilty and like a failure.  When others don’t meet them you may view it as not caring about you.  “If you loved me you would be more attentive when I’m upset,” or  “I shouldn’t have eaten that brownie, now I’ve totally ruined my diet.”

Labeling:  You call yourself names, such as “stupid,” “ugly,” “worthless,” “screwed-up.”  Instead of saying “I made a mistake” you say, “I’m a loser.”

Personalization:  You tend to take things personally.  Your mate disagrees with you and you believe its because she/he disrespects you as a person.

Blame:  You tend to either take on all the blame or place it on others.  The movie you took the family to see is awful.  It’s your fault for suggesting it.   Your last relationship ended entirely because of how your partner behaved.

 

Irrational Belief Patterns

Emotional Perfectionism:  You believe that you should only have and show positive feelings. “I should always feel happy, confident, and in control of my emotions.”  You may place a time limit on how long you can feel bad.  A family member died 3 months ago and you “should be over it by now.”

Fear of Emotions:  You feel out of control, weak, crazy, or a failure when you experience and show feelings of sadness, anger, or fear.  “I should never feel angry, anxious, inadequate, jealous, or vulnerable.”  You may avoid or deny negative feelings, becoming uncomfortable when they rise to the surface.

Fear of Conflict: You are uncomfortable with conflict and become shut down, defensive, run, or give in, believing that disagreement is bad.  “People who love each other shouldn’t fight.”

Entitlement:  You have high expectations and believe you are entitled for people and situations to match those expectations.  “People should be as I expect them to be.”  “Things should work out the way I want them to, and if they don’t it’s awful and I can’t stand it.”

Low Frustration Tolerance:  You believe that things should occur easily and without struggle.  When there is struggle you tend to become frustrated and give up.  You yell at the computer when you are learning a new application, or stop going to a dance class when the steps were difficult.

Perfectionism:  You believe that making mistakes equals failing.  You may fear trying new things that you’re not sure you could do well.  “People will reject or ridicule me if they see me as a flawed or vulnerable person.”

Fear of Failure or Coming up Short:  You believe that your self-worth depends on your achievement or surface attributes (such as how attractive you are, how intelligent you seem, or how much money you make).  “I am what I achieve, how I look, and what I have.”

Fear of Disapproval or Criticism:  You require other people’s approval and feel disrespected or worthless when given negative feedback.  Your wife complains that you didn’t take out the trash, you are sure she’s telling you “you’re a slob and never help.”

Fear of Rejection or Being Alone:  You view rejection as devastating and being alone as intolerable.  You believe yourself to be incapable of coping without the other.  “If I don’t have a significant other life is not worth living,” or “If I’m alone I’ll be miserable, unloved, and unfulfilled.”

How to Change Self-Talk

Mindfulness: Become an observer of your thoughts, feelings, and behaviors. Just notice them, trying to do so without adding further judgment.  Practice viewing the situation as if on a movie screen, or through someone else’s eyes.

Stop: If what you’re doing isn’t working its time to try something else.  Take a mental break.  Try shifting from the current pattern.  Tell yourself to “STOP!” or use a form of distraction (reading, watching T.V.).  Quiet thoughts with meditation or exercise, or literally “snap” yourself out of it with snapping a rubber band on your wrist.

Breathe:  Breathing signals the brain to calm down and will release physical tension.

Reflect: Listen to what you are saying to yourself, or believing when you are upset.  Journal your thoughts and compare them to the lists above.  See if you can recognize any irrational thinking patterns or beliefs.

Gather Evidence:  Pretend your thoughts or beliefs are on trial.  List evidence to support the statement, making sure to challenge them with the other side.  Make sure to use factual evidence, not opinion.  You would never send someone to jail because you believe them to be guilty or without a proper defense.

Ask Yourself These Questions:

  • Is it really true?
  • Am I jumping to conclusions?
  • Is it to my advantage to think this way?
  • Is there another way to look at the situation?
  • Is it really as bad as it seems?
  • What is the worst that could happen?
  • Can I handle it?
  • Am I using any key words (should, must, always, never, ought, have to, etc)?

Recognize:  Look for the patterns that will alert you that you may be misperceiving or viewing things from a distorted perspective.

Reframe:  Just like we can make a picture appear completely different by placing it in a new frame, we can do the same with our thoughts.  See if you can look at the situation from a new point of view that’s kinder, gentler, and more realistic.  For example, if your mother calls everyday to give you advice, perhaps you’re right that she doesn’t see you as capable, but it may be that she doesn’t know how else to connect.

Think Small:  A journey of a thousand miles begins with a single step.  Change is difficult and takes time.  Acknowledge small shifts rather than how far you have to go.  The brain learns through repetition, so it’s the daily small changes that will lead to long lasting change.

Laugh:  Find the funny whenever possible.  Sometimes we take life way too seriously.  See if you can find the ridiculous and silly in how you’re viewing things.

Finally, remember that making assumptions make an ASS out of U and ME.

 Footnote: Adapted from How to change upsetting self-talk by the Possibilities Program/ L. Allman, Psy.D.

Remember: when we change the way we look at things, the things we look at change.

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