Many of you have asked me if I could talk about things I have learned in therapy since I announced back in the summer that I was going back into therapy for my struggles with anxiety.
Well, first off, I didn’t end up going right away. It took me about 1.5 months to find a therapist who would fit my budget. After a long search, I found a very nice lady who offers a sliding scale because her therapy office is based out of a church. I had almost given up on it and then was thrilled when I found her.
My therapist uses a multimodal approach with a focus on Cognitive Behavioural Therapy, which helps us understand how our thoughts and feelings influence our behaviours. CBT was also one of my favourite forms of therapy that I learned about in grad school.
We all have thoughts that tend to be so automatic we don’t question or challenge them. For example, “I’ll never be able to find a job that I love because I’m not exceptional at anything.” or “It must be my fault that they don’t like me because there’s something wrong with me.” It’s amazing when you stop and think about how many negative thoughts go through the mind each day.
CBT helps bring awareness to these thoughts that lead us to have incorrect beliefs about ourselves and our situations. In the past, I’ve had great success when using CBT methods, especially when in recovery for my eating disorder.
In therapy, we’ve been able to identify that a large part of my anxiety is due to personal issues from my past and also that I make false assumptions and predictions about events in the future. I tend to predict that a situation will go poorly, when in fact, I have no evidence that this is the case.
One of my favourite forms of CBT is the Thought Record. The great thing about it is that it can be used by anyone, anywhere.
The Thought Record has been very helpful for me to reframe automatic thoughts. The more you use it, the easier it is to fill out and catch your negative thoughts in the process. Once you practice, you can even start doing it in your head if you find yourself in the middle of an anxiety-provoking situation.
If you click the image below, the Thought Record will pop up in PDF format that you can print for yourself.
Here’s an example of what each column means:
1. The situation/trigger. Briefly describe the situation that led to your unpleasant feelings.
For example, “a work presentation”.
2. Feelings. What do you feel?
For example, “Anxiety, guilt, doubt, fear.”
3. Unhelpful thoughts/images. Identify the negative thinking (or “hot thought”) behind your feelings.
For example, “My presentation is going to go horrible and my boss is going to think that I’m bad at my job. I’m a failure.”
4. Facts that support the thought. Find evidence that supports your unhelpful thought.
For example, “My boss has told me in the past that she’s disappointed with my presentation skills.” and “I didn’t prepare as much as I should have.”
5. Facts that don’t support the thought. Facts that provide evidence against your unhelpful thought.
For example, “I have worked on my presentation skills since my poor review and I have improved.” and “I’m not a failure and I’m doing my best.” and “Everyone has bad days at work.”
6. Give an alternative/more balance thought. Now that you’ve considered the facts, write down a healthier way of thinking.
For example, “While I have struggled with presentations before, I’ve practiced and prepared for this presentation and have no proof that this will not go well.”
7. Outcome. Re-rate how you feel now.
“Less anxious” “calmer” “reassured”
That’s just one small example that it can be used for, but it can be applied to so many different types of situations, thoughts, and personal struggles. It’s a really helpful tool to use for body image issues because many of us tend to have automatic negative thoughts about our body that can impact our entire day. Sometimes all you need is to re-frame your thought and move on with your day.
Of course, it takes a bit of practice to be able to reframe a thought (and find evidence that doesn’t support it), but it will get easier over time. Also, not every thought record that you do is going to be life-changing, but I can assure you that some of the ones I have done have really impacted me.
The first time I did the thought record with my therapist, I had this major ‘a-ha’ moment. She helped me write a more balanced thought (I actually couldn’t think of one, so she filled one out for me) and it brought me to tears because something just clicked inside of me. It was amazing how it helped me see a situation in a new light that I’d never thought about before. That one moment has had a huge impact on how I now think about the situation.
The Thought Record makes my thoughts more realistic and balanced, when anxiety tends to make them very up and down and unbalanced. With practice it helps you slow down or stop those automatic thoughts in their tracks. I find that I can “catch” them fairly quick now, recognize them for what they are, and realize that my thinking is not realistic or fair. It sure beats going along in life accepting every negative thought that comes to mind.
If you feel yourself stuck on an issue, try using the Thought Record. It may just help you see something in a new way!
thank you for this post. so often i find myself trapped in this kind of self doubt! i love the steps to help resolve these feelings (and i can totally relate to the presentation skills example)!
Angela, you just impress me more and more and more. :)
This is such a great post and helpful, to I think just about all of us. I was not aware of a Thought Record. Thank you for your courage and strength of sharing yet again.
Good for you for being proactive and taking steps to help yourself live a more satisfying life!
It’s awesome that you’re posting this. I suffer from anxiety & depression (the two go hand in hand for me), and when I first started having panic attacks, I didn’t tell a soul. One, because I didn’t know what was going on, & two, I was so embarrassed (hey, negative thought!). I suffered in silence for years. I did tell my MD but they just threw pills at me that made me numb. So I helped myself through self help books. It worked for a time, until I had my first major depressive episode. Then I sought help, and good for you for shopping around. I took what I first found because I was desperate, and she ended up making it so much worse. As soon as I was strong enough, I ended that relationship & found someone else, literally across the street. My new therapist did a loose version of CBT and helped me learn to reframe thoughts. She saved my live. & she helped me realize it’s not embarrassing, that it’s just life, and it happens, and no one person is singled out.
Anyway, I just wanted to say thank you for sharing, it helps motivate myself (also I have a degree in Psychology, so I really relate to you) and make me feel a whole lot less alone. Thank you, thank you, thank you.
Hi Kyndra, Thank you for sharing your beautiful story. I’m so happy to hear that you were able to find someone that could help you.
Congrats on your progress with anxiety and thank you SO much for sharing! I bookmarked the Thought Record :)
Thank you so much for sharing this! My goal for this month is to work on having a more positive attitude, both in my daily interactions with others and my own thoughts. This tool should be very helpful.
thanks so much for blogging about this – your honesty is so helpful to many!
Thank you so much for this Angela. I’ve followed your blog for a while and it’s wonderful how honest you are about struggles we all have but aren’t vocal enough about.
I’ve found N.E.T. and applied Kinesiology by my Chiropractor very helpful as well.
I’ve never heard of CBT before, it sounds a lot like the beliefs of Zen Buddhism that I’ve been reading. Can you recommend a book on CBT you may have found helpful (I’m with you on the not being able to afford to go to a therapist!)
Thanks so much!
Jacquie
Hey Jacquie! A few commenters suggested some books, I would check those out that were mentioned to see if it’s what you are looking for. All the best!
As someone who teaches CBT to clients, I love your illustration of the process! You are definitely using it well and I hope your progress continues!
Thanks Michelle!
Thank you so much for posting this today. This really resonated with my life, as I am currently seeking therapy for anxiety in relation to binge eating. Strangely enough, this was exactly the topic we talked about in my appointment this week and my doctor gave me similar sheets to use. I am glad to see someone else has used them successfully. Another tool I have been using that has been very helpful has been the book “Minding the Body, Mending the Mind” by Dr. Jane Borysenko. It has really opened up my eyes to the power of mindfulness in daily life.
As always, you are incredibly inspiring!
Thank you Laura! I will check out that book :)
I’m glad that your therapy is helping you too.
I think it is awesome that you are sharing your journey with this!! It really shows that you love yourself so much not to help yourself in whatever area of life you need physical or mental! Thank you for being an inspiration
Thanks for this post. I’m currently a grad student studying counseling psychology and writing a paper today asking about our “strengths” i really couldn’t think of any. At the moment I’m just feeling like I’m not “exceptional” at anything, like you said in your post. I think that it takes courage to work on changing your thought processes, and something I need to work on! Thanks for your more personal posts they are usually quite inspiring to me!
If you are studying counseling psychology that tells me that you have an inner desire to helps others. I can’t imagine a better strength to have. :)
What a timely post.
Last week it took a doctor (a surgeon of all specialists) for me to see how far my physical issues have progressed. I had gotten so stuck in the, “I’m broken/in pain/unable to do x, y, and z” that I forgot to recognize the progress I have made!
Then, tonight was the first time in far too long (many months) where that bright shiny part of me was able to drown out the evil Gremlin in my mind and I could hear the words, “I’m proud of you.” It brought me to tears right on my yoga mat, and then on the ride home when I repeated it over and over and over out loud.
Its amazing how much of our lives we live on auto-pilot. I love my yoga practice because it forces me to slow down and be present with all of my emotions, good, bad, or otherwise. I LOVE the idea of the thought record because it is another mindfulness tool. And I think we could all probably use it.
<3
I love yoga because of that too :) I’m glad that you experienced that feeling!
Me too…I really really needed it. :)
Thank you for posting this! I am going through CBT right now and do feel it is a very effective. It’s good to hear other peoples success stories using this technique. I appreciate your honesty in this post :)
Thank you so much for this post, Angela! Your Daily Glow blog posts inspired me to make an appointment with a therapist a few months ago…of course it was a long waiting period for the first appointment, which will be in a few weeks.
The way you describe how you picture negative outcomes because of events in your past sounds so much like me. It’s so uplifting to read your entries and hear about strategies like this that are working for you. I’ll try doing a thought record in my journal and see if it helps me too :)
My question, though: how do you stop yourself from analyzing past events where, say, the anxiety and negative thoughts influenced your actions? Whenever I feel like I have a personal “aha” moment, I sometimes revert back to certain situations in my past and think “why couldn’t I have THEN harnessed the self-love and confidence I’m feeling now, then xyz wouldn’t have happened, etc.” It’s so difficult not to beat myself up and forgive myself.
That is hard to do for sure. What has been working for me is allowing myself to feel those emotions of regret, or whatever they happen to be. It’s ok not to feel positive or proud of the way we’ve handled situations in the past- we’re only human. I try to channel those feelings as a reminder for what I want in the FUTURE and give myself examples of times when I didn’t let anxiety take over and how good I felt.
I’ve always thought of anxiety as a disorder that has isolated me from others, so its heartening to see not only your post, but also those of all your readers. Thank you for reminding me that I’m not alone and that there’s a light at the end of the tunnel.
Thanks Annie :)
Angela, you are just amazing for sharing your hopes and fears with us. You have inspired me to seek a therapist myslef and tackle my eating and other issues. Thank you!
That’s great to hear, I hope it’s helpful for you. :)
Thanks for that. I have to try it!
Once again I find you posting something I’m needing myself at just the right time. My love of oatmeal initially led me to you (and I think it makes me love oatmeal all the more).
Lately I’ve been struggling with my exercise (thank you workout log challenge) and with negative thoughts about weight, life, the universe and everything. I welcome the idea of doing something proactive instead of just letting negativity eat at me.
Thank you for your bravery, courage, and inspiration.
Ah, and the recipes too! Especially the oatmeal ones. :)
Proactive all the way :) Glad that you enjoyed the posts!
You should check out the book by Dr. Daniel G. Amen, Change Your Brain, Change Your Body. I caught him on a PBS special and was blown awayl Bought the book and double wow. It really helps on all aspects of life. One chapter your post made me think of is Ants. (Automatic Negative Thoughts). He tells how to overcome them similar to your post. Anyway, it’s a great book. Hope you will check it out!
Thanks Kat, I will check it out!
Thanks so much for this post, Angela. I used a similar thing while in therapy but had forgotten about putting it into practice. It is amazing how easy it is to believe untrue thoughts!
Great post Angela! I am glad that you found a great therapist who can help! I think this chart is a very clever idea and can help anybody including myself! :D
I love your post today! It’s nice to read, and learn from others about different topics then just food!! I try to be optimistic about everything and I always look at the positive, but I have a Husband who is Mr. Negative and he always makes me feel doubtful and bad about myself. I’m glad I have enough strength inside to ignore most of his comments, but sometimes it’s hurtful. He just doesn’t understand me, he doesn’t get blogging, he doesn’t get exercising, and he doesn’t get being healthy, it’s so hard to be strong and not self doubt when you live with that!
My therapist gave me exactly the same thought sheet to use. Seeing it again in black and white on your blog has actually made me feel a bit emotional, weirdly. Anxiety is such a hard and horrible thing to live with. I don’t ever think I, personally, will escape it but I think it can be managed and controlled.
I worked so so hard when I first tried CBT, you really have to want to change when undertaking it don’t you? Like you said you have to be proactive.
Something else I use are some worry questions to nip anxiety in the bud when it rears it’s oh so ugly head when I am out and about or something and a thought sheet isn’t practical. I have them stuck in the back of my diary. They might help you too:
What is the evidence to support my worry?
What is the evidence against my worry?
How would someone else view this situation? (choose someone rational, I use my mum or my husband)
Am I making a thinking error here? Thinking errors include catastrophising, jumpkng to conclusions, black and white thinking
I am so sorry you have to deal with anxiety though. Dig deep, keep strong and you will get through it.
The hubby’s work provides stress reducing techniques and this is one of them. It really helped him deal with his work stress when he was suffering burnout.
Angela,
Thank you so much for posting this!!! I am so happy to hear that you have found a therapist that you click with and that things are going well with her. As someone who also began therapy this summer for similar reasons, it is so encouraging to know that there are other people doing the same thing. Thank you for sharing the Thought Record. That is definitely a tool I can use. Have a wonderful day and keep glowing girl!
Hi Angela,
Good luck on your journey. I have had anxiety for years and I am now just beginning to turn the page back to a normal life. I have had many physical and emotional pains over the years that where completely debilitating but with good tools and a great councellor you can accomplish complete recovery. Do you deal with anxiety centre? These papers look familiar to me. If so they are phenominal people with true love in there hearts. Remember for the most part nothing is ever as dreadful as we imagine it to be. Be a guard to the gate of your mind.
Cheers
Thank you Tara!
I find CBT works very well…we learned about it during grad school as well it is very applicable to occupational therapy because our thoughts affect our daily routine and how we manage! Great post…totally hit home!
Thank you so much for this! I deal with rather severe anxiety and this is so helpful. You are very admirable for being so open about it!!
Thank you for this post Angela. I have body image issues, but I also have an issue with binge eating in stressful situations. This thought record is similar to something I’ve been trying to use in those times of stress. Anyway, I love your blog :)
Much love,
J.Lynn
I opened your blog today looking for something – I wasn’t sure what, but I’ve been having an “off” week. You provide such a positive message no matter what the subject matter, which is why I felt drawn to you today. Thank you for shining your Light to the world through this blog. I don’t think you know how many people you influence through your sharing – thank you thank you thank you!
I have tried many of your recipes as I am very passionate about healthy eating. I also happen to work for a company that shells flax. I thought as a thank you I would like to provide you with a package of our delicious flax which you don’ t need to grind or keep it in the fridge! It is also 100% Canadian. :)
Best Regards and keep up the good work,
Barbara
Thank you so much for sharing this!
Thanks so much for sharing this. :) I’ve never seen a thought record before.
Thanks for sharing this! CBT is my favourite form of therapy, and I hope to use it in the future when I become a registered psychologist. I want to work with people who have OCD and/or eating disorders.
Angela thank you for this post. It feels so good to know I’m there are others that are dealing wtih similar things. Meditating on positive affirmations is so helpful for fighting negative self talk. On days that I meditate, I feel so much more positive, self accepting and in control of my thoughts. Thank you for the thought record. I can’t wait to try it!
This post came at exactly the right time for me. This has been such a stressful week, I’ve lost track of the number of times I panicked and cried about something. Thanks so much for sharing. I will definitely try this in the future.
Thank You for this, I’m seeing someone new to assist me with my anxiety and eating disorder also. This can be a useful for a tool for her with other clients also. Thanks! :)
Thanks so much for this tool, when we think positive thoughts it so helps us in all aspects of our lives….making healthy choices and feeling good about ourselves and all the people in our lives….you are truly an inspiration.
Making false predictions about future events and assumptions about what others are thinking is me to a tee. I will definetely be trying the thought record. Your honesty really helps others not feel so alone in their issues. Thanks!
I have been following your blog for a couple of months now, and with my 30th birthday looming … I think I am ready to make some drastic healthy changes! You are an ispiration!
Thank you Kay…goodluck and happy birthday!
You’re so wise for someone so young. Thank you for this entry, especially!
Angela- I have been following your blog for over a year now, but this is my first comment! Just wanted to thank you for always being so open and sharing the thought record pdf. Such a wonderful tool to have when emotions and feelings get overwhelming. I enjoy your posts so much!
It appears I’ve struggled with anxiety all my life for as long as I remember. I have adopted many maladative coping mechanisms and refused to see myself as someone who has mental problems so I never seeked help. I have found this blog extremely useful, even heaven-sent, and am looking forward to using the thought record. I have also been using Jon Kabat-Zinn’s mindful meditation tapes and book “Full Catastrophe Living” that gives you strategies on how to deal with different types of stress as well as many relaxation techniques and yoga exercises. Thanks for the blog, Angela, and hope you have more similar entries.
I love the idea of practicing to retrain your thoughts. Negativity is definitely a habit, and one that can be broken, but breaking habits doesn’t happen easily. I was recently reading an article about habits that says over 50% of our actions are caused by habits (http://creationbasedhealth.com/lifestyle-habits/). It also mentions that there are always triggers for habits. I think I’m going to practice this to see what my triggers are for negative thinking and to see what I am thinking that’s not supported by facts!
Thanks!
I love CBT! I had that same click moment with automatic thought records and I still use them to help re-frame events causing me anxiety. Before I started them I had no idea why I would feel anxious.. it didn’t even seem connected to specific events. It really helped outline where and why I felt anxious and all the negative ‘should’ ‘should not’ type thoughts running through my head. I also like that its a skill to build on so I don’t feel bad if I need to keep practicing at it because it’s a process rather than a quick fix.
Since I began CBT, and doing Thought Records, I have found an improvement in my moods. After being in therapy for 9 months I could do thought records in my head. I have been diagnosed with Clinical Depression and Anxiety Disorder and my mood swings fluctuate wildly. When I feel “good” I don’t need thought records, but as daily stressors begin to fill my “bucket” and my emotions heighten, just when I need the records I find them difficult to do without the help of a therapist. In my case it is better to do a TR even for the smallest negative thought, that way I keep on top of things. In my case, meds are important as well. The combination of therapy and CBT and Rx helps keep a relatively stable me.
I am so glad to see that I am not the only one who has these issues. I’m constantly being told to stop being so negative and that if I tried harder I would be “Normal” ie no anxiety. As if anyone would wish this upon themselves. Thanks for the CBT idea. I’ve tried the TR and found them to be very effective, but for some reason, when I’m stressed I find them very difficult to do.
Great article. I’ve never used thought record before but I will definitely try it. I am recently having negative thoughts that I want to remove. They are eating myself from inside. I’m sure that this new (for me) method and these moving forward quotes http://hardquotes.com/life-motivational-quotes/quotes-about-moving-on-life will help me get through this.
Thank you for the “How to Reframe a Negative Thought” worksheet. I’m a psychology student and I think this is very useful tool.
Agi