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!
There’s actually a great book that goes through this whole process, but wouldn’t you know I don’t recall the name. It’s large, white, and paperback though..does that help? haha.
I did a group CBT class and did not care for it, but that’s due to the setting. I can absolutely appreicate the process however!
Might that book be Mind Over Mood?
Yes! That’s the one — very good book!
Shanna- I think the book you are talking about is called Mind Over Mood by Denise Greenberger. It is a really good book to read!
Angela- Great post!! Thanks for shareing! :)
Thanks Sarah!
Angela – it’s like you read my mind! I”ve caught myself ‘negative voice spiraling’ this week and while I’m getting much better at catching it early, this sounds like a great approach to try. Thank you!!
Thank you so much for posting this Thought Record and sharing your experience. I also experience a lot of anxiety, particularly in new situations. I tend to expect the worst, and then I find that I’m sometimes setting myself up for disappointment, or at the very least, making a perfectly pleasant experience stressful.
A lot of my anxiety comes from not wanting to let other people down or embarrass myself, and I find that it’s helpful to step outside my head for a minute and consider what I would say to a friend in a similar situation. Most of the time, I would never tell anyone else the things I say in y own head. It helps to remind myself that no one wants me to fail, and so I shouldn’t stress so much over the “what if’s” of not being “perfect”. Like you said in your example, we all have bad days, and if I have one, no one is going to think less of me.
Well said Amanda!
I feel the exact same as you! My anxiety is pretty similar in that I’m terrified of what people are thinking about me if I were to make a mistake in some way or say something wrong. I find that I’m overly critical of myself and would never be as critical of someone else as I am of myself. Thanks for sharing!
Thanks for sharing Angela – I think this is an approach which a lot of people would benefit from.
Ugh, this is so hard for me. No one is harder on me than I am. Thank you for posting this.
needed this! thanks ange!
read the book “Feeling Good”, it’s basically an in depth book all about CBT. has helped me get through bouts of depression and negativity
Thanks I will have to check it out!
Thanks for sharing this, Angela! I’m a champion when it comes to the downward spiral of negative thinking, and this will be really helpful as I try to not go down that path so often. Thank you for being so brave and honest about expressing what you’re thinking and feeling – it’s greatly appreciated. :)
Thank you for sharing. I’m actually reading “Cognitive Behavior Therapy for Dummies” right now, as prescribed to me. It’s interesting, though I think I’ve been thinking negatively for so long that it’s hard for me to catch myself when I do it. This Thought Record will help. Thanks!
it is very tough at first and it takes a long time. I still probably miss 85% of them, but the ones I do catch increase in frequency overtime.
Good post Ange! I learned a bit about CBT when I did my psych minor in university and found it really interesting. It sounded to me like a very logical way to go about reducing problems like anxiety. I think a log like this can be really helpful, especially when we can be quick to jump to conclusions and thing catastrophic thoughts without even realizing it at first. Sounds like you learned lots from the therapist!
Logical is a very good way to put it…and I find with my own thoughts being so illogical it provides a great balance!
Angela – thank you for this! I’ve been in CBT since this past spring (mostly for depression, but as these things go, we’ve dug up a bunch of fun stuff to deal with!) and negative thinking is one of my biggest hurdles – along with codependency and a complete lack of faith in myself. This chart is EXACTLY what I need to help me acknowledge the triggers and then let them go. I can’t wait to show my therapist next week – I think she’ll LOVE it!
A thought triangle (which i couldn’t find a good image of) is another cool CBT tool. Basically, it’s the same concept as a mood journal/log, but you work the triangle backwards and consider how you’d like to feel in a given scenario, then decide how you need to behave to promote those feeligns, and finally consider what thoughts would encourage you to perform the behavior that promotes the feeling. Hard to explain via comment, but I find it more effective than mood longs. So glad you are sharing your therapy experience. Therapy has such a stigma attached and it’s really not a big deal—everyone could benefit from talking to an objective, third party!
I’ve done that before (a long time ago in university) thanks for reminding me of it…going to look it up now :)
Thank you. My negative thoughts are rediculous. I didn’t realize how bad it was until I started writing in a journal. I was even talking to a fellow yoga teacher and she told me stop being so hard on yourself! I didn’t even realize how much I was talking down about my self.
I appreciate how willing you are to share.
I did CBT based therapy for three years and it was super, duper helpful. Once I got my anxiety under control, however, my therapy sessions became too much like to friends just chatting. So I switched to a psychodynamic therapist. I highly recommend trying both kinds of therapy if you can afford to do so. I have found that psychodynamic therapy allows me to explore the reasons why I came to have negative thoughts in the first place. I’m not saying either kind of therapy is better, I have just found them both to be really useful.
Cognitive Behavioral Therapy honestly changed my entire life. I put off finding a therapist for my social anxiety issues for SO LONG because I was convinced that I would be handed a prescription for meds and shown the door (I do think medication has a purpose and a place, I just didn’t want to be blind-prescribed if there was an alternative that would work for me). It took getting to the point of barely leaving my dorm room for me to finally get help. Thankfully, my university’s health services program had a therapist who specialized in CBT and they referred me to her. I didn’t have this exact thought record, but I did have a similar one as “homework” that I had for in-between sessions, and the most important exercises I did (later on) were the ones that forced me into the exact situations that provoked my anxiety. Seeing that they rarely, if ever, turned out in the horrible ways I’d imagined changed my entire line of thinking. I’m not in therapy now, but I am thankful every single day for those lessons I learned!
Thanks for writing about this, Angela. It’s easy for people to dismiss anxiety issues as something “everyone deals with” and to misunderstand the severity and implications they can cause. I’m glad you’ve been so open with your struggles; it’s nice to see someone in the blog world admit that sometimes, we can’t fix everything ourselves. I know a lot of your readers appreciate your honesty.
I’m so happy to hear that it was so helpful for you. I can relate a lot to your experiences. Thanks so much for sharing!
I have read a lot about CBT and I was very sceptical in the beginning. Then I found a list of common assumptions that people have which are not necessarily based in reality and I could recognize my attitude to life in a lot of them:
– If I don’t worry something will go wrong. Check
– The world should work as I want it to. Check
– I should always be happy. Check
Once I read about these assumptions in detail and why they are not necessarily true it really opened my eyes to the fact that I CAN have a different attitude to many situations. It is just a question of taking the time to think about the situation in detail rather than jumping to conclusions. It takes time but as I practice being more aware and mindful it has really helped with a lot of issues.
I’ve read that too ( actually I think we went over that checklist on the first day!) and it was helpful.
I really like when you post entries like this. I think of this as a “wellness” blog, inc. emotional, spiritual, and physical. I like exercise posts, and emotional posts like this one. For a while I found it a little too recipe heavy, although those are fun to try and read also.
Also, thanks. This chart came after an anxiety provoking situation in my day and I tried running through the tactics.
Thanks for your feedback Natalie!
I needed to read this today, Angela. Thank you.
I’ve been dealing with some seriously negative thoughts about a potentially great relationship I’m falling into because I’m new to this city AND he’s my coworker. I’ve been wracked with fear that I’m not interesting or beautiful enough for him, when in reality there is NO evidence to support any idea other than that he thinks I’m fun, enjoyable, and desirable. I hate anxiety, but I think I rationalize my anxiety as “logic” when it fact it is ANYTHING but logical.
Good luck with your healing, and thank you for helping me with mine.
Great post and something which I might try and put to use myself. Thanks! :)
it is so true that we are constantly thinking negative thoughts that have no factual support! This is a great technique that I should try and use!