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!
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