Step by Step, How Can CBT Help You?
Fear is a mighty thought. It can stop you in your tracks—real danger or not. The fear in phobias is no different. It can and often does control you. It can cause you to change your entire way of living just to avoid the source of your deepest fears. But what can you do about it?
Cognitive behavioral therapy (CBT) is one form of therapy used in the treatment of phobia. CBT has been used in many different situations to provide the tools you need to live a normal life. This therapy can help you manage your fear once you build the skills.
This step-by-step guide will give you the information you need to better understand this form of therapy. We’ll show you a little about how it works, what you might expect, and how you can use it to take control of your fear and learn to live a normal life again.
In order to understand how CBT works, let’s first take a look at how the mind works. As individuals, we can experience the same situation several times, but each time, our mind may react differently.
As an example, let’s say you’re asleep in the middle of the night and are awakened by the sound of a crash.
If you have a pet, kids, or a spouse you may think someone is hurt or that something was broken. What do you do? Do you jump up and check it out or do you stay in bed?
Now you are startled awake again by the same sound, but this time it sounds to you like someone is trying to break into your home. What do you do? Do you call 911? Do you grab something to protect yourself, or do you go back to sleep?
Once again, that crash sound wakes you up, but this time you hear the wind blowing outside. What do you do? Do you check the weather or go back to sleep?
In all three situations, the same crash occurred, but you reacted differently. The mind works in this manner. Each person can and will have a reaction that is different from another person or react differently due to the thought the mind has at the time. Understanding this is the first step in learning to manage your fears through cognitive behavioral therapy.
What Is Cognitive Behavioral Therapy?
Cognitive behavioral therapy is a treatment method that teaches skills which help individuals learn to take control of their ideas, actions, and feelings in order to conquer their fears.
Basic Parts of the Cognitive Model
Situations are not the problem. The way individuals react in the situation is what causes the problem. Let’s say you’re afraid of the dark, but you have to go to work after the sun sets. For individuals with this fear, anxiety and ideas begin to ramp up hours before it’s time to leave. The problem is not the dark, but the ideas that bring on the fear of the dark.
Ideas play a major role in our phobias and fears, which in turn affect our mood, situations, and behavior. Individuals with social anxiety or social phobia could be at a small gathering and wave at a friend across the room. If the friend doesn’t wave back, the ideas begin to take control. Questions like, Did I do something wrong? or Are they mad at me? begin to control the situation. This can lead the individual to leave the gathering instead of learning why the friend didn’t greet them.
Our behavior controls the way we feel and think. Not only do we think a certain way, but we also act in a certain way. The way we act causes certain ways of thinking. Avoiding our fears is one of the most common actions. Once you avoid the situation, your ideas now offer the excuses you need to steer clear of the fear. Once this circle begins, it becomes normal for the individual. An example is like the one above. Once you convince yourself that your friend is mad at you or that others don’t like you, you’ll stop putting yourself out there. Now it will be even harder for you to learn how to overcome the fear, because the self-defeating ideas are so strong.
Our behavior, feelings, and ideas work with each other. This means if you change a feeling, then your ideas and behavior will change. For example, let’s say you have a day planned with a friend, but you have a fear of storms. When you wake up, it’s raining outside. Now your anxiety kicks in and your ideas start to flow, which in turn makes the day a flop. Instead of going out with your friend, you sit at home watching the rain fall.
Changing your feelings, ideas, and actions is key. The more we work on changing even one small piece of the puzzle, the more other parts will change including our mood in a given situation. This is how cognitive behavioral therapy works. By changing small things about our feelings, ideas, and actions we can achieve larger outcomes.
Seeing how this model works you can look at your fears differently. This, in turn, will give you the tools you need to create more positive ideas, feelings, and actions when you confront your fears.
This guide will help you learn to use skills to create positive ideas, feelings, and actions to overcome your fears.
Will CBT Help You with Your Fears?
Of course, no cookie-cutter method works for everyone. However, if you remember that you are learning new skills and realize that the journey may be hard, you can get the most out of therapy. It’s like a baby learning to walk. If he only stands up once and then starts crawling again, learning to walk will take longer. It takes practice and consistency. So does learning these new skills. Once you learn the skills, they will become automatic, but you must practice.
Whether CBT will work for you is a question that only you can answer. You’ll get what you put into learning the new skills. On the other hand, your phobia could be deeply rooted in your mind. If so, it may take more work for you to be able to learn how to use the skills to manage the fear. If you must confront your fear daily or you have been avoiding it for years, it may take more effort on your part to use the skills successfully.
We’ll provide here the basics you need to learn the skills, but some may still need the help of a licensed therapist.
Getting Started: Identifying the Problem
Yes, changing your habits and the way you think sounds hard. However, once you recognize your desire to change, you’ll be able to overcome your fears. To do that, you’ll first need to identify what you wish to change in your life.
To begin, look at your life and your problems as if you were looking at a friend instead of at yourself. Consider the way your phobias have taken over your life. By writing down your fears from the start of your day, such as getting out of bed, driving in traffic, and going to work, you can see that you start by getting out of bed. You may have a hard time getting up in the morning, because you know you must drive in traffic. Getting out of bed is not the main problem, but it starts there. As you see your problems on paper it will help you understand the issues, so you can move forward to achieve your goals.
You can use this guide to better understand the problems you wish to tackle.
Identify the problems. What is causing your fear to trigger? What is your fear stopping you from doing? Are you late to work because you have issues getting up and getting ready for the day? Do you have a fear of driving in traffic? Do you have problems getting tasks finished? Once you identify the different issues you wish to change, CBT can help you with those issues.
Remember, it’s your reaction that causes the problem, not the situation. If your issues are external, such as situations or events, figure out your feelings connected to those situations or events. Are you sad or scared? Work to discover what your ideas are surrounding those events in order to move forward.
Now that you have written down your problems, describe how the issue affects your life. Just like with ideas, issues can be different from one person to the next.
Let’s say you go to the doctor because you’re not feeling well. You wouldn’t simply tell the doctor you don’t feel well. You would describe how you feel such as sore throat, runny nose, or cough. You might even go into more detail and describe your watery and itchy eyes.
With each issue, write down your emotions, ideas, and actions. This will help further identify the problems you want to work on.
Main Issues: Fear of traffic; fear of failure
Issue 1: Fear of traffic
Description: I have trouble driving to work. I need to take the interstate, or I’ll be late.
Ideas: I’m afraid of being in an accident. If I go a different route, it will take longer. I’ll be late for work. My boss will yell at me.
Emotions: Fear, anxiety, worry
Actions: Take back roads to get to work.
Issue 2: Fear of failure
Description: I don’t think I’m smart enough to do my job. I’m afraid of making mistakes. I think my co-workers do their jobs better than me. I’m afraid I’ll never get promoted.
Ideas: I’m worthless. Why even go to work?
Emotions: Sadness, fear, depression
Action: Avoid co-workers; never take on extra projects; avoid my boss
Using the example above, you can clearly identify the issues you want to change.
Next Step: Setting Goals
You now have a beginning point, and you’re ready to set goals. To set goals, you need to realize what you wish to achieve. For instance, a marathon runner’s goal is to reach the finish line and hopefully come in first. To do that she must exercise and have set goals in mind such as running a longer distance each day so she can go the distance in the marathon.
Ask yourself: What does it mean to improve? How will you know if you improve?
How will your life be different after you learn the skills? Are there things you’ll be able to do that were too hard previously? Are there things you want to do that you’re not able to do now?
Write down the goals you wish to achieve. An example might be that you’ll be able to drive in traffic.
Now, be more specific on those goals, such as driving on the interstate or taking on more projects at work.
Write down the actions you wish to see. Now, you’ll know if you’re achieving your goals.
Main Goal: Drive in traffic
Specific Goals: I want to be able to drive on busy streets. I want to be able to drive on the interstate and highway.
Actions to reach my goals: Practice driving without fear on any street.
Before we move on to the next step, take some time now to write down your issues and goals. Take your time, and be sure you recognize the real issues. Now is the time to ensure the issues you have and the goals you wish to achieve are specific, so you can set a realistic path toward reaching those goals.
This is possibly the hardest step in the process, because you may have been avoiding the problem. You may have had the fear for a long time and now it just seems normal, so it can be difficult to pinpoint the exact fear. You may have a phobia of traffic, but you may have convinced yourself that it’s normal to worry about having an accident when having an accident is not the main issue. Traffic in general is your main fear.
Using the CBT Emotions Model
Cognitive behavioral therapy is different from other forms of therapy. Traditional therapy is known as talk therapy; however, CBT works to help you understand and change your emotional course of action. The way CBT works is that you learn what your problems are and find the solutions to solve them through practice.
Three Parts of the Emotions Model
From the cognitive behavioral therapy viewpoint, three parts make up our emotional experience. They are ideas, feelings, and actions.
When you have ideas of fear and panic, you may feel physical sensations. Your heart may pound or your body tremble. The same goes for anxiety, you may feel tingling in your body, or your body may go numb. Many times, feelings of fear and panic can feel the same as a heart attack. Your feelings bring on physical signs of emotion.
Ideas can be complete sentences or just words that help you make sense of the situation you are in at the time. You may have images in your mind as well. Ideas are constant in your life and aid us in learning how to react in different situations. However, when it comes to fear, your ideas can cause you to freeze up.
Actions are the things you do and don’t do. You may avoid going to the store on a busy street or take side roads if you have a fear of traffic. If you’re afraid to speak in public you may avoid it, but if you enjoy speaking in public you may seek out those opportunities.
Your feelings, ideas, and actions all work together to create your emotions and moods. Changing just one of these parts will change the others.
Your Ideas Influence Your Actions and Feelings
Example: Cindy has suffered from fear of failure throughout much of her life. She noticed that panic sets in when she has an interview, takes a test, or is up for a promotion. Her mood worsens, and several times in the past she has felt so bad before an interview that she has cancelled it. She shakes, her heart pounds, and fear takes over. Cindy was recently laid off from her job, and must now look for a new one.
Cindy has an interview scheduled for a job similar to the one she had as a supervisor in an accounting firm. Her fear sets in the night before the interview. She has a hard time sleeping and the first thing on her mind when she wakes is the interview that afternoon. She thinks: I’ll mess up in the interview. The other person will get the job. It’s not an accounting firm, so the company won’t want me. She becomes so overwhelmed she feels exhausted. She convinces herself she won’t get the job. She decides not to go to the interview at all.
As you can see, Cindy’s thoughts were negative which caused her feelings and actions to be negative. Her thoughts brought about the entire avoidance of going to the interview.
How Actions Impact Ideas and Feelings
Example: Linda suffers panic attacks when faced with speaking in public. When a panic attack hits, she has feelings of her heart pounding, tightness in her chest, and dizziness. During episodes of panic, she sometimes has thoughts of going crazy or of losing control. Since she was recently promoted at work, she is expected to speak in public more often and is having more panic attacks. Normally, she will run to the bathroom or to her office to get away from the situation. She has missed meetings where she needed to provide information to the board of directors. Now, due to missing the meetings, her anxiety has increased, and the circle keeps building.
Linda’s reactions to her feelings are the main problem. The panic attacks are difficult, but they will not cause her to go crazy or lose control. However, such thoughts bring on more anxiety and panic. Running away and avoiding the meeting also adds to the anxiety. If she could attend a meeting and ride out a panic attack, she may learn that an episode usually lasts only a few seconds. Others in the meeting would not notice anything different and would not realize she was having a panic attack. However, because she has begun the action of hiding, she is trapped in a circle of avoidance and panic.
How Feelings Impact Ideas and Actions
Example: Tom has a fear of death. While at work, he learns that a close friend has been diagnosed with cancer. This brings on sadness along with fear. Suddenly, he feels tired and sick to his stomach. He tries to go about his day and finish his work, however, the fear causes him to have ideas and feelings that he is wasting his life and losing precious time. He is afraid he’s going to die and not meet his goals. When he gets home, he doesn’t discuss his fear with his wife. He now struggles at work and at home because of his fear of death and worrying about his friend.
The sadness is overwhelming when you learn a friend or loved one is diagnosed with cancer. Sadness is a normal feeling when you receive bad news about someone you love. However, Tom’s fear of death begins to overshadow the way he feels about work and himself. This feeling of sadness begins to cloud over his entire life even though it has nothing to do with his friend. His fear of death has taken over every aspect of his life. He withdraws, which make the feelings of sadness and the fear of death increase, so the cycle continues.
Progressing with the Emotions Model of Cognitive Behavioral Therapy
If you want to learn how to act effectively and manage your mood in difficult situations, it’s important to learn to separate your ideas, feelings, and actions. When we feel overwhelmed, our emotions respond, but we don’t stop to separate the parts of those emotions. Because of this, we may have problems changing our mood and are held captive to it.
By separating the different parts of our emotions in the moment, we learn what’s causing our emotions to stay the way they are or become worse. By separating our ideas, feelings, and actions, we learn how to change. Work to discover what ideas and actions are creating your mood to worsen. By learning all the parts of your emotions using the CBT model, you’ll become better at turning your problem moods toward better responses. You’ll begin to think and act positively in stressful situations to better manage your fears.
Discovering Parts of the Cognitive Behavioral Therapy Model
During the next week, pick different situations where you experienced strong, negative emotions. Now, use the cognitive behavioral model to discover the parts of those emotions. You may struggle discovering all the parts, but don’t worry. Just pay close attention to those that were difficult to discover as you track your ideas, feelings, and actions. If you’re having trouble discovering the actions of the emotions, pay more attention to your actions throughout the week. As with any exercise, it will become easier to discover the parts the more you practice.
Cognitive Behavioral Therapy and Your Mood
Since you now have a plan for the changes you want to make, and you have an idea of the CBT model for your emotions, we can go to the next step which is understanding, finding, and examining your moods. The reason for this next step may seem obvious: you want to change the way you think and feel during your phobia episodes. You may be concerned as you have been feeling worried, angry, or sad. At times it may be hard to know the exact emotion you’re feeling at any given time. This is the best place to start, since emotions are often difficult to separate.
You can have several different feelings or moods. The moods can be mild or intense and they bring with them thoughts and feelings. Sometimes, you may have more than one emotion hit you at the same time, which can be confusing. Other times, you may not feel anything. This step will give you the insight you need to separate and watch your moods to learn how they have control over your thoughts and behavior. This way you’ll be able to make the changes you wish to conquer your fears.
Discovering Your Feelings
We often have a hard time dividing our thoughts from our feelings. We use what we are thinking at the time as our feelings.
Examples: I feel when you should have said I think. “I feel like I can’t do my job as well as others.” These are not your feelings, but rather, your thoughts. Examples of feelings statements are “I feel embarrassed” or “I feel excited.”
Feelings are explained with only one word within the five groups of feelings which are sadness, fear, happiness, irritation, and hatred. There are many different words that can be used for those feelings.
A few of these are:
This is only a small list of feelings, but with this in mind, you can learn how to separate your feelings from your thoughts.
Feelings Are Important
Painful or fearful feelings are a part of everyone’s life. Of course, there are times we wish we could rid our lives of these types of feelings. However, you will learn through this step-by-step guide that these feelings are important and serve a purpose.
Feelings have two main functions:
- They are the signals that cause us to act.
- They are the signals to others that cause them to act.
Feelings provide information to us about the situation we are in at any given time. Feelings of fear let us know if we are in danger, feelings of anger may come when we’re being threatened, and the feeling of sadness may come when we lose someone dear to us.
Feelings often make us act too fast before we have time to think. This can be good if, say, a vehicle is barreling toward us. We can quickly jump out of the way. On the other hand, fear can set in when there is no real reason to be afraid. You may feel fear when you’re watching a scary movie even though you’re not in real danger. Because of this, you must learn not to react every time you feel scared. Instead, use this emotion as information.
Our feelings signal others as well, so they know how we feel and how they might best react. Our posture, gestures, body language, and facial expressions tell others how we are feeling. If you’re smiling or laughing, others will know you are happy. If you’re afraid, others will know this as well. As a matter of fact, this could be exactly how your fear or phobia began. For example, you may have had a parent that was afraid of spiders and would react with fear at the sight of one. Now, whenever you see a spider, your emotion of fear may kick in because of what you experienced as a child.
Watching Your Moods
As you see, feelings are important, but they can also make our fears more intense. This guide will give you the tools you need to look at your feelings differently, so you can manage your fears. In order to do this, you must first keep track of your feelings. Pick a time each day to think back about your feelings, or you can write them down as they occur. It’s important to write down every emotion you have each day of the week.
Follow these steps to watch your moods:
- Explain what was happening when you had the emotion. Example: You were talking with your boss.
- On a scale of 1 to 10, rate how strong the emotion was using 1 as mild or 10 as very strong. If you were happy for thirty minutes while spending time with your partner, you could rate it as 5 if it was neither strong nor mild.
- Next, write down the physical sensations you had at the time. Did you feel tense? Did your heart rate increase? Were you cold? It can be hard to divide your physical feelings from your emotions. You may not recognize physical sensations at first, but you will have them. If you find yourself close to your fear, such as seeing a spider or having to speak in public, you may not know what your emotion is at first, but you may have physical feelings such as a fast heartbeat, sweating, or shaking. In some cases, you may not feel anything physical at all. In this case, you may have to pay more attention to your body. See if you feel differently watching a movie or playing a game. This will help you learn how to notice those types of physical feelings so that when you’re afraid, you can learn how such feelings may make the situation worse.
- Watch your moods for one full week before going forward. It will be easier to write down your feelings at the same time each day, especially if you allow a quiet time in which to do it. If you worry you’ll forget, set an alarm. Once you start writing down your feelings, you’ll begin to see patterns in your moods and learn how they can help in managing your fears.
Recognizing Automatic Ideas in Cognitive Behavioral Therapy
What Are Automatic Ideas?
While using this guide, you have spent time discovering your feelings and physical sensations. At times, you may have a hard time figuring out why you are having certain emotions as they can come on without any notice. In some cases, your fear may rise when someone is telling a story that happened to them and mentions the object of your fear, such as snakes. You may begin to feel anxious even though the danger is nowhere to be seen. Now, we must learn the ideas that are associated with our emotions.
Ideas affect our experiences including our feelings. In this guide, we will be talking about certain thoughts that we call automatic ideas. Automatic ideas are those that we have throughout our day. We may not even be aware that we are having these ideas. With a bit of practice, you can learn to recognize them and learn how to control your mood and actions.
Our minds are constantly processing our ideas and thoughts, which exceed 50,000 per day. If we stopped every time we had an idea or thought, we would be overcome by just how much information we process. The good news is that our brain is like a filter. It lets some ideas come and go quickly while deciding what is important. The way it does this is by weighing the situation we’re in at the time and giving meaning to each situation. When the brain does this, we form opinions as well as ideas and thoughts.
The brain does a good job most of the time. However, there are times when our brain allows us to focus on small parts of information that aren’t important. This means that the small parts may not be true facts of the situation you are in at the time. Let’s say you were given a job to do which you had never done before. Your boss comes over to check your work. He gives you praise on a job well done but also tells you where you might improve. Instead of focusing on the job well done, your brain sticks to the parts that could use improvement. Even though your boss praises all but one or two parts of the job, your brain focuses on the negative. This might trigger your fear of social situations, and you may start having negative thoughts about the entire situation. You may experience feelings of sadness, disappointment, and/or anxiety.
Your automatic ideas can trigger feelings that are negative. You can more than likely recognize the feelings in a situation, but you may not be able to recognize the ideas connected with them. In many cases, it is these automatic ideas which trigger the feelings and actions. Learning how to study these ideas will help you to understand as well as manage your emotions and actions before your fear takes over.
Example 1: Brandy took a test and got 95 percent correct and 5 percent wrong. She was upset with herself because of what she got wrong. She thought she was going to do badly because she has a fear of taking tests. That fear caused her to shake and not be able to concentrate during test time. So, when she missed 5 percent she wanted to hide away because of her negative thoughts and ideas that she was not smart.
Example 2: Daniel took the same test and also missed 5 percent. He was excited, since he had studied hard. He was proud that he only missed a few. The thoughts and ideas he had were totally different than Brandy, and he decided that studying for tests truly helped him get a better grade.
As you can see, both received the same grade, but both felt differently about their results. Their automatic ideas need to be checked to learn why they felt so differently. Brandy felt useless, as if she were not smart, while Daniel felt proud. Brandy’s automatic ideas were negative, while Daniel’s were positive. You can see from Brandy and Daniel that their automatic ideas affected their mood and actions.
Automatic ideas can be words or images. Brandy may have seen herself failing the test and then imagined a future where she is working for minimum wage instead of her dream job. These thoughts were rooted in her fear of tests and fear of failure. No matter how your automatic ideas come to you, you can learn to discover their basic meaning and how they connect to your emotions and actions.
How to Recognize Automatic Ideas
It may be hard at first to recognize your automatic ideas, but once you get used to finding them, you will not have any problems.
Example: Carla finds out that her best friend Betty had a party and didn’t invite her. Her first feeling was sadness. When this happened, Carla had to separate her automatic ideas from how she felt. Separating her feelings from her automatic ideas, her thoughts were:
- Betty has a new best friend.
- No one ever invites me to parties.
- Everyone hates me.
By writing down the thoughts that were running through her head she could see why she felt sad. Now that she understood her thoughts, she could also see where her emotions were coming from. She recognized that her ideas/thoughts were somewhat irrational. She began to feel less sad about the situation.
We improve our understanding and alertness through a process known as metacognition. Discovering our own thought process will help us look at our automatic responses and check our responses by distancing ourselves. This is one of the most powerful tools you will learn to use in CBT.
It may be hard to discover the thought you may be having at the time, so you may have to look at the situation differently. As in the example above, ask yourself what it meant that Carla wasn’t invited to the party. You may realize that you, too, believe Betty had a new best friend. Then ask yourself what is the worst thing that might happen and why. The worst thing is that no one invites you to parties and everyone hates you. These may be two of your automatic ideas.
If none of this helps you discover the ideas/thoughts in the situation, use your feelings and then go backward. As an example, your feeling could be sadness, which could lead to ideas of everyone hating you. When you have negative ideas it’s more than likely something in your past brought on these ideas. By discovering this idea when it occurs, realizing that it is from a completely different situation, and then learning that the fear comes from a different time, you can learn how to manage your fears.
An Important Tool: The Idea Notebook
Writing down your ideas is the best way to learn which ones are causing unwanted actions and emotions. Learning how to use your metacognitive ability by keeping a notebook of your idea details will guide you to practice other tools in the process.
By creating an idea notebook, you’ll master a skill that will help you discover the ideas which are causing you to have unwanted feelings. By using this notebook to record your thoughts in different situations, including when you face a fear, you’ll become more skillful at managing your fears. By using this method, you’ll begin to learn the ideas at any given moment and be able to separate yourself from those ideas so the emotions will not be as strong.
Creating Your Idea Notebook
The best way to begin is to find time alone shortly after a fearful situation happened. Remember, you don’t want to write down your ideas and thoughts while the situation is happening as your feelings and emotions will be too strong. This can prevent you from finding your true idea.
Write down the situation in a few words.
Situation: I spoke to my boss, but he didn’t say anything back.
Ideas: He’s mad at me; He thinks I’m not important; I’m about to get fired
Feelings: Anxiety; Anger
If you struggle with the ideas, try listing your feelings first. Recognize the feelings you were having. Remember to separate your ideas from your feelings. Feelings are one word like fear, anger, joy, or sadness. You can write down as many feelings as you were experiencing at the time. Now, give your feelings a ranking from 0 to 100.
Recognize the ideas you are having during each situation. Ideas do not have to be full sentences. They can also be just one word or even images. Think about each feeling before moving to the next step. Using your feelings you can always go back and write in your ideas. Then give your ideas a ranking from 0 to 100.
Take time each day to use your idea notebook. This will help you separate your feelings from your ideas faster.
Use your idea notebook at least four days before going forward. The rest of the steps you’ll learn will rely on this notebook and will increase your ability to make good use of your idea notebook.
Cognitive Reorganization to Transform Your Thinking
Cognitive reorganization is learning to work with ideas that are not helpful for you.
Now that you have learned to recognize your mood and discover your automatic ideas, you might feel better about your feelings as you won’t let them be in control. The next step will help you make big changes in your ideas, feelings, and actions from a new place.
The reorganization will aid in helping you discover patterns in your ideas and thinking and change them to be more useful. This will help you trigger fewer or maybe no negative thoughts, which means you’ll see more clearly and have control over your actions. Cognitive reorganization uses your ability to recognize automatic ideas and feelings.
Cognitive reorganization is often confused with positive thinking. Positive thinking can have its problems: If you always think everything will be fine, eventually you’ll be disappointed. Likewise, just because you’re learning how to control your fears doesn’t mean all fear will be gone. Going to the extreme in either direction can cause problems. Denying your fears is not a good tool to cope with them.
As you use cognitive reorganization, you’ll develop a position that sees both negative and positive sides. This way you’ll begin to have less negative ideas to help you manage your fears.
When you have an idea that is positive and you can quickly change the way you think, you’ll begin to notice your mood shifts as well. In many cases, you will begin to notice before those negative ideas take hold and control your feelings. The most important thing to remember is to practice reorganization so it will become automatic and you’ll not have to work at it.
Cognitive Reorganization Notebook
In this section, you’ll learn to discover ideas associated with negative feelings. Any time you’re in a situation that brings on negative feelings or ideas, separate that situation into parts. Write down each situation, ideas, and feelings in a reorganization notebook, just like you did with your ideas notebook. Write down as many as you have, not just one.
Now, pick one of your automatic ideas on the list, and if possible chose the one that caused the worst feelings. If you’re having a hard time choosing only one that brought on the worse feelings, then think about the situation with the strongest feelings. Now that you have the strongest feeling, discover which one brought on feelings such as anger, sorrow, or regret. Before going forward, you must change your idea into a sentence.
Automatic Idea: What if I flunk the test? Change it to a sentence: “I will flunk the test.”
Automatic Idea: What if I forget the words to my speech? Change it to a sentence: “I will forget the words to my speech.”
Once you change your ideas into a sentence, you can move to the next step.
Create a variety of viewpoints about the situation. You will need to think about your automatic ideas from different angles, so you can start to think differently. Ask yourself the following questions: What does this idea affect? What if you did not believe it?
Answering these will help you decide if this idea is negative and if it will be helpful. If your idea makes you feel worthless or afraid, the idea is not helpful. If the idea is not helpful, you then need to look at your automatic idea from different angles, so you can change the idea.
Do you have proof to support the automatic idea? What proof do you have that the idea is not true?
Answering these questions will help you decide if the automatic idea is correct or not. If the information is not true, then it’s bad information you are relying on which will only make you feel worse. This could make your phobia worse and could bring on a panic attack. Like in an earlier example, if your automatic idea says you will flunk the test, but the proof doesn’t agree with you, then you’re relying on bad information. Fear causes negative automatic ideas. If you change them to be positive using proof from past experience, you’ll be able to manage that fear. The same goes for being afraid of spiders. If you see a spider and your automatic idea says it will bite me, but your proof doesn’t back that up, then you can change your automatic idea to positive such as: As long as I leave the spider alone, it won’t bite me.
By learning to look at the proof, you can learn more about the automatic ideas that are feeding your fear. By looking at the negative automatic ideas and working to change them into more positive ones you will be working toward a better life where your fear is not controlling you. You’ll begin to learn what proof will help and what proof is not helpful. By weeding through your proof, you will be able to work toward progress.
Is there a different explanation?
Answering this question will make you understand that your automatic idea is only a guess and it should be thought of as a guess and not proof. Like with flunking the test, this is only a guess. It should not have any weight—your proof shows that you can pass tests. It is the fear of taking tests that is holding you back and causing you to have the automatic idea of failure. Look at different ways for taking the test. You could think that you will pass the test with flying colors, you could at least get a passing grade, or you’ll do better than half the class.
You can think of all kinds of things. Some might happen and, of course, some might not, such as a tornado blowing away the building. However, by looking at different things that might occur, you can create new outcomes. This will help you change the situation and solve the problem. This can help you think about your automatic idea or ideas in a different way. You will learn to feel better when you’re in the situation, and that can help change your mood.
What could happen that would be the worst? Will you live? What could happen that would be the best? What will more than likely happen?
When your fear hits, you automatically have ideas of the worst things possible. This only serves to bring on more negative thoughts and feelings. Using the example of flunking the test, the worst thing that could happen would be to flunk the test. Flunking the test is only the beginning. Be sure to detail all of your thoughts and feelings about the situation. Examples: I won’t be able to get the grade point average I need. I won’t be able to get into the college I want.
Now, you need to dig a bit deeper. Will you live? Yes. Now, you need to look closer at your answers and answer more questions such as what will you do if you flunk the test or freeze at the podium? How will you feel after the test or after your speech? How will this situation look in a week, a month, or a year from now? In the future, when you look back at the situation, what happened that was good?
Now, look at the best way your situation could end. Remember to go into detail with this perspective as well. You could ace the test or not forget one word of your speech.
Once you can answer these questions, you will be able to manage your fear much better and you’ll learn that it won’t be the end of the world. Looking at the worst and best outcomes will help you see your fears in a different way.
If you had a friend that had the same fears in the situation, what advice would you give them?
Are you one that can give good advice or help others that are afraid? Most people are. But when it comes to our own problems, we seem to ignore our own advice. The reason could be that when we’re in a situation, we have a hard time overcoming anxiety when we’re afraid of something. The next time you are in a situation where you are fearful, pick one of your friends and think about what you would say to them to help them with the problem.
Example: Sarah works at an advertising agency. She has always worked in the background but has received a promotion and must now pitch the ads to clients. She is afraid to stand in front of the room of people and give any type of speech, let alone try to sell an idea. She’s afraid she will have a panic attack and run out of the room. Then she would not only lose the client for the company but would probably be fired as well.
Sarah feels like she is trapped and doesn’t know what to do. What advice would you give? Would you be able to show her how she can talk to more than one person at a time? Would you remind her of her awards in speech and how far she has come to get the promotion?
If you notice, the way you would support Sarah is like answering the questions above. You would not give her negative thoughts but would offer encouragement to help her through the situation.
What can I do about this?
Now that you have looked at your fear/fears in different ways, you should be able to come up with different plans. Instead of being in a situation without a way out, you can now change and shape the way you think about your fear. You can change your negative thoughts. Rather than think you’ll be bitten by a spider, you begin to think to leave it alone, so it won’t bite you. Rather than fear public speaking, you’ll uncover the confidence to speak in a crowd.
You can answer the question of what to do about a fearful situation by coming up with the best solution and following through.
Example: In a speech to the company, Denny made a huge mistake. His boss called him aside afterward and told him he had better get with it or he would be gone. Of course, Denny was upset. Later, he sat down and listed some solutions—no matter if they were possible or not.
His list looked like this:
- I should start looking for a better job
- Talk to my boss about the mistake and how I can fix the problem
- Write a list that will ensure I don’t make another mistake like this and show my boss
- Explain to higher-ups in the company how this mistake happened and ensure it would not happen again
- Blame it on someone that helped me with the speech
- Look at the mistake as a way to remember to check not only my writing again but others’ that might help me write speeches
- Drink alcohol before giving the speech so I won’t be so nervous
After writing down the list, Denny could look at more realistic ways to handle the situation. Of course, drinking before the speech would not be the right way to go to overcome your fear of speaking in public. However, checking over your writing again before giving the speech would be the better option. By doing this, Denny could focus on how to handle the fear instead of being more fearful of his boss’s words.
Answering this last question about what to do in a fearful situation is best done after you use the ideas notebook. Your ideas notebook will guide you in the right direction. You’ll have learned the best way to discover how to handle your fears. You will feel more power over your fears and the confidence you need to conquer them.
The Substitute Sentence
The next step is to come up with one substitute sentence that addresses most of the questions above. When you have automatic ideas, replace them with the substitute sentence. Of course, automatic ideas are hard to stop, but once you have one, remember your substitute sentence. This way it will become automatic; when you have the automatic idea, the substitute sentence will begin to appear in your mind at the same time. This should help you get your mood in perspective and help you stay in control.
This one sentence should be seen as many times as possible during your day to help you stay positive. The more often you see this positive sentence, the more automatic it will become. Your automatic ideas come naturally, and you want this new alternative sentence to become automatic. Once you start allowing this sentence to become automatic, you will start believing the new sentence instead of your negative automatic ideas that make your fear worse.
The more you work with your idea notebook the easier it will be to use your cognitive reorganization notebook. Practicing these notebooks will help you create an alternative sentence for your automatic ideas at any given moment. You will no longer need to write out your ideas in a notebook.
One of the best ways to tackle ideas, feelings, and actions is to write idea notes using cognitive reorganization to create an alternative sentence in cognitive behavioral therapy. It is important to practice as much as you can, so it becomes natural. It is best to write in your ideas notebook every day before moving forward. It may take some time, but the alternative sentence or words will become automatic any time you meet one of your fears.
Cognitive Behavioral Therapy for Cognitive Distortions
What Are Cognitive Distortions?
You have practiced identifying your ideas and using cognitive reorganization. As you practiced, you probably noticed that you have different types of ideas. In many cases, some of these you see again and again. Everyone has mental habits which are nothing more than certain ways of viewing things. There are ideas that often guide us to constantly read our situations in harmful ways. These have nothing to do with facts and may leave out important parts. In most cases, these ideas come on similar to automatic ideas but are known as cognitive distortions.
Example: You’re doing a group project at school or work. No matter what the rest of the group says on how to start the project, Debby keeps offering reasons why it will not work. She can only see how the project will fail. This is cognitive distortion or negative sorting.
We all need shortcuts in our minds to make quick decisions in situations, so we don’t have to waste time. Not all ideas are distorted but some are and, in certain cases, these distorted ideas cause us to make wrong decisions.
Example: You’re at the grocery store and you need to buy a bag of potatoes. You notice one bag has a potato with bad spots on it. You automatically search for a different bag, because you believe that particular bag of potatoes won’t be any good. You don’t have to write a list to figure out which bag of potatoes to buy.
On the other hand, when you use the shortcuts in the wrong way they become cognitive distortions. Let’s say you pick at a friend of family member’s flaws which can lead you to become angry. The same goes for work or school. You might find that missing an answer on a test or not correctly filing a paper can grow into you feeling like a failure.
Examples of Cognitive Distortions
Your fear is talking in front of a group. During a meeting at work, you need to give a productivity report. Your ideas start with: I will stutter; I will get fired; I won’t be able to find a new job; my partner will leave me; I will have a heart attack; I will be homeless; and so on and so forth. All of these what-ifs lead to more negative ideas.
You may have the fear of failure. You are working on a project that you need to finish quickly, but it’s late at night and you’re still not finished. Your ideas begin again: I’m not going to finish in time; I will lose my client; I will lose all my clients; I will end up going bankrupt; I will end up losing everything.
If you notice, once these what-ifs begin, they end up with you losing everything or possibly even dying. By thinking these ideas, the outcome will always be the worst-case scenario. Instead of thinking of the what-ifs, use cognitive reorganization to change the wording, so the end will not go as far as dying or being homeless. Consider the wording as difficult or uncomfortable. This way the negative thoughts will not grow stronger.
Win or Lose Ideas
You may have thoughts that only have two outcomes: good or bad. Everyone has ideas like these from time to time, however, there are always in-between outcomes that you may not be realizing. Our ideas often make us believe things that are not true, such as: If I go outside, I will see my greatest fear and have a panic attack. This could be spiders for example. Going outside does not mean you will see a spider and seeing a spider does not mean you will automatically have a panic attack. There are many in-between things that may occur. Think about all the other possibilities. If you have to overcome this way of thinking, you can always write down other solutions or outcomes until you learn to think about all the other possibilities automatically.
Ignoring the Positives
Only seeing negative ideas is also a cognitive distortion. An example might be that you have a fear of failure. You had to give an oral book report and the teacher stated that you did very well. You may have the idea that she only said that so she wouldn’t embarrass you further in front of the class.
By believing only the negative during the report, you noticed a few members of the class talking. This made you believe they were saying how bad you were, such as forgetting a word or two and having to look at your notes.
Once you only see the negative, you will begin to only see negative things in all that you do at work, school, or even play. You may be asked to play basketball, but your ideas are that you will be a bad player, so you don’t play as you want to avoid failure.
Once again, practice looking at the positives in the situation instead of only looking for the negative.
Being afraid of danger is important, however, when you have broad ideas you can make danger out of anything.
Example: Charles has a fear of death. His father died from a heart attack at the mall. Now Charles believes if he goes to the mall, he will die of a heart attack. If he gets in a large crowd, he will die of a heart attack. He believes he is destined to die from a heart attack.
One idea will lead to the next, but if you can stop at that first negative idea and consider something positive, you’ll learn to have more helpful automatic ideas.
Using “Should” All the Time
I should not be afraid of spiders. Cindy should not have a pet tarantula. You may get upset or even mad that others are not afraid of spiders like you are or you may get upset that you should not be afraid. Try to live in the now. Being afraid of spiders is not the real problem. Being afraid so much that you’re not enjoying life is the problem. First accept that you have a problem. Perhaps instead of trying to get rid of your fear of spiders, learn which ones are poisonous and what treatments are available for possible spider bites.
We often use labels for people such as she’s lazy, he’s a nerd, or I’m a scaredy cat. Labels use only one word without looking at the whole person. Instead of labeling yourself or others, try to ignore these labels and look for other, more positive traits. Write down all your traits—not just that you are a scaredy cat. You will soon begin to see your best traits and leave the negative ones behind.
When you are trapped in cognitive distortions, your thinking will only let you see one outcome. Of course, there are many different ways to see any situation. As you work on this section it’s important to remember that your goal is to have a flexible way of thinking, so you can see the various possibilities. Your main goal is to get rid of the negative automatic ideas and trade them with positive ideas.
Now that you have learned a new skill (recognizing distortions) you can add these to your automatic ideas notebook when you’re writing. The best way to remember these distortions is while you’re writing down your automatic ideas. This way you will be ready for the next section.
As you are writing in your ideas notebook, be sure to write down your distortions and of course, create a better response.
Opposite Action, Behavioral Motivation, and Experience
Earlier we explained that your behavior can affect your ideas and feelings. Now, you will learn how you can change your behavior to change your feelings and ideas. You’ve already learned how to change your ideas to guide you in helpful ways to overcome your fears. In this part, you’ll learn how to make your behavior work to overcome fears.
Opposite action is nothing more than using a behavior that is opposite your feelings to help you de-escalate. This means using a behavior that is opposite to the feelings you have when you become afraid. This will help you calm the feelings that sometimes bring on panic attacks.
If you look at the Cognitive Behavioral Model, you will see that ideas and feelings have an effect on your behavior. However, behavior can affect ideas and feelings, too. If you make a significant change to your behavior, it will also have a similar effect on your feelings. By changing the pattern of your behavior depending on your mood, you will allow ideas and feelings to become automatic.
In the past, therapy for anger could involve punching a pillow or a punching bag. This was thought to help one vent their anger. Today, it is thought that this action may actually intensify feelings of anger. When you use your feelings to try to conquer your fear it actually increases the fear. The good news is that when you use the opposite of your feelings, the fewer negative feelings you will have.
Stages for Opposite Action
Stage 1: When you have a strong feeling, decide if it is in your best interest or if it is harmful. Even unpleasant feelings can be helpful. Fear lets you know if danger is in the situation. But remember from the stages above that this fear you’re feeling may not fit your situation and therefore may not be a helpful feeling. Fear can make you think negative thoughts or cause unnecessary panic. If the fear is not helpful, using the opposite action could be helpful.
Stage 2: Decide what impulse is associated with your feelings. Every feeling has impulses to act in certain ways. Here are some of the impulses you may notice with different feelings:
- Irritation: Becoming involved in the impulse or even attacking
- Hatred: Avoidance of the situation
- Grief: Avoidance of the situation or not talking to others
- Fear: Avoidance of the situation where you may encounter your fear or running away when you encounter your fear
Stage 3: Participate in the opposite behavior of the impulse of your feelings until you no longer feel the intensity.
- Irritation: Step away for a few minutes from what is making you angry. If it’s a person making you angry, say something nice. Let your tension drift away. If possible, pet your dog/cat.
- Hatred: Sit down by what you hate or think about why you hate it. Don’t avoid it while doing this.
- Grief: Do something you like to do even when you don’t want to. Talk to a family member or friend.
- Fear: Get close to your fear and stay close to it. Think about the fear and see it clearly. Do not avoid.
Using the opposite behavior does work when you practice for several minutes at a time. Of course, it will not feel right to you, but you will begin to feel your feelings calming down. Just like the other stages above, it will take time and the more you practice the better you become at using this skill.
Cognitive behavioral therapy uses behavioral motivation for individuals with depression. It is similar to the opposite action but helps you with learning your opposite mood-dependent behaviors. Your fear or phobias can lead to depression if you often avoid your fear by staying at home. Learn to find your behavior by using the stages below.
Stage 1: Write down your behavior for seven days. Using whatever writing tool…writing tablet, notebook, or phone. Try to find time to write down all the activities you do several times a day. Use a scale from 1 to 10 and rate your level of doing well and level of pleasure for each activity.
Stage 2: Now you will be able to find the activities that have no real purpose in your day. These activities don’t add pleasure and you don’t do them well. Now that you can find them, get rid of them. Get rid of these activities that waste your time even if you have to block certain phone numbers, turn off your television, or delete games on your phone or computer. The idea is to get rid of things that drain your energy but do not give back to you.
Stage 3: Write down a list of activities you do well and ones that provide pleasure. These can be very large projects, such as writing your autobiography or short activities like baking cookies.
Stage 4: Create a calendar for your activities. Pick an item from Stage 3 and place it on your calendar for the next week. The problem is that most people often forget to do the activities they enjoy, so placing them on your calendar will help you become more automatic to do things you enjoy. By creating a calendar, you’ll be getting rid of your in-the-moment pick.
Stage 5: Do every activity as it comes up on your calendar. Now, repeat Stage 1. Write down your level of well done or pleasure. Once you have completed the week, decide which of the activities you want to place on the calendar for the next week.
Behavioral motivation can be hard to do because you’re working against your own biology. The main reason you may be depressed is that you’re avoiding your fears. If you are afraid to go outdoors because you’re afraid you will confront one of your fears, you may become more depressed. The more you do activities you enjoy, the more you’ll start to feel better. Keep doing activities you like even when you feel like doing nothing.
Remember, just like with fears, there is no quick fix for conquering depression. Feeling better will take time. It could take months before your depression is completely gone, but the more you participate in activities you enjoy, the more the depression will lift. And you will enjoy the chance to spend time with family and friends. Of course, the depression may still be there, but you’re working on it—that’s what counts.
Exposure Treatment for Fears/Phobias
If you have a fear of bugs, staying indoors may be your choice to avoid them. The problem is that the more you avoid your fear, the more negative your mind will become when you think about your fear. Whatever brings on anxiety or feelings of panic can often lead to unwanted actions such as staying indoors. Exposure therapy can help lower those magnified feelings and cognitive distortions. However, the longer you avoid, the harder it gets, so the process of fear just keeps circling and controlling your life.
The more you are exposed to your fears the better your chances of overcoming them. You may start by listening to or speaking words related to your fear until you can do so without feelings of panic. Next, photos are often used to help desensitize you visually to your object of fear. The next step may involve getting close to your object of fear or participating in the fear such as being in a crowd or giving a speech. The more confident you feel, the better you will be able to handle your fear in a healthy manner.
Stages for Exposure
Stage 1: Write down a list of fears or fearful situations.
Stage 2: Now place them in order of the fear that brings on the most anxiety to the fear with least anxiety. Place them under high anxiety, moderate anxiety, and low anxiety.
Stage 3: Pick just one of your fears and give it an idea record. Write down your automatic ideas that bring on the anxiety. Then, use the guide to reorganize your ideas.
Stage 4: Create your sessions for exposure. Exposure therapy will work best if you practice it three times a day for thirty minutes. Only use one of your fears throughout the week-long process. Remember, practice makes perfect, so conquering one fear at a time will yield the best results. You’ll get used to the guide with this fear and be able to move forward.
Stage 5: Practice exposure therapy often. Before you start, look at the idea record you created. Once you feel better about the trigger and have more confidence, it will be time to move to another fear.
If your fear/fears are intense, we recommend working with a therapist who specializes in cognitive behavioral therapy. A trained professional can guide you through the entire process. If you have low anxiety, you may be able to use this guide on your own and learn to manage your fears. But if in doubt, speak with a professional.