Mindfulness, Anxiety and Acceptance

Since acceptance can be such a difficult notion to grasp, in this post and the next, I’ve included videos that describe the nature of acceptance, and how and why we accept things even when they’re unpleasant.

Mindfulness and Acceptance

If you have any questions or comments, please leave them on the YouTube video page.

Anxiety, Cognitive Restructuring and Reframing Our Thoughts

In CBT we modify our automatic negative thoughts and cognitive distortions with a technique called cognitive restructuring. Cognitive restructuring involves changing our thoughts to make them more accurate and reflect reality better. And when we do this, we reduce our levels of anxiety.

Cognitive restructuring allows us to modify and reframe our anxious thoughts and worries to arrive at a more balanced perspective. It’s not a form of positive thinking. We’re not trying to change our negative thoughts into thoughts that are overly optimistic. We’re just coming up with ways of looking at things that are more accurate and realistic.

Cognitive Restructuring and Reframing Thoughts in CBT

If you have any questions or comments, please leave them on the YouTube video page.

Cognitive Distortions and Anxiety

When our worries persist and we can’t problem solve them or let them go, the next step is to use cognitive restructuring. But before we get to cognitive restructuring, let’s look at cognitive distortions.

Cognitive distortions are our negatively biased and exaggerated thought patterns that distort reality. When we engage in cognitive distortions, we perceive and evaluate our experiences, and the situations we find ourselves in, inaccurately. Our automatic negative thoughts are often full of cognitive distortions.

The following video explains a number of types of cognitive distortions. Any of these cognitive distortions can leave us feeling anxious, but the cognitive distortions most associated with anxiety are Jumping to Conclusions (Mind Reading and Fortune Telling), Magnification, Catastrophizing, Emotional Reasoning, “Should” Statements, and Personalization.

Cognitive Distortions in CBT

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

Cognitive distortions are exaggerated and negatively biased thought patterns that lead us to perceive reality inaccurately. They’re a way our minds have of convincing ourselves to believe things that aren’t really true. They show up all the time in our automatic negative thoughts, and they’re significant because our thoughts have such a big influence over how we feel and how we act. And when we treat these cognitive distortions as if they were facts, we end up feeling and acting based on faulty assumptions, usually in ways that contribute to things like depression, anxiety, low self-esteem, anger, and countless other issues.

As we learn to identify cognitive disorders in our thought patterns, we become better at recognizing when and how our minds are leading us astray, which helps us see the ways in which our thoughts aren’t accurate; and makes it easier to reframe our thoughts and think about things in ways that are less likely to have a negative impact on our mood or mental health, and can help us start feeling better. So now let’s look at some of the most common types of cognitive distortions.

When we engage in all or nothing thinking we see things as black or white with no shades of gray in between. Something or someone is either all good or all bad. If we don’t do everything right we’re a complete failure. One bad thing happens and our whole day is ruined. Someone makes a mistake or disappoints us and they’re irredeemable.

All or nothing thinking is a hallmark of perfectionism. It leads to unrealistic standards for ourselves and others, which can negatively affect our motivation and set ourselves up for failure and disappointment. If you find yourself engaging in all or nothing thinking, try to start recognizing and acknowledging to yourself that things are rarely simply black or white, and start looking for the shades of grey in between.

Overgeneralization is when we see a single negative event as a never-ending pattern of failure or defeat. You’re making dinner and you burn something and you think, i always ruin everything, i never do anything right. You’re in a rush to get somewhere and hit a red light and think, nothing ever goes my way.

Overgeneralizations are often stated in terms of always, never or nothing. If you find yourself overgeneralizing, look for exceptions, and try replacing words like always never or nothing with words like sometimes or some things. And this can help you see that one negative event doesn’t define everything, and helps make your thinking less negatively biased and more accurately reflect reality.

Mental filter refers to filtering out positives and dwelling on negatives. A mental filter is like one drop of ink that discolors a whole glass of clear water: that single drop of something negative colors everything. We pick one negative detail and dwell on it exclusively.

You get lots of positive feedback from your boss with one suggestion about how you could improve, and your takeaway is that you’re no good at your job, and you dwell on that one comment all day. You make a YouTube video that gets twenty positive comments and one person says how much they hate it, and you’re so discouraged you never want to make another video again. If you find yourself operating with a mental filter, learn to start asking yourself if there are any positives or even neutral things about the situation you’re overlooking, and then adjust your filter to let those aspects through as well.

Discounting the positive is similar to a mental filter, but instead of filtering out anything positive, we dismiss it and tell ourselves it doesn’t really count. We get a compliment or some praise and tell ourselves, well that doesn’t really count they’re just trying to be nice to me. Or we succeed at something, but it doesn’t really count because we tell ourselves anyone could do that, i just got lucky.

If you find yourself discounting the positive, take a moment to ask yourself, why doesn’t that count, what reasons do i have to just dismiss that? And most of the time we won’t be able to come up with a good answer. Which makes it harder to discount everything positive. And we can start giving ourselves at least a little credit when things go well. And there’s an exercise called three good things that i talk about in my video on depression that can help you stop discounting the positive, and you’ll find a time stamp link to that exercise in the description and pinned comment.

Jumping to conclusions involves interpreting things negatively without any facts to support our conclusions. When we mind read we make assumptions about what someone’s thinking based on their behavior without confirming with them what they’re actually thinking. If our partner is being quieter than usual we assume it’s because they’re upset with us. If we text a friend and they don’t reply fast enough we assume it’s because we’re not important to them or they don’t like us anymore.

We make these assumptions about what’s going through other people’s minds based on no conclusive evidence, it’s just our interpretation of their behavior, usually mixed in with projecting our own emotions into the situation. We’re feeling insecure about a relationship or friendship, and so we assume that their behavior confirms what we’re feeling and that they’re upset with us.

With fortune telling we predict the future, and that things are going to go badly, without any real evidence to back up the prediction. Again these predictions say more about how we’re feeling ourselves than they do about the actual reality of the situation. Fortune telling is a hallmark of the worrying that comes with anxiety or the hopelessness of depression.

If we find ourselves jumping to conclusions the best thing we can do is to simply ask ourselves, what are the facts of this situation what actual evidence do we have to support this conclusion? Is there any way to interpret the evidence to support alternate conclusions? Or is there any evidence we’re overlooking that suggests a different conclusion? And the goal isn’t to try to predict the right conclusion, but to recognize that there are lots of possible outcomes and we just don’t have enough information yet to know which one is going to come true. And so any conclusion we draw is going to involve jumping to conclusions.

With magnification and minimization we give greater weight to our perceived weaknesses and failures and to the strengths and success of others; and we give less weight to our own perceived strengths and success. It’s like looking through binoculars from each end. We look at our weaknesses and failures through the magnifying side of the binoculars, making them seem bigger and more significant than they actually are.

And then we reverse the binoculars when looking at our own positive attributes and successes, making them seem smaller and less significant than they actually are. And if you find yourself engaging in magnification or minimization, try imagining a friend or loved one in your shoes and see how you’d regard their qualities or results, and then see if you can’t be as generous to yourself in your assessment as you would be to someone else that you care about.

Catastrophizing is related to jumping to conclusions and magnification, and it’s typically what we do when we worry. We’re predicting the future and jumping to the worst possible conclusion no matter how unlikely it is. And we’re magnifying the consequences of this outcome and imagining it’ll be unbearable.

Catastrophizing often unfolds as a series of what-ifs: what if i made a mistake what if my boss finds out? What if i get fired what if i can’t find another job? What if i can’t pay my rent? And if you find yourself catastrophizing try asking yourself the following questions: you’ve already been asking yourself what’s the worst case scenario. So make sure to also ask yourself what’s the best case scenario? And then what’s the most likely scenario? And this helps you get a more balanced perspective and can help prevent you from automatically jumping to the worst possible conclusion.

And then ask yourself, if the worst case scenario did happen, how would i be able to cope with it? How have i coped with similar situations in the past? And this can help limit magnification of the consequences that so often goes along with catastrophization.

When we use emotional reasoning, we think the way we feel reflects reality. So we view ourselves and our situations based on how we feel, rather than on any external evidence. I feel this way therefore it must be true.

If we feel like an idiot that means we are idiots. If we feel anxious we know something bad is about to happen. If we feel depressed and hopeless we convince ourselves this means there is no hope. Or we feel angry so that means we must be being treated unfairly.

But the world doesn’t revolve around how we feel, and if we find ourselves engaging in emotional reasoning, we need to remind ourselves that just because we feel a certain way about something, doesn’t make it true and not to confuse feelings with facts.

The type of should statements we’re referring to here are the arbitrary rules we set for ourselves and others when we tell ourselves that things should be a certain way. I should make everyone happy. I shouldn’t make any mistakes. People should always be on time. When we use should statements we create unrealistic expectations for ourselves and others. When the should statements are directed towards ourselves we set ourselves up for guilt disappointment and frustration, and when we apply should statements to others we can feel let down disappointed or angry.

Often we try using should statements for motivation: i should go to the gym more often; i should stop eating junk food. But presenting these as shoulds can drain our motivation when we fail at something we think we should do, because we feel so bad about it. And should statements can make us rebel, because nobody likes to be told what they should and shouldn’t do, even if we’re the ones telling ourselves what we should do.

If you find yourself engaging in should statements, try rephrasing them with less judgmental terms like I’d like to, or I’ll do my best, or it would be nice if. That way we’re still acknowledging to ourselves what we’d like to do, or how we’d like other people to act, but we don’t have to feel guilty if we don’t, or as angry when people don’t behave the way we think they should.

Labeling is a form of all or nothing thinking and overgeneralization where we judge and label ourselves or someone else, usually in a very negative way, based on a single event or behavior, or attribute that doesn’t really define who we or they are. We knock our coffee off the table and it spills and we label ourselves an idiot. We try to make plans with friends and no one’s available and we label ourselves a loser. When someone has to reschedule a meeting and we label them a selfish jerk. Or they make a mistake at work and we label them useless.

When we use labels we don’t take context into account we don’t consider anything beyond what’s in front of us at this moment. We’re just reflexively assigning a negative label and using it to define the totality of ourselves or someone else. When we apply these labels to ourselves it hurts our confidence and self-esteem and can leave us feeling depressed. And when we apply them to other people it increases hostility and leaves little room for communication. The antidote to labeling is to recognize that one act isn’t defining: just because i made a mistake doesn’t make me an idiot; if someone disappoints us it doesn’t automatically make them a selfish jerk.

Personalization involves holding ourselves personally responsible for a situation that’s not entirely under our control. We take total responsibility for an external event that occurs and ignore any other important factors. As a consequence we end up completely blaming ourselves when something goes wrong, even when we may be only partially responsible, or not responsible at all for the results. Our kid gets sick and we blame ourselves for letting them sleep over at their friend’s house. We’re late for dinner because our partner isn’t ready on time, and we blame ourselves for not making sure they left work earlier.

Or instead of personalization, we can blame other people for things that aren’t totally their fault while overlooking our own contributions to the situation. If you’d reminded me about dinner tonight i would have been ready on time. If you weren’t always working all the time i never would have cheated on you. If you find yourself engaging in personalization and blame, take a moment to ask yourself if there are any other factors you’re overlooking that contributed to the outcome. And recognize that just because you have some responsibility for how something turned out, you’re almost never going to be in a position where you’re 100 to blame.

And if you have trouble accepting that it’s not entirely your fault, you can try using a responsibility pie, where you write down all of the factors that may have contributed to a situation, and then make a pie chart assigning a share of responsibility to each of these factors to help illustrate how you’re not fully responsible for the way things turned out.

And for some more tips on how to combat cognitive distortions check out my video on cognitive restructuring and reframing your thoughts and please like and subscribe and check out my other videos for more tips on how to manage negative thinking.

To see which cognitive distortions tend to arise in your patterns of thinking, you can complete this PDF worksheet from the Centre for Clinical Interventions (they refer to cognitive distortions as “Unhelpful Thinking Styles”). If you have any questions or comments, please leave them on the YouTube video page.

CBT and Mindfulness for Worrying and Anxious Thoughts

In the next series of posts we’ll look at how CBT and mindfulness can help us reduce and manage anxious thoughts and worries. We’ll learn to:

  • Tell the difference between productive and unproductive worry
  • Transition from productive worrying to problem solving
  • Respond effectively to unproductive worry with CBT and mindfulness strategies

In CBT, we focus on how to modify worrying and anxious thoughts so that they cause less anxiety. With mindfulness, we simply observe our thoughts, aiming to not allow ourselves to get caught up in them. And then we just let them go. And when we’re able to go of our anxious thoughts and worries, we reduce our anxiety. But before we get to these strategies, in this post and the next, we’ll learn a little about the nature of our thoughts.

You might be wondering, aren’t our thoughts important? Don’t we need to listen to them? How can we simply change them or let them go just because they’re making us anxious? Well, we do need to be aware of what we’re thinking, and what our thoughts are telling us. However, we also need to recognize that, most of the time, our thoughts are not facts. They are just subjective interpretations of events and situations. This is especially true of worries.

So since our thoughts are not facts, there’s no reason not to dispute or modify them when they’re causing anxiety. This doesn’t mean we’re trying to alter the facts or deny reality. We’re simply reframing our interpretations of our experiencing in ways that reduce our anxiety. Or we don’t even need to try to change our anxious thoughts and worries. We can simply acknowledge our thoughts and then just let them go, which is what we do when we relate to our thoughts mindfully.

Thoughts Are Not Facts

If you have any questions or comments, please leave them on the YouTube video page.

Introduction to CBT for Anxiety

Anxious Woman

Cognitive behavioral therapy, or CBT, is one of the most effective ways to manage anxiety. CBT for anxiety focuses on modifying thoughts and behaviors that are contributing to anxiety is ways that decrease anxiety. A basic premise of CBT is that if we change the way we think, we change the way we feel. And the same is true of behavior. If we change the way we act, we also change the way we feel.

In CBT we’re concerned with how our:

  • thoughts
  • feelings and emotions
  • actions and behaviors
  • and physiological symptoms and physical sensations in our bodies

interact with and influence one another.

Anxiety has a big effect on both our thoughts and our bodies. When we’re anxious, we tend to worry a lot, our minds start to race, and we get stuck in our heads. It can be difficult to focus on anything outside our own thoughts. And it can feel almost impossible to slow our minds down enough to concentrate, think clearly, relax or even fall asleep.

Anxious Man

Anxiety is also usually accompanied by uncomfortable physiological/physical symptoms and body sensations. We can feel lightheaded, tightness in our throats or chests, tension in our heads, necks and jaws, butterflies in our stomachs, weak in the knees, and so on. And we can experience symptoms such as heart palpitations, GI distress, headaches and countless others.

In this self-help series on anxiety we’ll learn strategies to manage these type of symptoms, as well as to reduce anxiety by modifying our thoughts and behavior. In the video below we’ll look at the connection between how we think and how we feel. And then explore the interrelationships between our thoughts, behavior, feelings and emotions, and physiological/physical symptoms and body sensations.

The ABCs of CBT

The next time you experience some anxiety, try recording your thoughts, feelings, behavior, and physical symptoms and sensations on this pdf worksheet. This exercise can really help us start to understand how our own thoughts, behavior, feelings, and body interact and influence each another when we’re feeling anxious.

In the next couple of posts we’ll explore the relationship between anxiety and behavior. Then we’ll focus on our thoughts, and finish up by looking at how to respond to emotions and physical symptoms associated with anxiety. If you have any questions or comments, please leave them on the YouTube video page.

Reduce Anxiety and Worrying with a Worry Record Worksheet

When we’re anxious and worrying, we tend to:

  • worry bad things will happen
  • worry over “what if” hypothetical negative outcomes
  • overestimate the likelihood something bad will happen
  • overestimate how bad things will be, and focus on the worst case scenario
  • underestimate our ability to cope if something bad does happen

The worry record is a CBT worksheet that helps us reduce anxiety and worrying with cognitive restructuring. We modify or replace our anxious thoughts and worrying with less negatively biased and more realistic thinking. It allows us to see things from a less catastrophic perspective. And this lets us come up with more likely scenarios than the worst-case scenario. And as a result our levels of anxiety decrease and we worry less.

Reduce Anxiety and Worrying with a Worry Record

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

In this video we’re going to learn how to reduce anxiety and worry with a worksheet from cognitive behavioral therapy called a worry record. I’ve made a few videos about worry recently where we’ve looked at the difference between productive and unproductive worry; and how we can turn productive worrying into problem solving; and how to just let our unproductive worries go or postpone our worry and use a worry period later in the day. And then when we do look at our worries, a worry record is a great tool to find different ways of looking at situations that are causing us anxiety and as a result experience less anxiety and have less reason to worry.

If you’ve seen my other videos you’ve probably heard me talk about the close relationship between our thoughts and our feelings. When we feel anxious we tend to have anxious thoughts and worry a lot. And these thoughts and worries feed back into our anxiety, making us even more anxious; which leads to even more worrying, and so on. But if we’re able to change the thoughts that we’re having about the situation that’s making us anxious, we can decrease the amount of anxiety we’re feeling.

And then as we decrease our levels of anxiety our thoughts will naturally become less anxious, and we’ll start to worry les; which leads to a further reduction in anxiety; which leaves our thoughts less anxious; and reduces how much we worry.

Now when we’re anxious and worrying our thoughts tend to follow a certain pattern. First, we worry that something bad or unpleasant is going to happen. And this can take the form of predicting a negative outcome like, i’m not going to be able to get everything done on time; i’m going to let everyone down.

Or i think they’re mad at me, they probably don’t like me anymore. Or instead of an actual prediction our worries can take the form of a what if statement. What if i can’t get everything done on time? What if i let everyone down? What if they’re mad at me? What if they don’t like me anymore?

And second, we overestimate the likelihood that this bad outcome will occur. I’m sure i’ll never be able to get this done on time. I know i’m going to let everyone down. They must be mad at me.

And then we overestimate just how bad things will be: i’m going to get fired; they’re going to break up with me. And we underestimate our ability to cope with that negative outcome if it does arise: i don’t know what i’m going to do; i’m not going to be able to deal with it.

So the worry record is a type of thought record that focuses specifically on anxious thoughts and worry, and helps us challenge these worries and: either modify them so that they’re more accurate and less negatively and catastrophically biased; or we replace these worried thoughts with new thoughts that more accurately reflect the reality of our situations. And in both cases these modified or new thoughts lead to a reduction in our anxiety because of this close connection between our thoughts and how we feel.

So now let’s look at how the worry record helps us do this. So in part one of the worry record we start off by describing the situation we’re anxious or worried about. So for example an important project we have at work. And then we write down our feelings and emotions, describing them with single words like anxious, worried, nervous.

And we also write down any physiological symptoms or physical sensations we’re experiencing, because these can be such a big part of anxiety. So maybe there’s some tightness in our throats and our stomachs feel really tense. And then we rate the intensity of these emotions and sensations on a scale from zero to a hundred.

And then we write down what we’re worried about, what we’re thinking or saying to ourselves, or just whatever’s going through our minds. It’s too much work, i’m never going to get it all done. Or i’m going to have to rush everything and do a really bad job.

And then we write down what we predict is going to happen. I’m not going to get it all done. Or if i do it’s not going to be very good and i’m going to let everyone down and i’m going to get in trouble with my boss. And then we rate how likely we think it is this prediction will come true on a scale from zero to a hundred percent.

And so these last couple of sections relate to our tendency to overestimate the likelihood that something bad will happen, and also overestimate how bad it will be. And so as the worksheet continues we’ll generate more accurate estimations in both of these areas. And then in part two we challenge and modify our worries and predictions.

So we start by writing down all of the evidence that supports our prediction and all of the evidence that doesn’t support our prediction. So maybe the evidence for is something like: i do have so much work to do; i don’t have very much time; i know that when i’m anxious i’m not able to work as effectively as i usually do so i can’t even get as much work done as normal; when i’m rushed i never do my best quality work; and i know how important this project is for my boss and my colleagues.

And then the evidence that doesn’t support our prediction could be things: like i’ve never missed a deadline before; no one’s ever complained about the quality of my work; i often feel stressed at first but i always manage to make it work in the end; even if i didn’t do as good a job as i could it’s still probably going to be good enough; and even if i do let people down i’ve worked here long enough with good enough results that i’m not going to get fired over this one thing.

And if we get stuck trying to come up with evidence that doesn’t support our predictions we’re stuck on any of the questions coming up at the bottom of the worksheet there are series of prompt questions we can use to help us with our responses.

And now we ask ourselves what’s the worst that could happen. Well the worst case scenario is probably, i could lose my job over this. And then we ask ourselves if the worst case did happen, what could we do to help ourselves cope. And this helps address our tendency to underestimate our ability to cope if something bad were to happen. Well i guess i could live off my savings for a while while i look for another job, and if i run out of money i could even live with my parents for a while until i’m working again. And obviously these aren’t great options—nobody wants to be unemployed or have to move back in with their parents—but remember we’re looking at the worst case scenario here, which probably isn’t going to happen. But even if it does, at least there are some things we can do, even if none of them are ideal. And just knowing this can help reduce our anxiety a little bit.

And then we ask ourselves what’s the best that could happen. And this question is important because when we’re feeling anxious and worrying we have such a tendency to fixate on only the worst case scenario, which is going to leave us feeling as anxious as possible. So we need to remind ourselves that the worst case scenario isn’t the only scenario. And in the best case scenario probably nothing that bad happens. And then we’re going to look at the most likely scenario.

So maybe the best case scenario is, i get everything done on time and it turns out pretty well. And maybe the most likely scenario is, i’m really stressed for a few days and struggle to finish on time, but in the end i do get everything done, and even though it’s not my best work it’s perfectly fine.

And then we ask ourselves what are the consequences of continuing to worry about this. Well worrying makes me feel like i’m doing something, but really i’d be much better off spending my time actually working on the project rather than worrying about it. And the more i worry, the more difficult it is for me to focus when i’m trying to work, the more stressed i get, and the harder it is for me to get to sleep at night. And when i’m stressed and tired i can’t get as much work done and the quality of my work suffers.

So now based on our answers from the last section we come up with modified and alternative ways of viewing the situation and predicting what’s going to happen that don’t cause us so much anxiety and give us less reason to worry. If i’m able to focus on work and not worry so much i probably will be able to get it all done. And i might have to work late or even on the weekend or ask for some help, but one way or another i’m gonna get it finished.

And then we write down our new prediction about what we think will happen, which could be the most likely scenario we identified above, or it could be something slightly different like, i’m going to be really stressed and struggle to finish on time, but in the end it’ll get done even if it’s not my best work. And we rate the likelihood that our new prediction will come true on a scale from zero to a hundred percent.

And then we ask ourselves how much do i believe my original prediction now, and we re-rate how likely we think it is that prediction will come true. And then we go back and re-rate the intensity of the emotions and physiological symptoms and physical sensations that we identified in the first part, and write down any new emotions or physical sensations we’re feeling now.

And now with these new ways of thinking about the situation a new prediction about what will happen that’s not so catastrophic, our levels of anxiety will decrease and we’ll have less reason to worry. And you can download a worry record worksheet from my site selfhelptons.com where you’ll also find my complete self-help course for anxiety.

Now let’s go through another example. So let’s say the situation is, we got in an argument with our partners this morning and they haven’t been responding to our texts or calls all day. And we’re feeling anxious and sad and impatient, and we notice some tightness in our chests.

So what am i worrying about thinking or saying to myself? What if they keep ignoring me? What if they’re really mad at me? What if we get into a big fight over this? What if they want to break up with me? And then we write down what we predict is going to happen. We’re going to have a big fight about this tonight and maybe we’re even gonna break up. And then we rate how much we believe this prediction.

And now in part two we look for the evidence that supports and that doesn’t support our prediction. They were upset this morning they haven’t answered my texts all day. They’ve seemed kind of distant lately and we’ve been arguing a lot. This is exactly how my last relationship ended.

And now we look at the evidence against our prediction. I can’t read their mind and so i don’t know what they’re thinking. Maybe they’re just too busy to respond right now. And i know they don’t like arguing over text so maybe they’re just waiting until we can talk about this in person. This relationship is so much different than my last one, there’s no point trying to compare the two. We’ve had plenty of arguments before and we’ve always worked things out.

And what’s the worst that could happen? Well the worst that could happen is that we break up. And if the worst did happen how would i be able to cope with it? I’ve had relationships end in the past and i’ve always gotten over it. I’ve got some close friends that would be there for me and i’d be miserable for a while but eventually i’d be okay. And again this isn’t great but remember we’re looking at the absolute worst case scenario, which is probably not going to happen. But even if it does at least we know that we’ve been in similar situations before and found a way to manage.

And now what’s the best thing that could happen? They’re just busy right now and they’ll text or call us back as soon as they have time. And what’s the most likely thing that could happen? Well we’ll talk about things tonight and probably even argue over them, and in the end we’ll resolve things and make up like we always do. And what are the consequences of continuing to worry about this? Well it’s just going to make me feel bad all day. I’m going to have trouble focusing on anything else. And i’m going to be in a bad mood when we do talk about things.

So what’s a more balanced or alternative way of thinking about this situation? I don’t know why they’re not responding to me. Maybe they’re just busy or maybe they’re just waiting until they get home so we can talk in person. And even if we do end up in a big argument, we’ll probably work things out and make up just like we always do.

And then we ask ourselves, what am i now predicting will happen? We’ll talk things over tonight and maybe we’ll even fight a bit, but in the end we’ll figure things out and it’ll be okay. And we rate how much we believe this new prediction. And we go back and re-rate how likely we think it is our original prediction comes true. And then we re-rate the intensity of the emotions and physical symptoms we identified in part one, and write down any new emotions or physical sensations we’re experiencing now.

So whenever we’re not able to problem solve what we’re worried about, or just let our unproductive worries go, the worry record is a great tool to help change our anxious thoughts, which then reduces our anxiety, and gives us less to worry about.

You can download the Worry Record worksheet in PDF or Word format. If you have any questions or comments, please leave them on the YouTube video page.

Anxiety and Automatic Negative Thoughts

Thoughts are constantly popping into our minds automatically. These thoughts are involuntary, and often we’re not even aware that we’re having them. And when we’re feeling anxious, these thoughts tend to be very negative. In CBT we refer to these as automatic negative thoughts (or ANTs).

Automatic negative thoughts are often responsible for initiating anxiety. And then they lead to more anxiety as we get caught up in vicious cycles and downward spirals that are extremely difficult to break. When we’re anxious, it can seem like there’s no end to our automatic negative thoughts. They keep coming all day long.

Automatic negative thoughts related to anxiety tend to involve:

  • Worrying about threats and danger
  • Catastrophizing and worst case scenarios
  • Assuming we’ll be unable to cope with things
  • What ifs?

Automatic Negative Thoughts and Anxiety

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

A lot of our thoughts are automatic. A thought just pops into our head without us even thinking about it. Some of our automatic thoughts can be pleasant or neutral, but more often than not they tend to be negative.

Automatic negative thoughts have a strong effect on our mood and how we’re feeling, and learning how to respond to our automatic negative thoughts in ways that help us feel better is an important part of mindfulness based cognitive therapy. So now we’re gonna look at some common automatic negative thoughts that people have that tend to be associated with depression, anxiety and anger.

When we’re feeling depressed we tend to have very negative thoughts. And these thoughts center around three themes: negative thoughts about ourselves, negative thoughts about the world, and negative thoughts about the future. Examples of automatic negative thoughts about ourselves are things such as: I’m such a loser. I’m no good. I keep disappointing everyone. What’s wrong with me? I can’t do anything right. I’m a failure. I feel so helpless. Nobody even cares about me.

And automatic negative thoughts about the world, which is just a general sort of negativity about everything: life is so unfair. Things should be easier. The whole world’s falling apart. Everything’s so stupid. Life stinks.

And automatic negative thoughts about the future: things are never gonna work out for me. There’s nothing i can do about it. I’m always going to feel this way. I’m never going to be happy. There’s no point in trying anymore. It’ll never get any better.

And when we’re feeling anxious we tend to have thoughts that overestimate the likelihood that something bad will happen. And we overestimate the severity of what will happen. And we underestimate our ability to cope with things.

And so we have automatic negative thoughts about threats and danger: oh no! What’s happening? This is terrible.

And automatic negative thoughts about our ability to cope with things: i can’t handle this. I’m never gonna be able to do this. People are gonna wonder what’s wrong with me. This is just too much. What am i gonna do? I should just quit now.

And all sorts of what-ifs which are probably the most common types of thoughts people have when they’re feeling anxious or worried what if this happens what if that happens what if what if what if

And when we’re feeling anxious, our thoughts are too a future-oriented, and we end up spending a lot of time and energy worrying about how things might be in the future. And even though these things haven’t occurred yet and may never occur, we tend to respond as if they’ve already happened, or that they’re inevitable. And so we wind up suffering the consequences right now. And even if the things we’re dreading never actually occur, we’ve already made ourselves pay the price and suffer over them whether they actually happen or not.

Our automatic negative thoughts that are associated with anger are things around the need for fairness and respect; becoming aggravated, frustrated or losing patience; violations of rules; and revenge.

This is so unfair. Why does this keep happening to me? I can’t stand this anymore. What’s wrong with him? You can’t treat people that way. He’ll pay for that!

And in the next couple of videos we’ll learn how we can improve our mood and help ourselves feel better by managing our automatic negative thoughts through cognitive diffusion and letting go of thoughts and with cognitive restructuring.

In the next post, we’re going to look at the nature of worrying. And then we’ll learn some CBT and mindfulness strategies to help reduce worry and anxiety. If you have any questions or comments, please leave them on the YouTube video page.

Systematic Desensitization for Anxiety

The last post was a general overview of exposure therapy for anxiety. In this post we’ll look at a very structured approach to exposure therapy known as systematic desensitization, or graduated or graded exposure exposure.

In systematic desensitization, we very gradually expose ourselves to things that cause us anxiety through a series of small, manageable steps. Systematic desensitization is the most common and effective treatment for phobias, including social phobia, but we can use systematic desensitization for any type of anxiety.

Systematic Desensitization and Graded Exposure

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

In the last video we learned how exposure decreases anxiety. But rather than plunging ourselves right into the middle of what’s making us anxious, we want to expose ourselves gradually through a process called graded exposure or systematic desensitization. Now we’re going to look at systematic desensitization in more detail.

The key to graded exposure or systematic desensitization is to break your exposure down into a series of small steps that will gradually lead you to your goal. So you start with a list of about 8 to 12 steps, and then you rate each of these steps on a scale from 1 to 10 in terms of how much anxiety they cause you. And so they form a sort of ladder with the least anxiety provoking on the bottom and the one that causes you the most anxiety at the top.

And then you work your way up through these steps, starting by exposing yourself to the ones that cause you the least amount of anxiety, and then going step by step until you make your way up to the top of the ladder. And so if you have a fear of spiders your ladder might look something like this. And notice at the bottom of the ladder we’ve started with just imagining a spider because perhaps anything involving an actual real life spider would be too anxiety provoking for you to be able to even start. And so you need to make sure that the first rungs on your ladder are manageable.

Or if you have social anxiety your ladder might look something like this.

And then once you’ve come up with your exposure ladder you start by exposing yourself to whatever’s on the bottom step of the ladder. And when you’re exposing yourself you want to feel a little bit of anxiety, up to about a three, but anything higher than that can be too much to start with now when you first expose yourself to something.

Your anxiety might spike a bit, so you want to be prepared for this initial surge of anxiety, and then if you do experience an increase in anxiety try some anxiety reduction techniques and then see if your anxiety starts to come back down to a 3 out of 10 or less.

But if your anxiety stays at a level of four or above then you don’t want to continue with the exposure because it’s causing you too much anxiety right now and it’s going to be a negative experience is going to increase the amount of anxiety that you associate with this step, rather than be a habituating experience that makes you more comfortable with this step.

So if your anxiety stays elevated then it’s time to do the three r’s: retreat, recover and repeat.

So first you retreat. And what this means is simply that you stop doing the exposure for now.

And then you recover and give yourself a chance to calm down until you’re not feeling anxious anymore.

And then you repeat and you start the exposure again.

And you continue with these steps of retreat, recovery and repeat as often as you need until your anxiety no longer rises above a three. And continue with your exposure to this step until you become habituated to it and your level of anxiety drops to below a three and then you’re ready to move on to the next step, which may have been a four out of ten before. But now as you’ve started to climb that ladder it’s now only a three out of ten which is low enough for you to expose yourself to that.

And you keep working your way up the ladder until you’ve habituated to each of these steps.

And eventually you become comfortable even with that step at the top of the ladder which may have caused you a 10 out of 10 on the anxiety scale before and now it’s down to a much more manageable level of about a three.

And so by gradually exposing ourselves to what’s making us anxious we can conquer even our biggest fears without ever getting too far out of our comfort zone.

If you have any questions or comments about this post, please leave them on the YouTube video page.

Anxiety and Exposure Therapy in CBT

When we’re anxious about something, it’s natural to want to avoid it. But avoidance is only a short term solution. Eventually we to need to face whatever’s making us anxious. And the longer we’ve been putting it off, the more anxiety we’ll feel when we have to do it. Or sometimes we may be able to avoid something that’s causing anxiety altogether this time. But then the next time we’re in a similar situation, it’s going to cause us even more anxiety.

In CBT, exposure therapy is an important B-for-behavioral technique to combat avoidance behaviors. Exposure therapy simply involves exposing ourselves to whatever is making us anxious, rather than avoiding it. And as we start to expose ourselves to the source of our anxiety—in other words, when we do things that cause us anxiety—we begin to feel more comfortable doing them, so they provoke less anxiety.

CBT, Anxiety and Exposure Therapy

If you have any questions or comments, please leave them on the YouTube video page.