Thought Records and ADHD

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

The thought record or thought diary is one of the most important tools we use in cbt. It helps us change our negative thinking by challenging and disputing our automatic negative thoughts.

Now the reason we want to do this stems from the basic premise of cbt that our thoughts are one of the main contributing factors to how we feel, so our moods and emotions are determined to a large extent by the thoughts we have in response to various experiences or situations we find ourselves in. If we’re feeling sad or anxious or angry about something, that’s usually the result of thoughts we had in response to some activating event or situation.

And the moods emotions and feelings we experience will be different depending on our thoughts. The tagline of cbt is change the way we think and we change the way we feel, and the thought record or diary is the most effective tool we have to help us do that. By using a thought record we can modify our thoughts to make them less negatively biased. And when we do this our moods emotions and feelings generally improve.

The thought record that’s on the screen now is from mind over mood, one of the most popular cbt workbooks, so you might be familiar with it. The one we’re going to use has the same sections, just organized in a format i find easier to write in. But the content in both is the same so it doesn’t matter which one you use, and i’ll post a link in the description where you can download a copy of both versions.

The first part of a thought record involves the abcs which i talk about in more detail in another video,and you can find all of my cbt videos organized together into a free course on my new website selfhelptoons.com so please check that out from the link in the description.

But to summarize, abc refers to the sequence that starts with an activating event or trigger; which is followed by beliefs, which are the automatic thoughts that are triggered by the activating event. And these thoughts lead to a consequence, which are the feelings and emotions we’re left with as a result of our thoughts.

So we start by writing down the activating event that triggered the abc sequence, which is the situation we found ourselves in when we noticed a negative change in our mood—i got an email from my boss asking me to go see him first thing in the morning. I was getting ready to go out to a party.

I saw a picture on instagram of some of my friends having a good time without me—and then we write down the beliefs or automatic thoughts that were triggered by this situation: what did i do? What if i’m in trouble? What if i lose my job? I just don’t feel like doing anything i really want to stay home. My life’s so boring i’m not going to have anything to say to anyone. I’m such a loser. I hate having to make small talk all night i never know what to say. What if i embarrass myself? Why wasn’t i invited, i thought we were friends? Don’t they like me anymore? Did i do something to upset them?

Sometimes it’s easy to identify our thoughts, but other times they may not be so clear, so if you’re having trouble identifying your automatic negative thoughts, here are some prompts that can help:

What was going through my mind just before i started to feel this way?

What images or memories does this bring up?

What’s so bad about this?

Why am i feeling this way?

What am i afraid will happen?

What does this mean about me or my life or my future?

What does this mean about the world or about other people or about what others think of me?

Now in the next section, we write down the consequences, which are the moods emotions and feelings we experienced. But sometimes it’s easier to start with our moods and then identify the thoughts associated with those moods after. And the mind over mood worksheet reverses the order and does start with moods followed by automatic thoughts, so if you find that way easier to work with, it doesn’t matter what order you do them in as long as you end up completing both sections.

And now we record our moods and how we feel as a result of a plus b. Our feelings can generally be described with single words, i feel sad, anxious, hurt, angry; not, i feel like they should have invited me, because that’s just a way of expressing a thought by prefacing it with the words “i feel like” and it’s not really a feeling but a thought, so anxious, worried, nervous. Or sad, depressed, anxious, scared. Or hurt, angry, betrayed, worried, lonely, sad.

And often our moods and emotions are accompanied by body sensations, so we can add these as well if we’re experiencing them: a lump in my throat; tightness in my chest; butterflies in my stomach; lightheadedness; starting to feel hot.

And then we rate the intensity of each feeling on a scale from zero to a hundred,the higher the number the more intense the emotion or physical sensation.

So now we look back at the list of beliefs or thoughts that we wrote down in order to come up with our hot thought, the hot thought is the automatic thought that’s most closely connected to our moods or feelings or physical sensations.

So if we look over our list of moods emotions and feelings the strongest feeling or primary emotion is sadness. So now we go through the automatic thoughts we identified to try to figure out which one of these thoughts is most responsible for our feeling of sadness. Sometimes it might be obvious what the primary thought responsible for an emotion is, but other times it’s not that clear, so we may need to go through all of the automatic thoughts we recorded and ask ourselves for each one, how much does this thought alone make me feel the primary emotion that i had in this situation?

So the thoughts, i just don’t feel like doing anything, and i really want to stay home, well they only make me feel a little bit sad, so they’re not the hot thought.

My life’s so boring i’m not gonna have anything to say, well that makes me pretty sad, but it also makes me anxious. I’m such a loser, well that thought makes me really sad, so this may be the hot thought. I hate having to make small talk all night, i never know what to say; and what if i embarrass myself, they make me a little sad, but mainly they make me anxious, so they’re not the hot thought.

So it looks like in this situation the hot thought most responsible for my feeling of sadness is, i’m such a loser, but we’ll also use the thought, my life’s so boring i’m not gonna have anything to say, as an example later on.

So now we circle or underline this hot thought that’s most associated with the primary mood emotion or feeling that we had. And then we rate on a scale from zero to a hundred how strongly we believe this hot thought. So that’s the abc part now we move on to the second section which is part d for dispute.

Since the hot thought is the main contributing factor to our moods emotions and how we feel, if we can modify this thought to make it less negative, then we should notice a corresponding change in our moods, emotions and feelings, which will also become less negative. So to do this we dispute the hot thought we just identified.

And i talk about the reasons we can dispute our thoughts in another video, but basically our thoughts are not facts. They are subjective interpretations of the world and other people and the situations we find ourselves in. So we’re not trying to change the facts, we’re just trying to see things in a different ligh,t one that doesn’t have such a negative impact on how we feel.

So when we dispute our hot thoughts we’re not denying reality we’re, just looking at the evidence to evaluate how accurate our hot thoughts are. And then if they’re not completely accurate, we modify them to make them better reflect reality. And when we do this we generally notice an improvement in our moods.

So the way we do this in the thought diary involves the two column technique. So in one column we write down all of the evidence we can come up with that supports our hot thought. And in the other column we write down all of the evidence we can come up with that doesn’t support our hot thought. So one side is the evidence that our hot thought is true, and the other side is the evidence that our hot thought may not be true.

So if our hot thought is, i’m a loser, maybe on the evidence that supports our hot thought side we come up with things like, i always feel awkward around other people, i never have anything interesting to say to anyone, i’m too shy, i’m not good at meeting people, i don’t have that many friends.

And then on the evidence that doesn’t support our hot thought side we come up with things like, i’m mainly just shy in groups or with strangers, i’ve had a group of close friends for years, if i were such a loser i wouldn’t have even been invited to the party, i’m good at lots of things that don’t involve social situations, i’m a loser is an example of the cognitive distortion labeling (if you’re not sure what cognitive distortions are i have a video all about cognitive distortions).

And if the hot thought is my life’s so boring i never have anything to say to anyone, maybe we come up with things like, i’m really quiet in groups and around people i don’t know, i always feel awkward at parties, i never know what to say, i get nervous and say embarrassing things, i spend most of the time looking at my phone hoping nobody talks to me.

Once i get to know someone i usually do enjoy talking to them; a thought that uses the word never is an over-generalization, which is a type of cognitive distortion, and so it’s not an accurate representation of reality; if it’s a topic i’m interested in i often do have a lot to contribute; if someone’s really friendly and outgoing i do find it easy to talk to them, i’m just not that good at initiating conversations.

And it’s usually more difficult to come up with evidence that doesn’t support our hot thoughts, and my video on cognitive restructuring has a number of questions you can use as prompts to help you come up with evidence that doesn’t support your hot thought.

And then we consider all of the evidence we’ve collected. And if we find the evidence does not support our hot thought, we write down alternative thoughts or explanations or ways of looking at things that better fit the evidence.

So for example if our hot thought was i’m a loser, we’ll probably find that the evidence doesn’t actually support that, and instead we might come up with alternative thoughts like, i find socializing hard, i’m not that comfortable around other people, i wish i were more outgoing. And these thoughts, while not particularly positive, aren’t nearly as negative or devastating to our mood as a thought like i’m a loser.

If we find the evidence partially supports our hot thought, then we come up with a more balanced thought or way of looking at things that takes into account both the evidence for and against the hot thought.

So if our hot thought is, my life’s so boring i never have anything to say to anyone, we might come up with a more balanced thought like, i feel like i never have anything interesting to say, but once i start talking to people it usually goes okay; or i never talk a lot at parties, but people seem to like that i’m a good listener. And again these thoughts aren’t necessarily positive, but they’re not as negative as our hot thought, so they don’t have such a negative impact on our mood.

And then we rate how strongly we believe these new alternative or balanced thoughts. And then we re-rate how strongly we believe our hot thought now. And finally we record how we’re feeling now and re-rate the intensity of our original moods emotions and feelings, as well as write down any new emotions or feelings we’re having and rate their intensity.

So once you’ve gone through all of these steps you’ll probably find that your original negative moods emotions and feelings are at least a little less intense. And perhaps you’ve noticed some additional emotions or feelings that aren’t as negative now.

One thing to keep in mind is just because you’re still having some negative moods feelings or emotions doesn’t mean the thought diary didn’t help. The main thing is that you’re able to notice at least some reduction in intensity of your negative mood feelings or emotions. So if you originally rated your level of sadness as 90 out of 100m and now it’s down to 75m well 75 out of 100 means you’re still feeling really sad, but it’s an improvement over feeling sadness at a level of 90 out of 100. And even a small improvement in how we’re feeling often leads to more change in a positive direction.

And as we start to use thought records a couple of things happen. First the automatic negative thoughts that we tend to tell ourselves a lot begin to come up less frequently, and instead the alternative or more balanced thoughts arise in their place, without us having to go through the thought record process.

And then the more we use thought records, the more instinctively our minds start to recognize our automatic negative thoughts, and reframe them into alternative and more balanced thoughts automatically.