Distressing thoughts and feelings

Are you prone to distressing thoughts and feelings?

If you’re prone to distressing thoughts and feelings you might want to try Cognitive Behavioural Therapy (CBT). CBT is a form of talking therapy which can be used to treat people with a wide range of mental health problems.

CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behaviour) all interact together. Specifically, our thoughts determine our feelings and our behaviour. It’s designed to help people to change disruptive thoughts, behaviours and feelings in order to successfully navigate the challenges that life presents.

“The best years of your life are the ones in which you decide your problems are your own. You do not blame them on your mother, the ecology, or the president. You realize that you control your own destiny.”

Albert Ellis, 1979

ABC model of CBT

Psychologist Dr Albert Ellis created the ABC model; a CBT technique used for analysing our thoughts, behaviour and emotions/feelings.

When we learn to use the ABC model, we can begin to intervene and take control of our thoughts, feelings, and behaviours. Its name refers to the components of the model. Here’s what each letter stands for:

• (A) Adversity or activating event
• (B) Your beliefs about the activating event. It involves both obvious and underlying thoughts about situations, yourself, and others
• (C) Consequences, which includes your behavioral or emotional response

The B is considered to be the most important component because CBT focuses on changing beliefs (B) in order to create more positive consequences (C). Often there isn’t much we can do about the activating event or adversity (A) as that’s normally out of our control.

The ABC 3 column form is a staple CBT worksheet, and you can use something like this — without the pretty baubles.

The ABC technique is designed to collect information about what lead to a specific problematic belief/thought. On a blank piece of paper, write along the top column (1) Activating event, column (2) Belief, and column (3) Consequences.

ABC Model in action

An example of how the model might be used to describe a particular situation is given below:

Activating event (A) Write down the event or situation that triggered your thoughts and feelings.	Beliefs/thoughts (B) Write down the thoughts that went through your head when the activating event occurred (or after it)	Consequences/action (C) Actions How did you act then? Emotions What did you feel then?
My boss asked if I’d completed a project yet.	My thoughts were: “He thinks I’m too slow” or “He’s always on my back.”	I retorted defensively that I’m nearly finished. I felt angry.

Additions to ABC model

While we have the ABC model, there are two other interesting areas to look at. The first is D for Dispute.

Dispute the Beliefs to find which are dysfunctional by asking yourself:

• what is the evidence that my belief is true?
• in what ways is my belief helpful or unhelpful?
• what helpful/self-enhancing belief can I use to replace each self-defeating or dysfunctional belief?

Looking at the above example, you can ask whether your beliefs are justified by the activating event. Or are they based on inaccurate assumptions or ‘mind-reading? In CBT world, mind reading or making assumptions about what other people are thinking are classed as thinking errors.

So, the above beliefs might be justified and accurate but also, they might not. It’s important to clarify whether the activating event and the evidence (if there is any i.e. he yelled at you in front of everyone) justifies your beliefs.

Balancing statements

On reflection, if you think the beliefs aren’t justified, then you might want to consider some Balancing Statements. You can then remind yourself of these if similar activating events occur again — to help keep what is happening in perspective. In the example above, possible Balancing Statements might be:

• “Maybe he does think I’m slow” but it’s possible he’s thinking “Perhaps I should have given her more time, it is a large project after all” or “I hope she doesn’t think I’m pushing her.”
• And you might think “I’m really just jumping to conclusions here because he always tells me I’ve done a great job.” or “He never complains about my work or me being too slow. I think I’ll just go confirm the deadline with him ‘cos he might need this quickly.”
• Rather than he’s always on your back, you might think “I’ve been here over a year, and he hasn’t bothered me before?” You might also try asking yourself what a trusted friend might say or think in the same situation.

This reflection will challenge your negative beliefs and hopefully, your angry feeling will dissipate.

Note that the important thing about Balancing Statements is that they seek to be balanced and accurate. If you believe there’s genuine evidence that your boss thinks you’re too slow, then it’s not the role of Balancing Statements to ignore that evidence. Rather it’s to reflect on it in a balanced way and then decide how that will influence your choice of actions.

The final part of the ABC model is the E for Exchange old unhelpful belief to Effective New Belief and Emotional Consequences. Ask yourself:

• What helpful/self-enhancing new belief can I use to replace each self-defeating or dysfunctional belief? i.e. “My boss was just asking out of interest, he doesn’t think that I’m slow at all.”
• Now, what are my new feelings? i.e Relaxed

Now work backwards

The above worksheet helps to determine how adaptive (or destructive) particular behaviours/emotions are. This can help us to catch our thoughts/beliefs. We use it to match these thoughts/beliefs events and consequences – usually working backwards!

Start by completing column C first i.e. “I felt angry.” Then identify the Activating event(s) and the exact Beliefs/thought(s) that accompany it.

These simple worksheets help us to build awareness of ‘how’ we think – they help us to see patterns and links over time. Most importantly, they help us see that our thoughts are often irrational, illogical and unhelpful so that we can
dispute them and replace them with positive self-talk.

So, if you find yourself having maladaptive or destructive and negative thoughts, you might want to try using this exercise. As I’ve often said, practice this exercise several times so that you can instantly recognise what is troubling you or causing you problems.

Over time, you’ll learn how to recognize other potential beliefs (B) about adverse events (A). This allows opportunity for healthier consequences (C) and helps you move forward.

Over to you

Have you had CBT and used the ABC model to help with your distressing or negative thoughts? Do you think it’s a model you could use for yourself or even with your children, as I did with mine when they felt out of sorts? Even just using the first model (above) is a great technique for showing older children how thoughts, feelings and behaviours all interact. I’d appreciate any comments or questions.