Probe further-“so the ring tone stops.“My mom didn’t pick up the phone and I thought ‘what if something happened to her?’ I felt sad.” This doesn’t quite match-wondering if something happened to your mother would typically provoke worry or anxiety.If the emotion doesn’t match the thought, then probe further-you may not be at the root of the situation. The patient should understand the difference between thought and emotion.“What would happen if you had the opposite thought? How would you feel?”.“What does that emotion make you want to do?”.Make clear the impact the thought has on emotion and behavior. Ask, “what else went through your mind?” Then ask, “which of these thoughts was most upsetting?”įrame the thought as an idea, not as a truth or fact.This may then provoke another automatic thought: “Why is my heart beating so fast? What’s wrong with me?” ![]() For example, the first thought may be “I’m going to fail the test.” This may provoke anxiety, leading to a physiological response and rapid heart rate.Automatic thoughts about their reactions (emotion, behavior, or physiology) can cause a vicious cycle.Probe if secondary automatic thoughts may have surfaced. Not “how will I get through it?” Rather “I can’t get through this.”.Not “I couldn’t get myself to start reading.” Rather “I can’t do this.”.Not “I must be sabotaging myself.” Rather “I was thinking, “I’m going to fail the test.”.The patient should be led to describe the specific thought as it occurred, NOT speculating on its intent. “Were you imagining something that might happen or remembering something that did?”.If the patient is unresponsive, ask what the patient thought would have been the worst that could have happened.Role play the situation with the patient.“Did you think you were going to ace the test?” Ask the opposite of what you think the thought was.Turn the reflection into present tense-past tense obscures the emotional response.Ask for a description of the physical sensation of the emotion.Ask the patient to imagine the situation, picture the time, and revisit exactly what the patient was doing. To elicit the automatic thought, try a range of techniques: The key question of identifying automatic thoughts is: “What is going through your mind right now?” Constructing behavioral experiments to highlight the discrepancy between the patient’s automatic thoughts and reality.Evaluating the automatic thought for validity and utility.Articulating the automatic thought explicitly.Automatic thoughts are expressed as more than one word.Ī key part of treating mood disorders is identifying the patient’s automatic thoughts and guiding the patient to evaluate them and overcome them.Emotions are one word: sad, anxious, angry, jealous, ashamed, hurt, suspicious, disappointed.These automatic thoughts then lead to emotions. “Why is my heart racing so fast? There’s something seriously wrong with me.” I can’t even get my eating under control.” A patient binge eats despite promising herself she wouldn’t.A patient feels anger, then reflects on that anger.A patient has a flashback of a traumatic event.Cognition: a thought, image, memory, or daydream.A patient thinks about an exam and how much is being tested, then continues thinking about how important her grades are and a cavalcade of other thoughts.Automatic thoughts may come in the form of verbal thoughts or images.Ī wide variety of situations can evoke negative automatic thoughts: Patients are often more aware of the emotion they feel than the thought itself. I’m finally going to be found out and fired.” Her negative automatic thought might be, “My boss probably thinks I’m doing a terrible job. For example, someone who has a core belief that she’s incompetent may be told that her manager wants to meet with her. Negative automatic thoughts arise unconsciously, often in response to a situation and sometimes unprompted. ![]() ![]() Read this article for more about negative automatic thoughts. ![]() Your immediate thoughts will often reveal underlying problems about your thinking which can be resolved through CBT exercises. Negative automatic thoughts are the unhelpful or even harmful thoughts you have automatically in response to an event, situation, or stressor. What are negative automatic thoughts? How can you correct them? Like this article? Sign up for a free trial here. Shortform has the world's best summaries and analyses of books you should be reading. This article is an excerpt from the Shortform book guide to "Cognitive Behavior Therapy: Basics and Beyond" by Judith S.
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