THE #1 TOOL FOR USING COGNITIVE-BEHAVIOURAL THERAPY
In the last thirteen years of actively practicing cognitive-behavioural therapy, I have seen one tool that stands out apart from all others. Disclaimer - I am not a ‘one-size-fits-all’ kind of therapist. What works for one individual may not work at all for another. People come to me with different goals, struggles, personality types, working styles. All of these factors must be taken into account when choosing the right plan or program as a solution. My job as a therapist is to have a big bag of tools and techniques that I can offer, taking into consideration all the variables I just mentioned. That said, there is one tool I have found that has resulted in the greatest success. I’m going to share it with you now, step by step, so that you can begin to use it on your own.
The tool is called the 5-COLUMN THOUGHT RECORD. The theory behind this tool is that our negative thoughts get us into trouble. When we have negative thoughts, they also coincide with negative feelings and, as a result, negative behaviours. In order to change our negative behaviours and feelings, we need to change our thinking. The problem is that our thoughts happen so quickly that we find ourselves down the dark rabbit hole before we can say, “boo”. Therefore, we need to slow down our thoughts in order to Catch them, Check them, and Change them (The Three C’s). So how do we slow it down? By writing the thoughts down as soon as they pop up. I’m going to outline the steps here for you. But to start, go get yourself a small journal that you can keep with you in your purse, pocket, nightstand, or desk. Ready? Okay, here we go:
Step 1: THE SITUATION
The situation answers the following questions: Where are you, Whom are you with, What time of the day, What’s happening in a sentence or two. In your journal, write down the answers to the questions listed above. We want to start building your awareness of the situations that might trigger your negative thoughts, feelings and behaviour so that you can both prevent them and manage them more effectively. For example, “It’s Wednesday at 7:00pm and I am alone on my way home from work. I am tired and walking towards the subway when I pass by a candy store.”
Step 2: THOUGHTS
In this next step, you’re going to write down one or two thoughts you’re having in the situation. For example, “I need to have some chocolate,” or “Chocolate will make me feel so much better.” Write down whatever thoughts you’re experiencing in the moment. There are some common ‘Thinking errors’ or ‘Thoughts distortions’ that we engage in, such as ‘Drawing conclusions without evidence, Making predictions, or Catastrophizing’. I will provide these for you in the next blog, along with the strategies for overcoming them. For the sake of not overwhelming you with too much information at once, let’s start with the basics and then add on from there.
"There are some common 'Thinking errors' or 'Thought distortions that we engage in, such as 'Drawing conclusions without evidence, Making predictions, or Catastrophizing."
Step 3: FEELINGS/EMOTIONS
This is where you document your feelings, such as angry, sad, frustrated, etc. For each emotion, give it a rating from 1-10, where 1 represents feeling that emotion very little, and 10 indicates that you are overwhelmed by that emotion. The goal here is two-fold. First, when we can identify and label our emotions, they immediately begin to lose power. Second, the more aware we are of our feelings, the more we can sense when they are coming down, closer to a neutral state.
Step 4: FINDING THE EVIDENCE
In this next step, you are looking for evidence that both supports and contradicts your thoughts in step 2. You will begin to look for evidence from your past that will help to build your argument for why your thoughts are not true. For example, for the thought, “I need to have some chocolate,” I would look to the past for situations in which there was chocolate present and where it was vital that I had it, and other evidence in which I did not need to have it. Here’s what I might write down. “Two weeks ago, we had a Halloween party at work and there were lots of chocolates around. I didn’t have any. It was hard but I did it.” Another example might be, “Last week I went out for dinner with my girlfriends and was offered chocolate cake for dessert. I declined and still had a great time that night.” And finally, “I took my kids out for ice cream on the weekend, and while I might be inclined to order my favourite chocolate peanut butter ice cream, I did not have any and felt so proud of myself afterwards.” It’s hard to argue with evidence. The goal here is to try to build and strengthen your rational voice, which may be on the quiet side in comparison to your negative voice.
Step 5: WRITING NEW THOUGHTS
You are on your last step. You’ve done the hardest work and may have experienced feeling a little silly when ‘Finding the evidence’. That is a normal part of the process. So get comfortable with finding the humour in that negative voice . Now, it’s time to take the information you’ve gathered in the last step and rewrite your original thought or thinking statement. For example, instead of “I need to have some chocolate,” the new statement could be, “Based on the evidence, I’ve said ‘no’ to chocolate on three separate occasions just in the past two weeks, which means that I don’t need it. I’d like to have it, but I don’t need it.” Can you see the difference in the statements? The first almost seems dire. The second is much more neutral and empowering, which increasingly leads to your goals. For the second statement, “Chocolate will make me feel better,” which is what we call ‘Making a Prediction’, it might be true that having some chocolate will make you feel better in that moment. Most likely, however, you will feel worse afterwards and now have two problems to deal with instead of the original one that led you to the candy store in the first place. One last thing to think about here. Can you find an alternate route towards home that prevents you from walking past the candy store so that you can eliminate this challenge altogether?
You’ve got the basics now. It’s your turn to start writing, finding the evidence and rewriting. That negative voice of yours is strong. In order to fight against it, you need a new, stronger, rational, compassionate one that can go into battle for you. Next time we’ll take a deeper dive into the types of common thinking errors and the steps to overcoming them.
Lots of love,