The next logical step

[mousme]

This is the next step after learning what kind of "automatic thoughts" we tend to indulge in.

This is what David Burns calls the "triple-column technique." It involves a bit of writing, and a lot of practice, but you can basically do this exercise in about fifteen minutes each day.

Step one: Take a piece of paper and divide it into three columns.

Label the first "Automatic Thought." Label the second "Cognitive Distortion." Label the third "Rational Response."

What you're doing now is the first step in "talking back" to your "bad" thoughts.


Step two is to write down your automatic thoughts in the left-hand column. Say you're late for a meeting. You're gripped with panic and self-loathing. Stop for a minute and ask yourself: "What am I thinking? What thoughts are going through my head that are making me feel bad?"

You might think something like: "I'm always late. I never do anything right. Now they're all going to look down on me and think I'm unreliable. I'll make a fool of myself. I'm such an idiot!"

So write each sentence separately and leave lots of room in the other columns to make sure you'll have space to write.


Step three: look at the Cognitive Distortions list and try to identify what's wrong with your thoughts.

Going back to the example.

I'm always late. overgeneralisation

I never do anything right. ]overgeneralisation

Now they're all going to look down on me and think I'm unreliable. mind reading; overgeneralisation; all-or-nothing thinking; fortune teller error

I'll make a fool of myself. labelling; fortune teller error

I'm such an idiot! labelling

Step four: This is the more difficult part, but it gets easier with practice. Now what you want to do is find a rational response to those thoughts, what Burns describes as "substituting a more rational, less upsetting thought" for the one you have in the right-hand column.

Don't worry if at first you can't find a response to every single thought. Even getting one done is a big step. When you can't find a response, just leave that one alone and come back to it in a few days.

Let's go back to the example, shall we?

I'm always late. Response:] That's silly. I'm not always late. Look at all the times where I've been punctual. If lately I've been tardy more often than I'd like, then I can work on that and devise a method for being on time more often.

I never do anything right. Response: That's hardly true. I do a lot of things right.

Now they're all going to look down on me and think I'm unreliable.
Response: Someone might be disappointed that I'm late, but it's not the end of the world. The meeting might not even start on time.

I'll make a fool of myself. Response: Oh come, now. I'm not a "fool." I may, this once, appear foolish by coming late, but this doesn't make me a fool. Everyone comes in late once in a while, and not everyone's a fool.

I'm such an idiot. Response: That's just silly. I'm not an idiot at all, and certainly being late doesn't make me one.

Suggested by fearsclave: Making a chart (or just writing it down) rating the severity of your depression from 0 to 5 before and *after* you've gone through the process. Often enough, you'll be surprised to find that you've moved up from a 4 or 5 to a 3 or even a 2.

Here are some definitions to help you out:
5 (Delusional Psychotic Depression): Same as Major Depression, but with psychotic features (hallucinations, delusional behaviour).
4 (Major Depression): Depressed mood; loss of interest or pleasure in ordinary activities; loss of energy; disturbed patterns of eating and sleeping; hopelessness; difficulty concentrating or making decisions; suicidal feelings m[a]y be present. No interest in sex.
3 (Dysthymic): Mildly depressive mood; low self-confidence; low energy; loss of interest and pleasure; pessimistic
2 (Hypothymic): Reasonably well-adjusted and functioning adequately, but low-keyed, slightly withdrawn; a follower rather than a leader; smiles infrequently; works efficiently; conscientious; often has obsessive-compulsive or perfectionist personality traits;
1 (Bottom of normal): Mild symptoms of depression, able to function in social, professional and interpersonal areas without disruption;
0 (Normal): No symptoms of depression. Functions well in social, professional, and interpersonal areas. Appropriate reactions to daily disappointments and successes

A word of caution from Dr. Burns: Writing down yor negative thoughts and rational responses may strike you as simplistic, ineffective, or even gimmicky. You might share the feelings of some patients who initially refused to do this, saying, "What's the point? It won't work —it couldn't because I really am hopeless and worthless."

This attitude can only serve as a self-defeating prophecy. If you are unwilling to pick up the tool and use it, you won't be able to do the job.

It seems a little harsh, but essentially what he means is "don't knock it until you've tried it."

It may not be the solution to the world's problems, but it certainly doesn't hurt, and even helps a lot. :D

Comments

[altoidsaddict.livejournal.com]

We did this in my freshman English class. It was unbelievably constructive, and I'm the last person to engage in anything "self-help"-y.

[mousme.livejournal.com]

I'm with you on that. Never been into the self-help thing either, but this was required reading for therapy for me about a year ago.

To my surprise I found it incredibly helpful. Glad you agree. :)