Cognitive Behaviour Therapy. Joseph Avy
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1. Inferences
Inferences are assumptions you make about the things that matter to you, which can be about yourself, others or about the world. For example, if your boss contradicted you during a meeting that was important to you, you might think, ‘he is undermining me’. Then you would be making an inference. This means that in that moment you have gone beyond the facts and made an assumption about what happened because it was significant to you. In this example you would have an emotional response: you might feel annoyed, concerned, anxious, angry or some other negative emotion.
The issue is whether your boss was undermining you or simply expressing a different opinion. In order to find out you would need to gather more information and evidence. Some of our inferences are accurate and some are not. In this ex- ample your inference has not been tested in reality.
If you had thought ‘he has a different opinion, he is not undermining me’ then your emotional response would be different.
Which of the following thoughts will lead to an emotion?
1. I saw a woman getting on a bus.
2. My workmates are ignoring me.
3. I'm a failure.
Thoughts 2 and 3 will lead to an emotional reaction. The second thought is an inference. It may or may not be true. Your colleagues have been ignoring you – they may just have been very busy with work. You need more information to assess the accuracy of conclusion. But if you conclude that you were being ignored then you would have an emotional reaction.
The third thought also leads to an emotional response but it is more profound in its conclusion. ‘I'm a failure’ is an evaluative thought.
2. Evaluations or beliefs
Inferences influence our emotions but do not fully provoke them. Evaluations, on the other hand, are thoughts that are fully involved in provoking emotions and feelings. When you have an evaluative thought you are making a judgement about yourself, about others, or about the world. For simplicity let's call evaluative thoughts ‘beliefs’. These are fundamental in provoking either constructive feelings and helpful behaviours or destructive feelings and sabotaging behaviours.
If you judge yourself as ‘useless’ when you are thinking about applying for a job, this may trigger additional thoughts such as ‘I won't get the job’. When you hold such a belief, you will probably feel anxious when you go for the interview. In a state of anxiety, you will probably not perform as well as you are capable of doing and the likelihood of you getting the job decreases dramatically.
Putting these principles and philosophies into a theoretical model helps you to see more easily how feelings, different thoughts, behaviours and events all interact with one another.
The easiest is the ‘ABC’ model of emotional response.
A = Activating Event (or trigger)
B = Belief
C = Consequences
The ‘A’ can be:
Real or imaginary
The trigger can be an actual event, such as losing someone or something important to you, or an imaginary one. It could also be an inference – a hunch – like imagining that someone is going to reject you before any rejection has taken place.
External or internal
External events are things that happen outside of your body, for example: someone's death, being rejected, failing at something or experiencing an accident.
Internal events are triggers that happen inside your body, for example: your thoughts, images, emotions, fantasies, memories and bodily sensations.
About the past, present or future
The event could be something that has happened in the past, something that is happening now or something that could happen in the future.
Key points to remember:
• ‘A’ can be an internal past event that was real. For example, losing someone you loved. All past events are internal because they exist in our memories.
• ‘A’ can be real, future and external. For example, making a speech at your friend's wedding next week.
• It is not the event itself that provokes your emotions but what you tell yourself or what you infer about it now that provokes your feeling.
• It's easy to assume that A causes C but that would not be accurate.
When the trigger happens at ‘A’, you feel, behave, think and experience symptoms. Because this happens quickly, you think ‘A’ causes ‘C’ (the consequences). So you may use expressions like ‘he made me feel angry’, or ‘my job makes me depressed’. It is as if we are not responsible for our own emotions.
Remember the 100 and 1000 people example earlier?
What is at the heart of your feelings is the ‘B’ (Belief) between ‘A’ and ‘C’. So it is your belief (evaluation) about the activating event that provokes your emotions, behaviours, thoughts and symptoms.
Beliefs
According to the ABC model we can have two types of beliefs: rational and irrational, or healthy and unhealthy.
1. Healthy beliefs:
• are flexible;
• are based on the things that you want, like, desire and prefer;
• tend to make sense – they are logical and consistent with reality;
• mean accepting that sometimes you may not get what you want;
• detach human worth from success or failure;
• lead to emotional well-being and set you up for goal achievement.
2. Unhealthy beliefs:
• are unrealistic;
• can be self-critical;
• are not based on acceptance or acknowledgement of reality;
• do not acknowledge or accept other possibilities (even though reality shows