Cognitive Behavioural Therapy For Dummies. Rob Willson
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2 In the ‘Consequences’ box, point 2, write down how you acted or what you felt like doing.Write down how your behaviour changed when you felt your uncomfortable emotion. Examples of the behaviour that people often identify as their actions in this box include these:Avoiding somethingBecoming withdrawn, isolated or inactiveBeing aggressiveBinge-eating or restricting food intakeEscaping from a situationPutting off something (procrastination)Seeking reassuranceTaking alcohol or drugsUsing safety behaviours, such as holding on to something if you feel faint
3 In the ‘Activating Event’ box, write down what triggered your feelings.As we discuss in Chapter 1, the A in ABC stands for activating event or trigger, which is the thing or things that triggered your unhelpful thoughts and feelings. Activating events or triggers to put in this box can include the following:Something happening right nowSomething that occurred in the pastSomething that you’re anticipating happening in the futureSomething in the external world (an object, place or person)Something in your mind (an image or memory)A physical sensation (increased heart rate, headache, feeling tired)Your own emotions or behaviourAn activating event can be pretty much anything. Use your feelings – rather than whether you think the event is important – as a guide to when you should fill out a form. To keep your ABC form brief and accurate, focus on the specific aspect of the activating event that you’re upset about. Use the table of emotions in Chapter 6 to help you detect the themes to look out for if you’re unsure about what may have triggered your thoughts and feelings.
4 In the ‘Beliefs’ box, write down your thoughts, attitudes and beliefs.Describe what the event (whatever you’ve put in the ‘Activating Event’ box) meant to you when you felt the emotion (what you’ve written under point 1 in the ‘Consequences’ box).The thoughts, attitudes and beliefs you put in the ‘Beliefs’ box often pop up on reflex. They may be extreme, distorted and unhelpful – but they may seem like facts to you. Some examples of these NATs includeHere I go again, proving that I’m useless!I should’ve known better!Now everyone knows what an idiot I am!This proves that I can’t cope like normal people do!Thoughts are what count, so think of yourself as a detective and set out to capture suspect thoughts. If your thoughts are in the form of a picture, describe the image or what the image means to you – then write them down in the ‘Beliefs’ box. We think not only in words but also in pictures. People who are feeling anxious frequently describe that they see catastrophic images going through their mind. For example, if you fear fainting in a restaurant, you may get an image of yourself on the restaurant floor with staff fussing over you.
5 In the ‘Thinking Error’ box, consider what your thinking errors may be.One of the key ways to become more objective about your thoughts is to identify the thinking errors that may be represented in the thoughts you list in this box. (Have a look at Chapter 2 for more details on common thinking errors.)Questions that you might ask yourself in order to identify your thinking errors include the following:Am I jumping to the worst possible conclusion? (Catastrophising)Am I thinking in extreme – all-or-nothing – terms? (Black-and-white thinking)Am I using words like ‘always’ and ‘never’ to draw generalised conclusions from a specific event? (Overgeneralising)Am I predicting the future instead of waiting to see what happens? (Fortune-telling)Am I jumping to conclusions about what other people are thinking of me? (Mind-reading)Am I focusing on the negative and overlooking the positive? (Mental filtering)Am I discounting positive information or twisting a positive into a negative? (Disqualifying the positive)Am I globally putting myself down as a failure, worthless or useless? (Labelling)Am I listening too much to my negative gut feelings instead of looking at the objective facts? (Emotional reasoning)Am I taking an event or someone’s behaviour too personally or blaming myself and overlooking other factors? (Personalising)Am I using words like ‘should’, ‘must’, ‘ought’ and ‘have to’ in order to make rigid rules about myself, the world or other people? (Demanding)Am I telling myself that something is too difficult or unbearable or that ‘I can’t stand it’ when actually it’s hard to bear but it is bearable and worth tolerating? (Having a low frustration tolerance)
© John Wiley & Sons, Inc.
FIGURE 3-1: The ABC form I.
Creating Constructive Alternatives: Completing the ABC Form II
When you feel more confident about identifying your As, Bs, Cs and thinking errors, you can move on to the ABC form II. This second form helps you question your unhelpful thoughts in order to reduce their intensity, generate and rate the effects of alternative thoughts and focus on acting differently.
The first five steps for completing the ABC form II (see Figure 3-2) are the same as those for the ABC form I. Then come five more steps. You can find a blank version of the ABC form II in Appendix B. In the ABC form II, column A is the Activating Event, column B is Beliefs, column C is Consequences, column D is Dispute and column E is Effect.
1 Examine your negative thoughts more closely.Ask yourself the following questions in order to examine and weaken your unhelpful thoughts:Can I prove that my thought is 100 per cent true?What are the effects of thinking this way?Is my thought wholly logical or sensible?Do people whose opinions I respect agree that this thought’s realistic?What evidence exists against this thought?Is my thought balanced or extreme?Is my thought rigid or flexible?Am I thinking objectively and realistically, or are my thoughts being biased by how I feel? Consider long and hard your negative or unhelpful thoughts in the light of the preceding questions. Don’t simply give glib ‘yes’ or ‘no’ answers. Instead, think things through and perhaps write down your challenges to your unhelpful thoughts in column D. See the list of questions and prompters at the bottom of the ABC form II, which can help you further with this.
2 Generate alternatives for each of your unhelpful thoughts, attitudes and beliefs.This step is critical as it’s your alternative thoughts that will help you to feel better! In column D, write down a flexible, non-extreme, realistic and helpful alternative for each thought, attitude or belief that appears in column B. The following questions may help you to generate some alternatives:What’s a more helpful way of looking at the situation?Do I encourage friends to think in this way?When I’m feeling okay, how do I think differently?Have any past experiences shown me that another possible outcome exists?What’s a more flexible or less extreme way of thinking?What’s a more realistic or balanced way of thinking that takes into account the evidence that does not support my thought?What do I need to think in order to feel and act differently?Some thoughts are more stubborn than others, and you won’t turn your thinking around completely in one go. Wrestling with NATs for a while before they weaken is typical and appropriate. Think of yourself as training your mind to think more flexibly and constructively over a period of time. Some intrusive thoughts, images and doubts can be made worse if you engage with them. If you have obsessive-compulsive disorder (OCD), health anxiety, body dysmorphic disorder (BDD), worry or a jealousy problem, be sure to develop the capability to live with doubt, and allow catastrophic thoughts to pass through your mind rather than challenging them. We explain