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CBT-changing how you feel by changing how you think-Part 1

Dr Melanie du Preez. February 2018

· Mind,Life Skills

We are happy today to share our first (hopefully of many) guest blog(s) written by our dear friend and colleague Dr Melanie du Preez. Melanie has been in private practice as a clinical psychologist since 2001. Currently she is also doing groups for teenagers at Parkmed Neuro-clinic. She is passionate about the welfare of children and teenagers. She received my PhD in 2012, with as theme Resilience in children. Her life philosophy is, in the words of Ghandi:”Be the change you want to see in the world.”

Please feel free to contact Melanie on her contact details above.

Introduction(Part 1)

Horace Walpole, 18th century author of gothic horrors said: ”The world is a tragedy to those who feel, a comedy to those who think.” This sentiment neatly encapsulates the premise of Cognitive Behaviour Therapy. All good and well in theory, but how do we change the way we feel by changing the way we think (as well as the way we act)?

CBT places focus on “here and now” difficulties and problems. Even though it could be useful to explore the past in order to understand where certain destructive patterns of thinking and doing originated, the process of CBT can be likened to driving a car on the highway. You check your rearview mirror sporadically to assess what could have a possible impact on your current situation. You keep your destination in mind and adjust your course and speed according to the safest and most effective way to reach it, being flexible and taking into account traffic etc. Still you stay focused on the readings from your instruments, stay aware of yourself driving and focus so that that you can react in an instant to any crisis.

According to CBT, our emotions aren’t caused by events, but rather by our interpretation (thoughts) thereof. Graphically it can be represented thus:

Say, for instance you walk past someone that you know and they don’t acknowledge you. You may think “She doesn’t like me” (cringing selfconciously) or “She’s angry at me (becoming anxious) or “She thinks she’s better than me” (becoming angry). CBT teaches healthier response “Maybe she didn’t see me”.

It becomes clear then that our thoughts influence our emotions, which in turn effects the way we behave-and the cycle repeats itself. CBT can be used as a tools to help us break these vicious cycles and the grip they can have on our lifes.

Diffirent emotions are often associated with particular types of thoghts:

Thoughts

Depression

  1. I’m worthless
  2. The future is bleak
  3. Nothing will ever change

Anger

  1. I’ve been disrespected
  2. It’s unfair
  3. I won’t stand for it

Anxiety

  1. I am in danger
  2. Something terrible is going to happen
  3. I can’t cope

Step 1

Identifying thought, feelings and behaviours

< >What was the situation?

< >What thoughts went through your mind during or just before that time?

< >What distressing emotion/-s did you feel?

< >What did you notice in your body?

< >What did you do?

Step 2

Understanding the links between thoughts, feelings and behaviour

Depression

Thoughts

  • Everything is useless
  • I am worthless
  • It’s all my fault
  • The world is a terrible place

Physical sensations

  • Fatigue
  • Difficulty concentrating and remembering
  • Sleep changes
  • Eating changes
  • Loss of interest

Behaviour

We tend to do less and less, especially of things we previously enjoyed. We tend to isolate ourselves from friends and family.

Anger

Thoughts

  • I’m being treated unfairly
  • I’m being disrespected
  • They are breaking a rule/standard
  • I won’t stand for it
Physical sensations
  • Heart racing or pounding
  • Breathing quicly
  • Tense muscles
  • Shaking
  • Sweating
  • Lightheaded
  • Stomach churning
  • Fist/teeth clenching
Behaviour
  • Staring/Angry face
  • Aggressive body posture
  • Attacking
  • Arguing
  • Sulking

Anxiety

Thoughts

  • I am in danger right now
  • The worst possible scenario is going to happen
  • I won’t be able to cope with it

Physical sensations

  • Heart racing
  • Breath gets faster
  • Muscles tense and prepare
  • Sweating
  • Pupils dilate
  • Digestive system slows down
  • More alert
Behaviour
  • Avoiding people or places
  • Not going out
  • Escaping or avoiding

Step 3

Making changes-Behaviours

 

If you want to feel diffirently, you need to do things differently. So much truth is locked up in this statement. Very often we react to situations automatically. In future, keep these questions in mind when faced with events:

  • What helped you cope and get through it?
  • What didn't I do or what did I avoid doing?
  • What automatic reactions did I have?
  • What would other people have seen me doing?
  • What were the consequences of what I did?
  • What happened later because of it?
  • Did it affect the way I felt later?

Now ask yourself, what could I have done differently?

  • What would someone else have done in that situation? (it might help to think about particular people that you know, and what they might have done differently)
  • Have there been times in the past when I would have done something else? 
  • If I had paused, and taken a breath, what would I have done?

Write down several options that you might have done differently if it had occurred to you, then ask yourself:

  • If I had tried that, how would the situation have been different?
  • How would it have affected what I felt? How would it have affected what I thought?
  • Would it have been more helpful or effective for me, another person or for the situation?
  • What would the consequences have been of doing something differently?

For further reference

  1. www.get.gg

References

< >http://www.coolnsmart.com/emotion_quotes/page/6/?cfilter=images [Internet:2018-02-10].http://www.dbtselfhelp.com/selfhelpcourse.pdf. [Internet:2018-02-10].https://www.anxietybc.com/sites/default/files/What_is_CBT.pdf. [Internet:2018-02-10].https://depts.washington.edu/dbpeds/therapists_guide_to_brief_cbtmanual.pdf. [Internet:2018-02-10]https://www.camh.ca/en/hospital/health_information/a.../cbt_guide_en.pdf[Internet:2018-02-10]

This post is for informational purposes only. It should not be considered therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local doctor/psychologist or psychiatrist or the SADAG Mental Health Line on 011 234 4837. If necessary, please phone the Suicide Crisis Line on 0800 567 567 or sms 31393.

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This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local doctor/psychologist or psychiatrist or the SADAG Mental health Line on 011 234 4837. If necessary, please phone the Suicide Crisis Line on 0800 567 567 or sms 31393.