Mind Over Mood: How to change the thought patterns that contribute to negative emotions

1. Mind Over Mood:How to change the thought patterns that contribute to negative emotions Nelson Binggeli, PhD Georgia Tech Counseling Center Welcome! v2.5

2. Mind over Mood • A two session seminar • Skills that participants will learn include: • How to recognize distorted thought patterns that contribute to negative emotions. • How to replace distorted thoughts with ones that are more accurate, believable, and functional. • Based on the principles of cognitive therapy • Application: depression, low self-esteem, perfectionism, stress management, chronic worry, panic attacks, social anxiety, anger, relationship problems • Title borrowed from Greenberger & Padesky (1995).

3. Structure of the workshop • 4 - 5pm • First session: Learn concepts and how to apply • Second optional session: Application • Participation: As much or as little as you like • I welcome you to share your thoughts and feelings • It is perfectly ok for you to not do so • Realistic expectations, for this workshop, and for yourself • An introduction to how cognitive principles could be helpful to you • Using them to effect change will take additional study and work

4. What causes emotions? • Question: What causes emotions? • Vignette: Suppose you are at a party and have been introduced to Alex. As you talk, Alex never looks at you; in fact, throughout your brief conversation s/he looks over your shoulder across the room. • What are you thinking and feeling? • Alex is rude. S/he is insulting me by ignoring me. Mood: ____ • Alex doesn’t find me interesting. I bore everybody. Mood: ____ • Alex seems shy. S/he’s probably to uncomfortable to look at me. Mood: ____ • Same situation, different thoughts and moods

5. The cognitive perspective • The cognitive model: • A = Situation -> B = Thoughts/beliefs -> C = Emotions & behaviors • The cognitive therapy model: • (1) thoughts influence emotions and behaviors • (2) sometimes our thoughts contain distortions and/or are not very useful • (3) leads to maladaptive emotions and behaviors • (4) recognizing and changing maladaptive thinking can lead to adaptive emotions and behaviors • Empowering and liberating • We often have no direct control over the situation • We can only control how we react (our thoughts and behaviors)

6. Ten common kinds of distorted thinking • 1. All-or-nothing thinking • On getting a C: “I failed.” • On having a lot to do: I’ll never get any of this done.” • 2. Overgeneralization • On getting a C: “I am no good at this.” • To a friend: “You NEVER listen to me.” • “I’ll NEVER get a good job. Nobody wants to hire me.” • 3. Mental filter (dwell on negatives, ignore positives) • 4. Discounting the positives (“positives don’t count”) • 5. Jumping to conclusions (Mind reading / Fortune telling) • “They’re going to think I’m stupid.” “I am going to fail.” Reference: The Feeling Good Handbook by David Burns, MD.

7. Ten common kinds of distorted thinking • 6. Magnification or minimization. Catastrophizing. • “They’re going to think I’m stupid.” “I am going to fail.” • 7. Emotional reasoning • I feel _____ (insert negative label), therefore I am _____. • 8. “Should,” “must,” or “ought to” statements • “I should never feel anxious.” • 9. Labeling (or name calling) • I am (insert negative label).” • 10. Misplaced blame • It’s ALL my fault.” Reference: The Feeling Good Handbook by David Burns, MD.

8. Reactions so far? • A common reaction: “So cognitive therapy says that it’s bad to feel negative emotions, and that we should always feel good and focus on the positive. This just distorts things in a positive direction, and it’s just not believable.” • Adaptive vs maladaptive emotions. Adaptive ≠ positive. • consider: anxiety / fear; anger; sadness • can be painful but guide an appropriate response • are based on more accurate and useful interpretations • Maladaptive emotions • cause confusion, inappropriate responses, hurt well-being • are driven by distorted thinking • Mental health = recognizing the difference

9. Moods and cognitive distortions are often mutually reinforcing • Once a mood is established, it is often accompanied by additional thoughts that support and strengthen the mood. • When we feel intense moods, we are more likely to discount, distort, or disregard info that contradicts our moods and beliefs.

10. Role of thoughts in maintaining psychological disorders • Depression • Views of oneself and one’s situation that are often marked by distorted thoughts (e.g., “I am inferior, worthless, nothing is ever going to work out.”) • Anxiety disorders • Overestimating the odds of the negative event happening • Overestimating the severity of the consequences • Underestimating one’s ability to cope

11. An overview of how to evaluate and modify your thoughts • 1. Identify the thoughts that are causing the negative emotions. • 2. Evaluate the accuracy & usefulness of these thoughts • 3. If appropriate, modify your thoughts to be more accurate & useful. • Exercise: Think about a negative emotion you recently experienced (see worksheet). • Caveat: Consider choosing an emotion of moderate (and not extreme) intensity for the purposes of this exercise.

12. Step 1. Identifying thoughts • How to identify the thoughts that influence your emotions and behavior • The concept of “automatic thoughts” • (1) Identify a situation in which you were experiencing an emotion • (2) Name the emotion(s) • (3) Pose questions • What am I telling myself? • What was going through my mind just before I started to feel this way? • What does this say about me? • What does this mean about me? My life? My future? • What am I afraid might happen?

13. Step 2. Evaluating & modifying thoughts • Pre-requisites are a willingness: • to consider that our habitual ways of thinking may be inaccurate and distorted, and to treat our thoughts as “hypotheses” rather than facts. (In other words, “don’t believe everything you think.”) • to use logic and evidence to evaluate our thoughts • How to do it: • Consider whether the thought contains any cognitive distortions • Pose questions about the accuracy and usefulness of the thought (e.g., what is the evidence? Is there another way of looking at it?) • Modify the thought to be more accurate and useful

14. Evaluating the accuracy & usefulness of our thoughts • Accuracy questions: • What is the evidence that supports / contradicts this thought? • Is there another explanation? Another way of looking at it? • Am I overestimating (a) the probability of the negative event occurring, or (b) severity of the consequences of the event? • What is the worst that could happen? What is most realistic? • If a friend had this thought, what would I tell them? • Usefulness questions: • What are the (dis)advantages of telling myself this? • What might be a more useful or helpful way of thinking? • To the degree the belief is true, what should I do about it?

15. “Homework” in between sessions • When you notice your mood declining, or experience an increase in anxiety … • Use the worksheet on page 5 • Write down (a) the situation, (b) your emotions, and (c) your automatic thoughts • Next week, we will work on questioning and modifying thoughts.

16. End of session 1

17. Mind Over Mood: Session 2 Nelson Binggeli, PhD Georgia Tech Counseling Center Welcome!

18. Purpose of today’s session • To better learn how to apply the concepts to your unique situation • Using the worksheet and a real example from your life • Choose an example with moods of mild to moderate intensity • Participation and sharing is encouraged, but not required • Realistic expectations, for this workshop, and for yourself • An introduction to how cognitive principles could be helpful to you • Using them to effect change will take additional study and work

19. An overview of how to evaluate and modify your thoughts • 1. Identify the thoughts that are causing the negative emotions. • 2. Evaluate the accuracy & usefulness of these thoughts • 3. If appropriate, modify your thoughts to be more accurate & useful.

20. Step 1. Identifying thoughts • How to identify the thoughts that influence your emotions and behavior • The concept of “automatic thoughts” • (1) Identify a situation in which you were experiencing an emotion • (2) Name the emotion(s) • (3) Pose questions • What am I telling myself? • What was going through my mind just before I started to feel this way? • What does this say about me? • What does this mean about me? My life? My future? • What am I afraid might happen?

21. Step 2. Evaluating & modifying thoughts • Pre-requisites are a willingness: • to consider that our habitual ways of thinking may be inaccurate and distorted • to treat our thoughts as “hypotheses” rather than facts • to use logic and evidence to evaluate our thoughts • How to do it: • Consider whether the thought contains any cognitive distortions • Pose questions about the accuracy and usefulness of the thought (e.g., what is the evidence? Is there another way of looking at it?) • Modify the thought to be more accurate and useful

22. Evaluating the accuracy & usefulness of our thoughts • Accuracy questions: • What is the evidence that supports / contradicts this thought? • Is there another explanation? Another way of looking at it? • Am I overestimating (a) the probability of the negative event occurring, or (b) severity of the consequences of the event? • What is the worst that could happen? What is most realistic? • If a friend had this thought, what would I tell them? • Usefulness questions: • What are the (dis)advantages of telling myself this? • What might be a more useful or helpful way of thinking? • To the degree the belief is true, what should I do about it?

23. End of session 2

24. Mind Over Mood: Vignettes Vignette 1: Illustrating how thoughts are based on interpretations (Sally & her daughter) Vignette 2: Illustrating differences between distorted thinking and more accurate & useful thinking (Jerry & Rick) Vignette 3: Identifying, evaluating, & modifying thoughts (Marissa)

25. Vignette 1: Illustrating how thoughts are based on interpretations (Sally & her daughter) • Sally is at home with the flu and asks her 7 year-old daughter Barbara to play quietly as she rested. • An hour later, Sally walks into the kitchen and sees crayons spread all over the floor, shredded colored paper, and an open bottle of glue on the table, and a half-drunk glass of milk on the counter. • What is Sally feeling and thinking? • Sally goes looking for Barbara and finds her sleeping soundly in the living room. On the cushion next to her she finds a large brightly colored card, covered in hearts, that read “I love you Mom. Please get well soon!” • Illustrates the importance of gathering additional evidence

26. Vignette 2: Illustrating differences between distorted thinking and more accurate & useful thinking (Jerry & Rick) • You've just moved to a new town, are interested in meeting people, and in dating. • You arrive home to your apartment. • You see an attractive person whom you recognize as a neighbor whom you have never spoken to. They are getting their mail. • You say hello, and introduce yourself. • They look up briefly, say hello, and continue to sort through their mail. • What might you be feeling and thinking? What are some possible things that a person could think and feel? • Vignette adapted from Hope, Heimberg, Juster, & Turk (2004).

27. Jerry • Emotions: Discouraged, embarrassed, depressed • Thoughts: • “She doesn’t want to talk with me.” • “I’m bothering her.” • “She thinks I’m weird or something.” • “I’m so inept that I made a bad first impression just saying hello.” • “I’ll never meet anyone.” • Behaviors: What is he likely to do in the future?

28. Rick • Emotions: Mildly curious, neutral • Thoughts: • “She must be expecting something important in the mail.” • “Maybe she is tired from work. I’ll try speaking to her again later." • “She might be a little hesitant to talk with a man she does not know.” • Behaviors: What is he likely to do in the future?

29. Characteristics of cognitive distortions • Differences between Jerry’s thinking and Rick’s? • Jerry appears more certain of his interpretations • Jerry: “She doesn’t want to talk with me.” • Rick: “Maybe she is tired from work. • Distortion: • Mind reading • Jerry’s thoughts are more extreme and absolute • Jerry: “I’ll never meet anyone.” • Distortions: • Overgeneralization, fortune telling, all or nothing thinking • Which thoughts lead to more adaptive behavior? • Jerry: “I failed, and I am ashamed to try again.” • Rick: “I’ll try speaking to her again later."

30. Vignette 3 (Marissa): Identifying, evaluating, & modifying thoughts • STEP 1: Identifying thoughts • Marissa was working at her desk when her supervisor came in to say hello. While they were talking, her supervisor said, “By the way, I want to complement you on the nice report you wrote yesterday.” As soon as her supervisor said this, Marissa became nervous and scared. She couldn’t shake this mood the rest of the morning. • Vignette adapted from Greenberger & Padesky (1995).

31. Step 1: Identifying Marissa’s thoughts • Q: When this happened, what went through your mind? • M: My supervisor is noticing and evaluating my work. • Q: What’s scary about that? • M: I don’t always do a good job. • Q: So what might happen? • M: Someday my supervisor will notice a mistake. • Q: What’s the worst that could happen then? • M: I could get fired. • Q: And then? • M: He’d give me bad recommendation, and I’d have trouble getting another job. • SUMMARY: “If I make a mistake, I’ll be fired and won’t be able to get another job.”

32. Step 2: Evaluating & modifying Marissa’s thoughts • Situation: Receiving a compliment from my supervisor. • Mood: Nervous, scared. • Thoughts: If I make a mistake, I’ll be fired and won’t be able to get another job. • Q: What is the evidence that supports / contradicts this thought? • M: My boss has noticed mistakes before, but my evaluations have been positive. • Q: Am I overestimating the probability of the negative event occurring? • M: He is required to bring problems to my attention and give me a chance to improve before firing me. It is very unlikely he would fire me from out of the blue because of one mistake.

33. End