Session Four: On Thinking
Prepared by Nicole Carter, MSW, RSW
Please do not copy or distribute this material without permission.
“Your emotions follow your thoughts, just as surely as baby ducks follow their mother. But the fact that the baby ducks follow faithfully along doesn’t mean that the mother knows where she is going!”
— David Burns
How Thoughts Contribute to Anxiety
As mentioned in the previous sessions, the way we think influences how feel, which influences what we do (which can then influence how we think – and the cycle continues). We have close to 50 thoughts every minute, and most go unnoticed and unexamined. Thoughts are merely clusters of hypotheses that are trying to make sense of the world around us, so it makes sense for us to put them on trial to ensure they are in fact valid and helpful to us - especially given the world’s current landscape where our thoughts can easily run wild.
How do thoughts affect how we feel?
Scanning our Thoughts for Accuracy and Helpfulness
Since most of our thoughts go unnoticed and unexamined, it can be helpful to work with a therapist to determine the meaning behind our thoughts, beliefs, and assumptions, and whether our thoughts are accurate and/or helpful. We may unknowingly be thinking in ways that contribute to our anxiety. For example, I might assume that getting into a plane crash is much more likely than it actually is after examining crash statistics, or that a house fire is more likely than it actually is after examining fire statistics. Or, I might assume that others are criticizing me when they’re in fact not, or that I might not be able to cope with something when I in fact might cope quite well given the chance!
Thoughts we May Want to Consider Challenging
While many of our thoughts are factual and helpful, others might be unknowingly affecting our anxiety. Some thoughts you might want to consider examining further might be:
Those that predict catastrophic outcomes
Those that assume we will not be able to cope
Those that are attempting to mind-read without knowing for certain what another person is thinking
Those that perpetuate avoidance due to fear
Those that use frequent extreme language, such as “always” or “never”
Those that place undue stress and pressure on ourselves, such as “should” statements
Those that are perfectionistic in nature or hold ourselves to unrealistic or impossible standards
Those that are black and white or jump to conclusions
Those that do not have sufficient evidence
Shifting our Thoughts to Change our Mood
One way to engage in thought challenging is to generate confirming and contradictory evidence for a thought, and then a balanced thought that takes both groups of data into account. Remember – the evidence you generate should not be perceived and should be able to stand in court.
Below is an example of someone charting their thoughts while using the evidence technique:
48 Questions That Can Help Challenge Our Anxious Thinking
Sometimes a list of questions can be helpful in challenging our anxious thinking and ensuring that our thoughts are accurate and helpful. Below is a list of common questions that are used in cognitive behavioural therapy to help reduce distress. Note: not every question will be helpful in challenging your specific thoughts, so put a star beside the ones that stand out for you so that you can come back to them later.
Am I thinking in terms of probability vs. possibility? (Does it feel more probable than it reasonably is?)
Am I thinking in terms of certainty vs. probability? (Does it feel more certain than it reasonably is?)
Am I jumping to conclusions too early? If I were to delay my conclusions by one hour, or one day, or one week, would my conclusions likely look different?
Am I using words or phrases that are extreme or exaggerated, such as always, never, forever, must, need, can’t, or every time?
Is the source of information reliable? What perception bias(es) might the source of information hold and why?
What are the chances that my fear will come true? Try identifying the actual percentage. For example, out of 37.59 million people in Canada, 7695 have been confirmed to have COVID-19, making my chances approximately 0.0002%.
What is the worst-case scenario and how likely is it? If it were to occur, although it would be hard, could I most likely cope?
Am I overvaluing my worry thoughts over more realistic thoughts?
What would I tell a close friend or family member if they were having this worry?
Am I speaking to myself as I would speak to a close friend or family member?
What are the advantages and disadvantages of thinking this way?
Are my thoughts serving me in a helpful way?
Am I engaging in black and white thinking? For example, “I can’t handle this.” What would thinking in the grey (or taking the “middle road”) look like?
Are my thoughts based on facts that would hold up in a survey of 100 people? 1000 people?
Would the way I’m thinking about a situation or myself match the way those close to me view me or the situation? How are those narratives different?
Is my worry generating clear steps towards problem solving? If not, it might mean that we are engaging in unhelpful worrying.
Am I mind-reading what others might be thinking? Is it truly possible to know what someone else is thinking?
If I do not have complete control over the situation, what other factors might be contributing to my situation? Consider factors such as environment, familial, neurological, mental health, other people, professors, teachers, isolation, stress, and so on.
Am I feeling over-responsible in this situation? Many of us discount other factors that contribute to the situation and focus too much on our own responsibility.
Am I discounting the fact that I am trying my best?
Am I putting things into categories such as right/wrong or good/bad or smart/stupid or healthy/unhealthy? Sometimes the answer isn’t so clear-cut.
Am I resisting the way my body wants to feel in this particular moment? Sometimes we have little control over the harmless sensations our body produces.
Am I paying special attention to certain sensations and ignoring others? Remember: Our bodies are noisy refrigerators and normal bodily processes sometimes produce harmless sensations. To illustrate this, try closing your eyes and waiting until you feel an itch on your body. It tends to happen quickly, which showcases that we tend to find what we look for!
Am I the only one responsible for this outcome? If I am only partly responsible, am I as responsible as I feel? What else could have contributed to this outcome?
Do I have concrete evidence that supports my thoughts? (Evidence that could not be disputed in a court of law)
Am I using the word “should” or “shouldn’t”? Using the word ‘should’ with yourself can place unhelpful pressure on you or make you feel unnecessarily guilty.
Does worrying about this make me feel like a more caring person? Do people who worry less necessarily care less?
Is it truly possible to prevent a bad thing from happening by worrying? Do people who worry more, necessarily have less bad things happen to them? If this feels so, am I equally as likely to win the lottery merely by thinking a certain way?
Is it possible to cause an outcome by merely thinking a certain way? You could be getting caught in the thinking trap, magical thinking.
Am I giving my thoughts too much power to influence outcomes? This can discount our own abilities.
Could looking for certain evidence be contributing to what I’m noticing and the conclusions I’m drawing? We tend to find what we look for and it can feel more probable than what is actually true. This is called cognitive bias.
Am I noticing the sensations in my body because I’m looking for them? For example, close your eyes and notice the feeling of clothing on your body. They were there all along – you just weren’t looking for them.
Could the way you’re thinking about this be influencing how you feel about a situation or yourself? When individuals imagine sucking on a sour lemon – they often experience sensations like salivation. This example shows us how connected our mind and sensations are.
Am I drawing conclusions based on how I feel, rather than by evaluating the evidence?
Do I feel that tolerating anxiety or emotional discomfort is too hard in this moment? Have I been able to tolerate distress or discomfort in the past? What happened?
Reflect on the amount of time you’ve spent worrying about an event occurring: Is there a difference between how much you worry about it and how often it has actually happened?
Will this still bother me in one hour, next week, one year? What does that tell me about how I’m viewing this situation now?
When I’m not bothered by the situation or feeling(s), do I think about things differently?
Am I being self-critical? What is more helpful: criticism or support and acceptance? Less criticism does not mean people ‘give up’ or are less productive. In fact, productivity tends to rise as we practice compassion and self-acceptance.
When I’ve experienced this in the past, what did I do or say to myself that helped?
Am I ignoring any strengths or positive characteristics that do not make this thought true, or totally true all the time?
Do I think the evidence is truer than it is because of how I feel? Are feelings necessarily facts?
Is this thought/are these thoughts true all the time? Was there a time in my life when these thoughts were not true?
Am I judging my thoughts as personally meaningful in some way? Is it possible that my thoughts could just be benign ones that don’t actually mean anything about me?
Am I behaving in ways that seek reassurance or avoid the possibility of certain outcomes? If I were to reduce these behaviours, would my predictions necessarily come true?
Am I “dodging discomfort,” or avoiding discomfort by doing other, more pleasurable things? Humans are often skillful at gathering the resources necessary to endure distress – how do I know this might be true for me, too?
Am I experiencing unhelpful, intrusive doubt? Helpful doubt is resolved quickly once the proper information or evidence is obtained.
Am I minimizing, forgetting, or not paying attention to important evidence that contradicts my beliefs? Thinking bias occurs for all of us: we pay more attention to and remember evidence that confirms our beliefs about ourselves, others, or the world, and ignore evidence that doesn’t fit.
Self-help Exercises
The evidence technique. When you notice a shift in anxiety or mood, jot down as many fearful or worry thoughts as you can identify, as well as your subjective distress rating between 1-100 (100 being the highest distress). Generate as much evidence as you can that confirms and contradicts your feared thoughts, like in the example above. Then, generate a balanced thought that takes both columns into account. You can then use your balanced thought as an anchor or a mantra for your wandering mind throughout the day.
Challenging the validity and utility of your thoughts using questions. You can also try the above technique but without the evidence component. After jotting down as many worry thoughts as you can, as well as your distress rating, read through the above questions to help you generate challenges to your thoughts. Then, generate a final balanced thought to anchor to throughout the day.
Try this: Close your eyes for thirty seconds and imagine yourself cutting into a juicy lemon, squeezing the juices into your mouth, and swallowing. Then, imagine eating a handful of sour skittles, followed by a handful of salt and vinegar potato chips. What do you notice happening in your mouth?
Most people will notice their mouths salivating just by the thought of drinking or eating these food items, even though the food item isn’t actually present. Thoughts work very much the same way: the way we think inevitably affects the sensations we experience and the way we feel. For this reason, it can be important to make sure the way we’re thinking is factual and serving us in a helpful way.
