CBT Technique: How to Change Automatic Thoughts

Do you ever find yourself reacting negatively?

I hate to admit that I’m my own worst enemy, and will always put myself down even if there’s no reason to.

“I’m not good enough.”

“I’m a disappointment.”

“Everyone thinks that I’m annoying.”

“I’ll be fired over this little thing.”

I am also guilty of overgeneralization, emotional reasoning and jumping to conclusions. I could go back to my years of trauma for blame, but even though I’m in a much better place (and quite happy), I am conditioned to thinking negatively. It interferes with my self-esteem, confidence and performance.

It’s been hard to change my way of thinking since it affects almost every aspect of my life,

An example: I’m always nervous and scared when it comes to my work evaluations. When my boss compliments me, I am still utterly anxious because I feel that he is noticing my work. Why am I anxious? Because there’s a possibility that he may find a mistake, fire me and I won’t be able to get another job.

I jump to the worst conclusions and don’t even take the genuine compliment to heart.

My automatic thought was a quick and strong reaction that comes through words, images or memories. To help identify my automatic thought, I need to take a step back and figure out why I am currently feeling this way.

What are some questions to help identify automatic thoughts?

  • What was going through my mind just before I started to feel this way? Was I anxious previous to this?
  • What images or memories do I have in this situation? Have I been fired before?
  • What does this mean about me? My life?
  • What am I afraid might happen?
  • What is the worst that COULD happen?
  • What does this mean about how the other person(s) feel(s)/think(s) about me?
  • What does this mean about the other people in general?
  • Did I break the rules, hurt others, or not do something I should have done? What do I think about myself that I did this or believe I did this?

Some of these questions won’t apply to you, and that’s ok. This is a general guideline on identifying your thoughts associated with your distress. These are here to help you understand your emotional reaction/moods. Different moods can be related to your situation: Depression, Anxiety, Anger, Guilt or Shame.
In my example above, I’m anxious.

My therapist would ask me to associate a percentage towards my mood; I would say that I’m 80% nervous and 90% anxious.

It took me years to figure out how to re-wire my brain, but I am pleased to confirm that I can now stop mid anxious thought to bring down those percentages to at least 40% (Any number lower than 90% is a win in my book!)
Automatic Thought

Sometimes though, I will still focus on one negative detail of an interaction instead of seeing the whole picture. I feel like most people are guilty of thinking this way – and I’m just here to say that it’s ok! The point is as long as you recognize what you’re doing, you’re one step closer to changing your automatic thoughts. This isn’t something that you can fix overnight. This requires a committed effort to change.

Now when I go into a performance review, I am still a little nervous, but I do accept a compliment even though I am red in the face. I’ve tried to change my perspective as well as trying to visualize the situation beforehand. Preparation has usually helped; when I feel in control of my words, I feel as if I’m being heard not only from others but from my inner voice.

I can do it

If you’d like to learn more or gain worksheets to outline your thoughts (these have helped me!), I highly suggest the book “Mind Over Mood.”

How to make sure your Therapist or Psychiatrist is a right fit for you

I recently went to see a new psychiatrist. I’m not always keen on seeing someone new, as it usually takes a lot out of me going over what has happened in my past. Even though I don’t feel those emotions today, reliving them bubbles up how I used to feel, and I generally become overwhelmed with emotion and completely drained. I initially put in a referral for this psychiatrist when I was 6 months pregnant and feeling incredibly low. Unfortunately, the earliest appointment that I could get was the last week of October, almost three months postpartum.

Why haven’t you seen me sooner?” was her first question, and I scoffed. I reiterated that I have been trying to nail down an appointment every time I saw my general practitioner and my OB, but no one from her office contacted me. She apologized and said referrals get lost, but I brought along a note from her office, dated in June. I knew it wasn’t lost, but I was waiting for my turn, getting a free service in Canada has its downfalls.

After 40 minutes of talking to her and putting my heart out on the line, she was quick to judge that I was misdiagnosed years ago, and I may be bipolar. She rushed through different dates to come back, what type of things I should expect from the next appointments and briefly touched on medications. I left the office feeling deflated and cried my way to McDonald’s, where I ate my feelings.
After discussing it with my husband and some family, I figured out the reason I was crying was not due to a misdiagnosis but due to her lack of empathy and arrogance over knowing me after 40 minutes. When I talked to my friend (who I know was diagnosed bipolar years ago), she mentioned I should go to CAMH  – Center for Addiction and Mental Health – for a second opinion. After my appointments in November, I will. I don’t agree entirely with her on this quick diagnosis, and if I am genuinely bipolar, I would preferably someone there give it to me straight.

I’ve been festering with this information for a week now, and it made me think of all the times that I went to seek out professional help and how upset I was at not finding the right person for me. It took me over 5 years to find my last therapist!

After talking with some friends and going through my own history, I’ve made a list of reasons why we stopped or changed our therapists/psychiatrists:

  1. They try to push their values onto you or sell things, like herbal remedies.
  2. They get upset when you don’t take their advice as if you’re personally attacking them.
  3. They keep agreeing with every word your saying and not giving you constructive criticism or being objective. Good ones will call you out and hold you accountable for your actions
  4. They call you by the wrong name. (This has happened to me, and I lost all faith in her)
  5. They’re barely attentive and/or keep yawning during your sessions (or even attempt to fall asleep!)
  6. They believe that all of your struggles are due to your sexual orientation
  7. They’re affectionate and want to end sessions with a hug. This is a HUGE red flag. I don’t even shake hands with any practitioners – this is just my general rule and should be there’s too.
  8. They’re too cold/impersonal. A good doctor will provide an empathetic environment
  9. You feel like you’re not progressing. It’s important to establish measurable goals!
  10. They disclose private information to others, including people you know who see the same therapist (IE Family Members or other Doctors)

Even though I’m unsure if she’s the right fit for me, I will still go to those appointments in November. I have no problem revisiting my old trauma and going over my behavioural patterns; I would just rather fully immerse myself in a doctor I know I can see for an extended period. If I am not fully satisfied by the end, I will definitely put in a call to CAMH and get a second opinion.

If you happen to go through any of those issues listed above, I do recommend seeing a new therapist. Just remember, if you do feel stuck in divulging your past or present, changing a doctor will not likely help. Reliving things are uncomfortable and can hurt in many ways, but it’s the only way you can potentially move forward and heal yourself.