I’ve had general anxiety since I can remember. My Dad, who was a psychologist, once said to me: “70% of us suffer with some kind of anxiety or depressive disorder – maybe they aren’t disorders, but the norm.” I honestly don’t think I know anyone in my life that doesn’t suffer from some sort of anxiety.
I’ve learned to cope with mine through counselling, low dose medication, and cognitive behavioral therapy techniques – the latter of which I feel helps the most in acute stress situations.
What exactly is cognitive behavioral therapy (CBT)?
The main idea behind CBT is quite simple: If you change the way you think, you can change the way you feel. Its not going to cure anxiety (I think we would all know exactly what it is and be using it regularly if so) but it sure helps manage it.
The technique I am about to describe is called the triple column technique, developed and named by clinical psychiatrist Dr. David Burns. It is intended to change your mindset and for me, it works wonders – I’m talking turning what could’ve been a terrible day into an amazing one.
First things first: identifying cognitive distortions
Cognitive distortions are those statements that the little voice in your mind makes about who you are and what is happening.
These are the 10 main distortions that can occur:
All or nothing thinking. When you see things in black and white instead of in shades of gray. Example: I’m a bad person.
When you extend a negative thought, so it reaches even further. Example: I never do anything right.
Mental filter. When you filter out all the good stuff to focus on the bad. Example: I didn’t accomplish anything today.
Disqualifying the positive. When you believe a good or positive thing “doesn’t count” toward your larger pattern of failure and negativity. Example: I guess I survived the talk — even broken clocks are right twice a day.
Jumping to conclusions. When you extrapolate an even bigger and broader negative thought from a small negative experience. Example: He said he didn’t want to go out with me. I must be an unlovable person.
Magnification or minimization. When you exaggerate your own mistakes (or other people’s accomplishments or happiness) while minimizing your own accomplishments and others’ flaws. Example: Everyone saw me mess up at the game, while Susan had a perfect night on the field.
Emotional reasoning. When you assume your negative feelings reflect the truth. Example: I felt embarrassed, therefore I must have been acting in an embarrassing manner.
Should statements. When you beat yourself up for not doing things differently. Example: I should’ve kept my mouth shut.
Labeling and mislabeling. When you use a small negative event or feeling to give yourself a huge, general label. Example: I forgot to do the report. I’m a total idiot.
When you make things personal that aren’t. Example: The dinner party was bad because I was there.
How to: Dr. Burns’ triple column technique
Once you understand the 10 most common cognitive distortions, you can start taking a few minutes a day to complete the triple column exercise. It is important to take a few moments and actually write this down, or type it out, as it helps to see the words in front of you.
Here’s how:
Make three columns on a sheet of paper. You can do this anytime, when you feel like you are beating yourself up, or maybe first thing I the morning or just before bed.
Label the first column what Burns calls your “automatic thought” or that mean little bully voice in your head. An example might read, My day was the worst. My presentation sucked, my boss hates me, and I’ll probably get fired.
Label the second column “cognitive distortions” then read your statement and identify & write down the cognitive distortions. There may be more than one – in the examples above there are at least four: overgeneralization, all or nothing thinking, mental filter, and jumping to conclusions.
Label the third column “rational response.” Think logically about what you’re feeling and rewrite your automatic thought. Using the examples above, you may write, My presentation could’ve gone better, but I’ve had lots of successful presentations in the past and I can learn from this one. My boss was confident enough to have me lead the presentation, and I can talk to her tomorrow about how it could’ve gone better. There’s no evidence at all that this one subpar day at work would get me fired.
Write out as many or as few automatic thoughts as you want. After a good day, you might not have any, and after a big event or conflict, you might have to work through a lot. After some time, you will likely find (as I have) that you are better at catching these negative automatic thoughts and rerouting them, or at least examine them further and changing them before they affect your broader outlook.
Does CBT actually work?
In a 2012 meta-analysis of 269 studies about CBT, it was found that while this simple talk therapy is most helpful in combination with other treatments, it is indeed very successful when specifically treating anxiety, anger management, and stress management.
References:
Hofmann, S.G., Asnaani, A., Vonk, I.J.J. et al. Cogn Ther Res (2012) 36: 427. https://doi.org/10.1007/s10608-012-9476-1
Burns, M. D. D. D. (2017). Feeling Good: The New Mood Therapy.
Disclaimer: Do I even need to say this? Please, please puleeeze do not construe this to be any form of medical information – if you need help, talk to your doctor or therapist.