this episode was pre-recorded as part of
a live continuing education webinar on demand CEUs are still available for this
presentation AllCEUs.com/CBT-CEU I'd like to welcome everybody to today's
presentation on cognitive distortions understanding and addressing them this
is one of my more favorite topics presentations if you will so if I found
even more hyper and excited than normally I probably am what we're going
to do is define thinking errors and explore the different types of thinking
errors a lot of people not just our clients but a lot of people experience
and my personal as well as professional experience has been that by addressing
identifying and addressing a lot of these thinking errors we can greatly
reduce stress if we reduce stress then we reduce how how much how often were
hyped up stressed out using extra energy have that HPA axis going and it improves
sleep improves mood there's a little bunch of stuff I have never met yet not
to say it won't happen someone who doesn't have or occasionally use a
couple of cognitive distortions they are not unusual that's kind of one of those
things that if you aren't regularly mindful and on top of it and kind of
sneak up on you so we're going to talk about how to encourage clients to be
aware of that we're also going to talk about how thinking errors and cognitive
distortions specifically can play into our basic fears of rejection isolation
the unknown loss of control and failure which you know generally the big ones
that trigger that fight-or-flight reaction so we have cognitive
distortions that are increasing our fear our sense of our need to fight or flee
it's going to increase our stress which is probably not going to be good in the
long term in our health on our health our mood and so then we're going to go
on to identifying ways to increase awareness of thinking errors address
them and maybe even start addressing some of those basic fears like fear of
abandonment so the cognitive distortions aren't as powerful if they if somebody
for example interpret something as a rejection if they've already dealt with
their fear of abandonment they maybe able to kind of let that one go
and say you know what not worth my time so why do we care how does it impact
people's recovery thinking errors or stinking thinking as we call in
substance abuse plays a large part in keeping people miserable if you see
things in extreme terms if you personalize things if you make judgments
based on feelings rather than fact I feel scared that's therefore this must
be terrifying it's going to tend to probably add a lot of additional stress
most of the stuff that we call mood disorders and addictions are made worse
by faulty thinking I'm not saying that faulty thinking causes depression
anxiety all that but it certainly doesn't help so if we can help people
start identifying this this is something small this is something they can start
doing the first day they walk out of your office which can give them some
hope and a little bit more awareness of what might be going on that's keeping
them stuck we can help clients not make mountains out of molehills focus on the
things that they can change and identify and eliminate thought patterns that are
keeping them stuck most of my clients my experience has been that they have three
or four cognitive distortions that kind of are there go twos and there are
themes within those thinking errors that help me understand why they react
certain ways to certain events and a lot of times you know interpersonal process
stuff we can go back and see where they learned that and then we can talk about
whether whatever they learned in the past still applies in the present so
cognitive distortions take a thought and manipulate it to fulfill people's
expectations of a situation or to conform to their current headspace in
general so if people are using all-or-none thinking you know they are
taking an event and making it conform to this all-or-none this person never ever
does this or always does this and generally when they're using those terms
it's not a good thing so we want to encourage
people to look at finding exceptions cognitive distortions like it says on
here also helps people or impacts people by encouraging them to look selectively
and notice things that can conform to their current headspace so if they are
in a bad mood they're going to notice the negative things I mean think about
it it's easy to fall into this trap if you get up in the morning and it's kind
of gloomy and raining outside and you know you've got a meeting that you don't
want to go to so you're not in the best mood getting up do you notice how good
breakfast tastes and are you thinking about all the exciting things and
whatever you know the fact that you're not going to water your garden or are
you focusing on hot crap I'm going to drive in this people drive like idiots
when it's raining a lot of times we focus on the things that can form with
our mood that's just human nature by being mindful we can stop ourselves and
we can say you know what no there are some really challenging things today and
I wish it weren't raining however I'm going to force myself to try to walk the
middle path focus on the fact that I have a job and yeah this meeting is not
the most pleasant but I'll get through it and figure out optimistic ways to
view the rain and all that kind of stuff okay maybe people do drive like idiots
so maybe you want to take the back roads in order to get to work today so you
don't have to drive on the interstate where it's a little more dangerous but
instead of focusing and getting stuck and dwelling on stuff you're making
solutions and you're trying to focus on at least something of a silver lining
irrational thoughts which we're going to talk more about next week our beliefs or
thoughts that you may hold that are generally extreme I must have love and
approval from everyone all the time so that usually involves some sort of a
cognitive distortion a lot of times all Arnon thinking they tend to be
unrealistic SiC is it realistic to think you're
going to have love and approval from everyone all the time no you know not
everybody's going to like you so figuring out how you're going to deal
with that and helping clients realize how unrealistic certain thoughts are is
helpful and sometimes when I'm working with teenagers or people who seem to be
resistant to this concept I might ask them you know okay tell me somebody that
you really look up to tell me somebody you favor and then I ask them you are
there people that don't like them and you know thankfully so far I haven't
been able to get an affirmative to the question of are they liked by everyone
generally even if it's you know Tom Cruise or whoever the popular person is
right now there is someone who dissents so then we can talk about well that
person is super talented super popular super popular and has all these things
going for them but there are still people that don't like them does that
make them worth less of a person and irrational thoughts creates feelings of
failure inadequacy and disempowerment if you're setting yourself up to this bar
that nobody can hurdle you know nobody's liked by everybody all the time
so you're setting yourself up for depression anxiety and frustration causes of thinking errors can also
include information processing shortcuts we use schemas when we interpret things
so when something happens we check back with our memories ago have I experienced
something like this before what can I interpret about it instead of having to
start from from jump to figure out what's going on here is this safe is
this dangerous the example I always give because I talk with my hands a lot my
Garmin thinks I run three miles every time I teach is because I'm moving my
hands and that just comes from the environment that I grew up in and you
know whatever but I am a very demonstrative person
tend to be kind of loud too and that's just kind of the way I am if you were
raised in an environment especially one characteristic of domestic violence
seeing or observing that may be intimidating especially if you can't
hear what I'm saying you can just hear that I'm talking loudly and I'm using
big gestures might freak some people out that would be an information processing
shortcut error because they're interpreting something in the present
that based on a past experience and the two are not the same we can help people
work through those mental noise my son bless his heart he's a teenager
and I think part of us just being a teenager but I will be talking to him
and he'll just like start off on some diatribe on something else he's been
busy thinking about something else while I've been talking and his mind is just
all over the place constantly and part of that is him being gifted his mind
works a lot faster so he gets bored with what I'm saying pretty quickly part
that's just being a teenager but helping people calm down the mental noise so
they can focus on what's being said and hear everything instead of just the
first part or little glimpses here and there so they can understand the entire
situation of what's going on you may notice it if you've been in a
meeting and you're just kind of you're drifting off you're half paying
attention and all of a sudden you hear something about budget cuts and all of
sudden you're paying attention now the mental noise was going on first and now
you're not sure you're having to try to play catch up and figure out what
they're talking about and how it applies to you and we also have thinking errors
that are caused by the brains limited information processing capacity and
you're like what we've got huge brains yes we do but a two-year-old does not
have the experiences or even the ability to process information in the same way
that a 22 year old does so things that you learned as a child may not be
accurate or even helpful now when you were a child it was really important
to listen to your parents and you know because you're dependent on them for
survival as a 22 year old you know theoretically you're living on your own
so it's less important you can get groceries for yourself
you can tend to your own basic needs if you will so taking those that same
experience is it good to be respectful of your parents and yadda-yadda-yadda
of course you know generally that's what we want to kind of strive for but not
all families are functional so in really dysfunctional families sometimes the
adult the 22 year old who doesn't rely on mom and dad to change their diaper
and feed them is able to set some boundaries and say you know what this is
what's important to me at crisis when we're in crisis we do not process
information nearly as well which is why it's important to write things down for
people who are in crisis and it doesn't just mean victims of crime it means
someone who got fired from their job who got into a car accident who just got a
diagnosis of some sort of long-standing not necessarily even terminal disease
anything that's going to throw them for a loop if you will is going to prevent
them from hearing and taking in all that information so it's important to help
people process things all the way through for the like with the example of
someone who gets a diagnosis of some sort of long-term illness they're going
to hear that and they're just going to probably zero in on that and not hear
60% of what said after that so it's important for somebody else to be there
with them or for the care provider to write it down to make sure they
understand okay yes this is diagnosis but these are our
options and this is what we need to do this is the treatment plan emotional
causes of thinking errors I feel bad therefore must be bad I hate my job
therefore this must be an awful place to work
possibly but possibly you've got other stuff
going on I'm scared therefore this must be a
scary event this is one that when I work with clients who have fears of flying
you know kind of what we talked about is emotional reasoning let's look at the
facts and see if it supports the fact that you're scared let's see if it
supports the fact that this is a terrifying experience now obviously we
talk about the emotions ahead of time and where it came from I'm not just
going to go well that doesn't make sense but at a certain point we might start
exploring the fracture basis to their emotional reaction morale causes of
thinking errors sometimes you can convince yourself it was the right thing
to do or it was the wrong thing to do and make judgments on yourself and other
people based on your moral reasoning and social causes well everybody's doing it
so or nobody's doing it so if you're thinking that because you see something
plastered across social media or plastered across the internet seemingly
24/7 and you're thinking well everybody thinks this way or likewise you're not
seeing something you're like well nobody thinks this way you want to examine that
because it may not be girly getting one perspective and that's whatever you're
seeing there have you talked to people have you gone in your local community
and examined you know from your peer group is everybody doing it is nobody
doing it what does the data say we use this type of reasoning a lot when we're
talking to youth about substance abuse prevention and sexual practices so what
is the impact of thinking errors and I alluded to this earlier they trigger
fight or flee most of the time so when we do that we set off our HPA axis
secrete a bunch of cortisol and create a cascade of excitatory reactions to
prepare us to survive it makes sense yes there is
to survive most of the time I would say you know just spitballing at 85 percent
of the time we are making threats or perceiving threats when there are none
there or there aren't any that are really worth our energy but thinking
errors cause depression anxiety emotional upset behavioral withdrawal
some people may try to escape by using addictions because they they're thinking
errors are so ingrained that they perceive the world is a really scary
hostile and welcoming place and they don't they feel hopeless and helpless to
change anything when your stress response is activated you're not going
to sleep as well and so you're going to feel tired a lot which will change your
sleep patterns which breaks down your ability to get quality sleep eating
changes may occur because when you're not sleeping and maintaining your
circadian rhythms you're eating hormones also get out of whack but also some
people just eat in response to stress physically we know there are a bunch of
stress-related illnesses but even if you don't have a stress-related illness if
you're under a lot of stress you may get more headaches backaches upset stomach
GI distress that kind of stuff and socially you may just not have the
energy or desire to interact with people so kind of putting yourself in the
position of someone who has a lot of cognitive distortions you can see how it
impacts every aspect of their life thinking errors and interventions
emotional reason feelings are not facts you know your feelings are your feelings
and they're coming from somewhere your brain is telling you there may be a
threat I hear you so let's figure out if there is one encourage people to learn
to effectively identify feelings and separate them from facts so the person
says I'm terrified about flying so we know why you're terrified what's the
evidence that you're in danger when you go up in the sky you know and a lot of
times people just have memories of what they saw on TV that
availability heuristic things that may be big but not frequent really kind of
stick with us you know right after 9/11 you know big event very scary stuck with
you about you know whether you were safe or not so asking the person what is the
evidence that this is dangerous in what ways is this similar to other
situations that you've been in you've had to fly or or do something that is
terrifying so give me another situation that's been like this and how have you
dealt with that because most of the time people have been terrified of multiple
things you know it's not just not just flying so we'll talk about other
situations where they have dealt with fear and that will give us an
understanding and that will remind them of their strengths about how they most
effectively deal with fear and we can start talking about that and if they
can't come up with anything you know go back to a less intense emotion like well
when you're scared what do you do when you're worried about something what do
you do that helps you feel less worried you know I don't want dwelling on it
pacing around in a circle things that intensify it I want to know what helps
because most everybody and you know I'm sure there's people out there who
haven't but everybody I've encountered so far has always had one or two things
they can do that help them feel a little bit less stressed not always the
healthiest but we try to start from there and work forward you know some
people smoke a cigarette some people go work out some people
drink some people you start there figure out what they've done before and build
kind of from there to figure out what to do encourage them to develop distress
tolerance skills whole other presentation but recognizing that fear
and the urge to escape comes in like a wave and goes out usually in about 20
minutes if they can deal with it give them things to do in order to not focus
on their distress for my clients with airplanes
it is when they have to fly I encourage them to do that game remember when you
used to fly and not fly but drive with your parents and long drives and you
would look at billboards and you would find things but something that began
with the letter A and then the B and C and D or something with certain colors
or whatever it was we always play these inane little games when we were driving
in a car to keep us from being bored but you can use the same sort of mental
games and high jinks to keep you focused and not focused on your anxiety the
other thing you can do is you know mindfulness exercise identify four
things that you can hear or see three things that you can hear two things you
can smell one thing you can touch the other one is using guided imagery
encourage them to try to focus on wherever they're happy places what does
it smell like what does the Sun feel like what does it feel like
temperature-wise yada-yada so they can distract their
brain if you will until that urge until that fear passes and they may need to
use it a couple of times depending on you know if they hit turbulence I know
when I'm flying I'm not particularly afraid of flying but when I hit
turbulence I'm saying a few Hail Marys and it's just kind of an automatic
reaction and then I kind of get grounded again and encourage people to develop
emotional regulation skills prevent as much distress as possible by preparing
ahead of time if you know you've got to fly what can you do to get good rest
what can you do to minimize the possibility that you're going to react
with strong emotions and again that's a whole other presentation we've got
videos on it on our youtube channel youtube.com slash all CEUs education and
you can also google it these are basic dialectical behavior therapy skills
cognitive bias negativity mental filter kind of all in together
when you focus on the negative and worry about the future the cognitive bias
means focusing on things and always interpreting things to a negative or to
a positive extent generally a negative cognitive bias is the one that our
clients experience or they wouldn't be feeling depressed and anxious but this
mental filter also encourages you to only see and focus on the negative
aspects of something so questions you can ask people what's the benefit to
focusing on the negative what are the positives to this situation and they may
look at you like you've got three heads and it may take some you know cajoling
to get some positives out of a certain situation if somebody gets fired that's
not a happy experience all right so what positives can we find in this situation
well you have an opportunity to find another job so we want to look at what
happened what was going on what contributed to the firing and help the
person learn from the situation so maybe in the next job it can work out a little
bit better and we want to have them look at what are all the facts you know
because sometimes somebody will come to you and go I got fired from my job for
absolutely no reason at all and there was no warning okay hmm
well knowing what I know you know and I'm not going to tell somebody this but
there has to be a process of verbal reprimands and stuff unless you're on
your probationary period so we might start talking about well tell me a
little bit more about what was going on and how this happened and what reason
they gave you so let me start getting an idea about what were some more of the
facts and you know what could we take away from this another activity I do
completely different from the questions is a coin toss activity if somebody
tends to be a negative Nellie that's fine however I want you to just
experiment for a week in the morning you wake up plus toss a coin if it lands
on heads you need to proceed as if you were the
most optimistic person in the whole world and put on those rose-colored
glasses and act as if and then on the days that it lands on tails you can just
you know be normal be yourself and at the end of each day I have them fill out
a diary if you will a journal to describe how their day went when they
were negative versus when they were positive how did people interact with
them how did their day seem to go and it's going to be a little bit exhausting
to be happy for an entire day if that's not your normal mode so I'm not
expecting them to go oh that was the best thing in the world but I do want
them to start noticing that things may go a little bit easier and I also want
them to notice that on the days that they were optimistic there were things
to be optimistic about they actually found the good things so then the next
week we can go more towards dialectics and walking the middle path so when they
have a negative font I want them to think of a corresponding positive
thought to balance it out disqualifying or minimizing the positive a lot of our
clients do this you know you say wow that was congratulations on your
promotion and it was no big deal great job achieving that goal anybody
could do it so a lot of times they don't feel good about themselves because
they've always minimized their own accomplishments they make it a month
sober they may minimize that accomplishment well it was only one
month or I've been here before you know just waiting for the other shoe
to drop I ask them questions like will you minimize this if it was your best
friend's experience or your child's experience you know if they got this
award would you be like anybody could have done that just put it on the shelf
somewhere probably not so encourage them to become more kind and compassionate to
themselves and treat them selves the way they would treat other
people that are important to them we talk about what's scary about accepting
the positive if I accept that I got a really good job and this is an awesome
experience it's intimidating you know people are expecting things now and if
you mess up you know people may judge you yeah all those things are true
however can you handle it so a lot of times we make it spend a lot of their
amount of time talking about what's scary about success because often times
success is kind of like climbing to the top of that mountain and then looking
over the edge terrified of heights absolutely terrified of heights so I
don't look over the edge and I can understand how someone who you know just
like somebody who is coming out of depression if they're in a bipolar
episodes especially but if they're coming out of that deep depression the
most dangerous period for them is when they're starting to feel better and
they're starting to accept that things are getting better and they're happy
again because they're like crap I don't know that I can fall from this I don't
know if I can endure the fall so we talk about how do you prevent that what would
happen is you know you failed or you started to get depressed again what what
steps would you take sometimes we disqualify the positive because it fails
to meet someone else's standards so asking the person might not be true here
you know when I got my degree I was met with well congratulations you're not a
real doctor but a PhD is a good accomplishment excuse me
so sometimes the people that you think you need approval from may not be able
to give the kind of approval that is important to you so encouraging people
to be able to give themselves positive feedback and be proud of their
accomplishments despite other people's judgments is really important to helping
them accept themselves and you know again get away from that fear of
and then because they know that they're good enough smart enough and gosh darn
it people like me availability heuristic is remembering what's most prominent in
your mind so like I said about the airplane crashes whenever an airplane
crashes we always hear about it whenever an airplane doesn't crash we don't hear
about that there's like 20,000 flights in the USA every day and none of them
crash but every once in a while one will and that's what we hear about
so we Zone in on that and think about it as being dangerous so asking people what
are the facts it seems like this is a really dangerous thing to do fly in the
air 30,000 feet above the ground what are the what are the actual facts about
it and you know are there other things that you do like driving on the
interstate which are similarly dangerous or more dangerous and I don't always
throw that part in there because I don't want them to become afraid of driving in
addition to flying but we do look at facts about whatever the prominent fear
is egocentrism my perspective is the only perspective so what I see is what
happened and I don't care what you say you don't necessarily know what happened
and if you've been a parent you know this is true because you may walk in and
go I can't believe you just did that but you don't realize that before you walked
in the other child had done something else that was equally as bad so figuring
out everything and seeing the entire picture is really important and not
getting stuck on well I saw this and this is the way it is so but a bang when
you go into a grocery store and you interact with it with a cashier who is
just terribly unpleasant and you know I was a cashier before it is a challenging
job I loved it but you can meet some challenging people
so thank in terms of all right this person is
being really unpleasant but is it about me you know my initial perspective might
be you're being really rude to me however if I step back
what other perspectives might be going on you know what my what else might have
happened and might be explaining this other than this person is just rude
personalization and mind-reading what are some alternate explained
explanations for the event that didn't involve you I put this on the same page
because they're really related thinking about you know again that cashier maybe
they had to really rude customers leading up to that maybe they were
supposed to get off three hours ago and their relief didn't show up so they're
having to work mandatory overtime there's a lot of things that could have
happened maybe their dog just died I don't know but I don't know what's going
on in someone else's head so I have to assume or I choose to assume 99% of the
time that it's not about me you know I checked my own self and I was like okay
was I reared that I do know okay if there's not anything obvious then I
assume that something else may be going on with them how often is it really
about you so encouraging people to think about that how many times was somebody
in a bad mood or grumpy or past you in the hallway and didn't say hi how many
times was that a slide against you versus they were off in la-la land or
something else that happened and you know they were in a bad mood before they
even really realized you were there magnification ask people are you
confusing high and low probability outcomes if somebody is saying that this
is the worst thing ever okay how much will it matter six months
from now we know that you know sometimes people get into arguments about leaving
the toilet seat up but the cap off the toothpaste or not putting their dishes
in the dishwasher you know when you live in the house with somebody there can be
arguments arguments at work arguments other places but a lot of times the
things that we get said about we may get more upset than we
need to be because we've got other vulnerabilities going on back here with
what stress build-up we didn't get enough sleep we haven't eaten in 12
hours whatever it is there could be a lot of reasons for it but encouraging
yourself when you start to feel yourself getting upset think how much will does
matter six months from now and is it worth my energy it's kind of what I put
on the end of that because it may matter a little bit six months from now but is
it worth dumping a bunch of energy into it right now or is it something you've
just got to let play out what have you done in the past to tolerate events like
these you know ask somebody nicely to change situation or you know how have
you handled other situations where you didn't have to think it the worst thing
in the world that it was just going to devastate and ruin your day
similar to magnification is all or nothing so I have people look at things
like love and hate perfection and failure all good intentions or all bad
intentions most of the time you know people are not totally perfect or
totally failures most of the time people don't have all good intentions or all
bad intentions now sometimes they may have all good intentions for a
particular episode or event but I think most of us are guilty of you know not
necessarily always doing the next right thing so encouraging people to look for
exceptions in love versus hate I love this person this week next / next week I
hate this person I never want to see them again what exceptions are there
what do you love about them what do you hate about them we look at behaviors
versus people we also look at you know imperfection versus failure because a
lot of people get stuck on this if I'm not perfect and I'm a total failure do
you hold other people to that standard and what things have you done that have
been really awesome and encourage people to focus on
the things they can control remembering what's most prominent we already talked
about the availab available 'ti heuristic belief in a just world or a
fallacy of fairness identify for good people who've had bad things happen you
know I encourage people to realize that sometimes you may be good you may be
doing all the right things and something crappy is just going to happen if they
believe that if they do the right thing and then they're always going to have a
good life and everything's always going to go well you know hear that word
always which is where another cognitive error bleeds in there it's important for
them to understand that sometimes think life just ain't fair so how do you deal
with it and accepting the fact that life isn't fair help from an early age helps
people deal with it when something happens that's unfair and they don't go
oh my gosh I didn't expect that to happen they can go well yep mama always
told me life ain't fair as she told me to go up and clean my room anyway
attributional errors labeling yourself not a behavior and a lot of us and a lot
of our clients tend to do this such as I am stupid versus I don't have good math
skills so global attributions are things that apply to the whole person
individual agency that is the worst agency ever versus that agency has some
really bad managers but it has some really good line staff encouraging
people to be specific about things that they have issues with with themselves
with other people that person that lives across the street is just totally crazy
and unreasonable about what you know if they're totally crazy and unreasonable
all the time about everything and in your face okay
but most of the time that's not going to happen so it might be about a certain
thing that the person across the street is totally crazy when my dog goes over
and uses the bathroom on our yard or something to encourage them to be more
specific stable means it's something that's not changeable at all so you know
I am stupid means I am and always will be versus you know I am ignorant to this
particular skill but I can learn it so you know I can learn to do math I've had
to learn to do math again as my son's exceeded my math abilities and internal
it's about me as a person versus about a skill or skill deficit one of the common
things that we use to give an example of this is if you see somebody walking down
the street and they trip and fall do you say that they are a total klutz
or do you think initially that person must have lost their balance because
they tripped on something on the concrete when you trip it's a single
event it's on the concrete it's external it's not that the person's clumsy is
that they tripped or they weren't paying attention because they were playing on
their phone versus they are a total and complete klutz one can be changed one is
more durable so questions for clients encouraging them to understand that
beliefs are the combination of thoughts and facts plus their interpretation
reality plus interpretation produces what we come to believe so we ask them
what are the facts for and against my belief and you can do this with positive
things too doesn't usually require it but you can so you might start out if
your group is somewhat resistant to doing some of these activities you might
start out with positive things but whatever works what is it what are the
facts for and against my belief is belief based on facts or feelings so
we've already identified the facts for and against now we look at this belief
and we're looking at these lists of facts for and against and if the beliefs
it's the facts then the belief is probably based on facts if the belief
doesn't fit the facts then we might look at well what is it based on may be
feelings so we can start exploring it does it focus on one aspect or the whole
situation you know there's generally a lot of
things going on if somebody gets in a car wreck
they oftentimes focus on the person in front of them that put on their brakes
too fast or you know turned without signaling or did whatever they did they
focus on one aspect of the situation instead of what other drivers were doing
what else was going on what they were doing in to paint the big context does
the belief seem to use any thinking errors and we've just gone through a
bunch of them all or nothing thinking magnification and selective attention
paying attention to the things that fit your hypothesis what are some
alternative explanations for what might have happened you know if you've been in
a car accident you've been rear-ended you might think that person wasn't
paying attention true could be or maybe they were paying attention and they it
had just started raining it hadn't rained for a while and it was really
slippery and they didn't judge the distance to stop in enough time happened
a lot in Florida so thinking of alternate explanations can help people
examine their beliefs it may not change them but it helps give them some
alternative thoughts what would you tell your child or best friend if they had
this belief what do you want someone to tell you about this belief and how is
this belief moving you toward what and who is important to you or away from
what or who is important to you so have them really examine if I hold onto this
belief that I am useless okay is it based on facts or feelings
does it focus on one aspect or the whole situation are you useless all the time
to everybody and I generally well I don't think I would ever ask somebody
that question directly I would ask them in what ways are you useful to people
and hopefully I have some information ahead of time like I know that they're a
parent and they work and yada yada no we might start examining some thinking
errors that might lead them to think that they are totally useless and so on
as we work through these questions so cognitive distortions personalizing mind
reading all-or-nothing thinking catastrophizing making mountains out of
mole hills over generalization taking one thing that happens and expecting it
to happen in all situations all the time every time I see someone that meets this
description I am expecting them to act this particular way should I should do
this but you know and the recency or availability heuristic all of these can
play in to our fears of rejection isolation the unknown loss of control
and failure when you personalize something negative if you think it's all
about me and I am the worst person ever well why should anybody like you and if
you feel like you're not lovable like you're not likeable then you may feel
isolated and depressed so you know you can kind of see how those things work
together what do we do the abcdes which you probably learned as the ABCs and
we've just added we keep adding letters the activating event is what happened
you got into a fight with your significant other the consequences you
got upset you are devastated you ran out and you slept at your best friend's
overnight okay in the meantime there were those automatic beliefs so what are
the obvious beliefs you had the first things that you can
rattle off the part that your significant other didn't love you that
they didn't have any respect for you then whatever it is then we want to look
at the negative self-talk and past tapes and things that you are also telling
yourself about whether you were unlovable and whether you deserved to be
treated like this we go back and we dispute the irrational thoughts we look
at the beliefs identify any cognitive distortions any irrational thoughts and
dispute those there are going to be some left you know maybe your significant
other was completely insensitive all right well we can't take that away if
that's what happened so we evaluate the most productive outcome is staying angry
worth my energy or is there a different way to approach this is there something
else I can do how can I best use my energy to deal with this situation
if it's worth my energy or let go of it if it's not worth my energy maybe you
got into this big old fight because your roommate forgot to clean out the litter
box you know it happened is it worth your energy to get all fired up about it coping skills distract don't react
encourage people to figure out a way and sometimes I call this practice to pause
to take a breath and distract themselves for a minute until they can get into
their wise mind until that adrenaline rush goes away and they can think
clearly talk it through to identify cognitive distortions and find the
middle path sometimes you're not going to talk it through with the person
you're angry at sometimes you can talk it through with your dog because you
know Freud used to remem talk to himself and figure out his own stuff but a lot
of times you can just glean a lot of information by journaling it or talking
if you're an extrovert you're probably going to talk if you're an introvert you
may write whatever it works for you get it out so you can evaluate it and find
the middle path you know the good and the bad in it
encourage clients to practice practice urge surfing and remind them that their
urge to fight or flee will dissipate if they don't keep feeding it have clients
pinpoint what they tell themselves about an urge that makes it harder to cope
with the urge whether they want to self injure whether they want to put their
fist through a wall or through somebody else's face or whether they want to
scream and yell at somebody and really put them in their place those are all
urges so what do they tell themselves about those urges that make it harder to
not engage that urge help them develop a list of empowering self statements to
constructively challenge anything that makes it difficult to cope with that
urge anything that's going to help is going to make them feel better so some
of these statements they can use are what's the evidence that I have to put
my fist through the wall what's the evidence that screaming that this person
is going to do any good encourage themselves to encourage them
to give themselves some space and some compassion recognizing that that person
is human they have a right to make mistakes or if they're angry at
themselves you're human you have a right to make mistakes and you have a right to
your feelings other empowering self-talk is I can do this I can get through this
this urge will pass whatever it is that helps them get through that 20 to 30
minute period where they may still feel that urge distressing thoughts worksheet
we already went through a group activity have them list thinking errors and you
can do it you know y'all know I favored putting flipchart papers around the room
and breaking my large group and 8 to 12 people or whatever into smaller groups
of 2 to 4 and having them go around to the different stations where after we've
already defined to discuss spanking errors
and and how they protected you until now we might have them go over to
overgeneralization and say let's talk about this how is it
protected you until now and they can list different ways for example if they
were victimized when they were younger than anybody that reminded them of that
maybe someone who is dangerous so in a way it acted to protect them in without
other information it just kind of served as a great big blanket barrier so
encourage them to look at how has this worked for you and you know it may not
be working very well but it served a purpose at one point a lot of times it's
a survival sort of thing a protection thing identify thinking errors that you
can currently eliminate Anna countering mantra so I need to be loved by
everybody all the time or I am the worst most useless person in the world or I
will never be happy those are all cognitive distortions extreme thinking
so what kind of countering mantras can they can we help them find what kind of
positive self-talk when they tell themselves that what can they respond
with help them identify thinking errors that they still hold on to and why and
start addressing them so if there are some things like I can never be happy or
everybody always leaves ok if somebody is determined to hold on to that you
know they can't see any alternate explanations then let's look at what
function is that serving for you how is it protected what does it do for you and
in what way is it helping you or how can we start addressing it remembering that
thought patterns are generally learned over a long period of time and they
serve a purpose and we are generally more beneficial than the alternative
for example if someone was emotionally abused as a child they may have
developed issues with authority figures in the present you know they are not
going to be disempowered again come hell or high water so we can understand from
you know an interpersonal perspective how that might have developed and how it
might have been beneficial at a certain point in their lives in order for them
to feel like they were regaining power is it functional now if they're working
with us it's probably not so what's a more effective response a change in
Outlook I mean seeing how this thought pattern is now destructive and how
alternate thought patterns may now be more helpful so helping people figure
out how they can deal with authority figures and helping them see how their
verbal and nonverbal behavior may be off-putting if they are thinking that
people who are an authority are always going to do them wrong so cognitive
behavioral therapy is a technique that helps people understand how their
thoughts create feelings and vice versa we help them identify and address
negative self-talk and you know in negative self-talk I put those cognitive
distortions all-or-nothing thinking negative thoughts that fuel the see the
consequence issues and events from the past don't need to continue to
negatively impact the person they can choose to walk the middle path they can
choose to deal with it they can choose to incorporate it into their life if you
will you know if someone was victimized when in the past you know I'm not going
to say well that's that's done that doesn't impact you anymore yes it does
it's something that occurred and something that will affect your hands
forth in forever more you can choose whether it affects you negatively and
keeps you stuck and depressed and feeling broken or whether you use it as
a source of strength to see what you've overcome
and use it maybe to help other people or you know find some positive uses for it
but it doesn't need to continue to negatively impact you and pull you down
thinking errors are learned and can be unlearned now as children like I said
children in the pre-operational stage in in concrete thought they can't think
abstractly so they can't see alternate possibilities it's kind of whatever is
in front of their face this is when they're generally thinking in
all-or-none terms so unless as adults we help them challenge that thinking
pattern as they get older a lot of times everything except for the most
rudimentary things like math skills go unchallenged so we have cognitive
distortions carry on into later life these thought patterns can help to form
and maintain a negative or vulnerable self-image and healthy thought patterns
can help people feel more empowered and worthy of love and it also helps them
become more able to feel compassionate towards other people if they're not
envisioning everyone else as always out to harm them hurt them or take advantage so before I get to the question part if
you need to go take the quiz you can feel free to go ahead and go do that I
do want to remind you we've got the Nashville counseling unconference coming
up in February February 23rd through 25th it up to 20 CEUs will be available
the whole conference is going to be 99 dollars in advance registration will
open in October of 2017 and we do have open right now the call for papers to
get a variety of presenters we're really looking for students who have at least a
master's maybe not licensed yet and people who are working in the field who
want to share their knowledge and experience this is not a sponsored
conference at being said I am going to pause this for a second so I don't
coughing your ear sorry about that okay are there
questions you know feel free to type them in the chat window and I can see
what I can do to address them what experience do you have with your clients
and cognitive distortions one thing I like about doing CBT and DBT techniques
in group is that they are so ripe for group activities and they're so right
for group discussion it's not as abstract as some other stuff that we
might talk about and it can really help people grab on to a particular tool even
if they only identify with one cognitive distortion they can walk out of the
group that day and go okay I see how I might think in all or nothing' terms a
lot so from now on when I hear myself say every time always are using extreme
word I'm going to use a different one it's a simple change but it can help
people start feeling a little bit better and a little more empowered to change
what's going on and what it feels like in their own head alrighty well it
doesn't seem like y'all have any questions okay wait a minute
yes Journal work is awesome for thinking errors and if somebody doesn't like
journaling I know I'm not great at journaling like prose longhand if you
can give them Question and Answer sheets I have a cognitive distortions checklist
that I have people go through and if they're having an unpleasant thought or
if they're in a really bad place I have them just kind of go through and try to
fill out examples of thoughts they're having that fit the current cognitive
distortions but yeah getting people to write it down and get it out and become
aware of their thinking patterns is so awesome you so I will just do another presentation
or do a presentation on Aging issues so that's excellent the presentation is in
your classroom it's in a PDF that you can download if you're looking if you
want to have it out to review for you know future reference or whatever you you miss sandy I think you were talking
about putting the journal worksheet on the website and yes I can do that I will
put it in additional resources I understand what you were asking now and
yes it is Thursday today Tuesday I thought it was Thursday I guess I was
getting like getting ahead of myself so it is Thursday everybody have an amazing
long weekend try to enjoy it stay safe whatever you're doing and I will see you
on Tuesday welcome to this week's book review each week I'll review a book that
I believe would be helpful to the general public and or clinicians I'm
never paid to do the reviews however in some instances I may receive a small
Commission if you purchase the item which helps defray the cost of our
podcast and providing the free educational videos the cost to you
however remains the same today we're going to be talking about self esteem
and this is the fourth edition I actually started out using this book
when it was back in the third edition and I absolutely loved it it's a very
comprehensive guide to helping people improve their self-esteem in the book
you're going to learn how to uncover and analyze negative self statements so
talking about that internal critic create new more objective and positive
self statements let go of judgemental self attacking thoughts and act in
accordance with what matters to you most so the book is 300 and some odd pages
and it goes on for a while but what it does is walk you through step by step
understanding what self esteem is because it's kind of one of those terms
that we talk about but we may not really know what it is and why just telling
yourself that you're okay may not work well the key is you have to
believe it so he starts talking about why people don't believe they're okay
even if they tell themselves they are then he introduces you to the
pathological critic and encourages you to explore why you listen to it and
learn how to disarm it it moves on from that point
to creating a balanced self-description accepting weaknesses and embracing
strengths recognizing that we're not perfect but nobody's perfect so
embracing yourself and cherishing yourself as you are he moves on from
there to identifying in combating cognitive distortions that keep you
feeling bad because a lot of times when we start looking at our weaknesses we
magnify them and when we look at our strengths we minimize them and that
keeps us feeling bad about ourselves so McKay goes into great detail about how
to combat some of those cognitive errors or thinking errors he encourages you to
explore your thoughts about compassion and developing self compassion one of
the reasons that many people have difficulty developing self-esteem and
being kind to themselves is because somewhere along the way they were taught
that having compassion for themselves or being kind can be seen as weakness or
failure or something negative so he really challenges you to look at your
beliefs about self compassion and self-acceptance he explores how to
reframe mistakes and accept phal ability because again even though we know we've
got strengths and weaknesses we're also going to make mistakes so accepting
those and learning from them and not turning them into something huge but
accepting that everybody makes mistakes then he talks about what to do with the
constructive and destructive criticism that you receive
sometimes on a daily basis to help you respond in a meaningful way and
basically it boils down to a bunch of techniques that will help you learn how
to take what's useful and leave the rest accepting that sometimes criticism is
not as much about you as about that other person's stuff and then he ends
with helping you clarify what you want and need and using your skills to get
those needs met more effectively so creating win-win situations and learning
how to assertively communicate with the people that are important to you
this book is written in really plain language with practical tools which is
one thing that I love about it you can read three or four pages get something
really useful and insightful and work with that for a while then come back the
next day or the next week and read another three or four pages so it can be
really useful for self-help or as a tool to guide individual or group therapy
sessions visual learning clients like to have it as a reference to review markup
and bring for discussion in the next session so a lot of times when I do
self-esteem groups I'll have each client get a copy of this book we go through it
page by page activity by activity we do them sometimes in class sometimes it's
homework and then we talk about what they learned and then they can go back
and review over the week between sessions what we talked about and get
those visual cues that help them remember the important skills I hope
you've enjoyed this book review and please feel free to log on it's self
esteem by Matthew McKay it does have a Google preview so you can read a little
bit more about what's in it and see for yourself and see if it resonates with
you as a good tool for self-improvement if you enjoy this podcast please like
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