Feeling Good Flashcards
Intro to CBT
Burns Depression Checklist check table pg 35
Table 2–2. Interpreting the Burns Depression Checklist
Total Score
Level of Depression*
0–5
no depression
6–10
normal but unhappy
11–25
mild depression
26–50
moderate depression
51–75
severe depression
76–100
extreme depression
*Anyone with a persistent score above 10 may benefit from professional treatment. Anyone with suicidal feelings should seek an immediate consultation with a mental health
take the BDC test at regular intervals to assess your progress objectively suggest a minimum of once a week
Bad feelings
Every bad feeling you have is the result of your distorted negative thinking. Illogical pessimistic attitudes play the central role in the development and continuation of all your symptoms.
Intense negative thinking always accompanies a depressive episode, or any painful emotion for that matter.
that the negative thoughts that flood your mind are the actual cause of your self-defeating emotions.These thoughts are what keep you lethargic and make you feel inadequate.your negative thinking has become such a part of your life that it has become automatic. For this reason I call negative thoughts “automatic thoughts.” They run through your mind automatically without the slightest effort on your part to put them there
10 Definitions of Cognitive Distortions. 1 All-or-Nothing Thinking/Dichotomous thinking
- All-or-Nothing Thinking/Dichotomous thinking All-or-nothing thinking forms the basis for perfectionism. It causes you to fear any mistake or imperfection because you will then see yourself as a complete loser, and you will feel inadequate and worthless.
This way of evaluating things is unrealistic because life is rarely completely either one way or the other. If you try to force your experiences into absolute categories, you will be constantly depressed because your perceptions will not conform to reality
- Overgeneralization
You arbitrarily conclude that one thing that happened to you once will occur over and over again
3 Mental Filter, /selective abstraction
. You pick out a negative detail in any situation and dwell on it exclusively, thus perceiving that the whole situation is negative. When you are depressed, you wear a pair of eyeglasses with special lenses that filter out anything positive.
Disqualifying the Positive
An even more spectacular mental illusion is the persistent tendency of some depressed individuals to transform neutral or even positive experiences into negative ones
An everyday example of this would be the way most of us have been conditioned to respond to compliments.
The hypothesis that dominates your depressive thinking is usually some version of “I’m second-rate.” Whenever you have a negative experience, you dwell on it and conclude, “That proves what I’ve known all along.”
you have a positive experience, you tell yourself, “That was a fluke. It doesn’t count.” The price you pay for this tendency is intense misery and an inability to appreciate the good things that happens
Jumping to Conclusions. Ex- “ mind reading” and “the fortune teller error.”
You arbitrarily jump to a negative conclusion that is not justified by the facts of the situation. Two examples of this are “ mind reading” and “the fortune teller error.”
MIND READING: You make the assumption that other people are looking down on you, and you’re so convinced about this that you don’t even bother to check it out..
THE FORTUNE TELLER ERROR: It’s as if you had a crystal ball that foretold only misery for you.You imagine that something bad is about to happen, and you take this prediction as a fact even though it is unrealistic
During a therapy session an acutely depressed physician explained to me why he was giving up his practice: “I realize I’ll be depressed forever. My misery will go on and on, and I’m absolutely convinced that this or any treatment will be doomed to failure.” This negative prediction about his prognosis caused him to feel hopeless. His symptomatic improvement soon after initiating therapy indicated just how off-base his fortune telling had been.
Magnification and Minimization
either blowing things up out of proportion or shrinking them
Magnification commonly occurs when you look at your own errors, fears, or imperfections and exaggerate their importance
When you think about your strengths, you may do the opposite—look through the wrong end of the binoculars so that things look small and unimportant. If you magnify your imperfections and minimize your good points, you’re guaranteed to feel inferior. But the problem isn’t you—it’s the crazy lenses you’re wearing.
Emotional Reasoning
You take your emotions as evidence for the truth. This kind of reasoning is misleading because your feelings reflect your thoughts and beliefs. If they are distorted—as is quite often the case—your emotions will have no validity
Should Statements/musturbation
You try to motivate yourself by saying, “I should do this. Paradoxically, you end up feeling apathetic and unmotivated
. Should statements generate a lot of unnecessary emotional turmoil in your daily life. When you direct should statements toward others, you will usually feel frustrated. When the all-too-human performance of other people falls short of your expectations, as will inevitably happen from time to time, you’ll feel bitter
Labeling and Mislabeling
Personal labeling means creating a completely negative self-image based on your errorsLabeling yourself is not only self-defeating, it is irrational. Your self cannot be equated with any one thing you do. Your life is a complex and ever-changing flow of thoughts, emotions, and actions
Mislabeling involves describing an event with words that are inaccurate and emotionally heavily loaded
Personalization
You assume responsibility for a negative even when there is no basis for doing so. You arbitrarily conclude that what happened was your fault or reflects your inadequacy, even when you were not responsible for it.
Personalization causes you to feel crippling guilt. You suffer from a paralyzing and burdensome sense of responsibility that forces you to carry the whole world on your shoulders. You have confused influence with control over others
In your role as physician you will certainly influence the people you interact with, but no one could reasonably expect you to control them. What the other person does is ultimately his or her responsibility, not yours.
Summary of Definitions of Cognitive Distortions
- ALL-OR-NOTHING THINKING: You see things in black-and-white categories. If your performance falls short of perfect, you see yourself as a total failure.
- OVERGENERALIZATION: You see a single negative event as a never-ending pattern of defeat.
- MENTAL FILTER: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that colors the entire beaker of water.
DISQUALIFYING THE POSITIVE: You reject positive experiences by insisting they “don’t count” for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences. - JUMPING TO CONCLUSIONS: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion.
a. Mind reading. You arbitrarily conclude that someone is reacting negatively to you, and you don’t bother to check this out.
b. The Fortune Teller Error. You anticipate that things will turn out badly, and you feel convinced that your prediction is an already-established fact.
- MAGNIFICATION (CATASTROPHIZING) OR MINIMIZATION: You exaggerate the importance of things (such as your goof-up or someone else’s achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow’s imperfections). This is also called the “binocular trick.”
- EMOTIONAL REASONING: You assume that your negative emotions necessarily reflect the way things really are: “I feel it, therefore it must be true.”
- SHOULD STATEMENTS: You try to motivate yourself with shoulds and shouldn’ts, as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “oughts” are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.
- LABELING AND MISLABELING: This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: “I’m a loser.” When someone else’s you attach a negative label to him: “He’s a goddam louse.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded.
- PERSONALIZATION: You see yourself as me cause of some negative external event which in fact you were not primarily responsible for.
your feelings are not facts
your feelings are not facts! In fact, your feelings, per se, don’t even count—except as a mirror of the way you are thinking. If your perceptions make no sense, the feelings they create will be as absurd as the images reflected in the trick mirrors at an amusement park. But these abnormal emotions feel just as valid and realistic as the genuine feelings created by undistorted thoughts, so you automatically attribute truth to them. This is why depression is such a powerful form of mental black magic
invite depression
Once you invite depression through an “automatic” series of cognitive distortions, your feelings and actions will reinforce each other in a self-perpetuating vicious cycle. Because you believe whatever your depressed brain tells you, you find yourself feeling negative about almost everything
This reaction occurs in milliseconds, too quickly for you even to be aware of it. The negative emotion feels realistic and in turn lends an aura of credibility to the distorted thought which created it. The cycle goes on and on, and you are eventually trapped. The mental prison is an illusion, a hoax you have inadvertently created, but it seems real because it feels real.
Goal
avoid painful feelings based on mental distortions, because they are neither valid nor desirable
once you have learned how to perceive life more realistically you will experience an enhanced emotional life with a greater appreciation for genuine sadness—which lacks distortion—as well as joy.
Depressed pt
that depressed patients see themselves as deficient in the very qualities they value most highly: intelligence, achievement, popularity, attractiveness, health, and strength.
He said a depressed self-image can be characterized by the four D’s: You feel Defeated, Defective, Deserted, and Deprived.
Almost all negative emotional reactions inflict their damage only as a result of low self-esteem
during periods of depression you lose some of your capacity for clear thinking; you have trouble putting things into proper perspective
. Negative events grow in importance until they dominate your entire reality—and you can’t really tell that what is happening is distorted.
It all seems very real to you. The illusion of hell you create is very convincing.
The more depressed and miserable you feel, the more twisted your thinking becomes. And, conversely, in the absence of mental distortion, you cannot experience low self-worth or depression
Maladaptive belief to others
In many cases you will be so persuasive and persistent in your maladaptive belief that you are defective and no good, you may lead your friends, family, and even your therapist into accepting this idea of yourself.
Worth
First, you cannot earn worth through what you do. Achievements can bring you satisfaction but not happiness. Self-worth based on accomplishments is a “pseudo-esteem,” not the genuine thing!
My many successful but depressed patients would all agree. Nor can you base a valid sense of self-worth on your looks, talent, fame, or fortune. Marilyn Monroe, Mark Rothko, Freddie Prinz, and a multitude of famous suicide victims attest to this grim truth.
Nor can love, approval, friendship, or a capacity for close, caring human relationships add one iota to your inherent worth.
The great majority of depressed individuals are in fact very much loved, but it doesn’t help one bit because self-love and self-esteem are missing. At the bottom line, only your own sense of self-worth determines how you feel
Specific Methods for Boosting Self-Esteem
Talk Back to That Internal Critic
Train yourself to recognize and write down the self-critical thoughts as they go through your mind;
b.Learn why these thoughts are distorted; and
c.Practice talking back to them so as to develop a more realistic self-evaluation system
What is the key to releasing yourself from your emotional prison
Your thoughts create your emotions; therefore, your emotions cannot prove that your thoughts are accurate. Unpleasant feelings merely indicate that you are thinking something negative and believing it
Your feelings are inconsequential. . In fact, to the extent that your negative emotions are based on mental distortion are unwanted.
Delusion of depression and zero self worth
You end so persuasive and persistent in your maladaptive belief that you are defective and no good, you may lead your friends, family, and even your therapist into accepting this idea of yourself.
Exercises
Commit some regular time and effort to this program, you can expect success proportionate to the effort you put in
work at the triple-column technique for fifteen minutes every day over a period of a month or two, you will find it gets easier and easier. Don’t be afraid to ask other people how they would answer an upsetting thought if you can’t figure out the appropriate rational response on your own.
Talk Back to That Internal Critic
In order to overcome this bad mental habit, three steps are necessary:
a.Train yourself to recognize and write down the self-critical thoughts as they go through your mind;
b.Learn why these thoughts are distorted; and
c.Practice talking back to them so as to develop a more realistic self-evaluation system.
“triple-column technique
draw two lines down the center of a piece of paper to divide it into thirds
Label the left-hand column “Automatic Thoughts
(Self-Criticism),”- write down all those hurtful self-criticisms you make when you are feeling worthless and down on yourself. Do not use words describing your emotional reactions in the Automatic Thought column. Just write the thoughts that created the emotion
the middle column “Cognitive Distortion,”Using the list of ten cognitive distortions see if you can identify the thinking errors in each of your negative automatic thoughts.
the right-hand column “Rational Response (Self-Defense).”substituting a more rational, less upsetting thought in the right-hand column try to recognize the truth.This rational response can take into account what was illogical and erroneous about your self-critical automatic thought.
Emotional accounting
quite helpful to do some “emotional accounting” before and after you use the triple-column technique to determine how much your feelings actually improve
. You can do this very easily if you record how upset you are between 0 and 100 percent before you pinpoint and answer your automatic thoughts
Mental Biofeedback
monitoring your negative thoughts with a wrist counter
Click the button each time a negative thought about yourself crosses your mind
note your daily total score and write it down in a log book
When you are down on yourself
ask what you actually mean when you try to define your true identity with a negative label
Once you pick these destructive labels apart, you will find they are arbitrary and meaningless
They actually cloud the issue, creating confusion and despair. Once rid of them, you can define and cope with any real problems that exist.
When you are experiencing a blue mood
you will experience a severe emotional reaction of despair and self-hatred
You may become inactive and paralyzed, afraid and unwilling to participate in the normal flow of life
Blue mood solution
Stop telling yourself you are worthless
Human life is an ongoing process that involves a constantly changing physical body as well as an enormous number of rapidly changing thoughts, feelings, and behaviors.
Your life therefore is an evolving experience, a continual flow.
Abstract labels such as “worthless” or “inferior” communicate nothing and mean nothing.
how to develop a sense of self-esteem
You don’t have to do anything especially worthy to create or deserve self
Turn off that critical, haranguing, inner voice
Three crucial steps when you are upset
Zero in on those automatic negative thoughts and write them down. Write them on paper
Read over the list of ten cognitive distortions
Substitute a more objective thought that puts the lie to the one which made you look down on yourself.
Most destructive aspects of depression
Any activity appears so difficult that you become overwhelmed by the urge to do nothing
lack of productivity aggravates your self-hatred, resulting in further isolation and incapacitation.