Change Your Thinking with CBT

Given the frequency of negative thoughts, a useful alternative to the standard thought-monitoring form is the two column technique. In the left-hand column, we record the ‘automatic’ negative thoughts that pop into our mind and label the faulty-thinking style that underlies them. In the right-hand column, we describe a more reasonable, balanced way to perceive our situation

Whenever he catches himself immersed in rumination, Victor acknowledges this (‘I notice that I am ruminating again’) and then switches his attention to whatever he is doing at the time. While his mind frequently returns to rumination, Victor is now more aware of times when it is happening, and he simply reminds himself that it is just rumination.

Through the practice of mindfulness, Victor starts to recognise that his thoughts are objects produced by his mind (strongly influenced by his depressed mood) rather than reflections of reality. This helps to create some distance from his thoughts.

During the recovery period the frequency of ‘bad days’ starts to diminish, however setbacks invariably arise. A healthy response is to accept setbacks when they occur—they are a normal part of the process.

It is far more helpful to enjoy and appreciate the good days, accept the bad days and to allow time and space for our mood to gradually improve.

Paradoxically, Amanda’s ruminations are moving her further away from where she wants to be.

Amanda also believes that being self-critical is the only way to motivate herself to change her behaviour: ‘If I feel really terrible about it, maybe I won’t do it again?’ Unfortunately it doesn’t work. The relentless stream of self-critical thoughts is demoralising and demotivating.

Positive beliefs about the value of worry and rumination are common obstacles to recovery, as they motivate us to engage in futile thought processes.

Positive beliefs about the value of worry and rumination are common obstacles to recovery, as they motivate us to engage in futile thought processes. Recognising and challenging these beliefs can help us to disconnect from rumination, and therefore hasten our recovery.

She reminds herself that she is doing the best that she can, and accepts that she will not always be able to meet her own expectations.

Fixing something, cleaning out a cupboard, cooking a meal or completing an outstanding task can challenge perceptions of helplessness, and this can also make us feel better.

In fact, any behaviour that gives us a feeling of achievement can lift our spirits.

One way to break out of this spiral is to engage in activity, despite our overwhelming desire to lay low.

By shifting our focus to the external environment, activity distracts us from rumination, and so provides a space for our mood to lift.

Although our motivation is low, once we get started we nearly always feel better, so it’s important to push ourselves, even when we can’t be bothered.

Do the opposite to what your depression tells you to do. If you are inclined to stay in bed, then get out. If you don’t want to go to the concert, then go. It’s important not to let your down moods take control and guide the way you act.

we will usually feel better doing something, as opposed to doing nothing.

Setting goals is the means by which we move towards the things that we want. Goals give us a sense of direction and purpose, and provide a focus that helps us to achieve things.

Knowing that she will be recording and reviewing her activities at the end of the day motivates Leonie to do a little more than she otherwise would.

when Leonie reflects on the activities in her log, she notices that she experienced more pleasure when she was spending time with people