CBT – Negative Automatic Thoughts and Thought Challenging 

We all have negative thoughts from time to time; they are often what make us feel low or anxious. 

The thoughts themselves can be distorted or the conclusion from the thoughts may also be distorted i.e. I didn’t remember calling my friend back therefore I am a nasty person.  Or our thoughts may simply be unhelpful, i.e. ‘this will take me til 3am to finish’ might be accurate, but focussing on it makes us feel worse.

To identify the negative thoughts, simply ask yourself “what was going through my mind?”. Clinicians might ask this when there is an emotion change and this can help us get to the unhelpful thinking patterns. 

If stuck identifying them, a therapist might:

  • Suggest opposite thoughts to the ones they think you might predict so that you become clear on what you’re not thinking 
  • Ask for the meaning of the situation
  • Ask for an image that you might be imagining 
  • Ask for more detail of the situation as this might get more thoughts to come out
  • Ask you to role play it with you to do the same
  • Ask you to identify where in the body you were feeling it and that can get you in the feeling again and then they may ask again what was going through your mind

If there is a discrepancy between your emotions and your thoughts then they might help you dig deeper into it to find out what other thoughts occur and whether there are other emotions involved. 

In addition, labelling the intensity of our emotions can help us prioritise which situations to focus on. Asking how intense that feeling feels now / later can help us understand whether it’s worth focussing on now or whether you’re over it, and if you’re over it then we can look at what behaviours or tools you used to do this as they might be useful in the future. 

Once we’ve identified the negative thoughts it can then help lift our mood to challenge them. 

How to challenge thoughts:

  • When challenging thoughts, imagine how taking your thoughts to court; look at evidence (not opinions) on both sides
  • You might be given a testing thoughts worksheet to use
  • ask “is there an alternative explanation for what has happened?”
  • If (the worst) happened, ask how would you cope? What else could you do?
  • Ask what the impact of the negative automatic thought is on your emotion
  • Ask what you’d advise a friend to do

Other questions can help us flush out practical, alternative ways of thinking about the situation. 

This can be illustrated with an example:

  • How bad is it in the grand scheme of things if your mother is upset?
  • How hurt is she?
  • How long was she hurt for?
  • Has she been hurt before and got over it?
  • Is she hurt now?
  • Is it possible for you to spare her hurting all the time?
  • If she wants to see you all the time, is it possible to ever do something for you and it not result in her hurting?
  • What would you have to give up yourself in order to do that? 

Sometimes or negative thoughts aren’t biased or inaccurate, they’re true.  In this case it can help to:

  • Problem solve
  • Challenge the meaning of them
  • Work toward acceptance

After a while you may be able to come up with an alternative more helpful way of thinking without going through the evidence.

Your clinician may ask you to read your therapy notes every day and when needed,  and it helps if you have your revised thoughts written down on card for later, to look at and repeat in order for the message to sink in. 

Of course,  you don’t have to challenge your thoughts, you can:

  • Problem solve
  • Distract yourself 
  • Use relaxation techniques 
  • Label the situation for what it is and accept it

If you want to do this then you can use the acronym AWARE: 

  • Accept emotion
  • Watch without judgement
  • Act as if not anxious
  • Repeat
  • Expect the best

Thought challenging may not work if there are core beliefs in the way, or if not all evidence is brought to the fore. 
In addition,  your clinician might not always challenge your thoughts if you’re too distressed, if they think that you don’t feel supported by them or aren’t on your side or if there are other important matters to focus on.
www.happii.uk is a website providing  about mental health and wellbeing. Happii.uk is provided by Anna Batho, a therapist working in High Wycombe and providing therapy in Amersham and the wider Buckinghamshire (Bucks) region.You can contact her here.

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