In This Chapter

^ Defining your goals for emotional and behavioural change

^ Motivating yourself

^ Recording your progress

F

■ f we had to define the purpose of therapy, its purpose would Not Be to

Make you a straighter-thinking, more rational person. Rather, the purpose of therapy is to help you achieve your goals. Thinking differently is one way of achieving those goals. CBT can help you change the way you feel and behave. This chapter helps you define your goals and suggests some sources of inspiration for change.

Aaron Beck, founder of cognitive therapy, says that CBT is whatever helps you move from your problems to your goals. This definition emphasises the pragmatic and flexible nature of CBT, and encourages clients and therapists to select from a wide range of psychological techniques to help achieve goals in therapy. The crucial message though, is that effective therapy is a constructive process, helping you to achieve your goals.

Putting SPORT Into I/our Goals

Many people struggle to overcome their problems because their goals are too vague. To help you develop goals that are clearer and easier to set your sights on, we developed the acronym SPORT, which stands for:

Specific: Be precise about where, when, and/or with whom you want to feel or behave differently. For example, you may want to feel concerned rather than anxious about making a presentation at work, and during the presentation you may want to concentrate on the audience rather than on yourself.

Positive: State your goals in positive terms, encouraging yourself to develop more, rather than less, of something. For example, you may want to gain more confidence (rather than become less anxious) or to hone a skill (rather than make fewer mistakes).

Think of therapy as a journey. You’re more likely to end up where you want to be if you focus on getting to your destination rather than on what you’re trying to get away from.

Observable: Try to include in your goal a description of a behavioural change that you can observe. Then, you can tell when you’ve achieved your goal because you can see a specific change.

If you’re finding it hard to describe an observable change, think to yourself: ‘How would the Martians, looking down from Mars, know I felt better simply by watching me?’

Realistic: Make your goals clear, concrete, realistic, and achievable. Focus on goals that are within your reach, and that depend on change from you rather than from other people. Try to visualise yourself achieving your goals. Realistic goals help you to stay motivated and focused.

Time: Set a timeframe to keep you focused and efficient in your pursuit of a goal. For example, if you’ve been avoiding something for a while, decide when you plan to tackle it. Specify how long and how often you wish to carry out a new behaviour, such as going to the gym three times a week for an hour at a time.

Some goals, such as recovering from severe depression, can vary a lot in terms of how long they take to achieve. Setting schedules too rigidly can lead you to become depressed or angry at your lack of progress. So, set your deadlines firmly but flexibly, accept yourself if you don’t achieve them on time, and persevere!

Homing In on HouJ \lou Want to Be different

Defining your goals and writing them down on paper forms the foundation of your CBT programme. This section helps you identify how you may want to feel and act differently.

Setting goals in relation to your current problems

To set a goal concerned with overcoming an emotional problem, you first need to define the problem, which we talk about in Chapter 6 (where we explore unhealthy emotions and behaviours and their healthy counterparts). Also refer to Chapter 7, in which we explore how attempts to make yourself feel better can sometimes make problems worse.

A Problem statement Contains the following components:

Feelings/emotions

A situation or theme that triggered your emotion

The way you tend to act in the situation when you feel your problem emotion

Befitting how you Want to feet as an alternative

CBT can help you attain changes in the way you feel emotionally. For example, you may decide that you want to feel sad and disappointed, rather than depressed and hurt, about the end of your marriage.

Aiming to feel ‘okay’, ‘fine’, or ‘relaxed’ may not fit the bill if you’re dealing with a tough situation. Feeling negative emotions about negative events is realistic and appropriate. Keep your goals realistic and helpful by aiming to have healthy emotions. Try to maintain an appropriate level of emotional intensity when faced with difficult events (take a look at Chapter 6 for more on healthy emotions).

Defining how you Want to act

The second area of change that CBT can help you with is your behaviour. For example, after going through a divorce, you may decide that you want to begin seeing your friends and return to work, instead of staying in bed and watching TV all day.

You can also include changes to your mental activities within your goal, such as refocusing your attention on the outside world or allowing Catastrophic (upsetting or worst-case scenario) thoughts to simply pass through your mind (refer to Chapter 5 for more on this).

Making a statement

A goal statement Is very similar to a problem statement – they have the same components, but the emotions and behaviours are different. A good goal statement involves the following:

To feel_(emotion)

About_(theme or situation) and

To_(behaviour).

So, for example, you may want to feel Concerned (emotion) about Saying something foolish at a dinner party (situation) and to Stay at the table in order to make further conversation (behaviour).

Maximising \lour Motivation

Motivation has a funny way of waxing and waning, just like the moon. Luckily, you don’t necessarily have to feel motivated about changing before you can take steps forward. Motivation often follows rather than precedes positive action – often people find they ‘get into’ something once they’ve started. This section suggests some ways to generate motivation and encourages you to carry on working towards goals in the temporary absence of motivation.

Identifying inspiration for change

Lots of people find change difficult. Your motivation may flag sometimes, or you may not ever be able to imagine overcoming your difficulties. If either of these situations sounds familiar to you, you’re in good company. Many people draw on sources of inspiration when starting with, and persevering through, the process of overcoming emotional problems. Sources of encouragement worth considering include the following:

Role models who have characteristics you aspire to adopt yourself.

For example, you may know someone who stays calm, expresses feelings to others, is open-minded to new experiences, or is assertive and determined. Whether real-life or fictional, alive or dead, known to you or someone you’ve never met, choose someone who inspires you and can give you a model for a new way of being.

Inspirational stories of people overcoming adversity. Ordinary people regularly survive the most extraordinary experiences. Stories of their personal experiences can lead you to make powerful personal changes.

Focus on taking a leaf out of an inspirational individual’s book, not on comparing yourself negatively with someone’s ‘superior’ coping skills.

Images and metaphors. Thinking of yourself as, for example, a sturdy tree withstanding a strong wind blowing against you, which can be an inspiring metaphor to represent you withstanding unreasonable criticism.

Proverbs, quotes, and icons. Use ideas you’ve heard expressed in novels, religious literature, films, songs, or quotes from well-respected people, to keep you reaching for your goals.

Focusing on the benefits of change

People often maintain unhelpful patterns of behaviour (such as, consistently arriving late for work) because they focus on the short-term benefit (in this case, avoiding the anxiety of being on a crowded bus or train) at the time of carrying out that behaviour. However, away from the immediate discomfort, these same people may focus on wishing they were free from the restrictions of their emotional problem (being able to travel carefree on public transport).

Completing a cost-benefit analysis

Carrying out a Cost-benefit analysis (CBA) to examine the pros and cons of something can help galvanise your commitment to change. You can use a CBA to examine the advantages and disadvantages of a number of things, such as:

Behaviours: How helpful is this action to you? Does it bring short-term or long-term benefits?

Emotions: How helpful is this feeling? For example, does feeling guilty or angry really help you?

Thoughts, attitudes, or beliefs: Where does thinking this way get you? How does this belief help you?

Options for solving a practical problem: How can this solution work out? Is this really the best possible answer to the problem?

When using a CBA form such as the one shown in Table 8-1, remember to evaluate the pros and cons:

In the short-term In the long-term For yourself For other people

Try to write CBA statements in pairs, particularly when you’re considering changing the way you feel, act, or think. What are the Advantages Of feeling anxiety? And the Disadvantages? Write down pairs of statements for what you feel, do, or think Currently, And for other, healthier alternatives. Tables 8-2 and 8-3 show a completed CBA form. You can find a larger, blank cost-benefit analysis form in Appendix B, which you can photocopy and fill in.

I may end up running off atthe I’ll be able to concentrate on what’s being

Mouth and people might not like me. said and I won’t seem so distracted.

Table 8-3 Second Cost-Benefit Analysis: ‘Costs and Benefits of Preparing in My Head What I’m Going to Say Before Speaking’

Costs Benefits

I can’t relax into the conversation. I may think of something funny or entertaining to say.

Sometimes, I feel like the conversation moves on before I’ve had the chance to thinkof the right thingto say. I cantake more care not to offend people.

After you’ve done a CBA, review it with a critical eye on the ‘benefits’ of staying the same and the ‘costs’ of change. You may decide that these costs and benefits are not strictly accurate. The more you can boost your sense that change can benefit you, the more motivated you can feel in working towards your goals.

Write out a motivational flashcard that states the Benefits of change And Costs of staying the same, Drawn from your cost-benefit analysis. You can then refer to this to give yourself a motivational boost when you need it.

A large aspect of achieving a goal, whether learning to play the guitar or building up a business, is about accepting temporary discomfort in order to bring long-term benefit.

Recording your progress

Keeping records of your progress can help you stay motivated. If your motivation flags, spur yourself on towards your goal by reviewing how far you’ve come. Use a problem-and-goal sheet like that in Figure 8-1, to specify your problem and rate its intensity. Then define your goal, and rate your progress towards achieving it. Do this at regular intervals, such as every one or two weeks.

1. Identify the problem you’re tackling. Include information about the emotions and behaviours related to a specific event. Remember, you’re feeling an Emotion About a Situation, Leading you to Behave In a certain way.

2. At regular intervals, evaluate the intensity of your emotional problem and how much it interferes with your life. 0 equals no emotional distress, and no interference in your life, and 10 equals maximum possible emotional distress, at great frequency, with great interference in your life.

3. Fill in the goal section, keeping the theme or situation the same, but specifying how you wish to feel and act differently.

4. Rate how close you are to achieving your goal. 0 equals no progress whatsoever, at any time, and 10 means that the change in your emotion and behaviour is completely and consistently achieved.

Using the form below, identify one of the main problems you wish to work on in therapy. A problem statement includes information about the emotions and behaviour related to a specific situation or event. For example: ‘Feeling depressed about the end of my marriage leading me to become withdrawn and spend until around 6pm each day in bed’ or ‘Feeling anxious about social situations leading me to avoid going to pubs, restaurants, and meetings, or to be extremely careful about what I say

If I do socialise’. Think of writing your problem statement as filling in blanks: Feeling_(emotion) about_(situation), leading me to_(behaviour).

Use the same format to identify the goal you would like to achieve, but this time specify how you would like things to be different in terms of your emotions and behaviour.

Rate how close you are to achieving your goal. 0 = No progress whatsoever 10 = Goal achieved and sustained consistently

Change doesn’t happen overnight, so don’t rate your progress any more frequently than weekly. Look for Overall Changes in the Frequency, intensity, And Duration Of your problematic feelings and behaviours.

Mercurial desires

People often find that they want to change their goals on a whim or a fancy. For example, you may have a goal of being more productive and advancing your position at work. Then, after going to a Summer Solstice rave, you decide that really your goal is to be free and to travel the world, communing with the essence of life. Whatyou choose asyour definitive goal is upto

You. But be wary of being influenced too easily by whatever’s foremost in your mind. Constantly abandoning former goals and adopting new ones can be a mask for avoidance and procrastination. Use the SPORT acronym, as described atthe start ofthis chapter, to assess the durability and functionality of each of your chosen goals.

In This Chapter

Understanding how common strategies can maintain (and worsen) your problems Examining and eliminating safety behaviours ^ Understanding why doing the opposite of your current strategies can help you

The first step in any kind of problem-solving is to Define The problem. This chapter is about assessing your problems and putting your finger on the ways in which your current coping strategies are part of your specific problem.

Often, the problematic behaviours that maintain or worsen emotional problems are the very behaviours that people use to help themselves cope – hence the common CBT expression ‘your solution is the problem’.

The reality is that you probably weren’t taught how to best tackle emotional problems such as anxiety, depression, and obsessions. We confess that even though we have been trained in the art of emotional problem-solving, when it comes to dealing with our own emotions, we can still manage to get it wrong.

In this chapter, we guide you towards identifying the fact that your coping strategies may make you feel better in the short-term but that they are actually counterproductive – and that they can make things worse in the long-term.

When Feeling Better Can Make \lour Problems Worse

Aaron Beck, founder of CBT and Dennis Greenberger, a well-known CBT therapist, note that, if you can turn a counterproductive strategy on its head, you’re well on the way to a real solution. This concept basically means that by doing the polar opposite of your established coping strategies you can

Recover from your problems. Exposing yourself to feared situations rather than avoiding them is a good example of turning a counterproductive strategy on its head. The more you avoid situations that you fear, the more afraid you become of ever encountering feared situations. Avoidance also undermines your sense of being able to cope with unpleasant or uncomfortable events. For example, never using a lift may temporarily stop your anxious feelings about being in an enclosed space, but avoiding lifts does not help you to overcome your fear of enclosed spaces once and for all.

Windy Dryden, who trained us in CBT, coined the phrase ‘Feel better, get worse. Feel worse, get better’ when referring to people overcoming emotional problems. Many of the things that you may be doing that actually maintain your current problems, are driven by a highly understandable goal to reduce your distress. However, when you aim to get short-term relief, you often end up reinforcing the very beliefs and behaviours that underpin your problems.

One of the most powerful ways of changing your emotions in a lasting way, is to act against your unhelpful beliefs and to act on your alternative helpful beliefs (Chapters 3 and 14 contain more information about forming alternative healthy beliefs).

Here are some further examples of what we mean by Problem-maintaining solutions:

Avoiding situations that you fear or that provoke anxiety. Avoidance tends to erode rather than boost your confidence. You remain afraid of the situations you avoid, thus you don’t give yourself a chance to confront and overcome your fears.

Drinking alcohol or taking drugs to block out uncomfortable feelings.

Often, those bad feelings persist in the long term, and you end up with the added problem of the effect of the alcohol or drugs (hangover, comedown). Also, you have the potential to develop a newproblem – substance dependence.

Concealing aspects of yourself that cause you shame. Hiding things about yourself – such as imperfections in your appearance, childhood experiences, mistakes from the past, or current psychological difficulties – can make you feel chronically insecure that someone may ‘find you out’. Hiding shameful aspects of your experiences also denies you the opportunity to find out that other people have similar experiences, and that they won’t think any less of you for revealing your secrets.

Putting off dealing with problems or tasks until you’re in the mood.

If you wait to take action until ‘the right time’, until you ‘feel like it’, or when you feel sufficiently inspired, you may wait a very long time. Putting off essential tasks may save you some discomfort in the short term, but undone tasks also tend to weigh heavily on your mind.

The following sections deal with common counterproductive strategies for coping with common psychological problems. We explain that doing what makes you feel briefly better may be perpetuating your problem.

Getting Over depression Without Getting \loursetf Dou/n

If you’re feeling depressed, you’re likely to be less active and may withdraw from social contact. Inactivity and social withdrawal are often attempts to cope with depressed feelings, but they can reduce the positive reinforcement you get from life, increase isolation, increase fatigue, lead to the build-up of problems or chores, and leave you feeling guilty.

For example, if you’ve been feeling depressed for some time, you may use a number of ultimately negative strategies to relieve your depression:

To avoid feeling ashamed about being depressed, you may avoid seeing friends. This coping strategy leaves you feeling more isolated and means you don’t get the support you need.

To avoid being irritable around your partner or children, you may try to minimise contact with them. Your children may become unruly, your relationship with your partner may suffer, and you may end up feeling guilty about not spending time with any of them.

To avoid the embarrassment of making mistakes at work, you may stop going to work on a regular basis.

To cope with feeling tired and to get some relief from your depression, you may take naps during the day. Unfortunately, napping can disrupt your sleeping pattern, leading to even more fatigue.

To see how your depression is affecting your activity levels, record a typical week on the Activity schedule In Chapter 10 (and Appendix B). Then, as we explain in Chapter 10, combat depression by scheduling your activities and rest periods (but not naps because napping during the day can disrupt night time sleeping) for each day, and gradually build up your activity levels over time.

Loosening \lour Grip on Control

Letting go of control is an especially relevant skill if you have any sort of anxiety problems, including obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). But, it also applies to other types of emotional problems, such as anger and jealousy.

Here are some common examples of how you may be gripping too hard on to the controls:

Trying to limit your body’s physical sensations because you believe that certain bodily symptoms will result in harm to yourself. For example, ‘If I don’t stop feeling dizzy, I’ll pass out.’

Trying to control and monitor your thoughts because you think that if they get out of control, you’ll go crazy.

Suppressing upsetting thoughts, doubts, or images because you believe that allowing them to enter your mind will cause harm to yourself or others. (This characteristic is very typical of OCD – check out Chapter 11 for more info.)

Trying to control your body’s physical reactions to anxiety, such as trembling hands, blushing, or sweating, because you think that others will judge you harshly if they notice your symptoms.

Trying to control the uncontrollable is destined to leave you feeling powerless and ineffective. Instead of striving for control, look to change your attitude about needing control by accepting the discomfort of certain types of thoughts or bodily sensations (head to Chapter 9 for more information).

If you try too hard to gain immediate control, you often end up:

Focusing more on feeling out of control, thus making yourself feel even more powerless than you did to start with.

Putting pressure on yourself to control symptoms and thoughts that aren’t within your control, thus making yourself feel more anxious.

Concluding that something must be deeply wrong with you because you can’t keep symptoms under control, thus making yourself feel more anxious, and experience more racing thoughts and unpleasant physical sensations.

The next time you feel anxious in a public place or find yourself blushing, sweating, or having disturbing thoughts, put the concepts in this section to the test by trying harder to stop yourself from having those thoughts, blushing, or sweating. Chances are that you’ll find your efforts produce even more of the thoughts and sensations you’re trying so hard to control.

Feeling Secure in an Uncertain World

The need for certainty is a common contributing factor in anxiety, obsessional problems, and jealousy.

Unfortunately, the only things you can be 100 per cent sure of, as the saying goes, are birth, death, and taxes. Over and above that, humans live in a pretty uncertain universe. Of course, many things are predictable and pretty sure bets, like the sun rising in the morning and setting in the evening. However, other things in life are much more uncertain. ‘Will I be pretty?’ ‘Will I be rich?’ ‘Will I live to a ripe old age surrounded by grandchildren and a few cats?’ Que sera, sera. Whatever will be, will be.

Trying to get rid of doubt by seeking unattainable certainty is like trying to put out a fire by throwing more wood on it. If you’re intolerant of uncertainty, as soon as you quell one doubt another one’s sure to pop up. The trick is to find ways to tolerate doubt and uncertainty – they exist whether you like it or not.

Here are some examples of how your demands for certainty may be reflected in your behaviour:

Frequent requests for reassurance. Constantly asking yourself and other people questions, such as ‘Is it safe to touch the door handle without washing my hands?’, ‘Do you find that person more attractive than me?’, ‘Do you think I’ll pass the exam?’, or ‘Are you sure I won’t get mugged if I go out?’ are all efforts to find some reassurance in an uncertain world. Unfortunately, excessive reassurance-seeking can reduce your confidence in your own judgement.

Repeated checking behaviours. Checking behaviours are actions you perform in an effort to create more certainty in your world. Such actions include checking several times that your doors and windows are locked, frequently asking your partner where they’ve been, seeing lots of different doctors to ensure that a physical sensation isn’t a sign of serious illness, and going over conversations in your mind to be sure that you haven’t said anything offensive. The irony is that the more you check, the more uncertain you feel. Excessive checking can be very time consuming, tiring, and can lower your mood.

Superstitious rituals. Superstitious rituals are things that you do to try to keep yourself safe or to prevent bad things from happening. Typically, superstitious rituals are not directly related to whatever it is that you fear most. Examples of rituals include touching wood, repeating phrases in your mind, wearing lucky clothes or jewellery, and avoiding unlucky numbers, out of a faulty belief that these rituals will stop unfortunate or tragic events befalling yourself or your loved ones. Engaging in superstitious behaviours can lead you to conclude that the ritual has prevented bad things from happening, rather than help you understand that many bad events are unlikely to occur regardless of whether you perform a ritual or not.

Avoiding risk. Risks – such as global tragedies, becoming ill, having an accident, making poor decisions, or committing a social faux pas – are unavoidable and are ever-present. You may be trying to eliminate risk by staying home or in ‘safe’ places, eating only certain foods, never deviating from set routines, overplanning for trips away, or overpreparing for unlikely events such as war, plague, or famine. In fact, risk is a part of life and can only be avoided to a limited extent. The more you try to eliminate all risk from your life, the more you’re likely to focus on all the possible things that could go wrong. You’re fighting a losing battle and are likely to undermine your sense of security even further. Focusing too much on the risks inherent in every day life will leave you chronically worried and cause you to overestimate the probability of bad things happening to you.

Trying to influence others. Examples of influencing others’ behaviour include, encouraging your partner to socialise only with members of the same sex, persuading your children to stay at home rather than go out with their friends, and asking your doctor to send you for another test. Demanding that other people act in ways to minimise your intolerance of uncertainty and risk can seriously damage your relationships. People close to you are likely to perceive you as controlling or suspicious.

Try to understand that uncertainty has always been a major feature of the world, and that people still manage to keep themselves safe and secure. You don’t need to change the world to feel secure. You simply need to accept uncertainty and live with it. You Can Happily coexist with uncertainty – it’s always been that way. Remind yourself that ordinary people cope with bad events every day and that you are likely to cope as well as others do if something wicked your way comes.

The next section deals with accepting uncertainty and letting go of unhelpful coping strategies.

Surmounting the Side Effects of Excessive Safety-Seeking

One of the main ways in which you maintain emotional problems is by rescuing yourself from your imagined catastrophes. Often, these anticipated disasters are products of your worried mind, rather than real or probable events. People with specific anxiety problems, such as the ones listed in this section, often take measures to reduce their anxiety and increase their sense of safety, but in effect make themselves even more intolerant of the inevitable uncertainty of everyday life.

The actions that people take to prevent their feared catastrophes from occurring are called Safety behaviours.

Avoiding, escaping, or trying too hard to stop a feared catastrophe prevents you from realising three key things:

Your feared event may never happen.

If your feared event Does Happen, most likely you’ll find ways to cope. For example, other people or organisations may be available to help you out.

The feared event may well be inconvenient, uncomfortable, upsetting, and deeply unpleasant, but rarely is it terrible or unbearable.

Anxiety affects your thinking in two key ways, it leads you to overestimate the probability and gravity of danger, and leads you to underestimate your ability to overcome adversity. Of course you want to keep yourself as safe as possible. But sometimes you may try to keep yourself safe from events that really aren’t that dangerous.

Additionally, some of the things that you do to eliminate risk and safeguard yourself may actually result in more discomfort and disturbance than necessary – using ultimately unhelpful strategies to avoid feared outcomes is very prevalent in anxiety disorders. Here are some examples of counterproductive safety behaviours that you might be using to cope with specific anxiety problems:

Panic attacks: Michael’s panic attacks are maintained by his fear that feeling dizzy will make him collapse. Whenever he feels dizzy, he takes a sip of water, sits down, or holds on to something. In this way, he prevents himself from finding out that he won’t collapse simply because he feels dizzy.

Social anxiety: Sally tends to overprepare what she’s going to say before she actually says it. She monitors her speech and body language and reviews in her mind what she did and said when she gets home. In this way, she maintains her excessive self-consciousness.

Post-traumatic stress: Since she had a car accident, Nina avoids motorways, grips tightly on to the steering wheel when driving in her car, repeatedly checks the rear-view mirror, and avoids being a car passenger. Because she’s being so careful, her anxiety about having another accident remains at the forefront of her mind.

Agoraphobia: Georgina’s afraid of travelling far from her home or familiar places for fear of losing control of her bowels and soiling herself. She has become almost housebound, and she relies heavily on her husband to drive her around. This means that she doesn’t go out on her own and never discovers that her fears are unfounded.

Fear of heights: James is afraid of heights because he believes that the ‘pulling’ sensation he experiences in high places means that he’s at risk of unintentionally throwing himself to his death. To cope with this sensation, he digs his heels firmly into the ground and leans slightly backwards to resist his feelings. He also tries to avoid high places as much as he can. These behaviours fuel his fear and leave him believing that somehow he’s more at risk than other people in high places.

After you’ve drawn up a list of your avoidance and safety behaviours, you can have a better understanding of what areas you need to target for change. In essence, the real solution to your problem lies in exposing yourself to feared situations without using any safety behaviours. You can then see that you are able to cope with anxiety-provoking events and that you need not rely on distractions or spurious attempts to keep yourself safe. Give yourself the chance to see that your anxiety is not harmful in itself and that anxious feelings diminish if you let them do so of their own accord. (Chapter 9 contains more information about dealing with safety behaviours and devising exposures.)

Wending \lour Way Out of Worry

One of the dilemmas faced by people who worry too much is how to reduce that worry. Some degree of worry is entirely normal – of course problems and responsibilities will cross your mind from time to time. Yet, you may be someone who worries all of the time. Being a true worrywart is intensely uncomfortable. Understandably, you may want to stop worrying quite so much.

Two reasons may account for your excessive worrying:

You may think that by worrying about unpleasant events, you can prevent those events from happening. Or, you may believe that your worry can give you clues as to how to prevent negative events from coming to fruition.

You may think that worry protects you by preparing you for negative events. You may believe that if you worry about bad things enough, they won’t catch you off guard and you’ll be better fixed to deal with them.

If you can convince yourself that excessive worry really doesn’t prevent feared events from happening or prepare you for dealing with bad things, you may be in a better position to interrupt your repetitive cycle of worries.

Ironically, many people worry about things in a vain attempt to get all possible worries out of the way so they can then relax. Of course, this never happens – worry’s a moveable feast, and something else always comes along for you to worry about.

If you worry excessively about everyday events, you may try to solve every possible upcoming problem in advance of it happening. You may hope that your worry will solve potential problems, and thus you won’t have to worry about them any more.

Unfortunately, trying too hard to put your mind at rest can lead to increased mental activity and yet more worry. All too often, people then worry that worrying so much is harmful, and they end up worrying about worrying!

Try to see your worrying as a bad habit. Instead of focusing on the Content Of your worries, try to interrupt the worry Process By engaging your mind and body in activities outside of yourself. Chapter 5 has some helpful hints on refocusing your attention away from you actively worrying.

Preventing the Perpetuation of l/our Problems

Sometimes, the things you do to cope with your problems can bring about the very things that you’re trying to avoid. An example of this is when you try to push upsetting thoughts out of your mind. Pushing away unpleasant thoughts is called Thought suppression, And can generally make unwanted thoughts intrude more often. Research shows that when people try to suppress an unwanted thought, it can intrude into their mind twice as often than if they accept the thought and let it pass.

Close your eyes and try really hard not to think of a pink elephant. Just for a minute, really push any images of pink elephants out of your mind. What happened? Most people notice that all they can think of are pink elephants. This demonstrates that trying to get rid of thoughts by pushing them out of your mind usually results in them hanging around more persistently.

Trying too hard not to do, feel, or think specific things, and attempting to prevent certain events, can actually bring about what you most fear and wish to avoid. For example:

Trying too hard not to make a fool of yourself in social situations can make you seem aloof and uninterested.

Trying too hard to make sure a piece of work is perfect can lead you to overrunning a deadline, or you get so nervous that you produce poor work.

Insisting that you must succeed at a task, like passing an exam or learning a skill, makes you concentrate too much on How well You’re doing and not enough on What You’re doing. This misplaced attention focus can lead to poor results.

Feeling jealous and repeatedly checking up on your partner, testing them or demanding reassurance that they’re not about to leave you, can potentially drive your partner away.

Lying in bed, trying to deal with fatigue when you’re depressed, can lower your mood further and may lead to feelings of shame and guilt about your inactivity.

Helping \lourself: Putting the Petals on ]lour Vicious Flotfer

The Vicious flower exercise Is a way of putting together different elements of your problem to aid your understanding of how your problem is maintained. Look at the example in Figure 7-1, and turn to Appendix B for a blank flower to photocopy and fill in. Follow these steps to fill in your own vicious flower:

1. In the Trigger box, write down the trigger that makes you feel anxious or upset.

2. In the central circle, write down the key thoughts and meanings you attach to the trigger.

3. In the flower petals, write down the emotions, behaviours, and sensations you experience when your uncomfortable feeling is triggered. In the top petal, write down what you tend to focus on.

Key negative thoughts, attitudes, or beliefs are at the heart of your vicious flower. The petals are your attentional, emotional, physical, and behavioural responses to the meaning you have attached to the trigger.

This chapter (and Chapter 6) gives you the kinds of emotions, behaviours, attention focus, and thoughts that you can fill in your petals with. If you suffer from anxiety, read Chapter 9; Chapter 10 for depression; Chapter 11 if you have an obsessional problem; and Chapter 13 for an anger problem.

One of the most important aspects of building a vicious flower is to think through how the petals affect the thought or ‘meaning’ that underpins your emotional problem. For example, the effect of anxiety on your thinking is to make you more likely to interpret experiences as more dangerous than they really are. The effect of depression is to make your thinking more gloomy and negative (refer to Chapter 6 for more on these and other emotions).

Focussing your attention on a sensation usually makes the sensation feel more intense. Acting upon an unhelpful thought or meaning usually makes the meaning seem more real. Unpleasant physical sensations accompanying

Your reaction can make upsetting thoughts seem even more real. You can design behavioural experiments to test out the effect of increasing or lessening a behaviour on your problems (refer to Chapter 4).

When you understand the mechanisms that maintain your problems, it will seem far more practical and sensible to target your petals for change.

The ‘physical sensations’ petal is the aspect of your problem that you’re least able to change directly because physical sensations are outside your immediate conscious control. However, you can minimise the impact of physical sensations by learning to tolerate them whilst you overcome your problem, and

To interpret them as no more dangerous than they really are.

Put down that shovel and empty out your pockets!

One of the best metaphors for the kinds of behaviour we discuss in this chapter is the idea that some of your coping strategies may be like unwittingly trying to dig your way out of a hole. Naturally, the first step to overcoming your problems is to put down the shovel – to stop your self-defeating strategies, and gradually work out more productive ways of overcoming your emotional problems.

Over time, you may seek out bigger and better shovels in the guise of bigger and better avoidance and safety behaviours. We regularly invite those of our clients who suffer with agoraphobia, panic attacks, obsessive-compulsive disorder, and body dysmorphic disorder, to share with us the contents of their pockets or handbags, which is often very illuminating. Examples of Safety props That people carry’just in case’ include, over-the-counter drugs, packets of

Tissues, antiseptic wipes, glucose sweets, handheld fans, make-up, plastic bags, paper bags, deodorant sprays, laxatives, and alcohol.

To help clients eliminate safety behaviours, we often encourage them to throw out or hand over these seemingly innocent everyday items in the spirit of getting rid of problematic solutions. Go through your pockets and handbag and collect all of your safety props. Throw them in the bin or hand them over to someone who knows about your problems and has an interest in helping you (this person can be anyone in your life if you are not currently seeing a CBT therapist). Be wary of purchasing or accumulating items to replace what you’ve already handed over or tossed away. Work on the basis that you only need essentials in your purse and pockets such as money, keys, and travel cards.

In This Chapter

^ Identifying healthy and unhealthy negative emotions

Understanding the thinking, behaving, and attention components of emotions ^ Defining the emotional problems you want to solve

Rhis chapter aims to introduce you to some of the key differences between the unhealthy negative emotions you may experience and their healthy counterparts. The information we offer also helps you to discover ways to identify whether you’re experiencing a healthy or an unhealthy emotional response.

You may be wondering why we’re focusing on Negative Emotions in this chapter and neglecting positive feelings such as happiness. You may be asking: ‘What Is It with these two? They’re so bleak!’ The reason for dealing with the negative is that few people pitch up for therapy because they’re having problems with positive emotions. Not a lot of people come to us looking for a way to overcome their relentless feelings of contentment. The emotions that give people trouble typically include guilt, anger, depression, and shame.

Although feeling bad when bad things happen is natural, you don’t need to make things worse for yourself by giving yourself unhealthy negative emotions. Healthy negative emotions are generally less profoundly uncomfortable and less problematic than their unhealthy counterparts. For example, feeling intensely Sad (a healthy negative emotion) is less uncomfortable than feeling intensely Depressed (an unhealthy emotion). Likewise, feeling intense sadness can prompt you to do things to improve your situation, but depression’s more likely to lead to your inaction and resignation.

Fortunately, you can Think What to Feel, To a greater or lesser extent, which can reduce your emotional discomfort. By choosing to think in healthy and helpful ways, you’re more likely to experience healthy emotions.

Naming \lour Feelings

If someone asks you how you feel, you may have difficulty describing exactly which emotion you’re feeling. You may not be sure what name to give to your internal experience, or perhaps you’re feeling more than one emotion at the same time.

Don’t get caught up on words! When you start to make a distinction between healthy and unhealthy feelings, what you call them isn’t terribly important. The main point is to be able to analyse your thoughts and behaviours, and to take notice of where your attention is focused (CBT refers to this as Attention focus). These three areas are ultimately your most reliable guides as to which type of emotion you’re experiencing.

For the sake of clarity, therapists can often encourage people to use different words for unhealthy and healthy alternatives to common feelings. For example, you could use the word ‘anger’ to describe an unhealthy emotion and ‘annoyance’ to describe the healthy counterpart.

Some people find it simpler to choose a descriptive word for their emotion and to add the term ‘healthy’ or ‘unhealthy’ to that word. Whatever way you prefer to describe your emotions is okay – the important bit’s understanding the category each emotion falls into. Different people have different ways of describing things. Think about how you’d describe an oil painting compared with the way a friend or art critic may talk about it. Similarly, people describe emotional states in diverse ways. You, a friend, and a psychotherapist (someone highly skilled in discussing emotions) may all use very different words to describe the same type of feeling.

If you’re not used to talking about the way you feel, you may have a hard time finding the words to reflect your feelings.

The following is a reference list of common human emotions and their synonyms, which you can use to increase your vocabulary of Emotive (relating to emotions) terminology. This list is not broken down into healthy and unhealthy emotions.

Angry: Aggressive, annoyed, bad-tempered, complaining, confounded, cross, displeased, enraged, fractious, fuming, furious, hostile, ill-tempered, incensed, irritated, livid, miffed, peevish, prickly, resentful, testy, touchy, truculent.

Anxious: Agitated, apprehensive, bothered, concerned, edgy, fearful, fretful, frightened, jumpy, nervous, nervy, panicky, restless, tense, troubled, uneasy, vexed, worried.

Ashamed: Belittled, debased, defamed, degraded, discredited, disgraced, dishonoured, humiliated, mortified, scorned, smeared, sullied, tarnished, undignified, vilified.

Disappointed: Crestfallen, deflated, dejected, discouraged, disenchanted, disheartened, disillusioned, dismayed, gutted, let down, thwarted.

Embarrassed: Awkward, diminished, discomfited, humiliated, ill at ease, insecure, self-conscious, small, timid, uncomfortable, unconfident, unsure of oneself.

Envious: Green with envy, malevolent, malicious, Schadenfreude, sour, spiteful.

Guilty: Answerable, at fault, blameworthy, condemned, culpable, deplorable, indefensible, inexcusable, in the wrong, liable, reprehensible, unforgivable, unpardonable.

Hurt: Aggrieved, broken-hearted, cut to the quick, cut up, damaged, devastated, gutted, hard done by, harmed, horrified, injured, marred, offended, pained, wounded.

Jealous: Bitter and twisted, distrustful, doubtful, green-eyed, sceptical, suspicious, wary.

LOVE: (we threw this one in just to lighten the mood) admiring, adoring, affectionate, besotted, blissful, crazed, devoted, enamoured, esteemed, fond, head over heels, infatuated, keen, loved-up, love-struck, mad about, on cloud nine, smitten, struck by cupid’s arrow, worshipping.

Sad: Bereft, blue, depressed, distraught, distressed, down, downcast, downhearted, grief-stricken, heartsick, inconsolable, melancholic, mournful, shattered, sorrowful, tearful.

Thinking What to Feet

One benefit of understanding the difference between healthy and unhealthy emotions is that you give yourself a better chance to check out what you’re thinking. If you recognise that you’re experiencing an unhealthy emotion, you’re then in a position to challenge any faulty thinking that may be leading to your unhealthy emotional response. Disputing and correcting thinking errors can help you to experience a healthy, negative emotion instead of an unhealthy feeling (see Chapter 2 for more on thinking errors and how to correct them).

A common axiom is ‘I think therefore I am’; a CBT version is ‘I think; therefore I feel.’

Feelings aren’t as one-dimensional as they may seem. How you feel is more than just the emotion itself, because feelings don’t just come out of thin air – they have a context. When you begin to make a distinction between your healthy and unhealthy emotions, look at the Interaction Between your thinking, your actions, your attention focus, your memory, your themes or triggers, and the way you feel. Take a look at Table 6.1 in the section that covers comparing healthy and unhealthy emotions further on in this chapter, which gives a clear breakdown of the characteristics of healthy and unhealthy emotions.

Understanding the Anatomy of Emotions

Figure 6-1 shows the complex processes involved in human emotion. Whenever you feel a certain emotion, a whole system is activated. This system includes the thoughts and images that enter your mind, the memories you access, the aspects of yourself or the surrounding world that you focus on, the bodily and mental sensations you experience, physical changes such as appetite, your behaviour, and the things you Feel like Doing.

As the diagram shows, these different dimensions interact in complex ways. For example, training your attention on possible threats is likely to increase the chance of anxious thoughts popping into your mind, and vice versa. Not sleeping well may increase the chances of you being inactive; continued inactivity can further disrupt your usual sleeping pattern. The advantage of understanding this system of emotion as presented in Figure 6.-1, is that it gives you plenty of opportunity to make changes. Changing even one aspect of the system can make changing other parts easier.

An example of change is becoming more active if you’ve been inactive, which may alleviate your feelings of depression and make it easier for you to challenge your depressive, pessimistic thinking. Being prescribed antidepressant medication, which works by effecting brain chemistry, can take the edge off your depression. Use of antidepressants can make it easier for you to train your attention Away From your negative thoughts and uncomfortable symptoms and Towards Possible solutions to some of your practical problems. (See Chapter 10 for more about overcoming depression.)

Comparing Healthy and Unhealthy Emotions

Deciphering between healthy and unhealthy versions of negative emotions can be challenging, especially when the process is new to you. Think of Table 6-1 as your emotional ready reckoner for the characteristics of both healthy and unhealthy emotions. Everything you may need to identify the emotion you’re experiencing is in this table. Plus, if you do identify that an emotion you’re experiencing is unhealthy, you can implement the thoughts, attention focuses, and behaviours of the healthy version to aid you in feeling better.

Table 6-1 (continued)

Is realistic about degree of disapproval from others

Responds to attempts from social group to return to normal

Is realistic about how long disapproval will last

Hurt (unhealthy) Other person treats Has rigid and extreme

One badly (self is attitudes undeserving)

Looks for evidence of Stops communicating with other other person not caring person/sulks or being indifferent

Overestimates unfairness of other’s behaviour

Punishes other person through silence or criticism, without stating what one feels hurt about

Thinks other person doesn’t care

Thinks of self as alone and uncared for

Dwells on past hurts

Thinks other person must make first move towards resolution

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Disappointment (healthy) Other person treats Has flexible and

One badly (self is preferential attitudes undeserving)

Focuses on evidence Communicates with other person about that other person does feelings care and isn’t indifferent

Is realistic about degree of unfairness of other’s behaviour

Tries to influence other person to act in fairer manner

Thinks other person acted badly but doesn’t think that they don’t care

Thinks partner finding Views partner’s Allows partner to express natural interest

Others attractive is normal conversation with other in opposite sex without imagining as normal infidelity

Envy (unhealthy) Another person Has rigid and extreme Focuses on how to get Criticises the person with desired

Possesses attitudes the desired possession possession

Something without regard for any

Desirable (self lacks consequences desired thing)

Table 6-1 (continued)

Emotion Theme Thoughts Attention Focus Behaviour/Action Tendencies

Remorse (healthy) Broken moral code Has flexible and Doesn’t look for Faces up to healthy pain that comes with

(by failing to do preferential attitudes evidence of others knowing that one has sinned something or by blaming oneself for

Committing a sin), the sin

Hurting or offending significant other

Considers actions in Doesn’t look for Asks for forgiveness

Context and with evidence of punishment

Understanding before or retribution

Making a judgement

About whether one

Has sinned

Themes Refer to situational aspects linked to emotion. Themes are the same for both healthy and unhealthy negative emotions. For example, when you feel Guilty (an unhealthy negative emotion), the theme for that emotion is that you’ve ‘sinned’ by either Doing Or Failing to do Something. Another way of saying that you’re guilty is that you’ve transgressed or failed to live up to your moral code. Remorse, The healthy alternative to guilt, results from the same theme as guilt. However, your thoughts, behaviours, and focus of attention, are different when you are remorseful and when you are guilty.

Themes can be useful in helping you to put your finger on the nature of the emotion you’re experiencing. However, themes are not enough to help you decide whether your emotion is a healthy or unhealthy one. Consider the following situation:

Imagine that you have an elderly aunt who needs your help to continue living independently. You usually visit your aunt at the weekend and do jobs that she’s too frail to do for herself, like changing light bulbs and cleaning windows. Last weekend you went skiing with friends instead of checking in on your aunt. Your aunt got impatient waiting for the light bulb in her hallway to be changed and tried to do it herself. Unfortunately, your aunt fell off the chair she was standing on and broke her hip.

Thematically, This situation is one in which you broke or failed to fulfil a personal moral code, resulting in hurting or offending someone else.

If you feel guilty (an unhealthy negative emotion), you are very likely to experience the following:

Type of thinking: Your thinking becomes rigid and demand-based. You conclude that you’ve definitely done a bad thing (sinned). You assume more personal responsibility than may actually be legitimate, discounting or not considering mitigating factors. You may believe that some form of punishment is deserved and/or imminent.

Focus of attention: You look for more evidence that you’ve sinned, or you look for evidence that others hold you responsible for the sin.

Behaviour (action tendency): You may desire to escape from guilty feelings in self-defeating ways – for example, begging for forgiveness, promising that you’ll never commit a sin again, punishing yourself, physically or through deprivation, or by attempting to disclaim any legitimate responsibility for the wrongdoing.

By contrast, you can think about the situation differently and feel remorse (a healthy negative emotion). Although the same theme (a broken or failed moral code, causing hurt or offence to a significant other) still applies, you experience the following:

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Type of thinking: Your thinking is more flexible and preference-based. You look at actions in context and with understanding before making a judgement about whether you sinned. You consider mitigating factors of the situation and do not believe that punishment is deserved and/or imminent.

Focus of attention: You don’t look for further evidence that you sinned. Neither do you look for evidence that others hold you responsible for the sin.

Behaviour (action tendency): You face up to the healthy pain that comes with knowing that you’ve sinned. You may ask for, but not beg for, forgiveness. You understand the reasons for your wrongdoing and act on that understanding. You may atone for the sin by taking a penalty and/or making appropriate amends. You avoid defensiveness and excuse-making.

The theme involving both guilt and remorse is the same, but your thinking, action tendencies, and focus of attention are very different.

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Action tendency Refers to an urge to behave in a certain way that you may or may not actually act upon. Different emotions produce an urge within you to do certain things. In some cases, you may actually do or say something, and in others you may just be aware that you Want To do or say something. Maybe Wanting To run out of a room and hide when feeling ashamed, or feeling unhealthily angry and Wanting To punch someone’s lights out, without actually doing so.

Spot the difference in thinking

As the example in the preceding section illustrates unhealthy emotions can spring from rigid, Demand-based thinking. Thoughts or beliefs like ‘other people must behave respectfully towards me at all times’ and ‘I should always get what I want without hassle’ can lead to unhealthy anger when other people and the world don’t meet these demands.

Healthy emotions spring from flexible, Preference-based thinking. So, thoughts and beliefs like ‘I prefer others to treat me respectfully, but they’re not bound to do so’ and ‘I prefer to get what I want without hassle, but no reason exists that this should always be the case’ can lead to healthy annoyance when other people and the world don’t meet your preferences.

Rigid thinking is a reliable indicator that you’re having an unhealthy feeling. When you think rigidly, you’re more likely to underestimate your ability to cope with and overcome the negative event in question. The more adept you become at identifying your thoughts, beliefs, and attitudes as either rigid and demanding or flexible and preferential, the easier you can work out whether your feelings are healthy or unhealthy.

When you feel Guilty, You think in an unhealthy, rigid, demand-based manner and may say things like the following:

‘I absolutely shouldn’t have left my aunt alone.’

‘Leaving my aunt alone was a bad thing and means I’m a bad person.’

‘I can’t bear the pain of knowing that I’ve done this bad thing of leaving my aunt alone.’

You may then continue to think in the following guilt-enhancing ways:

You fail to acknowledge that your aunt ultimately chose to try to change the light bulb herself. You fail to acknowledge that other members of your family can also check in on your aunt.

You ignore the fact that you had no way of knowing that the light bulb needed changing, and that you had not foreseen your aunt taking such a risk.

You expect that your aunt will blame your entirely. You think about the punishment that you believe you deserve.

By contrast, if you feel Remorseful, You think in a healthy, flexible, preference-based manner and may say things such as:

‘I wish I hadn’t left my aunt alone, but regrettably I did.’

‘Leaving my aunt alone may mean that I’ve done a bad thing but not that I’m a bad person.’

‘I can bear the pain of knowing that I’ve done this bad thing of leaving my aunt alone.’

You can then continue to think in helpful ways:

You can acknowledge your part in the accident occurring, but you can also consider that other members of the family failed to check in on your aunt.

You can acknowledge that you didn’t foresee your aunt taking the risk of changing a light bulb. Nor did you know that the bulb would burn out.

You can expect that your aunt may be upset with you, but you believe that you don’t deserve a severe punishment.

Taking legitimate responsibility for what happens in a situation enables you to think about the event in a holistic way. You don’t need to prolong uncomfortable feelings of remorse beyond what is reasonable and appropriate to the situation. Your ability to solve problems isn’t impeded by feelings of guilt.

Spot the difference in behaving, and Ways you Want to behave

Another way of figuring out whether your emotion is in the healthy or unhealthy camp, is to have a look at your actual behaviour or the way in which you feel inclined to behave.

Healthy negative emotions are accompanied by largely constructive behaviours, whereas unhealthy feelings usually go hand-in-hand with self-defeating behaviours. Problem-solving is still possible when you’re healthily sad, annoyed, remorseful, or regretful, but you have much greater difficulty planning clear ways to surmount your problems when you’re unhealthily depressed, enraged, guilty, or ashamed.

For example, if you respond to your aunt’s falling over with Guilt-based action tendencies, You may do one or more of the following:

Go out and get quite drunk, trying to block out your guilty feelings.

Visit your aunt in hospital and plead for her forgiveness.

Promise that you’ll never again let down your aunt, or anyone else dear to you, for as long as you live.

Decide that you won’t go on any other trips while your aunt is alive.

The preceding behaviours are problematic because they’re extreme and unrealistic. These actions focus on self-punishment rather than look at the reality of the situation and how you can, in this example, best meet your aunt’s needs.

On the other hand, if you’re feeling healthy remorse your Action tendencies, You may include some of the following:

Endure the discomfort of knowing that your aunt has been hurt (rather than getting drunk to avoid it).

Visit your aunt in hospital regularly and apologise for having left her alone.

Understand that your aunt needs continuous support but that you have the right to go away with friends.

Plan to stay with your aunt for a week or so after she’s discharged from hospital.

Resolve to plan your trips away more carefully and to arrange for nursing staff to be with your aunt when you’re unavailable.

The preceding behaviours are geared towards making sure that your aunt doesn’t hurt herself again during your absence. By taking an appropriate amount of responsibility for the accident, you can still look for ways to provide comfort for your aunt rather than concentrate on punishing yourself.

Spot the difference in what you focus on

In addition to differences in types of thinking and behaving, you can distinguish healthy from unhealthy emotions by checking out the focus of your attention. If you’re having an unhealthy emotion, your mind is likely to focus on catastrophic possibilities in the future based on the primary event.

If you’re responding to the injured auntie situation from a place of Guilt, You may focus your attention on the following:

Blaming yourself for abandoning your aunt and for the accident happening.

Feeling the pain of your guilt whilst neglecting to consider potential solutions to the problem of your aunt needing continuous care.

Looking for evidence that your aunt blames you entirely for the accident.

Looking for blame from other people, such as hospital staff and family members.

You continue to give yourself an unduly rough ride, thereby prolonging your distressing, guilt feelings by focusing on the bleakest possible aspects of your aunt’s accident.

If you respond to the situation from a place of remorse, you are likely to focus your attention on the following:

Accepting that leaving your aunt alone may have been a bad decision but that you had no intention of putting her at risk.

Feeling the pain of remorse over the accident but also trying to find ways to improve the situation.

Not seeking out evidence of blame from your aunt.

Acknowledging evidence that hospital staff or family members do not blame you for the accident.

Thus, your attention focus when you respond from a place of remorse enables you to take some responsibility for your aunt’s broken hip, but you don’t dwell on the potential for blame and punishment.

Spatting Similarities in \lour Physical Sensations

Butterflies in your stomach, blood racing through your veins, light-headed-ness, sweaty palms, heart pounding. Sound familiar? We expect so. If someone described these physical symptoms to you, you may try to guess what emotion they were experiencing. However, it would be difficult to confidently determine the specific emotion, because these sensations can accompany several different positive and negative emotional states. For example, you may get butterflies in your stomach when you’re excited, angry, anxious, or in love, as illustrated in Figure 6-2.

The sensations that you feel in your body also tend to overlap in both healthy and unhealthy negative emotions. For example, you may get butterflies in your stomach when you’re unhealthily anxious And When you’re healthily concerned. Therefore, using your physical symptoms as a guide to judging the healthiness of your negative feelings isn’t very reliable.

The main way in which your physical responses are likely to vary between the healthy and unhealthy categories is in their intensity. You probably find that

Sensations are more intense, uncomfortable, and debilitating when you’re having unhealthy emotions, such as anxiety and anger. You may also notice that uncomfortable physical sensations last longer when you are experiencing unhealthy negative emotions.

Incidentally, we believe that if you’re experiencing butterflies, sweaty palms, racing blood, light-headedness, and a pounding heart all at once, then you really Are In love!

Identifying Feelings about Feelings

Getting two emotions for the price of one is not such a great deal when two unhealthy negatives emotions are on offer.

CBT professionals call feelings about feelings Meta-emotions. The prefix Meta Comes from Greek and means ‘beside’ or ‘after’.

Sometimes, you can give yourself a second helping of unhealthy emotion by holding rigid demands about which emotions you believe are acceptable for you to experience in the first place.

A common example of feelings about feelings is found in depression. Many people have guilty feelings about their depression. This guilt often comes from the demands people make of themselves, for example that they mustn’t let other people down or put undue strain on loved ones. Here are some typical guilt-producing thoughts that are common in depressed people:

‘I should be contributing more to the running of the home.’

‘I must be able to demonstrate love and care to my children.’

‘My partner and children are worried about me, and I’m making them suffer.’

‘I shouldn’t be neglecting my friends in this way.’

Recognising your meta-emotions is important, because meta-emotions can prevent you from dealing with your primary emotional problems. For example, you may be feeling guilty about having depression. If you can stop feeling guilty, you’ll almost certainly find that you can work on overcoming your depression more effectively.

If you find that the concept of feeling guilty about being depressed really does strikes a chord with you, go to Chapter 10, where we discuss it in more detail.

Handy emotional health checklist

The following is an abbreviated list of the ways that can help you to find out the nature of a feeling and give it a name. The list can also help you assess whether an emotion is of the healthy or unhealthy negative variety.

Have you identified a word to describe how you feel inside?

Can you identify the theme of your emotion?

How does your emotion lead you to behave? Are your actions or urges to act helpful or unhelpful?

Are you thinking in a flexible way, or are you thinking in a rigid and demanding way?

What are you paying attention to? Are you looking at the event from all angles?

Is another emotion getting in the way of you being able to identify your first emotion? For example, are you feeling guilty or ashamed about your anger, depression, or other emotion?

Defining \lour Emotional Problems

The aim of CBT is to help you overcome your emotional problems and move you towards your goals. As with all kinds of problem-solving, Defining Your emotional problems is the first step in solving those problems.

Making a statement

Writing down a problem statement has three main components – the emotion, the theme or event (what you feel your emotion about), and what you do in response to that emotion. You can effectively describe an emotional problem by filling in the blanks of the following statement:

Feeling_(emotion) about_

(theme or event), leading me

To_(response).

For example:

Feeling Anxious About My face turning red in social situations, leading me to Avoid going out to bars and clubs and to splash my face with water if I feel hot.

Feeling Depressed About The end of my relationship with my girlfriend, Leading me to Spend too much time in bed, avoid seeing people, and take less care of myself.

When positives are negatives

Although this chapter deals with unhealthy negative emotions because these are the most common factors in emotional disturbance, you can’t forget that negative positive emotions do also exist.

An example of a negative positive emotion is holding a Rigid demand, Such as ‘I must get approval from my boss’ and then feeling a surge of delight when thedemand ismet. You may feel good about the approval and your confidence may soar for a time, but you’re still vulnerable to unhealthy negative feelings if you later fail to get your boss’s approval. If you hold a Flexible preference For your boss’s approval, you can feel healthily pleased if you get approval and healthily disappointed if you don’t.

Another example of unhealthy positive emotions is the feeling of euphoria associated with Hypo-manic (excessively happy or ‘high’) states. People who suffer from bipolar affective disorder (formerly known as manic depression) can experience alternating periods of extreme low-mood and extreme high-mood. During high periods, people with bipolar affective disorder are often prone to making rash decisions and behaving in erratic, sometimes risky ways. People with bipolar affective disorder may seem to be very happy when in fact they’re hypo-manic and suffering from a genuine psychiatric

Condition. Bipolar affective disorder can be treated effectively with medication and CBT. Many of the tips for overcoming Unipolar (or general depression)thatyou can find in Chapter 10 are also be very helpful for people with bipolar disorder. Appendix A lists organisations that you may find helpful.

If you think that you, or someone close to you, may have bipolar affective disorder, we strongly recommend seeing a psychiatrist to get a comprehensive assessment. Prescribed medication is an important part of managing the distressing symptoms of this disorder. Psychiatrists generally have more specialised knowledge about the disorder and appropriate medicationsthan general physicians.

One key CBT strategy for helping people to manage bipolar depression involves making an activity schedule (see Chapter 10). Write down a plan of your daily activities and stickto doing them regardless of your mood. The crucial point is to establish a Consistent\eve\ Of activity in your daily life. Sticking to a daily schedule of activities can help you avoid being under-stimulated during lows (thereby combating a downward spiral into depression) and helpyou avoid becoming over-stimulated during highs (thereby preventing an upward spiral into hypomania).

Rating your emotional problem

Human nature leads you to focus on how bad you feel, rather than how much better you feel. As you reduce the intensity of any emotional disturbance, you can find motivation in being able to see a difference. After you describe a problematic emotion, rate it on a scale of 0-10, based on how much distress the emotion causes you and how much it interferes with your life.

As you work on resolving your emotional problem by making changes to your thinking and behaviour, continue to rate the distress and interference it is causing you. Your ratings are likely to go down over time as you make efforts to overcome your unhealthy negative emotions. Review your ratings regularly, once a week or so. Doing this review helps remind you of your progress and replenishes your motivation to keep up the good work!

Share your ratings with your CBT therapist if you have one. Your therapist can haul out your rating records and show you the progress you’ve made if your motivation begins to flag.