IV. What choices of Cognitive Exercises do I have?

• Negative self-talk can only be unleashed by yourself.

• Automatic thoughts can lead to fear you never knew you had.
• Negative feelings about certain things can prevent you from:
  • trying a new sport； or
  • taking a new class； or even
  • taking public transport.

Changing these negative thought patterns is possible and can benefit your physical health, performance, and anxiety levels. Using cognitive exercises is an active process where you take part in your own recovery from fear or panic, and create thoughts and self-talk tools to help you when you feel stress coming on. Start by identifying what your specific distortions are, and then you may use them for thought tracking. From there you can use different tools to address each distortion so that when they come up again, you have a more positive way of approaching them. Your participation in this lesson’s exercises will be beneficial to you.

Thought Tracking

Thought tracking is a process where you can record anxious or panicky thoughts by writing them down in a journal. You can keep track of the day and time when they happen and the situation when they occur. Since they are in a journal, write down your thoughts and how you feel at the time. They are after all just for you, and you do not have to show or explain them to anyone if you do not wish to. The thoughts you track in your journal can include the things you say to yourself when you have anxious thoughts, your interpretation of the situation, and any reasons why you have based these thoughts on. It may feel strange at first to have to put your thoughts on paper, but it does not have to be perfectly written.

Instructions:

1. Organise your journal in columns (as per table below)
2. In the columns, record your stressful thoughts:
• Topic
• Day and time of the occurrence
• How did it happen
• Was the thought about the past or the future
• Describe the thought as detailed as possible , e.g. why and how you think you were a failure
3. Set aside some time to work on your thought tracking journal.

Here is an example of a page in a thought tracking journal for someone worried about failing in school:

Adapted from Hazlett-Stevens(2008)

You may notice there are also spaces for cognitive techniques to work after you have entered your worried thoughts, negative self-talk and beliefs about a situation that brings you worry. The next section will give you many choices of cognitive techniques so you can address the thoughts, self-talk and beliefs that lead to stress.

Using cognitive techniques to change Distortions, Negative Self-Talk, and Belief:

Now that you have identified the worried thought and have been specific about when it happens, the evidence that may support it, and the self-talk you will use because of it, there are many tools you can use to overcome the anxiety that can result from it.

Positive Self Talk and self-talk re-think:

Positive self-talk involves changing the negative things we say to ourselves so that we foster positivity and motivation for change, including lowering our own anxiety. You may feel it is awkward or unbelievable at first, especially if you are used to “beating yourself up” or using negative-self talk in response to worried thoughts or events. Positive self- talk is a simple tool you can use every day to increase your confidence, lower your anxiety and improve your performance.  For instance, instead of saying:

“I will never be able to drive over the bridge by myself”
“I am unattractive this way”
“I cannot be successful, I am just not good at anything”

You can re-phrase the negative self-talk to make it positive and encouraging:

“I will be able to cross the bridge by myself”
“I can be as beautiful as I want”
“I can be successful, I can be good at anything I choose to be”

Cognitive techniques for pathological worry:

These exercises are designed to treat pathological worry or the kind of worry that leads you to anxious thoughts which prevent you from arriving at a solution to the problem that you are worried about. These techniques will not necessarily stop you worrying altogether, but they will be constructive to help you solve the original problem.

Worry postponement for excessive worry or imagining the extreme:

Sometimes, our anxiety and concern on just one thing can take hold of all aspects of our lives. For example, worrying about commuting to work can make you think of being late for work all the time or losing a job altogether. Certain situations can naturally cause anxiety and when that happens, you can use worry postponement by stopping the worry right from the beginning and then choosing another time to worry about it when you are away from the situation, and are then able to deal with it constructively.

Imagining the extreme:

This is similar to worry postponement, in that you set aside time to allow the anxious thoughts to grow to the extreme, instead of letting it happen during the stressful or anxiety-causing event. By doing this, you can separate your thoughts from the event while it is happening to show yourself you can gain control over your own negative or anxious views of the situation.

Set aside a brief time to worry about your concern or event that brings you anxiety. Instead of worrying about your commuting to work while you are driving, you can do it during your scheduled ‘worry time’. You can then use the thoughts that stem from the worry time in your thought tracking journal. This will allow you to come up with realistic solutions to alleviate the worry and stop the anxiety festering during the actual situation.

Likelihood and Evidence:

Here, you examine the likelihood that your original interpretation about a concern or event could actually come true, based on a past event that was as negative and worthy of future worry as you originally thought.

Instructions:

1. Examine the likelihood whether this will actually happen.
2. Are you able to put in percentage terms how likely it will happen?
3. How likely will you be ‘a failure’?
4. What percentage terms will you put yourself down as ‘unattractive’?
5. If you are unable to cross a bridge, is it ‘forever’?

Try it and see for yourself, but remember that it may not be possible to actually add up a percentage like this.

Alternative Interpretations and Predictions:
In this cognitive strategy, think of other ways to interpret the event that worries you. Usually, an anxious thought may be linked to a past failure or future possibility. In the end, they are only ideas, and not facts. By coming up with other ways to look at an anxiety-causing situation, you may find that your one explanation or prediction was purely negative. You can also come up with other interpretations that are neutral or positive.

Instructions:

1. Write these down on another sheet of paper away from your thought tracking journal.
2. Write down both negative and positive results
3. Look at the results to see whether your interpretation of the event will actually happen, or that an interpretation of a past event is an actual fact.
4. On closer examination of the results and interpretation, ask yourself this:
• How many times did you ‘fail’ tests?
• Did you even have a failing grade?
• How many times did someone else actually say you were unattractive?
• How many times did you try to cross the bridge on your own?
5. How did you define failure?
6. Does it still count as a failure after your re-evaluation?

We often over-generalize or see a single event as a total catastrophe when it has only happened once. Or, our worry keeps us from even trying at all, so we have never actually done what we were worried about.

Reducing Catastrophes or Finding Positive Examples:
Here, you take the catastrophe you were worried about out of the equation, and replace it with a positive outcome. Instead of viewing the worst that could happen or the end is nigh, ask what would happen if that worry would actually come true?

One example of what many people are faced with nowadays is the possibility of losing their job:

• What would happen if you were laid off?
• Would you immediately be homeless?
• What are some of the alternatives?

You may have money saved up, or have colleagues that can help you find work temporarily while you look for another job. Since you have been working for the same company for many years, there may be more and better opportunities in the job market that you have never seen before. Although your original catastrophe can be as big as you want it to be, so too are the positive alternatives.

Another possible example is worrying about breaking up with your spouse or partner:

• What would life be like without them?
• Would you be able to find someone else?
• Would they have bitter feelings towards you?
• Are there more people out there that are possibly more suitable?
• Would your spouse or partner really be unhappy with you if you took steps to be happier?

Acceptance

Now that you have taken time to allow yourself to worry completely about an anxiety-causing event, have examined whether it is realistic, and have thought about positive alternatives, you have another option: acceptance.  You can accept that certain events can lead to anxiety, but you have tools to take apart the distortions, negative self-talk and extreme ideas that lead to the anxiety in the first place.

You can now analyse and lessen the stress of some of your past worried thoughts like:

“I’ll never be able to drive over the bridge by myself."
“That audience will hate my speech; I just know it!”
“I can’t seem to get to work on time. I’m going to get fired and be poor for the rest of my life.” 

By examining your worried thoughts and whether they are realistic, and then accepting them, the worried thoughts can be replaced with:

“I’ll probably be a little nervous when I drive over the bridge, but I’ll make it”
“There may be some people that do not like my speech.”
“I may be late this one time, but it doesn’t mean I’ll lose my job or be poor.”

Cognitive Techniques for core beliefs about self, world and future

Core beliefs are the basic foundation as to why we may interpret some events so negatively that they lead to anxiety. If your general views about yourself, the world and the future are negative, so will your everyday thoughts on daily events. These cognitive strategies target the basic beliefs instead of the everyday distortions which we can learn to address them through thought tracking and alterations to automatic thoughts and self-talk.

Re-thinking the past

After examining where many of your core beliefs come from, you may find many negative experiences that occurred while you were growing up, which influenced your belief in being “a failure”, or “unattractive” or “unable to try new things and take risks”.  Much like the tools used to address negative thoughts and self-talk, you can re-think these past events based on whether these beliefs can still hold true today after using positive alternatives. This does not mean that any disturbing events that you experienced when you were younger are:

• No longer true or were not painful in the past. It just means that based on you today, you may not need to hold on to those beliefs anymore.
• Suppressing pent-up emotions may lead to anxiety as you are so out of touch with your feelings.

For example, you may have grown up in difficult financial circumstances where you and your family may have struggled to maintain a home and have money for extra gifts and luxury items. Today, you are financially successful, but still have a worry that you will never have enough money to be happy, or that you still feel guilty when you spend the money you have earned.

Your thoughts today may stem from your past experiences of economic hardship with your family.  It may have been difficult, and often depressing in the past to not having financial resources to live well, but it is certainly not true for you today.

One way you can re-think your past experience is to consider what you have learned from your financial hardship. You may have learned to save money regularly and create a “nest egg” that your parents were unable to do. You may have learned to find better bargains so that you can carry on the same lifestyle as your successful friends, but spend less by doing it this way. Today, you don’t have to feel guilty about living well, or worry about losing everything. You can use re-thinking to re-shape your beliefs to adapt to your lifestyle of today.

In your thought tracking journal, you should make room to address the underlying beliefs that lead to anxious thoughts and write down alternatives based on the re-thinking.

Moderation in beliefs or constructing preventative beliefs:

Our core beliefs are often extreme in the way we cope or deal with the world. Two such examples are:

• You may believe that you should always control your emotions, because displaying them may be a sign of weakness.
• Suppressing pent-up emotions may lead to anxiety as you are so out of touch with your feelings.

Any extreme belief can be moderated so that you can have a lower level of anxiety which was originally caused by maintaining a rigid view of the world or your own sense of self-control. Instead of upholding a belief that any emotion shown means a lack of self-control, you can moderate this through positive alternatives, like laughing can mean you are in control of your happiness, or showing emotions to your closest friends, even if you are not ready yet to show them in public.
You may feel that absolute perfection is the only thing to be obtained. Instead of upholding this belief in every aspect of your life, let it become less restrictive and allow in imperfections in your life. For instance:

• letting yourself become more adventurous
• be more carefree when cooking at home
• lighten up more at work

All this would lessen stress and will still give you the freedom to relax your core beliefs.
In your thought tracking journal, you should make room to address the basic beliefs that lead to anxious thoughts and write down alternatives based on moderation.

Metacognitive Therapy:

Metacognitive therapy is an extension of cognitive therapy that intends to address two areas of worry:

• Negative beliefs about uncontrollability of worry
• Negative beliefs about the danger of worry and positive beliefs about worry