Can we learn to think differently? Part 1

Can we learn to think differently in different situations and thereby change how we feel and act in them?

Most of us know moments when we feel inadequate or not good enough. It might be the feeling of not being good enough as a parent, of being to blame for a conflict at work, or of feeling worth less than our friends. Moments like these can affect our mood and cast a shadow over the rest of the day. Days like that may otherwise begin well: We wake up, feel good and look forward to going to work, going to school or meeting friends. But when we arrive at work and are about to say good morning to colleagues, or say hello to friends at school, we may suddenly find ourselves in a low mood and feel anxious because a friend or colleague does not greet us in the way we expected. This can trigger thoughts such as: “They no longer like me.” We may find ourselves caught in thought streams about what we might have done wrong, or why our colleagues or friends did not say hello in the way we wanted. The stream of thoughts can be hard to get out of, and we often notice that it makes our mood even worse. In this way, an otherwise good day can end with a feeling of frustration that the day ended badly.

We may often feel that we have no control over our mood, and we may come to see the situation as the cause of our low mood, for example because a colleague or friend did not greet us in the way we had hoped. What we often do not notice is that we can actually influence our mood through our thoughts. Often, it is our negative thoughts, interpretations and evaluations of specific situations that shape our mood.

The cognitive diamond

The relationship between thoughts, feelings, behaviour and bodily sensations can be illustrated using the cognitive diamond. The cognitive diamond is often used in cognitive behavioural therapy, because our thoughts, interpretations and evaluations of a situation have a major influence on how we feel and act in it.

The model shows that our thoughts influence how we feel. Conversely, our feelings also influence how we think. When we are in a low mood, we will also tend to experience more negative thoughts. Thoughts also influence our behaviour and our bodily sensations. If we have thoughts about whether something may have happened to someone close to us, we will often feel discomfort in the body. At the same time, the thoughts can influence our behaviour, so that we seek reassurance that nothing has happened.

When we suddenly find ourselves in a low mood, it is therefore often not only because of the specific situation we are in, but also because of the way we think about, interpret and evaluate the situation. This is because thoughts, feelings, body and behaviour influence each other, as illustrated in the cognitive diamond.

Automatic thinking

An important part of understanding how a negative psychological state can continue is negative automatic thoughts. This is connected to the fact that our thinking is automatic, spontaneous and interpretive. Automatic thinking is present in all people and in all situations. This means that we spontaneously and continuously interpret situations and events, either as mental images or as thoughts. These interpretations arise quickly and can strongly influence the person’s actions and feelings. Everyone will experience automatic thinking becoming negative in certain moments or situations. This can happen, for example, in conflicts where we feel treated negatively or not acknowledged, and where our mood is pulled down. When automatic thinking often becomes negative in situations where we are treated negatively or are in conflict, it is connected to the fact that our anxiety system is often activated. When the anxiety system is active, it tends to pick up on negative information automatically. This is because the anxiety system needs the negative information to protect us from other similar situations.

Negative automatic thinking

Automatic thinking becomes a problem when it is predominantly negative across many of the situations we find ourselves in. If our thinking is predominantly negative, our mood will often be predominantly negative as well. This is in line with the understanding of the relationship between thoughts, feelings, bodily sensations and behaviour.

Negative automatic thinking is a particular way of thinking about, interpreting and evaluating situations that often pulls our mood down. Predominantly negative automatic thinking builds on underlying negative basic assumptions and rules for living about oneself, other people and the world. Basic assumptions are fundamental assumptions about how we understand ourselves, other people and the world. If a person’s basic assumptions are negative, they may sound like this: “I am not good enough”, “I cannot trust other people” and “The world is basically an unsafe place”. Rules for living are closely connected to our basic assumptions, because they are rules about how we should live, and they are formed on the basis of our basic assumptions. Negative rules for living might sound like this: “If I am basically not good enough, I must always agree with other people”, “Because I cannot trust other people, I do not share private things about myself with others” or “Because the world is an unsafe place, I only go into situations I can control”.

A person with a negative rule for living such as “Because I am not good enough, I have to do everything perfectly” will often have negative automatic thinking activated in a situation involving conflict. If she is sitting in a staff meeting and a colleague disagrees with her, she will quickly have negative automatic thoughts about not being good enough and about the colleague not liking her because the colleague disagrees with her. Here, her basic assumption “I am not good enough” and her rule for living “If I am not good enough, I must always agree with other people” are activated. Because of the person’s negative automatic thinking, interpretation and evaluation of the situation, she will experience it as yet another confirmation that she is not good enough.

The 5-column thought record

One tool often used in cognitive behavioural therapy to change negative automatic thinking is a 5-column thought record. This record helps us become aware of the negative automatic thoughts that arise in different situations. At the same time, it gives us a way to consciously change these negative thoughts into alternative thoughts. The 5-column thought record is built around five columns: the current problem situation, the negative automatic thoughts the situation brings up, the feelings the negative automatic thoughts lead to, alternative thoughts about the problem situation, and finally the feelings the alternative thoughts evoke.

Using the 5-column thought record: an example

Nadia gets up on Monday morning and is actually looking forward to the day ahead. She gets ready, eats breakfast and cycles to school. At school, she meets her two close friends outside. They are standing and talking about what they did at the weekend, and they ask Nadia what she did. Nadia tells them that she went to the hairdresser and to a birthday party with some friends. The girls say that it sounds like a nice weekend and that her hair looks good. Then they go into class when the bell rings.

Nadia finds it hard to concentrate during English class. She suddenly feels in a low mood. Nadia sits and thinks about why the girls went into class so soon after she had told them what she did at the weekend. Nadia also thinks about why the girls only said “it looks good”, and she starts wondering whether they might not have meant it at all. She also thinks about the fact that they did not ask more about how the birthday party had been. She concludes that it must be because they are not interested in hearing about her weekend, are not really interested in her at all, and only talk to her out of pity. She also thinks that this must be why they went into class so quickly after she arrived at school.

When English class ends, Nadia and the other girls are finished for the day. Nadia no longer feels like talking to the girls. She quickly says goodbye to them and cycles straight home. When Nadia gets home, she is in a low mood. She feels unwell and does not feel like doing anything for the rest of the day. Nadia feels frustrated that the day has ended in a low mood, since she had otherwise woken up in a good mood. Nadia gets under her duvet and watches Netflix for the rest of the day.

In the example with Nadia, we see how her negative automatic thinking ends up pulling her mood down, so that her day ends in a low mood and with a feeling that her friends do not want to be with her. Nadia is also frustrated that her good mood earlier in the day has now been ruined.

At that point, Nadia is not aware that it is her negative automatic thinking that has contributed to the low mood. Instead, she interprets her low mood as a sign that her friends do not want to be with her and only talk to her out of pity. In addition, Nadia is also not aware that her negative automatic thoughts about now being in a low mood also help maintain that mood until she goes to bed.

The following example illustrates how Nadia gains insight into the fact that she can make a difference herself by changing her negative automatic thinking.

Nadia has an appointment with her psychologist on Wednesday morning. Nadia feels that the mood from Monday has stayed with her for the past couple of days, and she still notices a negative mood and a lack of desire to see her friends, whom she had previously enjoyed spending time with.

Nadia arrives at her psychologist’s office, and they talk about how things have been since the last session. Nadia says that she has had some difficult days since Monday. The psychologist asks what Nadia thinks the reason might be. Nadia says it is because she has started to feel that her friends no longer want to spend time with her and only talk to her at school out of pity.

The psychologist suggests that Nadia use a 5-column thought record to show what had suddenly brought Nadia’s mood down. Nadia first writes down the concrete problem situation where her friends asked about her weekend.

Nadia first fills in the field: “current problem situation”. Nadia writes the situation down briefly and precisely, as she experienced it:

Nadia is then asked to write down which negative automatic thoughts arose after this situation. Nadia writes on the board that they were thoughts such as “my friends went inside quickly because they did not want to talk to me” and “my friends only talk to me out of pity”.

Nadia is then asked to write down which feelings this brought up for her. Nadia writes feelings such as “uncertainty”, “anxiety”, “loneliness” and “doubt”.

The psychologist pauses and looks at what Nadia has written so far. The psychologist asks Nadia what she notices when she looks at the thought record at this point. Nadia can suddenly see a connection: it is her negative automatic thoughts that lead to the negative feelings she experiences, and not necessarily the problem situation itself.

Nadia is now asked to try to come up with alternative thoughts about the situation. Nadia finds this difficult, so the psychologist helps her. Together they arrive at the alternative thought: “My friends actually showed interest in me by asking about me, but unfortunately they had to go quickly because they had to go to class.” Another alternative thought could be: “If my friends had not thought my hair looked nice, they could have said nothing, but they actually did say something.” Nadia is then asked to write down which feelings the alternative thoughts bring up. Nadia writes “acceptance”, “pleasure” and “gratitude”.

The psychologist asks Nadia again what she now notices when she looks at the thought record. Nadia says that she can see that she can do something active to change her mood by finding alternative ways of thinking about the situation. Nadia realises that the negative automatic thoughts are not the only way to think. The psychologist and Nadia talk about how negative thoughts are often automatic, and that this can make them feel like the true ones. They also talk about the fact that because the thoughts are automatic, you need to practise noticing them and then consciously try to change them. For the next session, Nadia is given the task of “looking for” the negative automatic thoughts, writing them down in the 5-column thought record, writing down the corresponding alternative thoughts and writing down which feelings the different thoughts bring up for her.

So what is the purpose of the 5-column thought record?

As the example with Nadia illustrates, an important aspect of the 5-column thought record is that it requires us to engage actively with our thoughts and with how thoughts influence our feelings. This happens, among other things, because the task is to find alternative ways of thinking about a given situation. By using the 5-column thought record, we move from passively accepting our thoughts and feelings as they are to recognising that it is possible to change the thoughts and act on that recognition.

Although it may seem straightforward to find new alternative ways of thinking and thereby change how we feel and act in a given situation, it is not simply a matter of inventing alternative ways to think about, interpret and evaluate situations. The alternative thoughts will not necessarily have an automatic and certain effect on our feelings. We need to believe in the alternative thoughts. We may be good at coming up with many different alternative thoughts, interpretations and evaluations, but if we remain convinced that the negative automatic thoughts about a situation are true, it will be difficult to feel and act differently in that situation.

We can gradually come to believe more in our alternative thoughts by experiencing the effect of thinking in alternative ways in situations where negative automatic thinking is active.

In Nadia’s case, she and the psychologist look back at a concrete situation to help Nadia understand how her negative automatic thinking affected her mood in that situation. Nadia can see the connection, but she has not felt the actual effect of the alternative thoughts, because she only changed her thoughts after the situation had already taken place. Nadia therefore needs to practise noticing the negative thoughts and experiencing how they affect her mood in concrete situations. In this way, she can immediately practise changing them into alternative and more positive thoughts. By noticing and changing her thoughts straight away, Nadia will experience an immediate effect in the form of a better mood.

Closing

In this article, we have gained insight into how our thoughts, interpretations and evaluations of a given situation can influence our mood. The focus has mainly been on negative automatic thinking, and on how we can learn to notice it and change it into alternative and more positive thinking. The article has described how using a 5-column thought record can help us identify and change our thinking and, not least, become aware that we can do something active to change it and thereby also change our mood.

This article is the first part of a two-part series. The next article looks more closely at basic assumptions and rules for living. More specifically, it is about how our basic assumptions underlie the way we think about, interpret and evaluate situations, and how we can change our basic assumptions and rules for living in a more positive direction, so they do not limit us in how we move through the world or pull our mood down.