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Working with Negative Thoughts

And introducing the amazing negadecagon

Derek Lee

on 1 October 2012

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Transcript of Working with Negative Thoughts

Negative Automatic Thoughts The ability to help clients recognise and challenge their negative automatic thoughts (NATs) is a fundamental skill in CBT NATs are situation-specific thoughts that are ignited, glow for a moment, and are then extinguished as the emotional reactions continue to smoulder We need to understand the situations in which they are ignited. Common themes will form part of our eventual formulation of the client's cognitive architecture within the context of their personal story This is the moment they need to be captured and recorded. It may be a phrase, a word or an image. It is often over-rehearsed, pre-conscious and laden with idiosyncratic meaning It is a skill to help clients identify their emotions accurately and distinguish them from cognitions Some common problems in distinguishing between different types of NATs Selective abstraction vs Maximisation/Minimisation In selective abstraction, the person is condemning the whole situation on the basis of a small negative component. In maximisation/minimisation, the negative and positive aspects are seen out of proportion without necessarily condemning the whole. Over-generalisation vs Global Judgements Over-generalisations are recognisable through the use of absolutes such as always, never, everyone, nobody Global judgements tend to be about negatively labelling people or situations in extreme ways such as completely or utterly bad. Dr Derek Lee http://www.psychodelights.com Working with Negative Thoughts Remember - it ain't cognition
if there ain't ignition Dichotomous reasoning Arbitrary inference Magnification/minimisation Personalisation Discounting the positive Over-generalisation Global judgements Moral imperatives Emotional reasoning Selective abstraction Also known as black-and-white thinking. Characterized by tendency to see things in terms of extreme categories rather than as shades of grey. For example, it is either a complete failure or a success. People are either good or bad. There are only two boxes. Also known as jumping to conclusions. More Inspector Clouseau than Sherlock Holmes -scraps of evidence that may be unrelated or irrelevant lead to unsound conclusions . Includes "mind reading" (knowing what others are thinking) and "fortune telling" (knowing what the future will be like). "My friend did not call. He probably hates me." Also known as the binocular trick. The negative aspects of a situation are magnified and assume too much importance while any positive aspects are played down. "My wedding speech was terrible because I stumbled over some of the words." Here clients see themselves as being responsible for things that are beyond their control. "It is my fault that my friend did not enjoy the film." Also known as reverse alchemy - turning gold into lead. It is about turning positives into negatives. "He said I was good at my job but he does not understand what I really do." Listen for a positive statement followed by a "but". A single incident becomes a general rule. "The lights are always red when I'm in a hurry". "All builders are untrustworthy". Listen for absolutes - always, never, no-one, everyone etc. Also known as labelling or awfulising. People or situations are judged in an extreme way. "He is a complete idiot." Listen for shoulds, oughts and musts. A set of rules for the behaviour of self and/or others. Herein lie the seeds of guilt, shame and anger. Here we are mistaking our emotions for facts. My feelings of dread mean that something terrible is going to happen, rather than seeing that the dread is driven by my thoughts of something terrible happening. A negative aspect is taken out of context - it becomes the focus of attention to the exclusion of everything else. The spot on my nose is more noticeable to me than it is to you. The newly decorated room is ruined because one corner of wallpaper is a little out of line. Help clients attend to shades of grey by ranking people or situations in terms of relevant qualities. Create doubt - one good point means the "bad" box is not the right one. Provide more boxes. Evaluate the relevance and validity of the evidence. Generate alternative explanations. Help clients see it from someone else's perspective. The challenge is to reduce the importance and scale of the negatives and increase awareness of the positives. Get rid of the binoculars - zoom out to see the bigger picture. Help clients recognise the limits of their responsibility. The use of responsibility pie-charts can be helpful. You were not the film director! Clients need practice to recognise positives in daily life, to make a note of them, and to challenge the basis of their strange alchemy - how do they know the person does not know their job? Why would they want to put you down? Undermine the validity of the rule by looking for the exceptions. Even one occasion in a lifetime when the lights were green means it is not
true to say "always". Help clients to see that their judgements are not supported by the evidence. If the milk boiling over is a "complete disaster", what do we call the chimney collapsing? Is every word he speaks idiotic? Challenge the legitimacy of the imperatives. From where do they originate? Do they apply to everyone in all situations, or only to some people in some situations? Remind clients of basic CBT model. Feelings arise from thoughts, and thoughts are not reality. Try to help clients gain a better perspective. Look at the whole picture. I am not just the spot on my nose. The corner of the room is not where the action is. The Amazing Negadecagon The Challenge of Thought Challenging I have developed the negadecagon to help therapists identify specific types of thinking errors and to suggest the kind of strategies that are best suited to challenging them.

There are overlaps in the categories and often some confusion as to what type of thinking error a client may be reporting. It is important not to get too caught up in this - the main point is to identify the type of bias in information processing that is occurring.

These biases may be driven by attentional processes, so that the negatives in a situation assume more importance to the client that other aspects. These include Selective Abstraction and Maximisation/minimisation. Thought challenging is thus focused on these attentional biases - helping clients attend to other apsects.

The biases may be more to do with the processing of information, such as in Personalisation, Arbitrary Inference and Emotional Reasoning. Thought challenging here is focused on helping clients re-interpret the situation.

Finally, the biases may be in relation to categorising data, such as Dichotomous Reasoning, Moral Imperatives, Global Judgements and Over Generalisation. Thought challenging here is about looking for exceptions and anomalies. situation ignition emotion Mnemonic - DAMP DOG MESs
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