A CBT workbook

[VowsOfSadness]

Hey guys, I hope to use this as a place to put my coping skills or to collect my info I have learned in Partial IP so that I remember to use them (kinda stealing Candy's idea--sorry!).

For example I hope to post:
(repost) Distordted Thoughts-CBT
(repost)Interpersonal Effectiveness-DBT
Thought Recordings--CBT
Problem Solving Worksheet
Distress Tolerance--Coping skills
etc.

and maybe they will help you guys along with me. I hope this is okay!
-Amanda

*CBT= Cognitive Behavioral Therapy
Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this fact is that we can change the way we think to feel / act better even if the situation does not change.

*DBT= Dialectial Behavioral Therapy
A form of cognitive-behavioral therapy for patients that teaches them skills to reverse their negative thoughts and behaviors. It emphasizes balance between acceptance and change in helping clients with serious psychiatric symptoms, in order to relieve those symptoms and improve the quality of life.

[VowsOfSadness]

I don't know if anyone has ever done any CBT (Cognitive Behavioral Therapy) but it is really big at all the places I've been to and one of the biggest and hardest parts of CBT is recognizing your thought distortions. Which are untrue thoughts that make you feel worse.

Thought Distortions

All Or Nothing Thinking- You tend to see situations as either Black or white. Look for the words "ALWAYS" or "NEVER".
Ex: "They Always pick on me"
Challenge: Focus on the word "Always", it means at all times INVARIABLY, FOREVER, PERPETUALLY. They may pick on me sometimes, but definitly not in ever interaction. As far as "NEVER" it means not ever, at no time, not in any degree, and not under any condition. Seems unrealistic doesn't it?

Overgeneralization- You see a single situation as an unending pattern of defeat, happenening over and over.
Ex: "I got an F on my English test I will never pass english again"
Challenge: Just because one thing does not go my way does not mean I am a failure. I can study and get better or ask for help.

Mental Filter- You focus on a single negitive event and ignore all positive details.
Ex: "That party was the worst, some guy looked at me funny!"
Challenge: That party was really fun, the only thing that went wrong was that guy looked at me funny; I will not let it ruin my good time.

Discounting The Positive- You recognize positive events but discount that you had any part of them
Ex: "I got an A on the test because it was easy"
Challenge: I got an A on the test because I studied hard and am bright.

Mind Reading- You believe you know how/what someone thinks
Ex: "When I got an F the teacher made a face, he thinks I'm stupid"
Challenge: The teacher could be trying to connect with me, I may need to ask for help. There is no way to know if he thinks your stupid unless you ask him or he says so.

Fortune Telling- You predict situations will turn out negitivly
Ex: "When I go home my mom is going to start yelling at me."
Challenge: I do not know how my mom is going to react she could be in a good mood. If I walk into the situation expecting her to be upset I will be upset too.

Catastrophizing- You expect and predict the worst possible outcome (this also includes any "snow ball effect statements" which are statements that start with small failure and turn into bigger failures, I failed my test, I wont get into college, I'll never get a job--one step at a time).
Ex: I got a C on that test, I will never get into college."
Challenge: Ask an advisor

Labeling- You attach lables to yourself and others (this can include things, such as "school is stupid")
Ex:"She acted like such a bitch"
Challenge: What is a bitch? What it means to me may not mean the same thing to someone else. Do I really think she is that? And besides Technically it is a female dog.

Should Statements- You try to motivate yourself or others by "shoulding them"
Ex: "You should dress pretty"
Challenge: All that matters is what is or what you deciede to do.

Personalization- You see a negitive event as solely occurring because of yourself
Ex: "I answered the question wrong and we lost the game"
Challenge: It is a team effort and I cna not be responsible for the play of my entire team.

[VowsOfSadness]

The interpersonal effectiveness skills (basically how to properly communicate with people) is one that I have found very helpful. I learned them in my IP program and would like tos hare them with you.

Interpersonal Effectivness is used for:
Getting what you want
Maintaining Relationships
Enhancing self-respect

It is the practice of of using better communication skills in rerlationships, it is never gaurenteed the skills will work each and every time.

TO GET SOMETHING YOU WANT USE DEAR MAN SKILLS
Describe (the current situation-stick to facts)
Express (your feelings with I statements "I feel/need/want")
Assert (yourself clearly by asking for what you want or saying no)
Reinforce (or reward the person by explaining positives and negitives)

Mindful (stay focused on objectives)
Appear Confident (use a confident tone with good body language)
Negotiate (be willing to give to get)


TO MAINTAIN RELATIONSHIPS USE GIVE SKILLS
Gentle (have good nonverbal signs)
Interested (listen to the other persons point of view and act interested)
Validate* (most crucial, let the other person know you acknowlege their feelings)
Easy Manner (having an easy manner makes it easier for people to communicate to you)


USE FAST SKILLS TO MAINTAIN SELF-RESPECT
Fair (be fair to yourself and the other person)
Apologies (don't be over apologetic "I'm sorry for being alive/making a request/something I have no control over" No apologies for your opinnion or disagreeing. The only time it is important to apologize is when you have done something wrong to the other person)
Stick To Your Values (Don't sell out your values or integrity for reasons that aren't important. "Stick to your guns")
Truthful (don't lie or act helpless when you aren't Don't exaggerate the situation. Don't make excuses)


A NOTE ABOUT "I" STATEMENTS:
I statements, when said seem less threatening and are therfore more likely to get a positive responce. If you can imigine your last conflict or fight you might recall being set off by some statements such as "YOU ALWAYS..." or "YOU NEVER..." and the feelings they made you feel.
So when talking to someone it is good to use I statements.

There is a traditional formula:
I feel __________, when you ___________, and I want you to _______________.

But these can also be used:
"I" statements:
I think...
I feel...
I want...

Statements of Personal Reference and Personal Meaning:
"This is the way I see it"
"In my opinion..."
"This is how I feel"
"This is what it means to me"

Statements of Request:
"I" want...
"I" need...

Statements offering compromise:
"I" would like this...
What would you like?
"I" think...What do you think?
"What would be an acceptable compromise?"
"Can we work this out--What time is agreeable to you?"

Asking for time:
"I'd like to discuss this in an hour"
Taking time to think, know what you want to be different,
thinking of compromise, etc.

AVOID demanding and blaming statements:
You make me...
You think...
You should/shouldn't...
It's your fault...
Don't you think...
If only you would...

Avoid Disguised YOU-Statements
These include sentences that begin with "I feel that you...." or "I feel like you...." Again, they immediately put the listener into a one-down position.

[Candy]

You are doing a great job here and I will copy off the stuff for my coping book if you do not mind. take care.

[VowsOfSadness]

Thought Recordings
A thought recording is used a lot in my partial IP and will (hopefully) be used a lot in here. It is a way to evaluate a situation and find distorted thoughts to make your mood better. I will start it the way we always start at IP.

A thought recording (or CBT in general) is used when we are feeling STRONG EMOTIONS, these are usually unpleasant.

They start off by teaching a three column thought recording (it is usually horizontal, but I do mine vertical so it will a bit odd).

EXAMPLE:

Column 1
Situation
Who: Who specifically is involved
What: Very plainly, what happened
When: at what time
Where: where
*never why, because you should know why (that's what they say, I don't quite get it but it works, I think the why is because of the what or strong emotions)

Column 1 EXAMPLE:
Situation
Who: Me and My friend
What: School/leaving school
When: April 2, Lunch
Where: school Lunch room


Column 2
Thoughts
Thoughts is a blank column (as far as who what when type of structure). The thoughts we are feeling are called "Hot Thoughts" because they come fast and are usually distorted. These thoughts stem from our core beliefs (which are values, true or untrue, we have learned over the years from various sources).
THE THOUGHTS COLUMN HAS AS MANY THOUGHTS AS YOU THINK, from 1 thought to 100 thoughts they are all written here.

Column 2 EXAMPLE
Thoughts
I hate school
School is driving me crazy
I can't think
It's so nice outside
I don't want to be here
I just want to be with my friend
Last time we left we were so happy
If I stay I'll die
I love my friend
At least I'm not hight


Column 3
FEELINGS
These are emotional feelings not physical (unlike My stomach hurts). And you need to do two things:
1. Match every feeling to an emotion
2. Rate it from 1-100 (or as I do 1-10)

*note: this is where mine usually differs.

Column 3 EXAMPLE (written in column 3 as a matching list or in cloumn 2 as I do.
Thoughts
I hate school (desperate, anxiety)
School is driving me crazy (Panic, fear, anxiety)
I can't think (Panic, Fear)
It's so nice outside (happy, anxiety)
I don't want to be here (Panic, Desperate, fear)
I just want to be with my friend (anxiety, fear, happy, desperate)
Last time we left we were so happy (happy, anxiety)
If I stay I'll die (anxiety, fear, panic, desperate)
I love my friend (happy anxiety panic)
At least I'm not high (happy, out of control, anxiety)

Cloumn 3
FEELINGS:
Panic- 100%
Anxiety- 85%
Desperate- 100%
Fear- 85%
Happy- 35%
Out of control- 90%

And as you may note these emotions are very high and the goal is to lower them. So the next step is to find Cognitive distortions, like the previous posted list. We find these by looking for thoughts that are abstract and try to make them concrete, or if they can be explain another way, or are not all true.

also as I go through I usually try to mark what kind of distortion I may find in my thoughts beside it, I may write "all or nothing" next to "I hate school" or maybe just "Abstract" by "School is driving me crazy" this helps to challenge your distortions.

Here is my Column 4 which is called "new thoughts" which are the same thoughts written distirtion free

Column 4 EXAMPLE
NEW THOUGHTS
Sometimes school's tough
I get distracted and overwhelmed at school
It can be hard to think and focus
It's so nice outside
I don't like being at school.
I can't always be with my friend even though I enjoy it.
Last time I left was fun, but I got a saturday detention.
If I stay I may be uncomfortable or unhappy
I love my friend, but if she makes bad decisions I can make my own and still respect eachother.
It is good to stay clean, but it does not excuse other behavior


Next is cloumn 5 which is just a blank feelings column to rate your new feelings, which hopefully may have gone down even just a bit.

Cloumn 3
FEELINGS:
Panic- 60%
Anxiety- 45%
Desperate- 80%
Fear- 30%
Happy- 40%
Out of control- 50%


and that, though complicated the way I wrote it is how to do a thought recording

[VowsOfSadness]

I got a fortune in a fortune cookie and I know it may sound stupid but it has really helped me.

I guess small things do count! It just reminds me of something that my T would have said.

"before you wonder 'Am I doing things right,' ask 'Am I doing the right things?' "

This is especially true for me! It doesn't matter how good I am at cutting back on coke etc., for example, I often say to myself, "Well it's just going to be this one slip" I must keep in mind the goal is to quit. And I can't keep asking god to help and to fogive me for the things I have done, when in the back of my mind I have plans or am thinking of doing it again. I can be the best _______ ever but if it's not right, if it's not good, none of it reall matters.

So I would wish you guys to do the best you can on the right track! Becuase even if you aren't so good or stead-fast at doing good things (whatever that may mean for you) at least you are on the right path and that is what matters!

[VowsOfSadness]

LABELS- A COMMON DISTORTION
*some lang trigs can be expected, not bigs ones though*

One of the Distortions that is common in hot thoughts is LABELING. It is often hard to turn a label into something concrete. I often even ask myself, what is wrong with a label. For example, if me and my mother have a fight I may think, "She's a bitch" or "I'm stupid".

The problem with lables is that they are allowing yourself to be distracted from the problem and may often cause feelings of guilt later on (I usually feel really bad about saying nasty things about my mom even if not to her face).

The Background on Labels
A label is an abstract term, meaning that it is something that is not clearly defined or means different things to different poeople.
Some examples of labels are:
Cuss word names (bitch, hoe, etc.)
Stupid
Fat (also this is NOT a feeling so if you are doing a thought recording or such this should not be in your FEELINGS column)

For some examples of Labels check out LABEL IT. A history of sterotypes

Now I'll show you how to challenge these thoughts. The common method is called ABSTRACT TO CONCRETE.

For example:
BITCH: Bitch is a female dog. Obviously this person isn't a female dog. What does this word mean to me?
ASK YOURSELF
What does this word mean to other people, is it the same thing for everyone? More importantly what am I really trying to say or express what am I really feeling about the situation?

Instead of my mom is a bitch, I might sya I feel that my mom is being mean, or I am being treated unfairly.

Instead of saying "I'm Stupid" I might be thinking, I made a mistake, I messed up, things can be changed, everyone makes mistakes.

See how there is much more behind one word than simply put.



*LANG TRIGS* BAD LANGUAGE MAY FOLLOW*
SOME OF MY LABELS
Life Ruiner- I messed up something for someone else, I am mad at myself, I am upset or let down in myself.
BITCH- I or someone is mean, they have not considered others feelings, they may be strong or I may hold this as a good thing but it has a hint of over-bearing, this comes with the added distortion "obviously no one lieks a bitch"
BAD- "I'm bad" means I messed up, so as a whole I am a bad person. Hitler was a bad person, rememberthat god said "Man is not built up by evil alone".
BROKEN- "I'm broken"- Glass is broken, a person is not broken. Broken to me is a sybol of decreased value as if I am or my self-worth is less than others. What I am trying to say is another distortion that I am not normal or not how I should be that I am unwanted and cannot change....NOT TRUE!

[VowsOfSadness]

FEELINGS

A LIST OF WORDS TO DESCRIBE FEELINGS
ANGRY/MAD/AGRESSIVE/ANNOYED
Agressive, bitter, furious, hosile, affronted, annoyed, antagonized, bitter, chafed, cross, displeased, enraged, exacerbated, exasperated, ferocious, fierce, fiery, fuming, furious, galled, hateful, heated, hot, huffy, ill-tempered, impassioned, incensed, indignant, inflamed, infuriated, irascible, irate, ireful, irritable, irritated, maddened, nettled, offended, outraged, passionate, piqued, provoked, raging, resentful, riled, sore, splenetic, storming, sulky, sullen, tumultuous, turbulent, uptight, vexed, wrathful

SAD
bereaved, bitter, blue, cheerless, dejected, depressed, despairing, despondent, disconsolate, dismal, distressed, doleful, down, downcast, forlorn, gloomy, glum, grief-stricken, grieved, heartbroken, heartsick, heavy-hearted, hurting, in doldrums, in grief, languishing, low, low-spirited, lugubrious, melancholy, morbid, morose, mournful, pensive, pessimistic, somber, sorrowful, sorry, troubled, weeping, wistful, woebegone

AFRAID/SCARED
afraid, aghast, anxious, fearful, panic-stricken, panicked, panicky, petrified, scared silly, scared stiff, shaken, startled, terrified, terror-stricken, abashed, aghast, alarmed, anxious, apprehensive, aroused, blanched, cowardly, cowed, daunted, discouraged, disheartened, dismayed, distressed, disturbed, faint-hearted, frightened, frozen, horrified, in awe, intimidated, nervous, panic-stricken, perplexed, perturbed, petrified, rattled, run scared, scared, scared stiff*, shocked, spooked, startled, stunned, suspicious, terrified, terror-stricken, timid, timorous, trembling, upset, worried

HAPPY
blessed, blest, blissful, blithe, can't complain, captivated, cheerful, chipper, chirpy, content, contented, convivial, delighted, ecstatic, elated, exultant, flying high, gay, glad, gleeful, gratified, hopped up, intoxicated, jolly, joyful, joyous, jubilant, laughing, light, lively, looking good*, merry, mirthful, overjoyed, peaceful, peppy, perky, playful, pleasant, pleased, satisfied, sparkling, sunny, thrilled, tickled, tickled pink, up, upbeat

Some words I liked
bitter, enthusiastic, exasperated, frightened, hostile, irritated, irate, threatened, worthless, powerless, uneasy, safe, humiliated.


SOME LINKS TO HELP YOU:

THESAURUS

DICTIONARY

ANTONYM/SYNONYM finder

Find your feelings with this Feelings List!


Guidelines For Expressing Feelings
Try to be specific rather than general about how you feel. Consistently using only one or two words to say how you are feeling, such as bad or upset, is too vague and general. What kind of bad or upset? (irritated, mad, anxious, afraid, sad, hurt, lonely, etc.).
Specify the degree of the feelings, and you will reduce the chances of being misunderstood. For example, some people may think when you say, "I am angry" means you are extremely angry when you actually mean a "little irritated".
When expressing anger or irritation, first describe the specific behavior you don’t like, then your feelings. This helps to prevent the other person from becoming immediately defensive or intimidated when they first hear "I am angry with you", and they could miss the message.
If you have mixed feelings, say so, and express each feeling and explain what each feeling is about. For example: "I have mixed feelings about what you just did. I am glad and thankful that you helped me, but I didn’t like the comment about being stupid. It was disrespectful and unnecessary and I found it irritating".

[VowsOfSadness]

A problem Solving worksheet.

Pretty self expanitory.

What is my problem?
Be specific.

What is my goal?
What do you want to achieve? Is it possible? Is it realistic? Are you willing to work for it? Has to deal with your problem.

3 Or More soultions
Things that pop into your head, have at least 3.

________________________

________________________

________________________

________________________


Pros and cons of each solution:
soultion 1: pros and cons

Solution 2: Pros and cons

Solution 3: Pros and cons

etc.

remember you may have a million pros but if the cons are really weighty like death, being arrested, or anything big to you it may outweigh the pros.

PICK ONE AND TRY IT!

EVALUATE YOU OUTCOME!

You can keep picking them and trying them. If it continually doesn't work you need to re-evaluate your goal. If it still doesn't work you need to look at your problem.

[Candy]

I just wanted to say that your coping skills are very helpful to me,and I hope you are going to continue to do more. It is great and I think it is very helpful to others. Keep up the great work.Thanks alot.

[Spidey]

if this isn't already in the sticky thread for the "must reads" on coping, it is now.

[VowsOfSadness]

hey guys thanks for teh encouragement I will try to get more up soon!

[VowsOfSadness]

Core beliefs are a big part of CBT. It is something taht is ingrained in all of us they can be good or bad. So lets examine our core beliefs, shall we?

CORE BELIEFS ARE...

How We see Life
What we believe to be true about the world, life, ourselves, and the people around us.

We develope core beliefs through....
-The expierences we have (both good and bad)
-By what is taught to us by our parents, teachers, religious leaders, etc.
-through the media (TV, radio, magazines)


Core beliefs are the roots of our Automatic thoughts or hot thoughts.
They can be about ourself, others, or the world.

Core beliefs can be TESTED by looking for evidence that they are true or not 100% true.

Core beliefs shift gradually, but over time they become stronger and more stable and exert a powerful influence over the way you think, behave, and feel.


ACTIVITY
Think of the four things listed under we develop core beliefs through... and name some things that could have occurred for a person to have the following beliefs:

1. Every problem can be solved with violence.
1.

2. School is just a big waste of time.
2.

3. If people know you take meds, they will think that you are crazy!
3.

4. My parents don't understand me, how can they help me?
4.

5.Marijuana is great, but I would never try anything harder like heroine or cocaine.
5.

6. Problem sloving just doesnt work for me.
6.

7. Once a cheater, always a cheater.
7.

8. Getting high/drunk makes all my problems go away.
8.

9. People are better off when they aren't around me or friends with me, they always end up hurt or dead.
9.

10. Everyone deserves a second chance.
10.


I don't know about you but I notice a lot of distortions in these core beliefs, which is often the case.

[VowsOfSadness]

Though not really CBT this has helped me a lot, It's called the serenity prayer. It is actually used in AA and NA, along with other 12 step programs.

*mildly religious*


God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

--- extended versions add this:

Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world
as it is, not as I would have it;
Trusting that He will make all things right
if I surrender to His Will;
That I may be reasonably happy in this life
and supremely happy with Him
Forever in the next.
Amen.

--Reinhold Niebuhr

[VowsOfSadness]

I have recently noticed that it is not only me who is having a hard timne with going to work, being at work, and the stress of work. I think it causes everyone some anxiety to some degree, but what can be done about it?? I tried to find some sources that would give help on dealing with depression and Anxiety at work.

When suffering from Depression, work habbits may be as follows:
-Working slowly
-Making mistakes more often
-Unable to concentrate
-Forgetful
-Late for work or meetings
-Not turning up
-Getting into disputes and arguments with colleagues
-Unable to delegate tasks
-Working, or trying to work, much too hard

First off somethings that have helped me:
-Taking a break when I need one (not like 30 mins, but like 5) going to the restroom where it is usually quieter. Washing my face and breathing for a few minutes.
-If I get frustraited on one task I move to another. For example I work at a movie theater, so if dealing with customers is starting to get to me and someone else is ringing also I move to maybe cleaning. So if you are working on a hard paper or something try something else for a bit then come back to it.
-ASK FOR HELP. ASK QUESTIONS. Trust me your employers would rather tell you what they expect and how they want it done then you doinging things aimlessly. Plus then you will know exactly what to do. And if you CANT do something or CANT do it ALONE ask for help and they may provide some. For example I once had to move heavy boxes and I just couldnt do it they got someone to help me.


And here is what I found on the Internet:
Improve your time management and organization skills.
Of the many things you can to in this area the best ones include getting a to do list that works, learning to say "no", asking for help when you need it, and stop setting unrealistic goals for yourself.
Relax and breathe deeply.
Whether you are feeling overwhelmed by the amount or work you have to do or if someone is "in your face", a good thing to do is to "breathe through your nose". You can't get as worked up if you force yourself to breathe through your nose. Your body simply can't maintain the same level of energy without that extra oxygen you get when breathing through your mouth.
Take more breaks from your work.
Even a five-minute break will help. Get away from your desk. Go for a walk - outside is better, but up two flights of stairs and back down is good too. Getting more exercise in general will help you reduce your overall stress levels and that will make it easier to reduce your stress level at work.
Lighten up.
Smile more. We all know laughter reduces stress. You will be amazed at how much more pleasant the people around you are when you make an effort to be pleasant yourself.
Learn to listen better.
Rather than getting upset when others disagree with you, listen actively and find the areas of agreement. Be assertive and stand up for yourself, but don't be rigid.
Fix your environment.
Make whatever adjustments you need to the lighting, temperature, noise level, and other controllable factors in your office.
Don't sweat the small stuff.
Realize that there are some things that just aren't worth worrying about and there are some things you just can't change. Don't waste time stressing over the things in either category.
Get more sleep.
This is another of the things you can do to reduce your overall stress that will have benefits at the office as well. In addition to reducing your stress, it will increase your energy level and your ability to concentrate.
Find a mentor
or a friend. Having someone to talk to can take a lot of stress off you.
Spend more time with optimistic people.
Negative people will pull you down to their level. Choose to work with people who have a positive attitude instead.

[balletomane]

That's really useful. Thank you, Vows.

[treasure]

i have most of that cbt info in a folder in a coping box, but i never seem to open the box at the right times, and haven't done a thought/feeling sheet for a long time. thank you for the reminder

[the edge of the world]

Vows, thanks -- I've copied and pasted these posts into a folder

[angelic212]

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for all this helpful dbt info
i will put into practice

[VowsOfSadness]

A quick guide to challenging thoughts:

Can any of these thoughts be proven wrong?
Are any of these thoughts based on information that I do not know?
Are any of these thoughts too abstract (they mean more than one thing, are vague or unclear)?
Take every abstract term and make it specific?
Design an experiment- Plan a way to prove what you are thinking.
Alternative explaination- can my thoughts be explained another way?