Thinking about Thinking...

THINKING ERRORS 9

Stress Management for Health Course

How to Reduce Thinking Induced Stress

Cognitive Restructuring "A technique in which people can learn how to break their habits of automatically thinking negative thoughts and instead introduce affirming, remembered, wellness inducing thoughts." (Professor Herbert Benson MD)

Cognitive Restructuring, also known as reframing, is a cognitive behavioural technique that can be used as a tool for identifying, challenging and altering the stressful thinking that fuels the fight/flight response, replacing these stress-inducing thoughts with a more flexible, more accurate, less rigid, less stress-inducing thinking style.

As we have previously discussed how chronic stress causes us to think more negatively and pessimistically, the more stress we are under the more negatively we think, which in turn increases our stress; it is a vicious cycle. Cognitive restructuring is a technique that helps to break this cycle. Cognitive restructuring is not about putting a positive spin on a negative situation but it is about seeing the entire situation accurately, good and bad. Cognitive restructuring can be a bit difficult to get our head around because it can be difficult to see how the way we think influences the way we feel, yet experience and numerous research studies have shown that it does.

Cognitive Behavioural Stress Management is a powerful tool. It is useful to help us deal with the most common forms of stress, the daily hassles. For example in one research study cognitive restructuring led to a fall in levels of the stress hormone cortisol in research subjects blood streams. It has not only been used to treat stress, anxiety and depression but has also been successfully used to help people cope with major life stressors and serious life threatening conditions such as aids and breast cancer. Cognitive Behavioural Therapy isn't a panacea for all ills but for the more serious forms of stress it can still be useful in helping us to cope with the stress more effectively.

There are cases where we cannot remove the stressor, for example looking after an elderly relative with chronic health problems, but the techniques outlined in this course will help us to cope better.

Cognitive Behavioural Therapy cannot be covered here in a few web pages. As a treatment it is given on a 1 to 1 basis, over 10 - 15 sessions. We only cover the basic bones here. If you are interested and want to learn more there is an excellent book written by two cognitive therapists called Mind over mood.

The ABCDE Model of Restructuring

Earlier in session 5 we discussed the A+B=C equation concerning A, the Activating event, B, the beliefs we hold about that event which lead to C, the consequences of those beliefs. Now we are going to go a stage further in the ABC model which is the same as the A+B=C equation. Now we are adding two more steps called D, which stands for dispute and E which stands for effective new thinking.

Cognitive Restructuring (ABCDE Model)

As we have already discussed, chronic stress can affect our thinking, distorting it and make any stressors more of a threat than they are. We have discussed how our thoughts, beliefs and perceptions can heighten our stress. We have also discussed how important it is to begin to become aware of our negative self-talk. Now all this information is brought together into Cognitive Restructuring which teaches us to not just accept our thoughts as being accurate (as we usually do), but to test them for their accuracy. We do this by adding (D) for dispute or debate to the original A+B=C stress equation and we also add (E) for effective, less stress inducing thinking which is created when we learn to see events more clearly.

How to Use the Cognitive Restructuring Sheets included in this Session

In this section we bring together what you have already read about automatic negative thoughts, stress inducing thinking, core beliefs, ABC log,etc. and look at one form to help you restructure your stressful thoughts. We have included a Log in this section which is a continuation of the ABC Log that you started to use in the first section of this session. To complete this new "Stressful Thinking Identification Log" it is useful to copy out the following sheets - "Stressful Thinking Errors Sheet" (which is a summary of Stress Inducing Thinking Errors), "Stressful Core Beliefs Sheet" (which summarises the Stressful Core Beliefs) and "Questions to ask to Restructure Stressful Thinking." These forms are all on the next three pages of this session. Have these in front of you for reference as you complete the log. Our "Example of How to Complete Stressful Thinking Identification Log" is also useful giving you examples of how the form could be completed. The Stressful Thinking Identification Log is a continuation of the ABC Log used in the first section of this session, but it adds D and E to help you Dispute your stressful thoughts/beliefs and think of Effective new approaches to deal with the stressors. It may be useful to use the same problems you used on the initial ABC Log and continue these through to D and E. Then start to use the log for further problems that you encounter, using it as a tool to help you restructure your thinking.