Hello. Welcome back. How are you feeling today? Okay, good.
Now, this is your fifth therapy session. And today, we're going to talk about the source
of your discomfort, your distress. Okay. Now, if you'd like to be reminded of what
we talked about in your previous sessions, I've made a recording, here. Okay.
Now, let's begin by looking at the diary that you keep for me every week, recording how
you feel at the end of every day. Is that it there? Do you mind if I take a look?
Thank you.
Okay.
Okay, I can see that you've had quite an up and down week. So, today's appointment will
be important for you because we're going to start to understand why your mood fluctuates
in the way that it does. Okay. Now, if you remember back to our second session,
we talked about how it's not events that determine how we feel—it's the way that we think about
them. So, events in and of themselves don't have the power to determine how we feel. We
have to attach a particular meaning to something in order for it to make us feel a particular
way. So, let's just draw you a quick diagram.
Okay, so, here we go. Okay, so, you have the event. This is a little
dotted line, here. I've drawn this because this actually doesn't exist, but this is how
it feels sometimes, it sometimes feels that something happens, and it just makes us feel
a particular way. But, actually, we have to go this route: we have a thought, and that
thought determines how we feel, and then how we feel determines what we do. So, positive
thoughts lead to positive feelings and positive behaviour. And then, of course, it works the
other way as well; so, negative thoughts lead to negative feelings and negative behaviours.
I'm going to give you that. Take it and have a think about it—turn it over in your mind.
Now, it is the case that we're not always aware of our thoughts, and there's a reason
for this: we have hundreds of thousands of thoughts every day, and if we were consciously
aware of all of them, we'd go mad, we'd get nothing done, it would be completely overwhelming.
So, what happens is, those thoughts that we have regularly are archived, in a way, into
our subconsciousness, they slip down just below the level of conscious awareness, so
to free up space in our conscious awareness where we can deal with new information.
And this is a very effective information processing strategy, as long as the thoughts are generating
positive feelings. But, as soon as they don't, as soon as they are triggering uncomfortable
feelings, we need to do something about it, we can't just let these thoughts continue
to operate automatically, on their own, in our subconscious awareness. We have to go
down and get them, and sort them out, I guess. Now, to begin with, if you're not used to
doing this, it can be quite difficult, because, as I say, they are in our subconscious awareness,
they're not readily accessible. But, with practice, it's quite easy to get them, and
I'm going to show you how to do that now. Let's look at your diary again.
Okay, so, the best time to access these thoughts is when we have a strong emotion, this is
usually a sign that the thought has floated to the top of our subconsciousness, so we
can reach down and get it a little bit more easily than maybe at other times. So, if we
look in your diary, I can see here, that, on Tuesday, your anxiety rose to an 8 out
of 10. Can you tell me what was happening then?
Okay. Mm, so it's a mistake at work? Okay, yeah.
Okay, so, if you look at your diagram—I'll just take that back for a minute—that's
the event, it's the mistake at work. And, you see, that doesn't have the power to make
you feel an 8 out of 10 in anxiety, it has to go this way. So, there was a particular
thought you had about that mistake that triggered that level of anxiety, and that's what we
need to think about. I'll give that back to you. There we go.
Okay, so, the interesting thing about anxiety is you need two trains of thought to feel
anxious. The first is to overestimate a disaster of some sort, predicting some sort of terrible
thing that's going to happen, and the second train of thought is to underestimate yourself—your
ability to cope. And you have to have both those trains of thought, and they have to,
kind of, combine with each other. If you just have one, you don't tend to feel
that bad. So, you may be predicting a disaster, but thinking, 'I'm quite resourceful though;
I'll be able to manage,' and you don't feel that bad.
Equally, you might be thinking, 'Well, you know what? I'm not that capable. I don't have
many resources, but, things tend to work out.' Again, you don't feel that bad. So, you need
both of those trains of thought—overestimating disaster, and underestimating your ability
to cope. So, let's see if we can work out what was
going on for you here. What was the disaster that you were estimating
when you made the mistake? Okay, that you might lose your job.
Okay, I think that's a relatively common overestimation in that situation.
And, how were you predicting you would respond, how were you underestimating yourself, and
your ability to cope with that? Mm-hmm, okay, that you wouldn't be able to
find another job, okay. Now, we need to get to the core of that thought,
to identify its real power—and we do that using three digging questions.
Okay, so, the first one: What does that mean about you?
You lose your job, and you can't get another one. What does that mean about you—your
worth, your value? Okay, so, you would think that you were useless,
worthless. Okay. And, the second question: How do you feel
that others would treat you as a result of that? How would they think about you?
Okay. Okay, so they would reject you. Okay, and finally, what would that mean about
your future? Okay, okay. So, you would live in poverty
and be miserable and alone. Mm-hmm, okay.
So, I'm just going to summarise that thought for you. So, you make the mistake at work,
and you think, 'This means I'm going to lose my job, I'm not going to be able to find another
one. This means I'm worthless, useless, and other people are going to reject me. And,
moving forward, I'm going to be poverty-stricken, miserable, and alone.' Does that sound about
right? Yeah, mm, that's interesting, because I think that anybody thinking in that way
would experience a high level of anxiety. So, your anxiety makes complete sense in the
context of your thoughts. So, there's nothing wrong with the way you're feeling—it's very
appropriate considering how you're thinking. The problem lies with your thoughts, and this
is what we're going to look at next week. We're going to look at evaluating those thoughts
that are triggering your distress, that are triggering your high levels of anxiety, we're
going to look at their accuracy and their helpfulness and see if there are some changes
that we can make there. How does that sound? Okay.
Now, what I'd like you to do between now and next week is to continue keeping your diary,
so at the end of every day, rating your emotions out of 10. But, I'd like you to add to that
if your emotions, say, get above about a 6, try and access the thoughts behind them, in
the way that we've done today, and jot them down for me, and then we can use those thoughts
next week to take us forward to the next step. Okay, do you have any questions or worries
about any of that? Okay, good, good.
Now, let me check our next appointment. Okay, here we go.
So, I can do the same time next week? Okay.
Good. Okay, I will look forward to seeing you then.
Take care of yourself. Bye-bye.