Healthy Thinking

HEALTHY THINKING
Virtual Counseling Center
CRESMET
Arizona State University

Sharon Bell
John J. Horan

Copyright 2007

INTRODUCTION

Hello.  I’m Sharon Bell, and I would like to welcome you to this lesson on Healthy Thinking.

My goal is to introduce you to a way of thinking that will lower your stress and improve the quality of your life.

Healthy Thinking is applicable to many situations in life. It is a way to think like a scientist, but instead of examining test tube reactions, you will analyze daily life events and how you think about them.

Healthy Thinking is not positive thinking and it is not about who you are as a person. There are situations in life where you need to react in a way that protects you. Healthy Thinking is simply choosing to think and act effectively in a given context or situation.

Healthy thinking is as simple as remembering your ABCs:

            “A” is an activating event.
            “B” is your belief or what you tell yourself about the event, and
            “C” is your consequent response.

I want to show you how stressful emotions like fear, anger, sadness, guilt, even physical pain and ineffective behaviors, may come from what you tell yourself about events rather than the events themselves.

Let’s look at an example:

Imagine you are a passenger standing in the aisle of a crowded bus:  That’s right; you are standing there with your arm extended, holding onto a rail as the bus lurches along its route.

Out of the blue you experience a sharp blow to your ribs.  It hurts!  Hold onto that image.

OK.  Now I want you to think about the emotions you may be experiencing. 

Some people may feel great anger in that situation.  Would you be angry?

Other people say they may feel fear.  Would you be afraid?  Maybe you would be both angry AND afraid.

Remember our ABCs.  “A” is the blow to your ribs, or the activating event that is followed by “C” anger and fear, the consequent emotions.

Did “A” cause “C”?  Did the jab to the ribs cause anger and/or fear?  Actually, no!  It is your belief about “A” that causes “C”.  If you are feeling angry you may be telling yourself that “Some idiot hit me.  He violated my rights; hurt me; now I feel like a victim.  He should not have done that.  I am more than mad.  I’m furious!!!”

If you are feeling afraid, you may be telling yourself something like “A predator has hurt me.  I need to protect myself or run!”

So let’s review:

Did the jab at point “A” cause anger or fear at point “C”?  (Yes or No)
Perhaps it was both the jab at “A” and the Belief at “B” that caused anger or fear at point C?  (Yes or No)

The only correct answer is that “B” caused “C.”  Your belief about an activating event caused your emotional consequences.  If there is any doubt about this, let’s continue the example: 

You turn around to see who jabbed your ribs.  It is not a raging lunatic or a predator after all.  It is a blind person who accidentally bumped you.

Where did your anger or fear go?  They probably disappeared automatically.  You are now telling yourself something very different at point “B” leading to different consequent emotions. Compassion or empathy for example.

Remember, Healthy Thinking is thinking, feeling, and acting appropriately in ways that lower your stress and benefit you the most, which was demonstrated nicely in this example.

 

OVERVIEW

Today’s lesson on Healthy Thinking has three parts.

Part one covers:

1.  The basic theory of Healthy Thinking.
2.  How to become a scientist of your own behavior.
3.  The importance of self-monitoring
4.  The “A” and “C” in the ABC Model of Healthy Thinking;

Part two focuses on:

            1.  How we make ourselves upset;
            2.  The relationship between beliefs and responses, the “B” of Healthy        
                 Thinking
          
Part three will enable you:

1.  To dispute irrational beliefs by adding a “D” to our ABC theory.
2. To generate healthy alternative beliefs that produce “E,” a new effective response.
3. To influence your environment with Healthy Thinking.

Some of the slides are accompanied by hyperlinks that will allow you to explore the concepts in greater detail; other links go to handouts for your personal use. Watch for them and let’s get started!

PART ONE

The Theory of Healthy Thinking

Although the theory of Healthy Thinking is rooted in stoic philosophy, Shakespeare, popular wisdom, and current psychological research, the writings of Albert Ellis and Aaron Beck over the past 45 years have made Healthy Thinking a predominant force in the mental health professions.  You can expand your knowledge of the Healthy Thinking background at the links below and, come back to it later, or stay with the flow of the current lesson.

The main point of Healthy Thinking is that thoughts about external triggers cause our consequent responses.  “A” does not cause “C.”   Rather our beliefs “B” about “A” produce “C.”

We delude ourselves, for example, when we say that an event or someone’s behavior caused us to become unhappy.  It is truly what we tell ourselves about the event that makes us miserable.

Let’s look at another example:
 
You fail a test. You tell yourself that you failed the test because the instructor does not like you and gave you an unfair grade. You are feeling angry toward the instructor and dwelling on the thought that he should not have acted the way he did.  You may be telling yourself: “It’s horrible when others cause me so many problems; and it’s not going to get better until someone takes a stand against him or I get away from this class!”

Let’s break this situation down.   Being given a failing grade is “A.”  Feeling anger toward the instructor is “C.”  Plotting confrontation or escape are possible behavioral extensions of “C,” which are actions that may or may not be in your best interest.  What might be going on at “B”?  Here are some possibilities:

“The instructor does not like me.”  That may or may not be true.  If it is true, why the anger?  You may also be telling yourself “I need to have everyone like me, or I am going to feel unhappy.”  Well that may be an unrealistic thought!  Your worth as a person does not have anything to do with whether someone likes you; often there is nothing we can do to make people like us.  For example, others may despise us simply because we remind them of an abusive aunt or uncle.  It would be nice if that person liked you, but it is hardly catastrophic that he or she doesn’t.

“The instructor acted maliciously toward me.”  That might indeed be true, but before deciding, it’s best to separate the facts from our assumptions.  How do my test answers compare with the rest of the class?  Did the instructor make an easily correctable mistake?  And so forth.  If after exhausting all possible alternative explanations, the evidence unmistakably supports a conclusion of malice, we then must look at the kinds of thinking that lead to the anger, and in the words of Dr. Phil, “What’s the rage doing for you?”  It is probably not enhancing your health and well being.  Would it not be better to think like a scientist and quantify the damage being done and then coolly and carefully consider what might be done about it?  Malicious people are a fact of life.  We are kidding ourselves if we think otherwise, or believe that life is intolerable when we encounter them.  Rage can elicit a behavioral reaction that is not in our best interests. 

To recap, sometimes our thoughts distort reality.  Other thoughts illogically lead to strong negative emotions that add to our personal distress and get in the way of acting effectively. 

Healthy Thinking aims to help you become aware of and change thought distortions and behavior patterns that exacerbate distress, and to correct them using a simple ABC Model as developed by Albert Ellis many years ago.  My objective is not to change every thought you have, just those that erode the quality of your life.

Remember, Healthy Thinking is not about who you are as a person. Healthy Thinking is about the choices you make. Your life may be on the right track today, but things happen. Change can be sudden and unpredictable. In spite of that, change is inevitable and it pays to have the ability to adapt to it. By learning to practice Healthy Thinking you'll be ready - not only for the changes that occur in the outside world, over which you may have no control, but also by helping you see things in your everyday life with clarity and detachment from negative or irrational thoughts, feelings and fears that could be holding you back from achieving your goals. Healthy Thinking will teach you to think like a scientist about your thoughts, emotions, and behavior.

How to become a scientist of your own behavior

Carl Sagan once said: “Science is a way of thinking much more than it is a body of knowledge.”

One of the goals of this lesson is to teach you how to take a step back from yourself and think like a scientist about your own thoughts, emotions and behavior.  We’ll identify patterns of responding to events or situations that aren’t working for us, monitor our responses to different situations, see how what we say to ourselves impacts how we respond, test the accuracy of our beliefs, and learn how to begin changing what we think. Let’s take a look at another example of thinking like a scientist:

State the problem: “A car cut me off in traffic on my way to work.”
Collect information: What am I telling myself regarding this problem? The most basic skill is observing. Observing is primarily what we see, but also what we hear, smell, touch, or taste may also be involved.  The way people see varies from person to person. You will begin to understand this concept as you learn more about how thoughts and reactions are related in the practice of Healthy Thinking.  Describing, another basic skill of the scientist, is writing or telling about our observations. A good description allows us to share information with others. Describing often includes identifying, or naming something.
Form a hypothesis, or inference based on collected information:Inferring is drawing conclusions based on what you see and what you believe you already know.  For example, the person who cut you off in traffic may have been avoiding an accident, had a legitimate emergency, or simply didn’t see you, or perhaps, in fact, did it recklessly and on purpose.
Test the hypothesis: Scientists test their hypotheses by making careful observations that rule out alternative explanations.  Is the other driver even aware of what has transpired?  Sometimes people act on unproven hypotheses.  Do you choose to become angry toward the person who cut you off in traffic?  Do you scowl, shake your fist, and feel your heart accelerate?  Do you chase the offending driver to ensure that your anger is communicated?

Monitor the results: Your conclusions derive from the adequacy of your observations. Are you still clueless about the other driver’s motivation in cutting you off?  Is it worth any effort on your part to discern that driver’s intentions anyway? What are the consequences of simply taking a relaxing breath and doing nothing as the offending driver disappears into the horizon? If you did get angry and give chase on the basis of an unsupported (or even supported) hypothesis, what might be the outcome?  Did you receive a speeding ticket or have an accident yourself? Are you now late for work? Did your blood pressure go up and now you don’t feel like working?

By learning to take a step back and observe your thoughts, feelings and behaviors like a scientist, you will soon learn there is less chance to make a mistake, unless you actively choose to do so. We learn to do this through self-monitoring.

The Benefits of Self-Monitoring

Self-monitoring has an amusing history in scientific psychology.  Many years ago Gary Stollak did an experiment to see if various forms of electric shock paired with fatty foods could help overweight people lose weight.  One of his control treatments involved simply keeping a food diary.  Of course science is self-correcting and we know today that the experimental shock treatments for weight loss were pretty naïve, and thus completely ineffective.  What’s noteworthy about Stollak’s experiment is that a placebo treatment, i.e., keeping a food diary, was helpful in losing weight.

Like hungry dogs on a T-bone steak, research psychologists pounced on that serendipitous finding!  The term “Self-Monitoring” was coined, and mountains of data began to accumulate that if we pay close attention, desirable behaviors will increase and undesirables decrease.  Self-monitoring became the behavioral equivalent of insight.  Socrates said “Know thyself;” the behavioral scientist urges “Know thy controlling variables.”

Self-monitoring is like preventive car maintenance. The better you are at identifying the symptoms of your car breaking down, the more likely that you will make appropriate repairs before there is serious damage. Self-monitoring teaches you to:

• Identify triggers (the “A”)
  There are times or events in our lives when we are more uncomfortable than others.  Identifying triggers helps us get over the sense of being victimized by unexpected or uncontrollable forces.

• Identify warning signs (the C)
  When we’re uncomfortable, most of us are aware of only a few specific symptoms.  Self-monitoring broadens the picture so that we understand what else contributes to our discomfort, and helps us formulate a strategy for change.
• Assess Progress           
  Self-monitoring provides us with a reliable historical record so that, during times of distress, we are less likely to downplay the success we’ve had or our ability to control the way we feel.

• Gain Control 
  Remember Socrates. Self-monitoring enables us to know ourselves, and thus the variables that control us.  Knowing what controls us is the first step in gaining control instead of allowing life to control us.

Consequent Responses, the C in ABC

What are the signs of distress? How do we know that someone is distressed?  Distress can be manifested in three ways: physical, emotional, and behavioral.  Physical signs of distress are quite simply the internal physiological changes within your body when distressed. Emotional signs of distress are the feelings and mood states that reflect distress. The behavioral signs of distress are the actions you may engage in while distressed.

Let’s generate a partial list of some signs of distress and place them into the three categories. You can click on the PEB List at the bottom of the screen to pull up a partial list.

Can you think of other examples that might be added to you list?

Now, let’s take a closer look. Are all emotions bad? Experiencing an emotional response at point C is not necessarily a bad thing.  Anxiety, for example, can help us perform better on some tasks and can protect us from danger. Without a little bit of stage fright, the performance of actors and pianists would be flat.  And having a little bit of test anxiety can motivate us to study.  But there is a point at which additional emotion becomes counterproductive. The Yerkes-Dodson law, one of the oldest in psychological science (1908), illustrates the difference between good stress and distress.  A little anxiety helps us do better; too much may cause us to fall apart. 

So it is important to pay attention to the intensity as well as the appearance of physical, emotional and behavioral responses.  Anxiety can be represented on a 0 to 10 scale, where 0 represents relaxation and 10, absolute terror.  On the Yerkes-Dodson graph, a rating of 8-10 means that you feel anxiety in its extreme—you are disabled by the emotion, you cannot function at all. You are in the danger zone of unhealthy response! A rating of 0 means you are experiencing absolutely no anxiety whatsoever, which may or may not be in your best interests. A rating of no more than 5 is optimal for stepping back and thinking like a scientist about the activating event and what you might do about it.

These are the distressing Consequences in the ABC Model of Healthy Thinking.  Notice that such consequences are very undesirable.  They degrade the quality of our lives.  Self-monitoring these Consequent signs of distress in our lives is an important ingredient to Healthy Thinking. You will soon see how all of the parts fit together.

Skill #2, The “A” in the ABC Model of Healthy Thinking

The Activating Event (What Happened?), the A in ABC

Take a moment and think of a problem you recently encountered. For example, “My husband told me that I ought to do more work around the house, but I needed to study for an important test. I was sad and angry and didn’t do any housework at all to prove my point. He wouldn’t listen to me otherwise.” Or perhaps, “My wife bought a cake at the grocery store. I was having trouble sleeping one night.  I got up at 2:00 a.m. and ate half the cake. Now I feel irritated with her for buying the cake. She knows that I eat when I am stressed.”

Think back to the physical, emotional, and behavioral Consequences list and come up with an example that caused you to feel distress in the past week.

On this slide you will see the “ABC Worksheet”. Print out this worksheet as many times as you like. You will use it repeatedly in and outside of this lesson as you practice and master the ABC skills. Write down your sentence that describes a recent situation under the “A” column and include how you felt or what you did as a result of the problem under the “C” column.

Let’s work through a previous example together.

A =   “My wife bought a cake at the grocery store. I got up at 2:00 a.m. and ate half the cake.

C =   Physical - exacerbated weight problem
         Emotional - irritation at spouse
         Behavioral - overeating

Simple!  You have now learned the “A” and “C” of Healthy Thinking.  Learning the ABC’s of Healthy thinking may feel awkward at first.  But soon you will recognize each trigger (the A) in your life that often proceeds to distress (the C).  Is this beginning to sound familiar?  In Part 2 of this lesson, we will examine the “B” in Healthy Thinking, and discover that there are alternatives to distress.

Let’s now take a short quiz to see how well you have learned this material.

This concludes Module 1. You may want to take a break before proceeding. It may be an excellent time to do a relaxation exercise.

As soon as you are ready, you may proceed to Healthy Thinking, Part 2.

I will see you there.

PART TWO

Introduction

Welcome back to Healthy Thinking and I am Sharon Bell. I hope your break was a relaxing one. At the end of this lesson you will be able to demonstrate:

1.  How we make ourselves upset;
2.  The relationship between beliefs and responses, the “B” of Healthy        
     Thinking

What Makes Us Upset?

Here is an exercise that may be useful in figuring out how we get ourselves upset.  At the bottom of the screen you will find a link to the “Life Events Stress Scale.” Print it out and place a check mark next to each event that you have experienced in the past 12 months. When you are done, add up the points for each event.

Calculate your score at the end.
Holmes and Rahe developed the scale in 1967 and reported that a score of 150 for events occurring within the past year produced a fifty-fifty chance of developing a stress-based illness.  Please do not apply this formula to your own lives.  We know from modern research that it is not simply the events themselves but how we respond to them that contribute to the consequent emotions leading to stress-based illness.  This exercise does allow us, however, to review what we tell ourselves about such events.
Notice that “positive” events such as “outstanding personal achievement,” and “Christmas” can be as stressful.
Now, let’s look more carefully.  Click on “Example 1” at the bottom of the slide. Bill, Sally, Tom, Deb, and Kelly were all asked to rank the same 10 events, 1 being the least stressful event and 10 being the most stressful.

Why do you suppose they are all different?   Probably Bill, Sally, Tom, Deb, and Kelly are all thinking differently about the events.  After getting fired, Tom might be telling himself something like:  “This must mean I am a failure; I will never get a job as good as this one.”  Bill on the other hand, could be thinking:  “I am going to miss the paycheck for a couple weeks, but not that idiot supervisor.  A competitor is sure to hire me and together we will put that company out of business.”
How do we learn to think so differently?   Many of our beliefs are fostered by messages received from important people in our lives:  Parents, peers, religious leaders, teachers, coaches, political leaders, and the like.  They are also influenced by previous life experiences and degree of contextual intensity.  In the life events example, Bill may be thinking about a time that he broke his leg when he stepped off a curb and Kelly may be remembering a flaming car accident during which several people were killed, both resulting in different stress rankings.
Therefore, a scientist may ask:

            1.  Is it necessary, because we grew up with a certain belief, that we must continue with the belief even if it no longer working for us?     
            2.  If life experiences contribute to our beliefs, is it possible to create new life experiences to reinforce new beliefs?

It is important to remember that we are responsible for our beliefs and whatever distress we inflict on ourselves because of those beliefs. 
Now that we have learned that “A,” the activating event, does not cause “C,” the consequent response…let’s take a closer look at the real culprit, the “B” in the ABC Model of Healthy Thinking.

Beliefs, the “B” in the ABC Model of Healthy Thinking

“B” stands for beliefs, especially the irrational, self-defeating beliefs that are the actual sources of our unhappiness. Why do we feel good about doing some things and not about others?

We feel the way we do because we think the way we do. Most of us take the way we feel for granted. We frequently speak as if events or other people "make" us happy or sad or scared or excited. But this isn't quite true.
Even when it seems as if we are reacting directly to events in our environment, if we look more closely we can see that it's not that simple. We don't react directly to an event; we react to our interpretation of the event.
About a decade after Albert Ellis began his classic work, Aaron Beck embellished the ABC theory in a separate line of research.  Beck began speaking of “Cognitive Distortions” rather than “Irrational Beliefs,” but regardless of whether you prefer the terminology of Ellis or Beck, our subject matter now is most definitely “B” in the ABC Model of Healthy Thinking.
Beck wrote, for example:
“A person who is trained to track his thoughts. . . can observe repeatedly that his interpretation of a situation precedes his emotional response to it. For example, he sees a car heading toward him; then, he thinks, ‘It is going to hit me,’ and feels anxious. Furthermore, when a person changes his appraisal of a situation, his emotional reaction changes. A young woman believed that a friend passed by her without saying hello. She thought, ‘He's snubbing me,’ and felt sad. After a second glance, she realized that it wasn't her friend at all and her hurt feelings disappeared.”

Just as we often take our feelings for granted, we often take for granted the thoughts that cause them. This is because most of the thoughts we have are not conclusions from reasoning about events; they are automatic thoughts, habits of thinking that come to us so effortlessly we assume they come from outside our own heads. Many thoughts that trouble us are called irrational beliefs or cognitive distortions.
Cognitive distortions, no matter how damaging they may be, are unconscious operations of the mind. People do not choose their cognitive distortions. Indeed, most people would deny the kind of reasoning that is behind their automatic nature. We act on them without being aware of them.
The first step to changing cognitive distortions, or irrational beliefs, is to recognize that we have them.  In Beck’s writings, these distorted beliefs fall into three broad categories:  Overgeneralization, Jumping to Conclusions, and Emotional Reasoning.  Now, let’s take a closer look at each.  I hope you can begin to see how some may apply to you.

Distortion category 1: Overgeneralizations 

Probably the most common mistake we make in our automatic thinking is overgeneralization. It's easy to see why. Each of us perceives new experiences in terms of old experiences.  Generalization from old to new is a more-than-acceptable process, and it is a shortcut necessary for survival.  We get into trouble, though, when we stop prematurely after generalizing and fail to see subsequent details that make each situation unique.  When that happens we distort reality, rather than understand it.

There are several specific forms of overgeneralization that many of us use at one time or another.

Mental Filter – This happens when we concentrate so strongly on one aspect of a task or a situation that we can't even see the rest. They are filtered out of our perceptions, as we focus on only one part of our concern. In running out of time on a test, for example, we might become so preoccupied with not finishing, that we have trouble concentrating on the questions.
Magnification/Minimization - This cognitive distortion occurs when we see the positive results of our actions as smaller than they really are and the negative consequences as much bigger.  The latter is called "catastrophizing" or simply "making a mountain out of a molehill.”  A low grade on a test, for example, must lead to “not passing the course, graduation jeopardy, career failure,” and the like.  Perfectionists often think in this irrational way, as do people who apologize for good work, thus minimizing their accomplishments.
All or Nothing Thinking - We engage in all-or-nothing thinking when we   describe events in black-and-white categories with no shades of gray.  “All politicians are corrupt; all clergy dedicated.”  “Unless we are world class, we are failures.”  “She had to settle for a silver medal.”  Although automatic thinking of  this sort may lead us to try harder; in the long run it may discourage us from trying at all.   This type of irrational belief can seriously disrupt learning a new skill or improving our performance in an old one.  A writer who sees her rough draft as either finished or failed will never really complete the manuscript. She may, instead, accept her first draft as potentially good, but leave it unfinished in             order to improve it.  Many students fail to produce good papers not because they produce bad ones, but because they never complete the good ones they start.
Disqualifying the Positive – People who disqualify the positive can't think, much less discuss a subject rationally because they use double standard. Negative evidence, no matter how weak or irrelevant, counts. Positive evidence, no matter how strong or persuasive, can be explained away.  “It is not that I’m smart, I just have good test taking skills.”  or  “Social connections, not personal competence got me the job.”  Could there be an element of truth in either of these self- descriptions?  Possibly, but the odds are huge that the faulty thinking represents a form of overgeneralization.

Distortion Category 2:  Jumping to conclusions
This irrational belief consists of going beyond the evidence you actually have and reaching a conclusion that makes things look worse than they are. Let’s take a look at three distinct forms:

Labeling – When we attach labels to people we force invalid conclusions about them.  “I am only a student; she is just a housewife.”  Labeling has something in common with overgeneralization in that the complexities of a person or situation are ignored, but it goes beyond in that the generalizing label usually has negative connotations as well. Labeling is pessimistic shorthand that leaves out more than it says and reinforces unfair stereotypes.  To think about people or situations in label terms and then to act on that label is irrational and can lead to stressful emotions and consequences.  “Americans are arrogant.” Is that true?  It may be for some, but not all. Because I am American does not imply that I fit that label.
Mind Reading – People who engage in this form of cognitive distortion have automatic thoughts that presume the worst about how they themselves and their             work are being judged by others.  “I did not hear from my boss about that job I finished.  He must be unhappy; my career here is in jeopardy.”   My kids forgot my birthday; I am obviously not the parent I hoped I was.”  Countless alternative explanations exist; we simply cannot read anyone else’s mind.
Fortune Telling – Fortune telling can be an especially dangerous cognitive distortion because any negative automatic thought about a future event can easily become a self-fulfilling prophecy:  "Oh, I know I'm going to bomb this test." "My paper is going to be too short." "I know the teacher is going to hate my report."  Because I expect to do poorly, I don't try very hard.  What's the point?  And so, sure enough, I do a lousy job, "proving" that I was right all along.  Essentially, fortune telling is a process of setting negative goals and then living down to them.

Distortion Category 3:  Emotional Reasoning
If we can recognize the automatic thought and think about it rationally, we are usually on the way to overcoming it. But emotional reasoning turns this process on its head. In emotional reasoning, we assume the automatic thought that produces a negative feeling is valid, and we then try to reason on the basis of our feelings. Thus emotional reasoning amplifies the effects of other irrational beliefs.
A basic assumption underlying emotional reasoning is "Where there's smoke, there's fire." Let's say you're preparing for a big test. It's natural that you'll be a little concerned about such a challenging event. And if you're overgeneralizing on the basis of your last test, and fortune telling that you will fail on this one, you'll be even more anxious and nervous.
The trouble with emotional reasoning is that smoke is not firm evidence of fire.  It could be just dust, or the residuals of two folks with a bad cigarette habit in a small room.  If you're scared about an upcoming test, it's probably because you're rubbing two automatic thoughts together and scaring yourself. People who allow themselves to get caught up in emotional reasoning can become completely blinded to the difference between feelings and facts.
Two specific types of emotional reasoning are especially debilitating. Let’s take a look at them.

Shoulda/Woulda/Coulda – This irrational belief consists of telling ourselves or others that we have an obligation to do something different from what we are doing.
Obviously we do have obligations. There are reasons why we should do some things and not others that are factual and not emotional. We get into trouble when “shoulding” takes the form of an automatic thought. In this form, the "should" comes to us as an abstract, universal obligation such that if we don't do what we "should" we are wrong and ought to feel guilty.
“The professor shouldn’t have wasted so much time talking about irrelevant topics.”
“That car shouldn’t have cut me off in traffic.”
There are many examples of shoulding. Let’s look at the difference between shoulding and a factual statement. “I should be doing my homework" is an automatic thought. But "If I don't do my homework tonight, I'll have twice as much to do tomorrow" is merely a factual statement that reports the consequences of a given action.
Blame & Shame Game – Shame is taking responsibility for things that happen over which we have no control.  In some cultures the behavior of one family member irrationally brings shame upon all members of the household.  Similarly, we may feel guilty for events that are unpreventable, or mistakes that are morally neutral. A child, for example, may feel guilty for “causing” his/her parents’ divorce when, in fact, the child had nothing to do with it.

Blame is the same cognitive distortion, operating in reverse. Instead of taking responsibility on ourselves, we shift it to somebody else. Remember the example in Part One when a student blamed the instructor instead of taking responsibility for a failing grade?
Behind both forms of irrationality lies the assumption that if anything goes wrong, it must be somebody's fault. There are no mistakes, only crimes, and the criminals must be found and punished!
Let’s work through the example we started at the end of Part Two together:

A =   “My wife bought a cake at the grocery store. I got up at 2:00 a.m. and ate half the cake.

C =     Physical - exacerbated weight problem
           Emotional - irritation at spouse
           Behavioral – overeating

B=     She shouldn’t have done that, she knows that I can’t control myself once I
          start eating. It’s her fault that I can’t lose weight. She always does this to me.
         
Do you see how the terminology all by itself can provide clues toward irrational beliefs?  How many can you identify? How about “shouldn’t,” “she knows,” “I can’t,” “her fault,” and “always” are the ones that I see in this example. Perhaps you can find more.

Ellis and Beck have provided us with rational counterpoint for irrational thoughts, perceptions, and ideas.  Irrational beliefs or cognitive distortions play a central role in producing our stress.  We now have learned the basic ABC framework for Healthy Thinking., In Part Three we will learn more about how to dispute irrational thoughts to produce a new effect in our daily lives.

Let’s now take a short quiz to see how well you have learned this material:

Now that we see how our thinking can run amuck, let’s figure out how to get back on track.  In Module 3, we will examine the “D” and “E” additions to the ABC Model of Healthy Thinking, and discover how to improve the quality of your life.

Module Two is critical to this course.  If any of its components are not clear, please go back and review before proceeding to the new material in Module Three.

As soon as you are ready, you may proceed to Healthy Thinking, Module 3.  I will see you there.

PART THREE

Hello.  Sharon Bell, again.  Welcome to Part Three of Healthy Thinking. 

This module will enable you:

1. To dispute irrational beliefs by adding a “D” to the ABC theory.
2. To generate healthy alternative beliefs that produce “E,” a new effective response.
3. To influence your environment with Healthy Thinking

Disputing Irrational Beliefs:  Adding the “D” to the ABC Model of Healthy Thinking

Once we understand that some situations routinely and predictably trigger an overreaction, we can learn to anticipate them. For example, we are more likely to become triggered when we are tired or needy.  As we become aware of our vulnerability, we can learn to reevaluate and challenge our impulses. We can also use this knowledge about ourselves to avoid hot topics when we're already feeling vulnerable.
Since we can predict certain trigger situations, we are able to counteract our automatic thinking or irrational beliefs, and rehearse in advance more appropriate things to say to ourselves and to others.   For example, to prepare for times when a parent criticizes us, we could practice saying, "If I ignore this, it will be over in two minutes. If I complain, it will take an hour to get out of my system." Or we could practice saying, "These are old habits. I don't need to defend myself to my parent now that I'm grown up."
There are many ways to dispute irrational beliefs. We will cover a few of them in this lesson, but you may be able to come up with other ways that work even better for you.  Please feel free to be creative and plug in your own disputation methods in the ABC Model of Healthy Thinking.
Click on the ABC Worksheet at the bottom of this slide and print out as many copies as you like. Now, let’s get to work.

Step One: Notice when you experience a physical, emotional or behavioral reaction. (the “C”)
Take a deep and cleansing breath. Let’s take a moment and reduce your consequent reaction to a manageable level no greater than 5 on a scale of 0-10 (remember the Yerkes-Dodson Stress Scale in Lesson One?)  Here’s how to apply it:
Remove Judgment:  The hard part in step one is to remove judgment statements that imply “good,” “bad,” “right,” or “wrong” when you take notice of your reaction.  Accept that a reaction has occurred and you are capable of practicing a new way of thinking.
Emotional Seatbelt:  I'm a big fan of seat belts. Not because it's the law, but because it's common sense. By wearing seat belts, drivers can greatly reduce their risk of being severely injured if they are in an auto accident. How is this any different from being impacted by the physical, emotional and behavioral  consequences of a triggering event? It only takes a second to click your emotional seatbelt in place to avoid going through the windshield of your sanity onto the  hood ornament of stressful emotion.  Now, click your emotional seatbelt in place, take a step back from the situation and begin thinking like a scientist.
Attitude:  Maintaining a positive attitude, despite life’s trials and challenges, is a  conscious choice. This alone will prevent you from racing off the brink of irrational beliefs. Victor Frankl, in Man’s Search for Meaning shares the  following: “… everything can be taken from a man but one thing: the last of the  human freedoms -- to choose one’s own attitude in any given set of  circumstances, to choose one’s own way.”
Balanced Mind:  One of the most amazing insights from mind-brain research is that when the mind is in a balanced state, the brain functions in a measurably balanced way.  Marsha Linehan (1993) teaches an incredibly simple approach to finding balance between the rational and emotional mind. Most of us have seen at  least bits and pieces of Star Trek, right? Remember Spock? He was rational, thinking, logical, and was not capable of emotion. On the other hand, Bones was all about emotion and didn’t express logic. As the captain, Kirk pulled valuable information from Spock and valuable information from Bones to make commanding and wise decisions. A balanced mind uses components of both rational mind and emotional mind to make Healthy Thinking decisions.   So let  Bones burn with emotion at Level 10 on the Yerkes-Dodson curve, and Spock can chill out at 0 if he prefers.  As long as you stay below Level 5, you will have the  ability to think and act in your own best interests.

With practice, this entire process can take between 2-10 seconds depending on the trigger and the intensity of your consequent response.
Think back to a time when you were really upset.   Take a moment and really get into that image.  Pause…  Do you remember what you were telling yourself at the time?  Can you tell yourself something else instead?   Pause…  OK.  Are you now below 5 on that Yerkes-Dodson scale?  If not, before proceeding, it would probably be best to stop and repeat this process until you can reduce the intensity of your reaction.
Only after finding your balance, write down the physical, emotional and behavioral components of your reaction under “C.”
What triggered this reaction? Write only 1-2 sentences down that will adequately describe the triggering event under “A.”

Step Two:  Identify Irrational Beliefs
You have already begun the disputation simply by removing judgment, clicking your emotional seatbelt into place, finding a positive attitude, and creating a balanced mind.
Now, let’s write down a few thoughts that come up for you as a result of “A” and “C.” For example, you just received your final test score of 72 and you are accustomed to a very high GPA. What are you telling yourself about this event?
            “My GPA is ruined.”
            “I’ll never recover from this. I am such an idiot.”
            “The professor should have given me a break.”

Hmmm…. Are any of these things really true? Check your validity. How is this working for you? Are you more or less upset than when you started writing the statements down?  Let’s take a look at identifying any irrational beliefs underlying this event.

Most certainly, it’s an overgeneralization to jump from a single test to a total GPA. All-or-nothing thinking is at play. Are you fortune telling to indicate that you will never recover? Are you labeling yourself as an idiot, when obviously you have a good GPA …so this is not true. What about emotional reasoning … asserting the professor “should” have given you a break.

Just looking at the terminology you are using helps identify personal irrational beliefs that many of us have.

Step Three:  Challenge Your Irrational Beliefs

Once the irrational belief underlying an automatic thought has been identified, it is
important to refute these beliefs by examining the evidence for them, and by looking
for alternative explanations. There are three simple ways to challenge your irrational beliefs:

Defining:   Semantic accuracy helps us avoid overgeneralizations about physical,  emotional and behavioral consequences. Be very careful about the words  "always" and "never". They are absolute words and should be used accordingly.  Just because I did something stupid does not mean I will always do stupid things. Or because something “is” does not mean “it will always be this way,” or “it will  never get any better.”  Statements like "I don't know how" really mean "I don't  want to," and "I can't" means "I won't".  Moreover, emotional disturbances do not happen by wishing, wanting, hoping, or desiring, but by demands that change the  meaning of “want” to "I can't live without it and I will never be happy until I get it.”
Debating: These are rhetorical questions designed to disqualify and destroy the  false belief. A debate between you and your irrational beliefs. It is here we hold  all beliefs to the scrutiny of truth… similar to placing the irrational belief on trial.  Where’s the evidence?  Is there proof?  Where is it written?  If a friend held that  same belief, would I accept it?  Let’s be scientists… what do the data show?  How  would that be so terrible?  What’s the worst thing that could happen?  What is the  probability of bad consequences?  How will my world be destroyed if…?  Why   do you hold onto a belief that causes so much duress?
Discriminating: Here we are confronted with similar yet contrary ideas that are brought to light as a result of debating. We discriminate between what is true and  what is a lie; we have needs and we have desires, preferences and wants; we have  good and bad.  Undesirable does not mean unbearable; hassles are not horrors; bad  times are not end times; difficulties are not damnations; being disliked by one  person does not imply universal disapproval.
Now let’s look at the “D” column on your ABC Worksheet:
“My GPA is ruined.”  Might be changed to “my GPA is certainly going to take a hit, but I will recover.”

“I am such an idiot.” To “Perhaps I did not study enough, sleep well, or understand the material well enough, but I know I am an intelligent person and will likely do much better the next time.”

“The professor should have given me a break.” Well, we know that “control” as a life strategy does not work very well; the professor had little to do with how I performed on the test.
Congratulations! You have learned how to dispute your irrational beliefs using your new skills as a scientist in your own life. Next, let’s take a look at the outcome of your hard work.

Emotional Freedom, a New Effect:  Adding E to the ABCD Model

This is the goal of "D" - a new philosophy toward life and the “E” in the ABC Model of Healthy Thinking. How did you get yourself to feel as a result of disputing your irrational beliefs?  First, your distress level is below a 5 on the 0-10 scale. You can now rationally think your way through a situation rather than be held hostage by physical, emotional and behavioral consequences. 

It is important to remember that you do not ignore these reactions as they are crucial to understand where you are in the present and they provide you with a place from which to move into the future. The goal is to think appropriately in each situation. There is freedom and courage in becoming a Healthy Thinking master.
Now let’s take a look at how we have modified our irrational beliefs from “B” and consequent responses in “C” to column “E.”
Go to the “E” column and re-write your physical, emotional and behavioral consequences that result from your new, healthy beliefs. Let’s go back to one of the first examples we used during this lesson… a failed test.  Perhaps now your anger has turned into momentary disappointment as you turn to the work of improving your grade.   And the other early example: “A car cut me off in traffic.”  Are you still angry and shaking your fist at the driver?  Perhaps now you notice a moment of relief in that accident isn’t about to happen, and then move down the road.

Influencing your environment with Healthy Thinking

As you practice Healthy Thinking over time, you will experience a change in your environment. Have you ever noticed what happens when someone enters a room in a nasty mood?   Say he’s scowling, distressed, angry and snapping at everyone.  What happens to the other people in the room?   Brings…them…down!  Right?

Now, take the same room of people. What happens when someone enters in a calm and balanced manner, cheerful, etc. What happens to the room? It may stay the same, become calmer, etc. One thing is certain, people are not reacting to that person in a fearful manner.

It is important to remember the distinction learned in part one that Healthy Thinking is not the same as positive thinking. It is about thinking rationally and appropriately according to each unique situation.

Now, let’s work through a few new examples. Print out the ABC worksheet at the bottom of the slide and work along.

Example 1:

            You are studying for a final exam scheduled Monday morning. Your mother just called and wants you to come to dinner on Sunday night. You notice that your heart rate goes up, you begin to sweat and you feel angry and frustrated. You want to tell her “no,” but you hesitate…

            First…take a deep breath……….remove judgment, click your emotional seatbelt in place, find your positive attitude and balanced mind.

            What do you notice?

            C=heart rate goes up
                 Sweating
                 Angry
                 Frustration

            What triggered this reaction?

            A=      Mother invites you to dinner the night before a final exam.

            What are you telling yourself about this?

            B=       My mother never just asks…she expects me to be there no matter what.
                        She won’t understand the pressure I am under on this test.
                        If I tell her “no,” I’ll never hear the end of it.
                        I am going to fail this test!

            How can you dispute these irrational beliefs?

            D=       I prefer to study for my final exam. My mother may be disappointed at first, but she will be proud when I do well on this test. I will make it a point to call her when I get my grade. She may bring it up again and over  time, she will begin to understand what I need to do to be successful.

            What is the new effect?

            E=        I don’t know what this may mean for you, but for me it would probably motivate me to focus and do well on the test to provide evidence that will back up my new beliefs. Over time, my mother has learned what I need to  be successful so I influenced her in a positive manner as well.

Let’s work through another example:

Example 2:

            You have been married for two years. You were recently accepted into a prestigious graduate program. Two weeks ago your husband happily informed you of his job promotion and transfer to another city. The increase in income will make life much easier. You notice that you have not had a good night’s sleep since that announcement.  You’re irritable, sad, and have not been interested in walking the dog or playing tennis…a game that you have always enjoyed.

            First…take a deep breath……….remove judgment, click your emotional seatbelt in place, find your positive attitude and balanced mind.

            What do you notice?

I may not get this opportunity again, but perhaps there is a better one around the corner that I don’t yet see. This job promotion and transfer has a significant impact on my life as well, I am an important member of the marriage team and believe it is time to address this with some good old fashioned pros and cons. He is a smart man and will understand this methodical approach so we can both be at peace with the outcome. Is there a  better university in the new city? I am willing to place my goals on hold temporarily in order to figure out how to make everything work. I wonder if my husband will agree on creating a timeline for my education.  Did he really “do” this to me? He is not responsible for my reaction to his promotion. I am the only one who is responsible for this reaction. This may be an important milestone in his career. Can I support him as well as reach my goals?

            What is the new effect?

Summary of Healthy Thinking

In this lesson we have pulled together all the information into a complete ABC Model of Healthy Thinking. You have learned the theory of Healthy Thinking, how to think like a scientist and the benefits of self-monitoring.

Then, you learned how to recognize your reaction. The physical, emotional and behavioral consequences (the “C)

Next, you looked for the trigger that led to the reaction. (the “A”)

Then, you took a deep breath, clicked your emotional seatbelt into place to keep you from going through the windshield of sanity and identified your irrational beliefs in a Healthy Thinking manner. (the “B”)

You began defining, debating and discriminating your irrational beliefs (the “D”) and found a more effective philosophy in life by establishing a new, Healthy Thinking belief to replace the old, irrational beliefs leading to a more effective response. (the “E”)

Now let’s take another short test to help pull this information together:

I hope that you have already started to benefit from this Healthy Thinking material. Because change takes time, we do not expect you to meet all your goals overnight. This is why many of you will be participating in other lessons or coming back to this one. We encourage you to continue to keep your goals realistic and simply practice, practice, practice. It truly is as simple as learning your ABC’s.

Remember “failure” is just a word without negative or positive connotations. Should you slip, keep practicing and moving forward, or come back to this
material as you move toward all your goals in life.                   

Thank you.