The main tenet of early Cognitive Behavioral Therapy (CBT) as developed by Aaron Beck, MD and Albert Ellis, PhD is that thoughts trigger emotions and influence behaviors. That is, if we are experiencing a negative emotion it is because we first had troubling (irrational) thoughts that triggered the negative emotion. Put more simply, unpleasant emotions or emotional states are the product of irrational thinking. If we are able to think about ourselves and situations rationally, our emotions will track with reality and we shall be less troubled by disturbing emotions. This was actually a pretty radical idea in the field of clinical psychology at the time (the early 1950’s), as it was in many aspects at odds with the traditional psychoanalytic theories of why people feel depressed or anxious.
Over time, CBT expanded upon that initial idea to incorporate the idea that emotions, thoughts, and behaviors are an interrelated system that all act on and influence each other. Each component influences all the others in a non-linear, simultaneous fashion. For example, what we are doing in the moment (our behaviors) can influence our in-the-moment thoughts about our capabilities and the world around us. Those thoughts then trigger further emotions (positive or negative) that lead to additional thoughts about ourselves and our situations, which trigger additional emotional experiences and subsequent behavioral choices, etc. In general, negative experiences, whether they be thoughts, feelings, or behaviors that are perceived as unsuccessful, will lead to further negative thoughts and feelings.
(I think it may be fair to say that CBT is still trying to sort out the potential problems raised by the seemingly lingering idea that people who are distressed are so because they are thinking “irrationally”. It’s a bit of a thorny topic and there isn’t sufficient room to explore it here. In my opinion, it is not helpful (nor justified) to say that another person is irrational or over-sensitive. People have reasons for doing, feeling, and thinking the things they do. Understanding those reasons is an important part of the therapeutic work.)
An important part of the idea that thinking leads to negative emotion involves the concept of automatic thoughts. Automatic thoughts are thoughts that emerge into consciousness from unconsciousness without us trying to think them. From the perspective of the person who has them, automatic thoughts just appear out of the blue. We all have automatic thoughts, and probably very frequently.
CBT postulates that automatic thoughts arise from deeply held, core unconscious beliefs we have about ourselves, other people, the world and our ability to influence it, and the future. In other words, unconscious negative core beliefs are the source of the negative automatic thoughts that we notice in consciousness. Stressful situations will tend to activate negative core beliefs and, therefore, we shall experience more frequent negative automatic thoughts when we are under stress. Because the thoughts are automatic (i.e., they just appear), people may accept them as true or factual, even though, with some analysis, their tendency to omit important data is typically readily apparent.
The types of automatic thoughts about which we are concerned in therapy are thoughts that involve judgments or assessments about our self, other people, the world in general, and the future. For instance, a negative automatic thought about oneself might go something like, “I’m a loser” or “I never succeed”, or “There must be something wrong with me”. An automatic thought about another person that triggers negative emotions might go something like, “Wow, she is so perfect…I wish I had her life” or “That person is a complete creep”. An automatic thought about the world in general that triggers negative emotions might go something like, “Things like this shouldn’t happen” or “It’s not fair that they expect me to do this.” Finally, an automatic thought about the future that tends to trigger negative emotions might go something like, “This will never work” or “Things just always get worse.”
As you read through the automatic thoughts in the last paragraph, you probably noticed that all of them involve elements of generalization, extremes, black and white thinking, or demands about how the world “should” work. Basically, automatic thoughts ignore or deny the existence of the detail, variability, and nuance that is a part of all things and situations. When it comes to automatic thoughts, things are all one way or all another. People are perfect or abysmal. We ourselves are completely worthless and at the total mercy of unreasonable and arbitrary conditions. The future is bleak and devoid of hope. Life should not make such demands of us.
So, how do we work with these types of thoughts?
Noticing that they are active in our consciousness is the first step. That is why mindfulness is such a core skill. When we are taking a mindful perspective to our thoughts and feelings—that is, being present with them in the moment and observing them without the need to to deny them or push them away—we are in a better position to notice them and respond to them effectively.
The second step is taking a careful listen to them. What is being included in the thought and what is being omitted? Do you notice elements of black and white thinking or extremes in thinking? Do you notice the presence of generalizations (e.g., “He always does that”)? Do you notice demands about how people should behave or how the world should be ordered? (“She shouldn’t have said that!”)
The third step is to do the work to develop an alternative thought to counterbalance the automatic thought you detected and analyzed. The alternative thought will need to add in some information and/or take into consideration details that the automatic thought omitted. Alternative thoughts, therefore, add balance and detail to the nuance-bereft automatic thoughts. In the beginning, generating alternative thoughts can seem a little like an exercise (in truth it is!), but with practice, you will notice that your mind starts to formulate those types of thoughts on its own.
For example: An alternative thought to “I am a loser” could be “Sometimes I don’t succeed, but that’s normal for everyone. Much of the time I get done what I need to do and things work out OK. It’s not helpful for me to over-focus on the situations that don’t go my way. I can learn from them, but then I can put them down and focus on the future.”