Topic 5: Behavioral Activation & Automatic Thoughts {by 2/23}
[Behavioral Activation] – Watch MDD-7: Behavioral Activation – Introducing Daily Activity Schedule. Answer the following: (1) Based on what you know about this client so far (e.g., information from his assessment and his Weekly Activity Monitoring Log), what specific activities or tasks would you like to see on his first Daily Activity Schedule? (2) How would monitoring this client’s thoughts (and believability rating) and emotions (and severity rating) be helpful for future cognitive work?
[Automatic Thoughts] – What are some possible reasons why it is difficult for some clients to differentiate thoughts from emotions? Why is it important to know the difference (see Tables 7.3 & 7.4)?
Your original post should be posted by 2/23. Have your two replies posted no later than 2/25. *Please remember to click the “reply” button when posting a reply. This makes it easier for the reader to follow the blog postings.
Dr. Adam M Volungis 
Feb 17, 2023 @ 14:57:44
Some of the things that should be included in his first daily activity schedule would be a slightly earlier wake time, eating breakfast, walking his dog or other outdoor activities like gardening, maybe spending some time with either his girlfriend or his friends depending on the day and what kind of time he has, maybe even scheduling in some time in either to plan the activity or date night or even for getting ready for the plans. Another thing that could be included are some household chores that needs to be done like the dishes or laundry that he sometimes has a hard time completing.
It helps figure out the clients perceived experience and feelings during different activities in his day. With emotions, it helps give more context to what emotions are being felt when or during what activities, and how severely they are being felt. The monitoring can also give more of a look into thoughts and feelings that may not be consistent with the activity at hand. Such as, it is expected that he will have lower emotion rating during activities that are generally seen as not as great to complete. Or having a low rating for emotions or persistent thoughts when he should be having fun with friends. When it comes to the thoughts specifically, it is important to have these ratings to see his thought patterns and get a better look at his automatic thoughts throughout the day and during what activities. Which ones are more persistent than others, which are more negative, and which need the most attention.
Overall, this differentiation is not taught, it is left for people to just figure out on their own. Sometimes clients may be out of touch with their emotions and may not understand how to feel them or interpret them, some may mistake their thoughts for emotions meaning they are misinterpreting a thought as an emotion. For example, feeling stupid is not an emotion, it is a thought that is associated with the emotions of sadness, shame, or even hurt.
Knowing the difference between a thought and an emotion then accurately labeling the experience can be extremely helpful. Both of these channels work differently and need to be understood as two different entities that work together. When a thought is correctly understood as a thought rather than an emotion, the individual can challenge the thought and understand why they are thinking this. Thoughts are often opinions or assumptions that can be changed. With emotions there is less of a likelihood to want to change the experience and rather feel the emotions that are experienced in the moment. This mistake of confusing the two could lead to identifying these “emotions” as a characteristic of oneself or just make the situation worse overall. Understanding the difference between thoughts and emotions can lead to a more positive outcome in different situations.
Feb 22, 2023 @ 17:07:20
Hi Tiana! I like that you mentioned that the monitoring of thoughts and emotions within an activity log can help understand the severity of emotions. I think this is very important and not something I immediately thought of. The severity of an individual’s emotion will show the level of pleasure or distress they are facing, will spark conversation, and promote insight into the areas of the client’s life should be focused on most. I thought your point that the differentiation between thoughts and emotions is not taught was interesting. Although this skill is difficult to teach, I feel this skill can grow with practice and learning more about both thoughts and emotions.
Feb 18, 2023 @ 21:19:30
I would like to see Mark wake up early so he does not rush while getting ready for work, walk his dog, and go out with his girlfriend, Melissa. Mark has mentioned that he does not like rushing to work every morning, which impacts how he starts to feel during the day. Also, he has expressed that walking his dog brought him lots of joy, and it would be helpful for Mark to have something to look forward to (either in the morning or evening). Additionally, going out with Melissa has proven to be an event that tends to create some stress and the catalyst for withdrawal behaviors for Mark, so implementing a day to a specific place/restaurant could help with some of those feelings. Monitoring his thoughts and emotions can be helpful for the future because recording this data can make patterns more visible. These patterns can show what events or tasks tend to be stressors or have negative feelings surrounding them. That way, it can be discussed in future sessions to see what could help reduce some of those negative feelings.
It can be difficult for clients to separate emotions and thoughts because they are used interchangeably. It could also be because after experiencing distressing or positive situations, people often name the thoughts they have instead of the emotion. When you feel stressed, you might not be able to both feel and identify the physical symptoms, but instead, you might say, “I’m stressed because of ….” or “Doing ___ stresses me out.” So when it comes time to label emotions, it is harder to identify because it feels like there is no one word to describe it (even though there might be).
Knowing the difference between the two can make it easier to see what thought patterns are happening in response to those emotions. If someone feels guilty, their thought could be “I’m a terrible person”. This thought at that moment, might not be true. And it would be easier to challenge and offer up contradicting information for someone to see that they are not so bad. But changing the emotion, guilt, would be harder (but not impossible) since it could be a core belief for that person. That would mean cognitive restructuring and helping them understand why they have those feelings of guilt.
Feb 19, 2023 @ 17:28:14
Hi Esther!
I strongly resonate with your reasoning behind why it is hard to differentiate between thoughts and emotions. It is so important to normalize having different emotions. What makes the difference is the thoughts a person has while feeling these different emotions. If an individual is able to change their negative thoughts when having unpleasant emotions it will give them a more positive outlook.
Feb 20, 2023 @ 10:07:30
Hi Esther! I absolutely agree with your response to the first question. We would want to see him wake up earlier to create less rushing in the morning and implement more dog walks to make sure he has more enjoyment. Creating plans beforehand when going out with Melissa would be super helpful in lessening his stress and negative feelings as well. I also agree with your response to the second question. Thoughts and emotions are used interchangeably creating a barrier for people to truly understand what they are feeling rather than what they are thinking. Using cognitive restructuring would be a great idea to help with changing negative beliefs. However, I feel like we would need to start with teaching clients the difference between thoughts and emotions as well as help them understand that thoughts are not facts and negative emotions do not last forever.
Feb 25, 2023 @ 20:08:06
Hi Esther,
You made great points about why it is so hard to understand and determine the difference between thoughts and emotions. Most of the time the two terms are used interchangeably. I like how you used the example of positive and negative thoughts in this situation. Most individuals will have a negative thought and that can lead to a negative emotion, but these two things are very different. It’s important to learn the difference between the two as it can help the individual better understand why they are experiencing a specific emotion.
Feb 18, 2023 @ 21:48:45
Based on what we know about the client, the specific activities, or tasks I would like to see on his first daily schedule would be to take the dog for a walk before and/or after work as this is an activity that seems to bring him joy and this can help eliminate some of his negative emotions around his workday. It would also be nice to see him be able to wake up early enough for not only a dog walk but also to make a nice breakfast for himself. He mentioned the importance of eating a better breakfast which could also help improve his mood throughout the day. Setting aside time to do household chores such as dishes and laundry, and completing these tasks, as they help him feel accomplished. It could also be nice depending on the day he chose to do an activity with his girlfriend either a date night or a daytime adventure or have a social event with his friends. Monitoring clients’ thoughts and emotions with be helpful for future cognitive work because it provides a wide understanding of the client’s emotions and thoughts revolving around their daily activities. The schedule gives a better view of any consistent thoughts or emotions that may relate to specific activities throughout their day, or even point out activities they do their best to avoid. This allows the counselor to understand the client’s thoughts and emotions throughout their day and if they are using their time wisely.
A possible reason why some clients may have a difficult time differentiating their thoughts from their emotions is that they may simply get confused or just not fully understand the difference. It is important to give examples to a client as to what a thought is vs an emotion. For instance, a thought can be described using a full sentence or a phrase and an emotion can be described using one word. It is important to know the difference because it makes the treatment process easier. With this information, it is easier to provide minor and achievable changes in their days to better their mood and overall pleasure and accomplishment throughout the day. Thoughts can also assist in discovering negative automatic thoughts to help improve their emotions.
Feb 20, 2023 @ 21:56:12
Hi Melissa!
I really liked how you picked the activity that brings the most joy to the client as the first activity to monitor for them! I think that the prioritization of joy for motivation is something that can be overlook as it is not always deemed as productive, even though it can be for clients with depression. I think tracking a client’s avoidance of activities is super important to see why they may be avoiding it and how it may be costing them (physically or emotionally) to perform these specific activities. I had not thought of that aspect, but I definitely think it’s important to keep track of!
Feb 22, 2023 @ 12:13:19
Hi Melissa,
I like how your goals for Mark will help him feel accomplished. I think with these little goals throughout the day, it can help him change his mood if his mood goes south. These goals can also help him feel more motivated throughout the day. It can give him a little push to keep moving forward rather than the negativity consuming him. I agree with what you said about thoughts and emotions providing a better understanding for the client. With monitoring these thoughts and emotions, it can show the therapist what activity provides what for the client. It can help show what activities bring them pleasure and what can cause distress. I feel that it is important to follow thoughts and emotions for that reason. The therapist will be able to see what can provide pleasure and enjoyment to the client. With this, it can give the therapist a guide to help the client gain more pleasure/enjoyment with other activities.
Feb 19, 2023 @ 11:58:13
It seems that Mark struggles with initiating adaptive behaviors due to anxiety and depressive symptoms. On his Activity Schedule, I would like to see that he wakes up at an earlier time so that he is not rushed to work in the morning and is able to engage in valued behaviors like making breakfast and walking his dog. While it may be difficult to initiate his morning routine, he may feel more productive and accomplished during the day. In addition, I would like to see Mark spend more time with his girlfriend, such as going on a date night, walking the dog together, or doing an activity outdoors. Lastly, I would like Mark to allot time during the week to spend time with his friends. By initiating these social behaviors, Mark’s feelings of pleasure while spending time with others may inhibit his social withdrawal.
Monitoring thoughts and emotions during daily activities is useful in identifying pleasurable or difficult behaviors that elicit negative reactions. When the client reports feeling pleasure and accomplishment after a scheduled activity, the therapist may then encourage them to engage in this behavior more often. On the other hand, if a client reports that a particular environmental stimulus triggered negative emotions or automatic thoughts, the therapist may process the emotional/cognitive reactions with the client. In addition, it is important for the therapist to understand the intensity and duration of the client’s reported emotions, as well as the believability of their thoughts. The therapist can determine what negative automatic thoughts should be prioritized during the therapeutic process.
Some individuals may find it difficult to differentiate thoughts from emotions due to the attentional bias toward strong emotions. Automatic thoughts are often overlooked because they are reflexive and appear in shorthand, while emotions are more potent as they can be demonstrated through physiological reactions. In addition, some clients may find it difficult to articulate emotions or thoughts due to low emotional intelligence, or they were raised with limited communication surrounding emotions. These clients may confuse the two when recounting an event. It is important to know the difference between thoughts and emotions to determine the source of a maladaptive behavior. Through the therapeutic process, the client may learn that their thoughts are invalid and lack utility, but their emotional reactions are valid as they are congruent to what the individual was thinking.
Feb 19, 2023 @ 17:46:36
Hi Abby!
I strongly resonate with your thoughts on why it can be helpful to monitor thoughts and emotions during Mark’s daily activities. It is significant to know how a client is feeling after each activity so we can understand what is producing negative thoughts and emotions. If we can pair tasks with activities that promote pleasure, the client will potentially have more pleasurable thoughts and still be accomplishing a task.
Feb 20, 2023 @ 10:18:39
Hi Abby! I agree with what you have mentioned in your response! Having Mark wake up earlier would cause less stress and more time for him to do what he needs to do like eat breakfast and maybe even walk his dog like he wants to. It may be difficult for him, however starting small like 15 to 30 minutes rather than 1 hour or more is a good place to start. Spending more time with his girlfriend and friends is a great idea as well. I think also implementing time to create these plans rather than waiting until the last minute may be an even more helpful task to implement on top of spending time with them because this is where most of his negative feelings and thoughts begin to emerge. I also like your addition of the positives of monitoring thoughts and emotions during daily activities. It is definitely a helpful tool for the therapist when trying to understand what helps or makes things worse daily for a client and what to focus more on during sessions.
I also really like your response to the last couple questions. I did not even think about the bias clients may have towards strong emotions but this is definitely a major downfall. While low emotional intelligence is definitely a key factor to think about, I think the overall lack of resources to find this information is definitely a part of the problem that needs to be addressed. It is absolutely important to determine the source of a maladaptive behavior and using these thoughts and emotions is a great place to start.
Feb 19, 2023 @ 16:35:05
Based on what we know about this client so far, I would like to see him try to complete the following on his daily activity schedule: waking up slightly earlier, making a good breakfast, spending more time with his dog (this can be used as the outdoor activity), and doing another social activity (this can be date night).
Monitoring this client’s thoughts and (believability rating) and emotions (and severity rating) would be helpful for future cognitive work because it is the first step in identifying and trying to change his negative automatic thoughts. How the client thinks and feels during specific tasks will allow us to gain insight on his state of mind during these activities. What a client is thinking and feeling will determine if he is going to keep doing his daily activities. I believe that because of Mark’s symptoms it is so important to pair a task with a pleasurable activity so he will be more opted to complete the task. This is very important for those who are significantly struggling with depression symptoms.
It is one thing to have a thought but how much that thought resonates with him will determine how much they actually believe it. There are many occasions where an individual will have a negative thought, but it won’t have a major effect if the individual does not actually believe it.
Possible reasons why it may be difficult for clients to differentiate thoughts from emotions is because many people mistake emotions for thoughts and don’t know the difference between them. For example, an individual’s thought could be, “I hate myself.” the emotion is likely that they are feeling guilty about something they did. It is important to differentiate between thoughts and emotions because CBT is focused on changing the way people think. It is normal to have a variety of different emotions including guilt. But instead of having the negative thought of, “I hate myself.” A more positive thought could be, “I will do better next time.”
Feb 20, 2023 @ 12:33:01
Maria,
It is so important for a therapist to be able to get a deeper view into their thoughts and emotions when attempting to change negative automatic thoughts. As you stated, this assists the therapist in gaining insight into the client’s state of mind while conducting their daily activities, this can help identify activities with which the client has a hard time and why they may have a difficult time before, during, or after the activity. I like that you noted with this client and many depressed individuals, it is important to pair a task with something that brings the individual pleasure as this could provide more support in the completion of a task that is not enjoyable but maybe needs to take place, such as house chores.
Feb 20, 2023 @ 22:02:47
Hi Maria!
It is super beneficial to track a client’s thoughts and emotions during activities to see how intensely they may be feeling their emotions, but it is also true that it can help track to see whether or not the client will continue to do said activities. If a client is experiencing intense negative emotions with activities it is likely they will not continue to perform and the activity and the goal associated has to change to be realistic. I had not thought of that aspect of tracking activities for a client, but after reading your response I think it is one of the most important aspects of activity tracking along with tracking the client’s automatic thoughts.
Feb 19, 2023 @ 16:53:58
Specific activities/tasks that I would like to see on Mark’s first Daily Activity Schedule include waking up earlier, making a nice breakfast, taking his dog for a walk, going out with his girlfriend on a date, and spending time with friends. These are all tasks that Mark has specifically mentioned that he enjoys and tends to feel positively about after completion, and therefore including tasks that are more likely to receive high pleasure and accomplishment ratings is prioritized. Monitoring his thoughts (with a believability rating) and emotions (with a severity rating) will be helpful further along in therapy because thoughts with strong believability and emotions with high severity can help point you to potential negative automatic thoughts. When a high emotion is triggered, this can be an indicator of an underlying automatic thought. It can be helpful to “store away” this information to bring up later in therapy when discussing automatic thoughts. The more believable an automatic thought is to a client, and the more it corresponds to intense emotions, the more likely this thought may be worth working on with the client in future cognitive work.
It may be difficult for clients to differentiate thoughts from emotions because people process their experiences differently and may have varying cognitive capacities. For example, some may not know that a thought tends to involve a phrase, while an emotion is described in one word. Some clients may lack the vocabulary for articulating emotions, or may struggle to label their own emotions. Also, clients may better understand their “emotions” through bodily sensations. Therefore, it can be helpful to provide clients with examples of how thoughts and emotions are related to one another, but different in nature. Providing examples of emotions, as well as examples of thoughts, can help a client become more self-aware so that thought tracking can be better facilitated in therapy. It is important when tracking negative automatic thoughts that a client can recognize when they are experiencing an emotion, and understand how to identify the thought that preceded it. It will not only help you better plan and guide treatment, but having a clear understanding of thoughts vs emotions will allow the client to walk away from therapy with a better ability to evaluate and modify future thoughts independently. Further, being able to attach thoughts to particular events and environmental stimuli will help the client experience his or her circumstances from a new and modified perspective, to hopefully elicit more adaptive responses and ultimately enhance their quality of life.
Feb 20, 2023 @ 12:42:47
Maggie,
I agree with you that it is important for the client to be including activities throughout their that bring feelings of high pleasure and accomplishment. I also agree that it is so important to identify and track automatic thoughts. The client and the counselor could then take these automatic thoughts and attempt to turn activities that bring lower pleasure and accomplishment to him, into activities that do bring him accomplishment or pleasure. For instance, he talks about his disinterest in house chores, pinpointing the negative automatic thoughts around chores, and flipping them could make accomplishing these chores much easier for the client. I agree with your overall statement on the importance of differentiating emotions and thoughts, as you mentioned it can be very difficult for some individuals to do this but for the therapy process, it is extremely important to make sure your clients know the difference in order to improve their daily life.
Feb 22, 2023 @ 20:50:43
Hi Maggie,
I agree with your point about understanding emotions and bodily sensations. I think we forget sometimes that not everyone has the words to explain what they are feeling. It could be because they were never taught how to do so, or they have not had the chance to express themselves freely. It goes to show you how important psychoeducation & meeting clients where they are.
Feb 20, 2023 @ 21:13:56
Based on the information provided in the role-play sessions with Mark, I would like to see a few specific activities and tasks on his first Daily Activity Schedule. First, I believe Mark would benefit significantly from planning a pleasurable activity in the morning and with his friends or Melissa, even if the activity is small or mundane. Mark shows some classic signs of depression whereas planning social and/or pleasurable activities in the morning may help him to stay on track with his goals in therapy. In a previous discussion another student had mentioned the use of pairing a not-so pleasurable activity with one that is pleasurable. Based on Mark’s presenting problems and the assessment provided for him, I think pairing these activities is a great way to encourage his participation not only for the homework he’s been given, but throughout the day as well. Specific activities I would like to see Mark incorporate into his daily schedule is waking up earlier in the morning so he is able to have more time to properly start his day. If Mark allows himself more time in the morning, he could eat a good breakfast and spend more time with Melissa and his dog. Starting his day off with activities that give him pleasure is a great way to practice a small shift in his current lifestyle and maladaptive habits.
Monitoring Mark’s thoughts and emotions would help in a fundamental way for future cognitive work. Not only does it help as a therapist to gain more insight into Mark’s thoughts and feelings but it could help Mark significantly. Monitoring these thoughts and feelings can help Mark identify his automatic thoughts, cognitive distortions, and potentially maladaptive expectations he places on himself and the activities/tasks he partakes in. Additionally, using the Daily Activity Schedule to monitor Mark’s believability rating (regarding his thoughts) and severity rating (regarding his emotional arousal and how he actually feels) helps to distinguish the two from each other. This is vital to CBT because clients (like Mark) are able to differentiate not only their thoughts from their emotions and feelings, but their behavioral patterns throughout their day as well. Matching a client’s thoughts and feelings to their behavior is extremely helpful for the therapeutic process because it provides a deeper understanding of the client’s cognitive-behavioral triad and it is useful for execution of cognitive work in future sessions.
It can be hard for some clients to differentiate between their thoughts and emotions because it is hard to understand which they experienced first. Additionally, thoughts that are automatic, are just as they are named – automatic. This can make it difficult for clients to identify them because the thought happens almost immediately in response to something in their environment. To this point, automatic thoughts can lead a person to then (almost immediately) feel a certain emotion and/or physiological arousal. When a client is able to spot the differences between their thoughts and emotions, it helps to identify which are maladaptive to their well-being. For example, if a client understands the difference between a thought they are having about a certain situation and can then identify the emotion that follows, they are more likely to assess whether or not the thought holds truth and is rational to the circumstances.
Feb 22, 2023 @ 21:00:40
Hi Aly,
I like how you brought up Mark’s potential morning routine. I agree, I think he seemed to look forward to it in the mornings, and waking up late hampered that. This would be the first thing I would address with him. By working towards waking up earlier, Mark could have the time he needs to have more pleasurable mornings without feeling like he is rushing against the clock.
Feb 20, 2023 @ 21:52:05
One of the biggest things I would want to see in Mark’s daily activity schedule is planning to wake up early and actually executing it, even if it is not at the time he planned but still earlier than he normally does. I think this is important to have a good start to his day to really motivate him, as he mentioned he hasn’t been feeling motivated in starting his day at all. I would also want to see him intentionally set time to walk his dog. Mark talks about this in each session and it seems to be something he really misses doing. This could be another big motivator to get his day started and keep going as well.
I think monitoring his thoughts and emotions surrounding these activities would really exemplify his core beliefs. If he continues to have negative thoughts when not executing a planned activity at the same time or at all, then it might help us be more in tune to which negative core beliefs he has about himself. It would also help to see them monitored to compare and see which thoughts appear the most to then work on validating and either changing or coping with these thoughts to help alleviate some of Mark’s displeasure.
It can be difficult for clients to differentiate thoughts from emotions because automatic thoughts are so quick to present themselves that the individual does not realize what they are thinking before the emotion shows up. As a result, the individual is able to more readily and easily identify the emotions following the automatic thoughts rather than the thoughts themselves. It is important to know the difference because the thoughts can be modified, but the emotions following the thoughts are reflexive in nature.
Feb 21, 2023 @ 09:24:05
Hey Whitney, I like your goals set for M. They are small enough to actually be done, but still impactful enough to have him feel good about having done them. As you said, these smaller activities can be enough to get him feeling good and motivated to begin to make more changes and have him feel more comfortable scheduling in the future. I also like how you see this homework activity as being a good precursor to our psychoeducation to core beliefs. This assignment can be a good gateway to showing a client the evidence of their thought patterns and how that relates to a maladaptive core belief system.
Feb 22, 2023 @ 11:10:07
Hi Whitney,
I agree with you on having Mark wake up early and hopefully executing it. The morning can be a big part of how the day might go. If the morning does not go well, then it might set up for how the rest of the day will go. It can put them in a negative mood. Having a “good” morning can set up the day better than rushing in the morning. I think having a smaller activity such as walking his dog will help him with his well-being. He has stated that he missed doing it. Suggesting this activity might bring something enjoyable back into his life. It can also be something to look forward to at the end of the day. I also like how you used core beliefs in the importance of monitoring thoughts and emotions. The therapist can see the client’s different thoughts and behavior patterns throughout the day. The therapist can also show the client these patterns to help them understand their own thought process throughout the day.
Feb 25, 2023 @ 19:59:23
Hello Whitney,
I liked the example where you explained the difference between thoughts and emotions. When being in complex situations we often focus on our subjective/emotive judgments that make us feel a certain way, and tend to ignore the cognitive processes that are happening in our mind. These processes are often linked to our core beliefs and for clients might be harder to realize that their emotions are often consequences of their thoughts.
Great post!
Feb 21, 2023 @ 08:54:41
For M’s activity schedule there are a couple things that I would like to see. The first is a more in depth breakdown of his mornings. Mornings and waking up/getting out of bed seem to be a constant struggle/area of distress for M, so I would like to see him plan a morning out in advance to see what he wants or expects of himself and compare that to what he actually does. This can help set a good baseline for his expectations of his mornings and we can problem shoot what worked/didn’t work and how to improve for next time. And the other thing, as Prof. V. said to M in the video, I would want to see some social activity scheduled into his day. Withdrawal seems to be one of his common coping skills, but that is helping perpetuate his depressive feelings, so whether it is walking with his dog at the park, going out with his girlfriend, or hanging out with friends, I’d like to see something from him where he’s trying to make a point to go out and do things with others. Monitoring his thoughts with believability and emotions with severity would be important/useful because we’ve seen him often express that when he thinks about doing things he often gets himself worked up or anxious from just the thought of it, but when he actually does it it is not nearly as bad as he set it up to be. This would be useful when doing cognitive work because it is good data to show him that doing the things he is worried about doing is never as bad as he expects them to be and that sometimes he even enjoys doing them (or at the very least, isn’t miserable doing them).
In the case of automatic thoughts, it can be difficult for clients to differentiate between these thoughts and emotions because they are often thought so quickly in response to a stimulus (cognitive reflex) that the emotion it elicits (because the emotion is so strong) is the only perceptible part of this chain. It becomes difficult to recognize that there was a thought-emotion chain because the negative emotion is so potent it is the only thing you can focus on. Additionally, the language we use makes it difficult to differentiate between the two. The phrase “I feel worthless” is expressed in terms of emotions (“I feel”) but the content expressed (“worthless”) is a thought. Helping clients know the difference is important because we want to change their maladaptive thoughts and thinking, not their emotions. Changing the language of “I feel worthless” to “I think I am worthless” helps us because we can emphasize to the client the pattern cycles that lead to that line of thinking to help break it, as opposed to an emotion which is something we validate and allow our clients to feel.
Feb 22, 2023 @ 22:22:05
Hi Lucy, I really enjoyed your post! I definitely agree that a detailed breakdown of Mark’s morning would provide more insight on the antecedents to his negative thoughts that may make his mornings difficult. While we already know that he has difficulty getting out of bed, making time for breakfast or walking his dog, it would be important to know his thoughts in the morning. Like you mentioned, he may have set high expectations for himself but feels defeated and upset when he is unable to meet them. The Activity Daily Schedule would be beneficial in bringing awareness to automatic thoughts that determine Mark’s productivity in the morning.
Feb 22, 2023 @ 09:59:02
Two of the biggest things I would like to see is the client getting up earlier and his date night. Some specific activities I would like to see are waking up earlier and making breakfast. The client has stated before that he wants to eat a good breakfast. Breakfast is the most important meal of the day. If someone is being rushed and hungry, it can set the client’s mood for the rest of the day. Rather than that, I would like for the client to have a morning routine and do it slowly. It can create a good baseline for how the rest of the day might go. For date night, I would like to see the client plan their dates in advance. Though sometimes it is exciting to do a “spur of the moment” date night, for the client, it has caused more harm than good. It has created more issues for the client and their significant other. I would like to see the client plan out their dates in advance. It can be as simple as deciding on an activity such as going to the movies, taking a walk outside, or a special activity that means the most to the two of them. I feel that with this, the pleasure of date night will go up. Hopefully, it will not give the client more added stress when they want to spend time with their loved one. In the video, both the therapist and the client talked about which activities might seem the toughest to do. The client talked about these two due to the negative automatic thoughts he has towards them, mainly waking up in the morning. As a therapist, I would love to see these on his daily activity schedule. I think that it is important for the client to try to do these activities. If they do not go exactly as planned or goes “out the window”, it is my job to help the client to learn ways to do these activities. Monitoring the client’s thoughts and emotions can help set up what can be done later in sessions. If a client does not feel comfortable with something, then the therapist and client can work together to find something else. The therapist can also use the thoughts and emotions to see how the client thinks throughout the day. These can be used to see what kind of thoughts can either set the client off with negative thoughts or the opposite. It can also show the client to see what they think throughout the day. With this information, the therapist and client can collaborate and see what the next possible step is for the client.
Though thoughts and emotions can trigger one another, they are different. If there is overwhelming stress in the client’s life, the client might not be aware of their thoughts and emotions. It can be difficult for them to understand fully. For example, something can happen where thoughts about it can be pursued. The client can be confused about what is going on. They will try to understand the thought that came up. However, sooner or later, the emotion of it will come up. Then the client will believe that the emotion of the situation is due to the thought they had. It is easier to know emotions rather than thoughts. We might automatically think that because we thought of something, this is why the emotion popped up. We can never truly understand why we think the way we think. However, we know the basic emotions that we can develop. It is important to know the difference because they are different in nature. Though they do have a collaborative process on some occasions, they are two different things. It is important for the client to understand the difference. The client can think one thing, but can feel another.
Feb 22, 2023 @ 14:38:46
Hey Ashley, I definitely agree that Mark waking up earlier and eating breakfast would be very beneficial for him. Him not starting the day off on the right food seems like it can cause a snowball effect for the rest of his day, and breaking the habit at its root could be very beneficial for him. I also really liked your inclusion of him doing his routine slowly. He is usually so rushed in the morning that it sends his whole day out of wack, and I think him doing this new routine slowly could lead to him having a better mood throughout the day. I also enjoyed how you described that emotions are easier to know than thoughts, because I didn’t think of it that way, but it feels very true. When we experience thoughts and emotions, we’re usually more apt to remember the emotions we felt rather than the thoughts we had.
Feb 22, 2023 @ 10:42:43
Mark’s first Daily Activity Schedule should start with waking up earlier, so he has plenty of time to prepare for work. Between then and leaving for work, I would like to see Mark having a meal and taking the dog out, even for a few minutes, to play in the yard. After work, I want to see Mark trying to fill his evening with activities to keep him motivated. For example, Mark could take his dog to a local park to go for a walk, so he incorporates daily exercise and time with his pet. Around the house, Mark can spend time working on basic activities of daily living, including laundry and dishes, while listening to a podcast or his favorite music. Mark should have a set time each night to sit down with his girlfriend for dinner to increase quality time together. At least once weekly, Mark should set aside time to visit friends or go on a date night with his girlfriend. The plans should also be made a few days in advance so that Mark does not feel rushed at the last minute. Monitoring Mark’s thoughts and emotions can be helpful for future cognitive work because it helps both Mark and the therapist understand which activities spark the most joy and which elicit negative responses. Moreover, monitoring believability and severity helps both parties better understand the likelihood of completing the activity and how difficult the client perceives it to be. All factors work together to help create the most effective Daily Activity Schedule through trial and error.
It may be difficult for some clients to differentiate thoughts from emotions because both activate automatically when a particular stimulus is presented. For example, an individual may be more inclined to think, “I feel like I can’t do anything right,” than “I think I can’t do anything right,” after an unsuccessful attempt at a specific behavior. It is essential to recognize the difference to help the client spot areas of maladaptive functioning. While the clients’ feelings are valid, they need to learn that thoughts and feelings are two different aspects of the CBT triangle.
Feb 22, 2023 @ 14:33:09
Hey Megan, I liked your inclusion of motivating activities when discussing Mark’s daily activities log. It’s important, especially for clients like Mark, to include daily activities that help to increase their overall motivation. I also agree that it’s important for him to not only plan date nights with his girlfriend but also try to spend more quality time with her. The date nights are important, but I also think that them spending quality time with each other when they get home from work would also be beneficial for not only Mark but also the strength of their relationship. I also enjoyed your inclusion of the automatic nature of thought and emotions when discussing why people have difficulty differentiating them. Their automatic nature increases the difficulty of identifying and separating them.
Feb 22, 2023 @ 19:15:14
Hi Megan! I really loved that you mentioned that it is important for Mark to do basic daily living tasks around the house. I completely agree and think it would be great for Mark to get some tasks around the house done to boost productivity and hopefully make him feel accomplished and motivated. He also mentioned previously that it is difficult for him to get those things done sometimes and that he feels better when he gets it done.
Feb 22, 2023 @ 14:28:43
One specific activity that I’d like to see on Mark’s daily activity log is to get out of bed earlier in the morning, additionally him making breakfast and/or taking his dog for a walk when he does so. Him just keeping up earlier would be a step in the right direction, but ideally it would be nice to see him utilize that time. Another activity I’d like to see is him spending more time being present with his girlfriend or hanging out with friends. It would be nice to see him spend more time with his girlfriend and be present with her, as opposed to just playing video games. It would also be nice to see him set some time aside to go on dates with her, as those have been an area of issue in the past. Monitoring Mark’s thoughts with the believability rating and his emotions with a severity rating could be helpful for future cognitive work because it can help him to parse out the difference between his thoughts and emotions. Individuals in general, especially those suffering from depression can struggle to differentiate between their thoughts and emotions, which can make it tricky to engage in modifying negative automatic thoughts. Helping Mark, or any client, to monitor their thoughts and emotions can help make this process more fluid and more successful in the long run.
Similarly to what is discussed above, some clients struggle to differentiate their thoughts from their emotions. The importance of this is discussed above, it assists with modifying negative automatic thoughts. There are many possible reasons why some clients struggle to differentiate their thoughts from emotions. One explanation is that automatic thoughts are typically experienced with strong emotions. If an individual is consistently thinking a particular thought and feeling a particular emotion at the same time it can be easy to see why they would be hard to distinguish. This feature is not unique to automatic thoughts either, many thoughts often come in tandem with emotions, and especially when an individual gets swept up in the emotion. Basically, the main reason is that thoughts and emotions are so interconnected it can be difficult to distinguish them.
Feb 22, 2023 @ 17:02:26
Hi Jack! I really like how you pointed out that him just getting up earlier would be a step in the right direction. I think this is a great place to start, as it is not overwhelming and is something that is very doable for him. If I had several major changes in my daily routine at once, I for sure would have a more difficult time succeeding at each change. I think it is beneficial to explain to the client that these goals and changes do not have to be huge, but just should be a step in the right direciton, as you explained.
Feb 22, 2023 @ 17:46:24
Hi Jack! I agree that automatic thoughts are typically experienced with strong emotions simultaneously–which makes thoughts and emotions particularly difficult to distinguish. Especially for anyone who has not taken the time to explore, or been exposed to, the idea that emotions and thoughts are separate, this may be particularly hard to grasp at first. As when you become overwhelmed with emotion, it can be hard to do anything but focus on the emotion itself–meanwhile your thoughts may be completely unregulated or unnoticed. Thus, it’s important to clarify the difference between thoughts and emotions because this could be the difference between staying in maladaptive patterns or evolving into adaptive, more satisfying, and helpful patterns.
Feb 23, 2023 @ 10:47:42
Hey Jack, I like your emphasis on stating that you just want to see Mark wake up earlier. Ideally, as you said, he can use that time to do things in the morning, but knowing how much of a struggle area this has been for him that may be asking too much from him. So simply just getting up earlier is a great step in the direction of having him starting to add things back into his daily morning routine.
Feb 23, 2023 @ 14:14:49
Hi Jack,
I like how you said monitoring thoughts and emotions can help make the process fluid. It really is important and will help the process in therapy. The client and therapist can work together to shift the the more negative thoughts and emotions into more positive ones. This will also teach them to differentiate the two giving them more insight on what may trigger the negative thoughts and emotions and work around that.
Feb 22, 2023 @ 17:00:03
Based on what is known about Mark, I would like to see him put in an earlier wake up time, so he does not have to rush to work. With more time before work, Mark would have the opportunity to engage in activities he likes such as walking his dog and starting his day with a good breakfast. This would help Mark start off each day on a positive note and would make sure he is making time for himself to engage in preferred activities. I also would like to see a scheduled time frame to be with his girlfriend, or a friend. Mark has explained in previous videos that he tends to socially withdraw, so hopefully making a commitment with someone will help him stick to that and ensure he is socializing.
Monitoring the client’s thoughts and emotions can help to guide the treatment and where the problem areas causing the most distress are occurring. In addition, the monitoring of both thoughts and emotions will help the client and the therapist to be more aware of what is going on and the areas growth/change is needed. Monitoring thoughts and emotions can also provide insight into the potential connections between the two and how one may be leading to another in the individual’s life.
It may be difficult for clients to differentiate their thoughts from emotions if they do not typically pay attention to their emotions and thus are not aware of them and how they present. Additionally, the client may have thoughts that consistently lead to the same emotion which can make the boundary appear unclear between the two. In addition, a client might have a difficult time differentiating between thoughts and emotions if they do not clearly or accurately understand the differences between them.
It is important to see the difference between thoughts and emotions so we can understand how they are influencing and leading to one another. Once this awareness is formed, the client and therapist can work on changing and challenging these thoughts and emotions to work towards more adaptive functioning.
Feb 22, 2023 @ 17:35:48
Hi Emily! I really like your point that clients may have thoughts that consistently produce same/similar emotions. You could see how these blurred lines can make a client confused when trying to distinguish between thoughts and emotions–I know I certainly have many examples of my own thoughts that tend to produce the same/similar emotions/feelings. I think that making this point clear to clients will help them better understand how emotions stem from thoughts, such that not every unique thought produces a similarly unique emotion–variations of both can be intermixed, thus producing countless “combinations.”
Feb 22, 2023 @ 19:01:28
Hi Emily!
I agree with you that it is important for Mark to be scheduling social interactions into his weeks due to his tendency to withdraw when feeling down or tired. He explains having a lot of fun and positive experiences with his friends and I think it would be great for him to schedule in that social time in order to prioritize it. I also agree that it would be important for Mark to be monitoring his thoughts and emotions because we can see where the areas of growth and change are really needed. It would be great to see his thoughts and emotions if/when he doesn’t follow through on an activity. I think the thoughts and the strength of the believability of those thoughts could lead to some good insight about core beliefs for Mark and we could find patterns of thinking that need to be addressed or reframed. Great job!
Feb 23, 2023 @ 14:05:47
Hi Emily,
I too think monitoring the clients thoughts and emotions is an important guide in treatment. It will help the therapist help the client and allow them to work together in working towards shifting negative thoughts and emotions into more positive ones. I like how you said monitoring the two can also provide insight into the connection between the two. With this I think it really think it’ll help the client see new perspectives.
Feb 22, 2023 @ 18:53:00
Based on the information we have on this client so far, I would like to see on his Daily Activity Monitoring Log that he got up early before work with enough time to either make himself a proper breakfast, spend time with his dog, or both. I would also like to see that after work he uses his time before bed to spend time with his girlfriend and dog, maybe even getting outside and going for a walk with his dog or on a hike with his girlfriend, as he said that being outside helps him and that he really enjoys walking his dog and wants more time spent with his girlfriend. I would also like to see that he makes time to either watch tv or play video games for himself without spending all his free time doing that. Additionally, I would enjoy seeing that this client took time to be productive around the house with tasks they typically procrastinate or avoid doing like laundry or dishes.
Monitoring this client’s thoughts and emotions would be helpful because if he doesn’t follow through on a task, then I would want to see what his thoughts are and how strongly he believes them because these automatic thoughts could give insight into his core beliefs, and I assume that his depression is greatly impacted by negative self-talk, from the information I’ve seen about this client. It would also be interesting to see when he follows through on his plans how he feels. This client has mentioned that he often enjoys experiences but struggles with initiating or beginning the activities. Therefore, I wonder if having a plan would help with that and how he would feel about himself after accomplishing his goals. This could help to show him that he is capable of accomplishing things, finishing tasks, and help with his self-efficacy if that is an issue.
Feb 22, 2023 @ 22:30:35
Hi Becca! I enjoyed reading your post! I did not think to include scheduling time for watching TV or playing video games on the Daily Activity Schedule. Initially, I viewed these activities as maladaptive coping behaviors that fuel Mark’s social withdrawal. However, after reading your post, I think Mark should definitely include a small portion of his day to these activities as Mark finds them pleasurable. In addition, Mark could reward himself with an hour of ‘screen-time’ at the end of the day after completing house-hold tasks and walking his dog. This may increase both his feelings of accomplishment and pleasure.
Feb 23, 2023 @ 15:14:18
Hi Becca,
I agree, Mark should still make time for playing video games and other fun activities that are not wicked productive but not get sucked into those things. I would bet that setting the amount of time beforehand would help him get off when he needs to do something different.
Feb 25, 2023 @ 12:40:21
Hi, Becca! I like that you incorporated at-home activities like video gaming into Mark’s Daily Activity Log. Although it is excellent for Mark to get out of the house and be productive, we all still need something to do in our downtime. Mark could probably use video gaming as a reward at the very end of the day once he has accomplished everything he sought to do, but it is important that he does not spend the entire night glued to the screen as that is counterintuitive. I also agree that monitoring negative core beliefs is important when a client does not follow through with a task. Depending on the client’s level of functioning, the planned activities may be too complex, and feedback from negative core beliefs can help revise the plan into something more manageable.
Feb 22, 2023 @ 19:13:45
Based on my knowledge of Mark, I would like to see him engage in waking up earlier on his Daily Activity Schedule. His sleep patterns have been discussed in previous videos and during this week’s video, MDD-7, Mark himself stated that he wanted to focus more on his morning return and attempting to get up even just half an hour earlier. With that, I would like to see him be able to sit down for breakfast, it does not need to be a gourmet meal but make sure he sets aside time to sit and eat in the morning rather than rushing. Furthermore, I would like to see some social engagement whether it is with his girlfriend or making time to call one of his friends after work. Doing a simple check-in with his friends can lead him to feel more confident in spending time with them on the weekend rather than isolating and withdrawing. Lastly, I would like to see some kind of outdoor activity whether it is a long walk with his dog or as he mentioned, spending time gardening.
With that being said, monitoring Mark’s thoughts and emotions on believability and severity ratings will be helpful for later cognitive work. Pinpointing what activities are more believability and obtainable will let both Dr. V and Mark know that these are activities to continue engaging in. These activities can be used for motivation and coping strategies. Finding out what activities are less believability is equally as important as Dr. V and Mark can discuss reasons why they are less believability and if they are something Mark actually wants to work on and maintain. The same can be said for monitoring severity ratings. This lets both Dr. V and Mark know what areas are more emotionally severe and gives room to discuss and develop treatment planning. Additionally noting more emotionally distressing activities leaves room for a discussion on what automatic thoughts were being experienced which can be later discussed in future sessions.
Thoughts and emotions are closely linked, so it may be hard for some clients to be able to differentiate them. Our thoughts attribute to our emotions, when we experience a negative automatic thought, we typically feel negative emotions shortly after. Clients are coming to therapists to work on their psychological distress, which may mean they do not understand the difference between their thoughts and emotions. It is important to know the difference between the two due to their similar and connected nature. We know that our thoughts and emotions are connected thus creating behaviors. If clients are able to know the difference between thoughts and emotions, this will then help them work on their behaviors. Being aware of negative automatic thoughts will warn the client they may experience negative emotions and or behaviors. They will then be able to obtain a new perspective and make the changes necessary to eliminate these thoughts or emotions.
Feb 23, 2023 @ 14:58:15
Hi Gitte, I like your connection between the thoughts and emotions with the behaviors of the client. A lot of times the behaviors are what people on the outside notice first when interacting with someone under psychological distress, but in some cases the behaviors are the last thing to change in therapy.
Mar 01, 2023 @ 17:44:31
Hi Gitte, I completely agree with what you have discussed about believability and severity ratings. It is important to observe both the higher and lower ratings to determine what activities are obtainable for Mark to complete. These topics of discussion are important in sessions to help Mark gain more awareness of his thoughts and feelings during his daily activities. He can refer back to these daily activity logs to change routine or patterns that he defaults to when something upsetting has occurred.
Feb 23, 2023 @ 11:02:24
Mark should add some specific activities to his daily activity schedule: outdoor activities, some sort of social event, and his process of waking up / getting ready. For the outdoor activities, Mark stated that he wanted to walk his dog and garden more because he enjoys doing those things. Those would be great activities to improve Mark’s mood and bring him pleasure after work. Mark should also incorporate social events, such as going out with his girlfriend or hanging out with some of his friends. Mark stated that social events usually cause him to feel stressed, but if he plans the social event thoroughly he may enjoy it more. Mark also mentioned that he struggles to wake up and be productive in the morning. He suggested eating a good breakfast might help start his day on a more positive note. Monitoring the client’s thoughts and emotions can be helpful for future cognitive work because it allows the client and clinician to get a better understanding of how the client feels during and after their daily activities. Tracking their thoughts and emotions may reveal a pattern that will spark discussion in the following session.
Clients may confuse their thoughts and emotions due to a lack of education on the difference between the two. They may believe that emotions and thoughts can be used interchangeably and no one has corrected them. In addition, the individual may find it challenging to identify how they feel so they express their thoughts instead. If this is the case, it is important that the clinician provides the client with examples of emotions and thoughts to demonstrate how they differ but are interrelated. If clients do not pay attention to how they are feeling then that also poses a challenge. The clinician and client need to work together to bring awareness to the client’s thoughts to better understand their feelings.
Feb 24, 2023 @ 13:38:46
Hi Taylor, I liked that you brought up wanting to see Mark plan events with either his friends or girlfriend. As mentioned, and as seen in the videos, Mark has talked about how going out can be stressful and how he internalizes certain situations when they are not as planned. Having Mark take the time to plan out a dinner with his friends or girlfriend a few days ahead can alleviate this distress. Furthermore, providing education on thoughts and emotions to clients will allow them to understand the difference between the two and explain how they connect. It is important to bring that sense of awareness as this can lead to developing strategies to help the client’s automatic thoughts. Nice post!
Feb 23, 2023 @ 13:57:07
Based on what I know about Mark I would like to see walking his dog, spending time with his girlfriend/going out, waking up early, eating breakfast and seeing friends on his daily activity schedule. These are all the activities and tasks that Mark has mentioned where he finds enjoyment in. This would ensure that Mark can start his day off on a good note and have things to look forward to throughout his day.
Monitoring the client’s thoughts and emotions can help with determining where negative automatic thoughts arise from. It could also help point out where the client is least motivated or causing them distress. By monitoring thoughts and emotions the therapist will be able to plan treatment around it and work towards shifting negative thoughts into more positive ones. It will also give the therapist a chance to work with the client to change what is needed.
To clients it may be difficult for them to differentiate thoughts from emotions because they might not understand that they are two different things considering they come up at the same time. I think it is important for the therapist to explain the difference and present some examples so the client is able to monitor the two and understand the difference when they are experiencing certain thoughts and emotions. This will also positively impact the clients experience in therapy allowing them to work through their thoughts and emotions and learn how to shift them into positive ones.
Feb 25, 2023 @ 20:58:59
Hey Reba,
I like how you stressed the importance of monitoring one’s activities. The client and clinician can discuss their day, how they felt about each activity, and what thoughts were going through their minds. By doing so, they may find automatic thoughts occur during certain activities, times of day, or settings. This information allows the clinician to tailor the treatment plan to ensure client success. Very nice post!
Feb 23, 2023 @ 14:51:07
Mark should work on including social and outdoor activities because they are things that he has mentioned several times throughout the videos. Making a plan for their date nights well ahead of time may benefit Mark and Melissa because it would take out some of the stress that comes from choosing, and it can act as something to look forward to at a certain time of the week. Planning to take the dog for a walk in the park may also be something for Mark to look forward to and is a relatively healthy thing for him to do. These two activities should maybe not be on the very first schedule on the same day as they will be somewhat difficult to accomplish, but beyond that, I think Mark should work on adjusting his morning routine so that he is able to put a few checkmarks down. Taking the little wins may help get him through that part of his day, just saying he was able to get out of bed and brush his teeth might be a good thing for him to look at and feel accomplished.
If Mark were to monitor his thoughts and emotions, it might give him and the therapist more insight into how he gets through his day and the real struggle. If there is a specific thought that is keeping Mark down or some emotion that he has an issue getting over, tracking those things will help identify a potential solution. Having a believability rating will also indicate whether these thoughts are passing through or a reoccurring phenomenon.
We experience our thoughts and emotions in such quick succession that we may not know where one ends and the other begins. For people who don’t understand the connection between their thoughts and emotions, it would be even more difficult to make a differentiation because there has been no distinction in the past. Some folks may not even know that their thoughts are different from their emotions, emotional literacy is far from commonplace. Knowing the difference will make addressing each individually much easier, if the person wants to change some of their automatic thoughts but only understands them to be emotions, that will make treatment much harder.
Feb 25, 2023 @ 21:07:07
Hi Kayla,
I enjoy your idea that Mark should work on adjusting his morning routine. Adding all of these activities at once may cause Mark more stress, so it is important to slowly integrate them into his life- and I agree that the morning routine should be the first addition. I too like to add somewhat easier tasks to my to-do list to prove to myself that I accomplished a lot that day.
When Mark starts getting into a routine in the morning, he may feel more accomplished and ready to add something else. This may boost Marks’s confidence too! Overall, really nice post!
Feb 23, 2023 @ 15:24:40
Based on the previous sessions with Mark, I would like to see him wake up earlier and incorporate eating breakfast in his morning routine. Additionally, I think it would be beneficial for him to walk his dog before and after work. The time walking his dog may prepare him for a stressful day at work and help him destress after. For his social relationships, having him schedule activities with his friends on the weekend or planning a date with his partner (e.g. a gardening date or walking his dog together). These social interactions would provide him opportunities to get out of his house and not self-isolate.
Monitoring his thoughts and emotions would help track any maladaptive thoughts and negative emotions that are present during specific activities. With this information, the client can be more aware of their thoughts and feelings. Additionally, the believability and severity ratings are helpful for cognitive work in allowing the clinician to address specific thoughts that clients may have experienced. The clinician can help clients process those thoughts that have come up when participating in specific activities. Moreover, the clinicians may encourage Mark to incorporate more activities that he enjoys and invokes a feeling of accomplishment.
Thoughts and emotions can be difficult to differentiate because they can be perceived simultaneously. Automatic thoughts are reflexive and can present themselves without any awareness. One’s emotions can be influenced by automatic thoughts, which can bring up feelings that are difficult to associate with reflexive thoughts. Additionally, words used to describe emotions may be attributed to thoughts, blurring the distinction between them. It is important to understand the difference because this distinction may help clients change their maladaptive thinking. By being aware of their automatic thoughts, clients may manage their responses to stressful situations.
Feb 23, 2023 @ 16:55:10
In the future I think that it would be good for Mark to be able to wake up in time to both have a good breakfast and walk the dog. However I’m not positive that it would be realistic to start off with all of those activities in the morning. I think that I would start with a wake up time that would leave him feeling less rushed and allow him time to have breakfast, and then schedule time to take the dog out later in the day. A walk with the dog should give Mark both some exercise and some emotional support. I also liked Dr Vs idea of scheduling and working out the details of date night ahead of time so that it would be less stressful and rushed. Mark’s relationship seems like a potential point of support that should be taken advantage of and appreciated.
Since thoughts and emotions are connected, recording both may give us insight into the beliefs that lead to an emotional disturbance. Mark’s depression seems to be linked to thoughts about worthlessness, loneliness and isolation, which leads to feelings of sadness, and hopelessness. Although we have a general idea of the themes, it could be useful to understand the specific situations where these thoughts come up. Additionally, moments of strong emotion might be good points to investigate for important automatic thoughts.
CBT talks about thoughts and feelings in a way that is more precise than our common language. I think that a lot of people use the word feel to describe intuitive cognition that isn’t entirely conscious, rather than to refer to an emotion. Automatic thoughts typically are very quick, intuitive, and not always immediately conscious. A lot of people refer to “thinking” when they mean slow and deliberate cognition. Quick, emotionally charged thoughts may seem very distinct from intentional thought, even though they are both cognitive. Often it seems like we remember how we felt about a thought more than the specific thought itself. This is especially true of strong emotions. Emotions very rationally proceed from thoughts. If we perceive something as unjust, it is entirely natural to respond with anger. Because of this natural connection I think that we are inclined to see thoughts and feelings as one unit of meaning.
Feb 25, 2023 @ 12:46:24
Hi, Jonas! I like that you recognized that squeezing in breakfast and a dog walk may be too much to fit in before work. One of Mark’s goals is to wake up earlier, so he feels less rushed to make it to work on time. Mark could begin with breakfast and take the dog out to the yard to use the bathroom. Over time, Mark can train his body to wake up earlier and earlier, which may allow him to eat and take the dog for a walk while still getting to work on time.
Mar 01, 2023 @ 17:52:09
Hi Jonah, I liked how you differentiated between thoughts and emotions. The swiftness of how emotions are often entangled into thoughts which can influence how people define thoughts and emotions. When asking people what they are thinking, I often receive someone talking about their emotions. Psychoeducation regarding these two concepts can help clients understand how to change their thoughts and better understand why they may have certain emotions.
Feb 23, 2023 @ 22:08:41
Watching the videos and lectures, I think that would be important that Mark Daily Activity Schedule includes the tasks that not only seem to have a significant effect on his thoughts and emotional aspects, but also the ones that he evaluates as important to himself. I would encourage Mark to keep tracking a schedule where one of the goals would be to wake up early, and complete his morning routines, in order to enjoy his breakfast time, the way he wants to. Listening his narrative, another significant trigger that links to Mark mood is the difficulties he experiences when planning and taking decisions about how and where to have a good time with his girlfriend. I think would be important for Mark to plan and communicate to his girlfriend his plan, in order to have sufficient time to prepare, and arrive on time to the planed event/place. It seems as one of the activities that means a lot to Mark is walking his dog. For instance, encouraging Mark to incorporate some of the above activities to one another might be a beneficial daily goal, such as having a date in the park early in the morning, while walking the dog. Therefore, even when completing partly one or the other tasks would help Mark understand more about the ways he thinks and feels when modifying and planning his daily activity in this particular way.
2. Monitoring Mark thoughts would be important to help him understand and identify both his strengthen and weaken areas. In addition, monitoring his thoughts would help Mark to track their patterns, the effect they have in his emotional state and behavior, and also the long/short terms consequences that they have on his activities. Completing “homework” such as daily activities would not only help Mark to identify the above facts, but also would help the therapist track the negative patterns that client is experiencing. Therefore, collaboratively they would be able to use the needed techniques and goals settings to help the client improve his cognitive mindset and emotional state.
In contrast to the professionals in the field, for clients might be hard to differentiate emotions and thoughts because when experiencing a specific situation (especially difficult one). They are not always aware about the thinking process, but instead tend to be focus on their emotional experience. Therefore, they might have a hard time viewing the situation more objectively and realistically, and instead they are concentrating on their emotive interpretation. As Dr.V discussed cognitive distortions could also play a role in these cases, where the client has the tendency to view the situation into more extreme lens, and is unable to see other factors that are rational to the situation.
Feb 25, 2023 @ 18:14:42
Hi Olgena,
You make a great point about trying to find different ways where Mark can communicate his plan to his girlfriend ahead of time. That way she can be just involved in making sure the plans are successful. If they are making plans to go out to dinner as a couple it could help alleviate Mark’s anxiety and stress if he knows his girlfriend is also helping to make sure the night is a success. Another thing Mark can do is to maybe implement a buffer time when he is going out so he won’t be late. This means that if they know they have to be at dinner for a reservation at 6 pm then they should plan to be there by like 5:30-5:45. This would give them extra time to drive there, find parking, and check in. It would cause a lot less stress for both of them and allow them to have a nice night without that excess worry.
Feb 23, 2023 @ 23:36:36
After watching the therapy sessions between you (The Clinician) and Mark (The Client) I think the main thing I would really like to see is Mark making more time for himself in the morning as this would allow him more time to do the things he loves. He mentions that he loves to make a nice breakfast with his girlfriend and take the dog on a walk when he has extra time in the morning. He mentioned that these simple tasks make him feel happier, but he often doesn’t have the time for this. Since these small tasks seem to uplift his mood, I think finding ways for him to implement these tasks into his morning would greatly impact his mood for the day. Since he seems to find joy in walking his dog, if it’s possible he should implement certain times throughout his day when he can take his dog on a walk, even if it is just a short walk around the block. Another big thing I would like to see Mark do is to make more time for social events, such as going out on dates with his girlfriend or meeting up with friends in general. Mark seems to have quite a lot of anxiety about setting up plans as well as executing them. Being able to monitor his thoughts and emotions around these certain activities can give the clinician a better opportunity to detect patterns in the client’s behavior.
Being able to monitor the client’s thoughts, emotions, and believability rating is essential when it comes to cognitive work. It can be very difficult for a client to identify a specific emotion as well as separate their emotions from their thoughts. Being able to monitor these three things can help the client and clinician determine what is causing the most stress in their life and affecting their positive progress. Also monitoring these three things can help a client go back and use the previous thoughts and emotions to better understand how they think and feel in the future. Consistent monitoring of the client’s thoughts and emotions can help them become more self-aware.
The biggest struggle some clients have when engaging in therapy is knowing how to differentiate their thoughts from their emotions. It’s very common for people to get thoughts and emotions confused as they tend to go hand in hand. Thoughts tend to become very automatic, which is one part that can confuse individuals, because emotions may be heightened and tied to those specific thoughts. Being able to separate these two can become very confusing, especially if it occurs as an immediate reaction to their environment. The psychological response that the client may feel from a specific thought/event can cause the individual to place that emotion with that specific thought. Building awareness for the separation of thoughts and emotions can drastically help the client better understand and address their maladaptive behaviors. Being able to separate the emotion from the thought and identify why they feel this way can allow the client to find ways to better cope and address the more negative thoughts.
Feb 24, 2023 @ 13:32:13
Hi Stephanie, I completely agree with you wanting to see Mark making more time for himself in the mornings. Mornings seem to be very important to Mark, so seeing him get up even half an hour earlier may help him manage his mood better throughout the day. I also agree with your statement on how difficult it can be for clients to separate their emotions and thoughts. Monitoring emotions and thoughts are not only beneficial for therapists to collect data and see where pertinent issues are but help clients know where their distress is stemming from. Great post!
Feb 25, 2023 @ 19:48:05
Hello Stephanie,
I like that you make a strong point about the importance of monitoring the clients’ thoughts and emotions. This process does not only help the client and the clinician identify and examine these elements, but is also an important part of the CBT structure that is supported by standardized instruments, interventions, and homework that best serve the clients’ corresponding conditions . Without the use of these weekly/daily tasks would be hard to analyze the given narratives and statements objectively.