Topic 6: Automatic Thoughts & Core Beliefs {by 3/4}

[Automatic Thoughts] – Watch MDD-11: Automatic Thoughts – Modifying.  Answer the following: (1) Did the client provide some realistic possible alternative explanations? How would this information be helpful in modifying his own negative automatic thought? (2) The client was able to separate himself from his negative automatic thoughts relatively easily. What made this particular technique especially helpful for this client? (3) Is there another Socratic technique that might be effective in modifying the client’s negative automatic thought?

 

[Core Beliefs] – (1) What are core beliefs?  (2) What are the therapeutic gains that come from modifying core beliefs?

 

Your original post should be posted by the beginning of class 3/4.  Have your two replies posted no later than 3/6.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

65 Comments (+add yours?)

  1. Connor Belland
    Mar 01, 2021 @ 11:27:39

    1.) Mark was able to come up with a few realistic alternative explanations such as maybe he was actually busy with work or wasn’t feeling up to it. This information was helpful for him because he was able to see the situation from Jeff’s point of view and look at the situation in a less negative more realistic way. He was still “filling in holes” but this time in a more realistic and less negative way. In the future now hopefully this will help him have more realistic automatic thoughts and not as many negative thoughts as he can now hopefully use this idea of viewing a situation from other perspectives.
    2.) Mark was able to use this alternative explanation thinking separate from this negative automatic thoughts. He also realized that he had forgotten about a second transaction he had with Jeff where he said they should try to go out for lunch next week. Mark realized that the separate emotions brought on by the initial negative automatic thoughts may have been clouding his comprehension of this second event which should have made him feel better but didn’t even remember it happened until later when he had begun to view the overall situation deeper. Conveying to him the difference between thought and emotion was important here because it helped him see just how powerful the emotion was caused by negative automatic thoughts that it could cloud his judgement, seeing the alternatives of the thought and changing it also helped him see the whole situation with Jeff more realistically.
    3.) When Mark tried out the activity of looking at the situation if it happened to someone else it helped him to modify his thoughts a bit. He looked at it as if it had happened to Melissa. He was able to quickly come up with some alternative explanations for her and realized how easy it was to view the situation from a different lens if he was in a different role or wasn’t personally involved with the situation. This sort of depersonalized the situation for him and realized he was being unrealistic with his earlier thinking when he saw it from more of an outside perspective. Looking at the situation form a variety of perspectives helps him modify his thinking about the situation
    Core Beliefs-
    1.) Core beliefs or sometimes called schemas are our minds templates that are formed and modified based on experiences we have during development. They are things we believe to be true or our view on a certain situation based on past experiences that influence our automatic thoughts and whether they will be negative or positive. These core beliefs become less modifiable the older a person gets.
    2.) Core beliefs have a strong influence on a persons decision making and their automatic thoughts so it can be very helpful to modify some of these core beliefs. Many core beliefs can be learned from experiences but aren’t always accurate or valid and can skew a persons automatic thoughts. Modifying these negative core beliefs can help people view situations more realistically and therefore have more realistic automatic thoughts. Helping clients “discover” their own core beliefs can really help them modify them and see situations and have more realistic or accurate automatic thoughts.

    Reply

    • Althea Hermitt- Mcpherson
      Mar 01, 2021 @ 15:06:47

      Hey Connor, I like that you mentioned schemas and how they are formed and continuously modified based on the experiences we have during development. It would make sense that we would believe these things to be true based on our experiences. It just goes to show how much culture impacts the way we think, feel and behave as it serves to influence our automatic thoughts. The importance of cultural competence in the work we are embarking on is also vital when we look at how factors such as genetics and biological vulnerabilities, significant events, and social interaction with primary supports contribute to an individual’s core beliefs.
      I am very happy that negative core beliefs can be modified because if not this could lead to chaotic situations and unrealistic expectations like you mentioned.

      Reply

    • Beth Martin
      Mar 02, 2021 @ 02:01:08

      Hi Connor,

      You make a great point about how the depersonalization really seemed to help Mark. He seems to really benefit from looking at things from an outside perspective without “him” clouding things. I’d be really curious to see if this helps him in other situations too, or if it’s mostly helpful when Mark already has some thoughts about how things could be interpreted and isn’t too deeply down the rabbit hole.

      Thanks for posting!
      Beth

      Reply

    • Tayler Weathers
      Mar 03, 2021 @ 13:45:02

      Hi Connor! I think you’re spot on by saying “Core beliefs have a strong influence on a person’s decision making”! Core beliefs influence the situations people put themselves in, the people they keep around them, the opportunities they accept and turn down. It’s kind of like that saying “we accept the love we think we deserve” – if someone believes they are worthless or unlovable, then they make decisions that match that. They might not go on a date, or not even ask. I think this would be a great thing to explain to clients. Like reciprocal determinism, the things we think about ourselves and feel change our behavior and influence our environment, and vice versa.

      Reply

  2. Althea Hermitt- Mcpherson
    Mar 01, 2021 @ 14:49:16

    (1) Did the client provide some realistic possible alternative explanations?
    I think Mark did come up with some realistic alternative explanations for Jeff’s not going to lunch with him. The alternative explanations Mark came up with are:
    1. Maybe Jeff was legitimately busy.
    2. Jeff has gone out with me multiple times before so maybe he does like me.
    3. Sometimes Jeff initiates spending time together and does ask to go out to lunch.
    4. Even though Jeff didn’t go to lunch that day he did say that they should try to do something next week.
    How would this information be helpful in modifying his own negative automatic thought?
    This information can help Mark to examine the evidence and come up with his own alternative explanations in the future instead of ruminating or feeling so beaten down with his negative automatic thoughts.

    (2) The client was able to separate himself from his negative automatic thoughts relatively easily. What made this particular technique especially helpful for this client?
    It was helpful for Mark to separate himself from his negative automatic thought because he believes it so much that even without evidence he still tends to feel these intense emotions. This will help Mark to see the flaws in his own core belief and thinking. It will also allow him to realize that there might be alternative explanations for the situation. It is also helpful for Mark to learn how to look at the situation from another lens by separating himself from his thoughts by thinking about what he would tell someone else who is going through the same situation. He will be able to practice coming up with some positive alternative explanations he can tell himself once confronted with these negative automatic thoughts. It can also help Mark to see that Jeff’s response might not have had anything to do with him personally based on all the evidence of potential alternative explanations. This can also help to remind Mark that his thoughts can be habits that he can challenge and break especially when he feels like an upsetting situation has occurred.

    (3) Is there another Socratic technique that might be effective in modifying the client’s negative automatic thought?
    Assessing the impact of believing the negative automatic thoughts: This technique helps to assess the clients’ distress and consequence of believing or not believing certain negative automatic thoughts. In the case of Mark, the therapist could use this technique to assess Mark’s belief that his friends don’t like him or want to spend time with him. Therefore the therapist could ask Mark, what is the outcome of believing that your friends don’t like you or want to spend time with you? What is the outcome of not believing that your friends don’t like you or want to spend time with you? What could be the outcome of changing your thoughts? This will be helpful for Mark because it gets him to start thinking differently which can result in different emotions and behaviors.

    [Core Beliefs] – (1) What are core beliefs? (2) What are the therapeutic gains that come from modifying core beliefs?
    Core beliefs refer to an individual’s deepest level of beliefs which helps to organize how that individual interprets, processes, and deal with incoming information from the environment. Core beliefs are generally rigid, overgeneralized views of oneself, others, and the world. Whenever a situation occurs the individual deeply held beliefs that are at the core and central to influencing human behaviors aids in the cognition of the situation. The core beliefs an individual holds about a situation will determine their emotional experience, their behavioral response, and their physiological response. Many factors contribute to an individual’s core beliefs these include, genetics and biological vulnerabilities, significant events, and social interaction with primary supports.
    Therapeutic gains that come from modifying core beliefs are as follows:
    1. Modifying core beliefs helps clients to shift their perspective and therefore how they interpret, process, and deal with situations and the world.
    2. Modifying core beliefs also can be helpful in altering emotional experiences, physiological responses, and behavioral responses.
    3. Modifying Core beliefs can help the client focus on changing their thinking by letting go of those negative core beliefs and focus on building new or reshaping old core beliefs in order to become more adaptive.
    4. The individuals in this case Mark will be able to reduce his current and future stressors without help from a therapist.
    5. The Therapists can now focus on other presenting problems.
    6. Modifying core beliefs can help the client to look at themselves in a more positive light, for example in Marks case, He will begin to accept that he is worthy of being loved by others and that he will not be loved by all but by some and that it is ok to not be loved by all.

    Reply

    • Beth Martin
      Mar 02, 2021 @ 01:57:11

      Hi Althea,

      I liked how you tied in core beliefs to how Mark’s worthlessness is impacting how he assesses his interactions with his friends – it really helps illustrate how “core” they are! I agree with how the separation of emotion from the self with Mark will help him get some practice in how to come up with alternative explanations for negative events in his life too. I’d imagine the more practice he gets, the easier it will be in real life when he’s stressed out.

      Thanks for posting!
      Beth

      Reply

  3. Bibi
    Mar 01, 2021 @ 20:32:18

    [Automatic thoughts]
    1. I felt like the client was able to provide realistic alternative explanations. For example, in the thought that Jeff doesn’t want to hang out with him, he acknowledges the fact that he might just be busy and then relates it back to his own life and the fact that he has also been really busy these past few weeks. He was also able to think about his own situation and relate that back to his friend. He was able to understand that his friend might be working on something, his supervisor might have dropped a bunch of work on him, or he might just not have the energy for social interaction. I think it really worked for this client to be able to step into the other person’s shoes and that really helped him change his automatic thoughts.
    2. I think that the fact that the client was so open and ready to discuss the problems was what made this method effective. He even acknowledges that if he was talking to Melissa that he would tell her all of the alternative explanations that he had come up with in this exercise. He was able to separate the problem form himself and he acknowledged that he would give the same advice to someone else but that it can be difficult then to tell himself the same advice. I think that it helped him realize that there were clear alternative explanations and that it might be easier to separate himself from the thought and experience directly and instead think about what he would tell someone else. This helped him see the thought as less threatening to himself personally.
    3. I think that evaluating how much he believed each thought was true/helpful would have been really effective. It seems like he realized pretty quickly as he was going through them that his automatic thoughts might not be as realistic as he had previously thought. I think it would have been interesting to see how he would have rated the thought before the modification/ explanation process and how he rated the thoughts after.
    [Core beliefs]
    1. Automatic thoughts can be considered as external representations as internal core beliefs. For example, if you have the thought that “they don’t want to hang out with me because nobody loves me,” it could be the result of the core belief “I am unlovable.” Core beliefs are deeply ingrained in the individual and are the source of automatic thoughts.
    2. Modifying automatic thoughts can be helpful to most clients. However, getting at the source of these automatic thoughts and modifying the core beliefs can be really important to changing the way that the patient thinks. However, if a therapist is working to change an individual’s negative core beliefs, it is important that they be replaced with more positive alternatives (for example, “I have reasons to be loved by others” in contrast to “I am unlovable”). Modifying negative core beliefs has the ability to further change the frequency and content of negative automatic thoughts. This can change overall outlooks on life as well as dimmish distress felt by the individual. Overall, modifying an individual’s core beliefs can provide substantial benefits in terms of reducing distress and changing thought patterns.

    Reply

    • Althea Hermitt- Mcpherson
      Mar 01, 2021 @ 21:41:25

      Hi, Bibbi I also felt like Mark was able to provide some nice realistic alternative explanations. I liked that you mentioned that Mark was able to think about his own situation and got a new understanding that Jeff might have been working on something, his supervisor dropped on him last minute, or that Jeff might not have the energy for social interaction. I also think if Mark has a lot of practice examining the evidence and separating himself from his thoughts it can help him to change or challenge these automatic thoughts that come up when potential upsetting situations occur. I think Dr.V also did a great job with psychoeducation and the therapeutic relationship which could have made it easier for Mark to be open and ready to separate himself from his negative automatic though.

      Reply

    • Tayler Weathers
      Mar 03, 2021 @ 13:47:25

      Hi Bibi! I agree that looking at Mark’s belief would have been effective. He might realize that, before he remembered that Jeff came back and asked for a rain check, he believed it a lot; but then after, not so much. Mark’s affect seemed to brighten a bit after this revelation, and he got more interested in the work, I think because he could tell that he didn’t believe it as much anymore – so having him evaluate believability on a regular basis with the evidence might be the difference between him stewing for an hour versus a day.

      Reply

    • Lilly Brochu
      Mar 04, 2021 @ 09:26:16

      Hi Bibi!

      It is important to highlight that Mark was able to relate his own feelings and experiences, and rationalize that another person may also have similar experiences as well. By taking the perspective of others, Mark seems to understand and challenges his own automatic thoughts a bit better. Going forward, I really feel as though perspective taking or evaluating the evidence are two techniques that should be used to identify and modify Mark’s negative automatic thoughts because they are so effective at this point in therapy.

      Reply

    • Christina DeMalia
      Mar 06, 2021 @ 14:16:30

      Hi Bibi,

      I agree that it would have been really interesting to see Mark process and rate how much he believed the automatic thoughts he had about Jeff. Obviously he believed them strongly in the moment, because he spent time ruminating about it after while eating alone, and saw it as something major that effected his whole day. However, even just talking through the situation in this session, he seems to realize that the thought is not all that realistic. He is slow to come up with alternative explanations at first, but he is eventually able to find them. This process also helps him remember that Jeff did come back to his office at the end of the day and suggest they do something some other time. What was interesting about this is that as soon as Mark started to come up with some alternative explanations or evidence against the thought, more positive thoughts came up such as remembering this conversation with Jeff. If Mark takes the time to examine how realistic and truthful some of his automatics thoughts are, it might give him the push he needs to focus on some evidence for more positive thoughts.

      Reply

  4. Beth Martin
    Mar 02, 2021 @ 01:53:27

    Automatic Thoughts

    1) Mark was able to come up with some realistic possible alternative explanations when discussing his friend, Jeff. While Mark has previously said that he thinks that Jeff blowing him off means he doesn’t like him, he was able to come up with alternatives. Jeff may have been genuinely busy, and he did suggest going out for lunch on a different day. Mark being able to provide realistic alternative explanations to his automatic thoughts is helpful. It provides insight into how Mark sees his thoughts, and the rationale around them. If he is already thinking that Jeff is actually busy vs. hating him, he has done the groundwork for providing himself “evidence’ in the future when he’s fixating and going down the rabbit hole as to why Jeff (or another friend) doesn’t have time for him. This will help him change is automatic thoughts in the future, having practice rationalizing them out.

    2) Being able to separate himself from his emotions helps Mark massively as his emotions heavily influence how much he endorses his negative automatic thoughts. When he felt incredibly hurt and rejected by Jeff, he was unable to see the past his negative automatic thoughts due to that strong emotion, despite the evidence around him that would have told him his thoughts were incorrect (Jeff was at work, offered to go out and grab lunch on a different day). This separation means that Mark can learn how to look past his emotions and focus on the specific automatic thoughts, evaluating them and determining if they’re negative and maladaptive, or genuine.

    (3) I think, along with examining the evidence, assessing the impact of believing the negative automatic thoughts could be a helpful and effective Socratic technique for modification. Mark seemed to really benefit from separating himself from his negative automatic thoughts, and I think that increased sense of awareness, from any angle, of the impact they can have is helping him. Sitting down and discussing what Mark believes are the consequences and outcomes of this thoughts could increase this awareness. Also, working through a scenario where he challenges this negative automatic thought and walks through how changing his thoughts would impact his life/emotions seems like great practice for learning how to challenge them in the future.

    Core Beliefs

    (1) Core beliefs are internal, extremely rigid, and an overgeneralized view we hold about ourselves, the world around us, and how things work (e.g., socially). Therefore, they act as guidelines that give us rules for how we process information we get. They are also “all-or-nothing”, meaning there’s no grey or middle ground when it comes to core beliefs, we hate someone based on our rigid views or we don’t – there’s no “meh, they’re alright”. Core beliefs exist in three main categories: helplessness (“I’m unable to do anything right”), worthlessness (“I’m a bad person”), and unlovability (“I’m a bad person who’s unable to do anything right, why would anyone love me?”). These negative core beliefs are biased, meaning individuals who have them ignore evidence that proves them wrong in favour of anything that supports them. Finally, they tend to develop in childhood and teenage years, with biological vulnerabilities and significant life events contributing to their development. Despite the negative core beliefs having a poor effect on clients, there are some that are positive and adaptive, helping people cope with stressors they encounter.

    (2) There are many therapeutic gains that can come from modifying core beliefs. Firstly, it reduces current distress that an individual is experiencing, and it gives individuals a “buffer” against any other events that cause them pain. Core beliefs can lead to extremely negative world views and therefore taint the perspective of an individual in therapy. Modifying them can help change how a person looks at their current situation, especially if they have strong impacts on their automatic thoughts, e.g., an individual who has a core belief that they are unloveable may have automatic thoughts that assume that their friends and loved ones don’t care for them, and begin to self-sabotage. Modifying this core belief, in this example, would help lessen the intensity of their negative automatic thought. Core beliefs can be the foundational building blocks for several aspects of negative thoughts and emotions, so modifying them should have knock-on effects in therapy and affect.

    Reply

    • Anna Lindgren
      Mar 05, 2021 @ 10:49:25

      Hi Beth,

      You raise a good point in how much Mark’s negative automatic thoughts are affecting him, so much that he doesn’t register the direct evidence against it (Jeff stopping by to make plans later). I think your suggestion of weighing the consequences of believing his negative automatic thoughts is a good one. Mark is already showing increased self-awareness, which is the first step to modifying. This technique, as you said, would further prompt more self-awareness with his thoughts and provide more of a framework to handle future negative thoughts as well.

      Reply

  5. Tayler Weathers
    Mar 03, 2021 @ 13:41:55

    [Automatic thoughts] 1. Yes, Mark gave some realistic (though very vague) possible alternate explanations for why Jeff might not be able to go to lunch with him. Most of them were that Jeff was just busy. I think this is useful to Mark because he understands stress at work, and seems affected by it – so he could relate to that possibility and maybe it felt more real. It’s also the most realistic. Of course people might be busy at work, or stressed! That’s kind of how work goes, for the most part. 2. Mark was able to separate his negative automatic thought so easily, I think, because his negative automatic thought (and the root core belief) is so personal. It was easy for him to give explanations to the hypothetical Melissa because he seems to assume she is liked, loved; he at least knows that he likes/loves her, so he doesn’t assume that people would turn her down for personal reasons. Plus, maybe since she doesn’t work at the same place (presumably) he could come up with other reasons without his own emotions. In any case, it was less emotionally charged for him to believe that Melissa’s coworker would turn her down for a valid reason than it was for him. I think that’s because of his personalization and the weight he gives to his own affect (i.e., he felt crummy after Jeff turned him down, so he kind of assumed that he was right and Jeff hated him). 3. I think it could be useful to look at the impact of believing the negative automatic thought: there was a clear correlation between feeling bad, sad-eating McDonalds, feeling worse, and then forgetting that Jeff circled back at the end of the day. I know Mark seems to acknowledge the negative beliefs, and even said “maybe I’m dwelling too much on the negative,” but I think spelling that out could be useful so when he does feel that way, he could remind himself why that isn’t a useful thought. I also think decatastrophizing could help by giving him some tools to respond to the situation. Jeff is busy? Okay, ask another coworker. Call a family member or friend who might be free. Try to watch a video you like. Get the sub you wanted, or at least don’t eat alone in your car! Finding solutions to stop the backslide I think would be very helpful.

    [Core beliefs] 1. A core belief is a “rigid, global, overgeneralized” belief about the self, others or the world. Core beliefs are like “worldviews” or “lenses” that people use to interpret data, kind of like assumptions. Importantly, core beliefs are the foundation for automatic thoughts and emotions, so a negative core belief might lead to negative automatic thoughts and negative emotions, like it seems to with Mark. 2. Modifying core beliefs is important because it is the only way to really create long-lasting change. You can train individuals to respond to negative automatic thoughts, but the one day they’re too tired to do so can cause a backslide. Or, the one time they seem confirmed by the data. So, changing the negative core beliefs helps immunize (like the video says) against some of those bumps in the road. It also makes cognition more streamlined, because having to catch yourself on a negative automatic thought forever would be exhausting! So, if you can start to automatize thinking “well, he doesn’t hate me, so he must be busy,” your life will go a lot smoother.

    Reply

    • Yen Pham
      Mar 05, 2021 @ 12:44:13

      Hi Tayler,
      Thank you for your posting! I have enjoyed to read it and I agree with you that along with Socratic technique that might be effective in modifying Mark’s negative automatic thought it will be helpful if we provide him a knowledge of decatastrophizing could help by giving him some tools to respond to the situation. As you mentioned if Jeff was busy we can suggest Mark to call others or do some other his favorite thing such as watch a video. However, I think that it is also helpful if we guide Mark to shift attribution biases. In the case of Mark, we know that he seems to have an internal attribution rather than external attribution. So, we can shift his internal to external attribution by asking an open question like that “Do you think other factors that make Jeff could not go out to have lunch with you rather than you thought he did not care about this relationship?”

      Reply

    • Nicole Giannetto
      Mar 11, 2021 @ 18:19:57

      Hi Tayler. Great post! I liked how you offered several examples of decatastrophizing that Mark could use. These mentioned support systems that Mark could reach out to if he needed some cheering up, or just to catch up in general. One good thing Mark could do is to identify a few supports he could call if he needed, and also maybe note a few places or kinds of food that he would enjoy or find comfort in going to/eating.

      Reply

  6. Elizabeth Baker
    Mar 03, 2021 @ 15:30:23

    [Automatic Thoughts]
    1) Mark did provide some realistic alternative explanations in that he said Jeff was not intentionally trying to make him upset, or make him feel that Jeff did not want to spend time with him, and that he was probably extremely busy and did not have available free time due to his excessive workload. Mark also stated that he would not know how he would respond if he were in Jeff’s shoes, but he did consider that Jeff was busy despite his initial remark (in last week’s vignette) of Jeff not looking too occupied. Having these alternative explanations will help Mark reanalyze his encounter with Jeff and consider factors that he either missed or dismissed due to his negative feelings and upset mood. While he continues improving his skills in processing his experiences and coming up with alternative explanations for distressing situations, he will eventually be able to validate or invalidate automatic thoughts that develop from future negative encounters and will use these skills instead of only ruminating about the upsetting encounter(s).

    2) I believe Mark was able to separate himself from his negative automatic thoughts because he instantly remembered his latest interaction with Jeff. That is, he remembered that Jeff had checked in with him, asking if he wanted to do something together. He also remembered that he and Jeff have a routine of checking in on one another and that sometimes Jeff does initiate interactions and asks to hang out. Remembering this invalidated Mark’s negative automatic thought of Jeff not wanting to spend time with him and not liking him, and made him feel silly about even getting upset over the encounter. Remembering these moments also allowed Mark to reanalyze his encounter with Jeff and allowed him to realize that there were factors that he missed and dismissed due to his negative emotions and thoughts during the negatively perceived interaction.

    3) I believe the Socratic technique of decatastrophizing perceived negative outcomes would be helpful in Mark’s current situation. This technique will help Mark process the worst possible outcome, which may be that Jeff does not want to be around Mark anymore and the friendship diminishes, and come up with potential coping strategies to identify and alleviate the distress that will follow this worst-case scenario. He will then be able to process the best possible scenario, which may be that Jeff would apologize to Mark after the workday is over and explain why he responded with his dismissive tone. Finally, Mark will process a more realistic scenario, which may be understanding that Jeff was actually busy and that he will ask Mark to hang out when he is available. Mark will then individually scale all three of these scenarios and come up with moments that validate his ratings. Thus, allowing Mark to have multiple perspectives of his encounter with Jeff and considering possible factors that made the interaction distressing, and allowing Mark to challenge and alter his negative automatic thoughts of Jeff not liking Mark or not wanting to hang out with him.

    [Core Beliefs]
    1) Core beliefs are the foundation of our cognitions, personal factors, and how we perceive the world. Core beliefs are formulated as we develop and experience various events throughout our childhood and adolescent years, sometimes even in our adulthood. They influence how we perceive ourselves as well as the world, and influence our internal (e.g., processing events) and external behavior when interacting with the environment.

    2) Core beliefs can hinder one’s ability to function adaptively in distressing situations; as in Mark’s case, for example, he may have the core belief that he is undesirable, which influenced his automatic thoughts of Jeff not liking him nor wanting to spend time with him after he quickly dismissed Mark’s invitation to do something together. These automatic thoughts made Mark extremely upset as he believed that Jeff no longer wanted to be friends, and he continued ruminating about the experience. Modifying core believes allows the client to truly analyze their own experiences during childhood or adolescence that have caused them to develop negative core beliefs, thus allowing them to go through the process of validating and/or invalidating these core beliefs. Doing so will alleviate some distress in the client as s/he finally understands why s/he has been responding negatively to various situations. Modifying core beliefs also allow the client and therapist to identify some of the client’s positive core beliefs and coping habits that can help the client adjust their behavior during current and future distressing events. Additionally, modifying core beliefs allows the clinician and client to collaborate on effective interventions now that the clinician understands the client’s core beliefs and how their core beliefs influence how they interact in their environments.

    (It’s also my birthday tomorrow!! :])

    Reply

    • Cassandra Miller
      Mar 03, 2021 @ 19:24:20

      Hi Elizabeth,

      First of all, Happy Birthday 🙂 tomorrow!

      I like that you brought up the idea that core beliefs are especially significant to one’s functioning in distressing situations. Negative core beliefs tend to make individuals exhibit increased stress in these situations, often with other negative thoughts such as rumination. With the example you used for Mark it became obvious that his automatic thought of Jeff not wanting to spend time with him immediately reinforced his core belief of being unlikeable/unlovable. I also liked the fact that you mentioned that the weight of this negative thought influenced the core belief so much that he was unable to view Jeff rescheduling as a way to alter the automatic thought or core belief to recognize that he is liked by his friend (since someone that does not like you would not ask to reschedule). All in all, great reflection!

      Reply

  7. Anna Lindgren
    Mar 03, 2021 @ 17:53:38

    [Automatic Thoughts]
    1. Mark was able to identify other possible explanations for Jeff not wanting to go to lunch with him. The strongest evidence was the fact that Jeff came back to Mark’s office at the end of the day to make plans for the following week, a fact that Mark forgot in his initial retelling of the event because he was so focused on the negative emotions he was feeling from the initial interaction. Although, the fact that he forgot this detail is very telling of the level of distress he felt from the initial encounter, and that he was possibly screening out evidence against the automatic thought/core belief. Mark was able to come up with lots of other explanations when he was coached to take Jeff’s perspective and think of some possible reasons why he wouldn’t be able to go to lunch other than simply not wanting to spend time with Mark. The collective evidence against the negative automatic thought will help Mark to reprogram his thinking patterns in the future. With practice, when he has a negative emotion from an interaction, he can identify the negative thought and modify it by considering the evidence against that thought.
    2. Using his girlfriend, Melissa, as an example in the “separating the self from the thought” exercise was helpful because Mark was able to come up with even more evidence against the thought extremely easily. He was even self-aware of the fact that it was easier for him to refute the negative thought when thinking about it happening to his girlfriend as opposed to himself. This was helpful because when Mark was thinking about the situation hypothetically affecting his girlfriend, someone he cares for, he was able to rapidly think of numerous pieces of evidence against the negative automatic thought. With practice, he may learn to extend the same kindness to himself and be able to challenge his own negative automatic thoughts more easily.
    3. I think that another Socratic technique that may have worked well for Mark would have been de-catastrophizing the event. In this technique, Mark would be asked what the worst possible outcome, best possible outcome, and most realistic outcome of the event would be if it were to happen again. This can help him regulate his thoughts better in the long run by thinking more logically about the consequences of the event, instead of believing his negative automatic thought is valid without question.

    [Core Beliefs]
    1. Core beliefs are an individual’s most central and strongly held ideas about the self, others, and the world. Aaron Beck theorized that negative core beliefs generally fall into one of two categories: unlovability and helplessness. These negative core beliefs may go unnoticed by the individual until they are in a period of psychological distress (e.g., during a depressive episode). Core beliefs are formed from an individual’s personality and past experiences.
    2. Since core beliefs tend to be the root of negative automatic thoughts, modifying core beliefs can improve clients’ overall cognitive wellbeing and therefore their emotional wellbeing. It may take a while for the client to go from intellectually understanding that the core belief is not valid to truly believing it and replacing it with a more adaptive core belief. Once the client has modified the core belief, their negative automatic thoughts relating to it should decrease, and therefore the negative emotions that those thoughts bring on will also decrease.

    Reply

    • Cassandra Miller
      Mar 03, 2021 @ 19:33:36

      Hi Anna,

      I really liked your idea of using the Socratic technique, de-catastrophizing the event, for Mark. I think if he really looked at the worst and best possible outcomes, he would be able to find some middle ground that is less catastrophic. I also think it would help him realize that the chance of this negative outcome that he perceives as valid being true (Jeff not wanting to be his friend) is actually much less likely than he figures; which can open him up to the idea that there are positive outcomes that have the potential to occur. You are right when you say that this will help him alter his thoughts to more logical ones. Maybe even allowing him to become more aware of the dramatic negative response that he had to this negative automatic thought about Jeff.

      Reply

    • Lilly Brochu
      Mar 04, 2021 @ 10:06:05

      Hi Anna,

      Mark’s ability to perspective take when being prompted to pretend to give Melissa guidance about the same problem as his own can be seen as a major strength of his. In therapy, this strength could be used as a tool going forward in being able to identify his negative automatic thoughts in a more objective way. From watching this week’s video, I have hope that Mark will be able to sense a pattern in his negative thinking through this technique (and others), and will be able to identify and modify his thoughts in a more adaptive way.

      Reply

  8. Cassandra Miller
    Mar 03, 2021 @ 19:02:43

    1.
    Mark did provide some realistic possible explanations when Dr. Volungis asked him about other reasons why Jeff may have decided not to go grab lunch with him. Two of the main ones that Mark brought up were:
    1) He’s really busy and probably has some deadlines to get done (so this invitation decline may have had nothing to do with Mark)
    2) Just because he is supposed to be working on xyz does not mean he has it all done or is doing it in a timely manner – Dr. V further challenged this by adding that Mark is sometimes stuck with additional work that his supervisor randomly drops off for him so it is possible that this same situation may have occurred with Jeff
    3) They have gone out many times before
    4) Jeff has asked him to go out before
    5) Jeff could have actually been busy
    6) Jeff asked him to reschedule for the next week at the end of the day
    This information was very beneficial as it allowed Mark to view this situation from a different angle, outside of his own emotions. Once he considered alternative explanations for the thought, he was left unsure about its validity. In addition, the evidence that he used against the thought also allowed him to remember a very important detail, which was that Jeff had stopped by his office at the end of the day asking to re-schedule for next week. This detail, though significant, had been blocked by Mark due to the overpowering strength that his negative automatic thoughts and overarching belief of being unlovable had on him.

    The technique of separating himself from his negative automatic thoughts did provide a very easy task for Mark because it allowed him to view the thought with more clarity. By thinking about what he might say to his wife, he was able to think much more rationally because he was not clouded by his own negative self-views (enhanced by his state of depression). He cares about his wife and provides rational information to Dr. Volungis in regards to how he would respond to her in this imaginary situation; as far as even saying that the friend might be lactose intolerant and can’t eat at the restaurant (which is a stretch). He quickly rattled off ideas with a dramatic difference in his processing time because this strategy allowed him to think about the thought on a much deeper level. He then was able to apply it to himself again and felt a little silly for his prior strong emotional response to the negative automatic thought (“Jeff doesn’t want to spend time with me”).

    Another Socratic technique that might be beneficial for Mark could be shifting attributional biases. This technique focuses on asking the client if there could be any other people or related factors that influence the outcome of this situation, even if only a little (specifically for Mark his negative automatic thought). Mark did have an interesting response when Dr. Volungis asked him to keep his evidence for the thought specific to Jeff and this situation. Mark had tried to refer to other situations with friends and then seemed to feel a little taken aback when he only listed two pieces of evidence for this automatic thought (especially when it was carrying so much weight for him). Thus, it could be useful to examine other factors that could influence these negative thoughts, such as when his other friends cancelled on their dinner plans with him and his wife. This strategy could prove quite helpful in separating certain event associations that strengthen certain negative automatic thoughts.

    2.
    Core beliefs are the general rules that influence how one acts in specific situations. These rules shape how one views others and how they evaluate them. They can more specifically be described as beliefs that are broad and general that one holds in their mind based off of experiences/events that have shaped the way they view certain situations. Thus, these beliefs become a lens for the way that a person interprets a situation and can lead to many negative automatic thoughts confirming this belief. The individual is often not aware of the belief or the negative automatic thought that is supporting it, rather they accept this generalized view as accurate and logical. It also influences the way that one judges the efficacy and appropriateness of their actions and can significantly influence one’s perception of their own worth. The more negative a core belief, the more likely that individual will have negative automatic thoughts supporting it.

    There are many therapeutic gains that come from modifying core beliefs because the individual is able to start changing the way in which they perceive events. By altering this lens, they begin to examine negative automatic thoughts and change the amount of weight they allow them to have. In turn, these thoughts begin to occur less and less which begins to limit the validity of the prior negative core belief. It also changes the emotions that these individuals experience in regard to negative core beliefs as they are able to recognize that these thoughts are not valid and thus do not feel as poorly about them. By altering these core beliefs to more positive versions, the therapist can make many gains as the client begins to experience an increase in positive affect.

    Reply

    • Alexa Berry
      Mar 04, 2021 @ 14:27:00

      Hi Cassie,

      I think you make a great point when you say that Mark had blocked out the fact that Jeff had gone and asked him to go out to lunch the following week. To me, this seemed as another instance of Mark discounting the positive. Mark tends to get very upset by the feelings his automatic thoughts provoke and has strong behavioral responses as well. Your rationale for Mark using the “shift attributional biases” technique was interesting to me because this was not one of the strategies I had considered for Mark to use, but after reading your explanation I agree with you. Some other socratic techniques I thought he could use were decatastrophizing or assessing the impact of believing negative automatic thoughts.

      Reply

  9. Anne Marie Lemieux
    Mar 03, 2021 @ 22:35:47

    With support and prompts, Mark did a great job of coming up with possible realistic alternative explanations to why Jeff would not want to have lunch with him. It also created an epiphany that Jeff had come back to him and asked him to try again another time. A detail he appears to have previously appraised as irrelevant. Yet, upon reappraisal using the tool of the thought record he was able to identify as benign-positive. In examining the evidence he was able to recognize the distortion of his thought. Which in turn will help him to be better able to objectively question his thinking verses assuming all of his automatic thoughts are true based on emotional responses to them. In imagining how he might guide Melissa through this same scenario he was able to depersonalize the event and not have it automatically take on a negative lens. He was able to show appropriate empathy and perspective that he had previously denied himself. Another Socratic technique that may have been beneficial to this process could have been having him assess the impact of believing the negative automatic thought. For example he could have been asked “What could be the outcome of changing your thought?”.

    Core beliefs are the deeply held values or beliefs about how we view ourselves and the world. They are typically developed at an early age through social and family interactions, positive and negative life events, including trauma, and genetic predisposition including temperament and cognitive capacities. Over time these beliefs are solidified through reciprocal reinforcement. There are multiple benefits to working with a client to modify negative core beliefs. The first is it can positively impact how they see themselves and in turn how they experience and perceive their life. It can also help to reveal positive core beliefs that have been shadowed by the negatives. In enhancing the positive core beliefs clients will hopefully have adaptive coping strategies to independently manage psychological distress in an adaptive manner.

    Reply

    • Maya Lopez
      Mar 04, 2021 @ 18:37:44

      Hey Anne-Marie,

      I love how you used the word appraisal because that’s exactly what happened, Mark didn’t appraise Jeff coming to him later in the day as anything positive or important because he was so busy ruminating and stuck in his own negative automatic thought cycle. I also think you brought up a good point about empathy and that he would have shown Melissa lots and denies it for himself. Mark has a tendency to overlook the positives and focus on negatives which I think inhibits him from having some empathy for himself.

      Reply

    • Michelle McClure
      Mar 05, 2021 @ 18:43:40

      Hi Anne Marie. I really liked how you brought out that Mark was able to do some really great work with support and assistance. I think that is one of the most important things that happens with therapy, why you can’t always get the same result from a self help book. Another person offering you their expertise and wisdom but also their support and encouragement. I think talking someone through things is much more helpful and encourages insight that the person may be unable to get to on their own without the support and encouragement of their therapist. Have a good weekend.

      Reply

  10. Lina Boothby-Zapata
    Mar 03, 2021 @ 22:42:04

    [Automatic Thoughts]

    1) During the exercise of examining the evidence – AT Table 7.7 Mark provides the following information for his AT “Jeff doesn’t to spend time with me” For Mark the evidence was “the fact that Jeff didn’t make eye contact, he was typing” (no verbal cue). Jeff answered, “I don’t have time for this” (Verbal cue). Then, the counselor and the client went into the exercise of looking for evidence against the thought or other explanations. Mark identified other possible explanations; “Jeff was legitimate busy”, “Mark has gone out with Jeff before for lunch mostly on Fridays”, “Jeff stopped by at his door and he said let’s do something this week”. “Jeff sometimes has come to Mark to offer to go out for lunch.” The first insight for Mark is that he can’t believe didn’t take in consideration the evidence against the thought. He agrees that the evidence against the thought is accurate Further, this provides the counselor the opportunity to point it out about how the Automatic Thoughts are invasive and repetitive. The client probably doesn’t realize about them. And also, this an opportunity to begin to talk about core beliefs.

    2) During the session, the counselor asked Mark to go a little bit further with Separating the self from the thought. They pretended that Melissa (Mark’s girlfriend) had a similar situation, and she looks distressed and she said something similar like “Jackie didn’t want to go out for lunch today”. Mark came up with different reasons about Melissa’s situation; “maybe Jackie didn’t have the money,” “maybe she didn’t have the time,” “maybe she ate already,” “maybe she was busy,” “maybe she is lactose intolerant.” After Mark realized this exercise with the counselor he realized that he provided with multiple explanations and helped the client to detach from the experience and reduce the intensity of the feelings related to the situations.

    3) Mark is the “ideal” CBT client and makes the sessions so smoothly and naturally that the techniques come out by itself. Hen I will this J Beck technique “Testing Your Thoughts Worksheet” Table 12.2 According to J Beck, this is a simplified version of the Recorded Thoughts. This is an opportunity to Mark to train himself for the future when he is not longer in therapy but a new challenge could emerge. Furthermore, this worksheet combines Socratic techniques such as; decatrastophization, alternative explanations, the impact of believing a thought, separating self from the thought, and the downward arrow.

    This worksheet has the following questions
    1. What is the situation?_________________________________
    2. What I am thinking or imaging? _________________________
    3. What makes me think the thoughts is true?________________
    4. What make me think the thought is not true or not completely true? ___________________
    5. What is another way to look at this? ___________________________
    6. What’s the worst that could happen? What could I do then? __________________________
    7. What is the best that could happen? _____________________________
    8. What will happen if I keep telling myself the same thought? ____________
    9. What could happen of I change my thinking? ________________________
    10. What could I tell my friend [think of a specific person] if this happened to his or her?______

    [Core Beliefs] –

    Core beliefs are the template that provides our rules for our information processing. These rules or lenses with which we interpret the world are characterized as rigid, global, and overgeneralized views about the self, others, and how the world works. According to with CBT theory, there are three categories of core beliefs. The first category is helplessness; this category represents the individual’s ineffectiveness in getting things done, protecting oneself, and achieving. The second category is worthlessness in terms of bad, unworthy, dangerous to other people. And the third is Unlovability; this category was added J. Beck lately during her investigations. It is important to remember that we don’t need to modify all core beliefs; sometimes it is unnecessary. Changing Automatic Thoughts maybe be enough because they are no long-term values. Real true patterns, maybe a Negative AT are an external representation of the core beliefs.

    Key elements of the core belief are; Usually comes from childhood and adolescence, contributing factors including significant events and people with biological vulnerability. Negative core beliefs can be shaped and replace for more accurate core beliefs and develop throughout history. Core beliefs have a genetic/biological predisposing; negative core beliefs are biased. A savvy therapist will use positive core beliefs to modify the negative core beliefs.

    [Benefits]

    Benefits of changing negative core beliefs. Dr. V brings our attention to a parallel with the vaccines that strengthen the immune system against the virus. In the same way as the CBT treatment modifying AT and core beliefs, the individual can apply his techniques/skills to new situations that he will confront. The client, in the future, will be able to cope with his AT or core beliefs if he relapses. The CBT acts as an “immunization” to resist future stressors. Another benefit is that the more we understand the client’s core beliefs, the more we know the AT. The counselor always needs to identify the client’s core beliefs. However, no every client needs to address his core beliefs.

    [Questions]

    Is it possible that an individual can develop a core belief by a present traumatic experience such as war, natural disasters, accidents, or sexual abuse? And how can we cognitively explain the formation of this new core belief?

    How can we differentiate between Automatic Thoughts and intermediate beliefs?

    What do you as a counselor when a client wants to talk about past experiences because the client argues that this is why he is suffering in the present. ?

    therapeutic gains that come from modifying core beliefs?

    Reply

    • Yen Pham
      Mar 05, 2021 @ 13:02:04

      Hi Lina,
      Thank you for your posting!
      I agree with you that along with the Socratic technique that will be helpful if we test Mark’s thoughts by Beck technique: the “Testing Your Thoughts Worksheet” Table 12.2 . I really like some questions such as (4) What make me think the thought is not true or not completely true? (5) What is another way to look at this? (8) What will happen if I keep telling myself the same thought? (9) What could happen of I change my thinking? These questions are helpful for Mark to test his thoughts. They also help Mark to modify his thoughts as well as to shift his attribution biases.

      Reply

    • Michelle McClure
      Mar 05, 2021 @ 19:04:27

      Hi Lina! How are you? It feel’s like its been awhile since we talked. I like how you talked about how much easier it was for Mark to distance himself when he used the same situation and put his girlfriend’s in it. I liked how you listed the excuses Mark was able to come up with for his girlfriend’s friend. It is funny how sometimes when you take emotion out of a situation how much easier it is to gain perspective on it. I hope you have a great weekend.

      Reply

    • Nicole Giannetto
      Mar 11, 2021 @ 18:14:20

      Hi Lina! First, I liked that you listed the questions that are used. This offers a nice visual to reference while reading the posts. I also liked how you focused on the part of the session where Mark was asked to explain what he would’ve offered for advice to Melissa if she was experiencing the same situation. Hearing how easy it was for him to come up with realistic and empathetic reasons/support showed that he knows what is the ideal way of processing these types of situations, but he needs to utilize those skills for himself when he’s experiencing these ruminating thoughts.

      Reply

  11. Michelle McClure
    Mar 03, 2021 @ 22:45:41

    1. When looking at the evidence for and against the thought Mark was able to think of several reasons both for and against. Mark was able to recognize that he himself gets busy at times and it was possible that his friend was busy. When looking at the facts Mark was able to recognize that his friend often asks him to lunch and even made a point to tell him that he would like to go out to lunch on another day. When separating himself from his automatic thoughts, Mark was able to say that he could recognize that his automatic negative thoughts were probably not true and there was likely an unknown reason why his friend could not go to lunch. When asked if there were other reasons why his friend did not go to lunch Mark was able to come up with multiple reasons why that may not be the case, both professionally and personally. This is helpful in modifying his negative automatic thoughts because by examining the evidence against the negative thought it makes the thought seem less believable.
    2. Mark was able to separate himself from his automatic thoughts after some time passed and he was able to look at the situation less emotionally and more objectively. He was even better at separating himself when he tried to see the situation as though it had happened to Melissa. Mark was able to make several excuses for Melissa’s friend without much effort. Mark was able to come up with more excuses for Melissa’s friend then he was able to do for himself and his friend and did so quickly.
    3. I think a good technique to use when trying to get a client to modify a negative automatic thought is to have the client assess the impact of believing that automatic thought. This technique would help the client to recognize the amount of distress that the negative automatic thought is causing them and how much less distress they would feel if the negative automatic thought was not true.

    Core Beliefs
    1. Core beliefs are deeply buried assumptions and central ideas that guide our behavior, how we see ourselves and how we perceive the situations in our lives. They are deeply held beliefs about ourselves, other people, the world and how the world works. These beliefs are typically created in childhood or adolescence and are resistant to change and though usually subconscious has an important impact on our lives, for positive or negative.
    2. Negative core beliefs can be and should be changed to increase a person’s optimal functioning. Negative core beliefs are resistant to change and usually require therapeutic interventions. There are so many gains that can made from changing negative core beliefs to neutral to positive beliefs. This can latterly change a person’s life for the better. Therapeutically it is beneficial because changing negative core beliefs can lessen the amount of distress a person feels in the life domain affected by the core belief.

    Reply

    • Anna Lindgren
      Mar 04, 2021 @ 15:43:17

      Hi Michelle,

      I really like the point you made about incrementally changing core beliefs. Since these beliefs are central to the way the person views themselves and how they fit into the world, it would be impossible to change it from a negative core belief to a positive one, and the client would likely feel misunderstood if we tried that approach. Instead, making a more incremental shift to a neutral core belief is a great starting point.

      Reply

    • Elizabeth Baker
      Mar 06, 2021 @ 18:51:11

      Hello Michelle,

      I think your alternative Socratic technique to combat negative automatic thoughts is a great idea. Analyzing the impact of clients’ negative automatic thoughts and how they would feel if that negative automatic thought was not true is a way for clients to separate themselves from their negative thoughts, and to generate alternative perspectives of the situation that had caused the negative automatic thought. If they find that thought to be quite impactful and true, this understanding can help the client generate coping strategies to effectively alleviate distressing emotions when the client encounters the same or similar uncomfortable experiences.
      I also enjoyed reading your definition of core beliefs, especially how negative core beliefs are resistant to change. Negative core beliefs are absolutely ridged and extremely difficult to change and takes consistent effort to alter, and as we know, sometimes individuals struggle with even identifying their negative core beliefs, as well as trying to alter them. Great post!

      Reply

  12. Lilly Brochu
    Mar 04, 2021 @ 08:58:08

    [Automatic Thoughts]

    (1) Mark provided several realistic possible explanations for Jeff’s reasoning as to why he did not want to go out to lunch. Mark mentions that…
    – Jeff is probably busy and has deadlines to meet at work
    – Jeff mentioned that they should try to go out to lunch next week instead
    – Jeff only has time to have a quick lunch in the office because of work load
    – Jeff has had a long week and does not have energy to go out for lunch
    This information is helpful because it shows that Mark can take different perspectives of others (regardless of his own feelings) and shows that there is some understanding that not everything is directly related or caused by himself. Moreover, it provides the therapist with an idea of how well Mark is able to rationalize with his own negative automatic thoughts. If Mark is able to provide different explanations for events that tend to be personalized, it is the first step in identifying, modifying, and coping with his automatic thoughts.

    (2) With Mark, I have noticed that he tends to respond better when given direct evidence that disputes or dismisses the validity of his negative automatic thoughts. For example, Mark was able to separate himself from his thoughts when Dr. V had him “pretend” to give advice to his wife, Melissa, who encountered the same issue at work. By looking at his situation through a different perspective, Mark was able to rattle off a ton of different reasons as to why Melissa’s co-worker was unable to go out to eat at that particular time (e.g., does not have money to go out to eat, they already ate lunch, busy with work). This technique in particular seemed to open Mark’s eyes a bit about how other individuals have their own things going on in their life, and it was a reminder to consider other perspectives.

    (3) Mark seems to respond well to the other Socratic techniques that are used during this session (e.g., examining the evidence, separating self from negative automatic thought). Another Socratic technique that may be effective in modifying the client’s automatic negative thought would be to assess the impacts of believing the negative automatic thought. This is typically effective for clients who have been progressing well with other CBT interventions so far. This technique involves asking the client the outcomes of believing their negative automatic thought and then assessing the outcomes of not believing it. Depending on how Mark responds after asking about his believability of the possible outcomes of his negative thoughts, this will guide the session towards understanding his differing thoughts and emotions, and how they change according to the situation.
     
    [Core Beliefs]

    (1) Core beliefs act as a “blueprint” that provides individuals with the guidelines, or rules, to process information taken in from their environment. These core beliefs tend to be “all-or-nothing” statements, and are *generally* rigid, global, and overgeneralized views about oneself, those around them, their environments, or the world at large. Furthermore, there are key characteristics of core beliefs that are important to recognize and understand. Core beliefs tend to develop between childhood and adolescence due to the significant life events and transitions that take place during this time. Also, negative core beliefs are biased due to the fact that they have been created and applied across a series of contexts and over a long period of time. Core beliefs derive from three major categories: helplessness, worthlessness, and unlovability. Individuals can have negative core beliefs that fall into just one of the three categories, or they may overlap each other. These negative core beliefs are reinforced by negative automatic thoughts, strong negative emotions, and behaviors. It is possible to modify negative core beliefs with a more adaptive approach to their beliefs. Finally, people do hold positive core beliefs about themselves, but they tend to get overlooked due to their own presenting problems or distress.

    (2) In order to provide long-term change in CBT, therapists may need to take a step further than modifying negative automatic thoughts, and explore their clients’ negative core beliefs as well. By assisting clients in modifying their negative core beliefs, the client has the potential to break free of their rigid pattern of core beliefs, and change the way they view themselves, others around them, and their environment. Moreover, modifying negative core beliefs tends to alleviate a great amount of distress for the client because it helps to modify or change the source of where the negative automatic thoughts are coming from. It is also important to identify, improve upon, and use any positive core beliefs the client has already or develops throughout therapy to highlight their strengths, and how they benefit them in and outside of therapy.

    Reply

    • Lina Boothby-Zapata
      Mar 05, 2021 @ 20:45:23

      Hi Lilly,
      thank you for your post, I like the way that you describe core beliefs, it is simple and you touched all the bases. I was wondering about the core beliefs if is it possible that an individual can develop a core belief by a present traumatic experience such as war, natural disasters, accidents, or sexual abuse? And how can we cognitively explain the formation of this new core belief? It seems to be that it is possible to create positive and negative core beliefs. I am still wondering what is the cognitive process that happened to have a new core belief. It is amazing for me to know that in some circumstances mental health disorders can be created at present time, I had the idea that psychopathology was originated in childhood due to traumatic or significant experiences. Another question is that, if we developed in our adulthood negative core beliefs that evolve into Depression, do we have the same capacity to heal and no having the diagnostic anymore?

      Reply

    • Elizabeth Baker
      Mar 06, 2021 @ 19:18:10

      Hello Lilly,

      I really enjoyed reading your definition of core beliefs. I liked how you stated that core beliefs are the foundation of various cognitive distortions and that they are biased to the situation that caused them to develop. That is, the negative core belief of “I am unloveable” may have developed from an individual experiencing abuse, neglect, and frequent ostracization from family and friends. Thus, that biased view of “I am unloveable” from these past negative experiences leads the individual to have a biased view about themselves, which will influence how they interact, or not interact, with their environment. I also liked how you stated positive core beliefs tend to be overlooked due to the more intense and distressing situations individuals experience. It is so important to help clients discover their positive core beliefs as well as their negative core beliefs as this may help with the invalidating negative core belief process. Identifying positive core beliefs may also influence the development of adaptive coping habits as the client tries to validate or invalidate their negative core beliefs.

      Reply

  13. Yen Pham
    Mar 04, 2021 @ 10:51:53

    A. Automatic Thoughts
    1. Did the client provide some realistic possible alternative explanations? How would this information be helpful in modifying his own negative automatic thought?

    Mark provided some realistic possible alternative explanations, what would be another way to interpret what’s going on with Jeff such as he is really busy and he probably has some kind of deadlines to get done or get work done. It’s not necessarily that Jeff doesn’t have time for Mark, but maybe he doesn’t have time to go out to eat, because he needs to eat a quick lunch in the office. I think that’s some pretty good evidence against the negative automatic thought as well as this information is helpful in modifying his own negative automatic thought. Mark has time to reflect on other’s reaction. He realizes that when someone supposes to do something or to plan on something but not everything will go well as they wish because of many factors in life. Mark also aware that he may not know exactly why, but maybe other had other stuff to do that had nothing to do with him. Therefore, Mark seems to blame Jeff less than he is sympathetic and is more positive thoughts about Jeff not going to lunch with.

    2. The client was able to separate himself from his negative automatic thoughts relatively easily. What made this particular technique especially helpful for this client?
    Sometimes, having clients separate themselves from their thoughts helps to observe the context of a situation more objectively. A common method is to ask clients to consider what they would tell a family member or friend if they had a similar thought. In the case of Mark, Dr. V used this method to ask Mark such as “What if Melissa comes home from work and looks kind of distressed, distraught… You say, “How was your day?” and she says, “Well, I asked one of my friends that I usually go out to eat with for lunch and she didn’t want to have anything to do with me” and she gave similar details like yours? What would you tell Melisa if she had a similar thought as you?” This method is so helpful to open Mark’s thoughts and minds on others. He said that it is so easy to think of what he would say it to Melissa, but when it comes time to say it to himself, it’s almost impossible. However, he finally realizes that there are all sorts of different things. He thinks that it is kind of silly to distress and get upset with Jeff.

    3. Is there another Socratic technique that might be effective in modifying the client’s negative automatic thought?
    Along with Socratic questioning is a common term used in CBT that refers to asking Mark direct questions about his negative automatic thoughts to help him “get to the truth” in his own words. It will be helpful if we guide him to assess the impact of believing the negative automatic thought. This technique is relatively simplistic, and it can be effective with Mark because he is motivated and receptive to our CBT interventions up to this point. We can ask this question in general form (e.g., “What could be the outcome of changing your thought?”). Additionally, we can guide Mark to shift attribution biases. There are generally considered to be three different types of attributions are personal internal/external, permanent stable/unstable and pervasive general/specific. In the case of Mark, we know that he seems to have an internal attribution rather than external attribution. So, we can shift his internal to external attribution by asking an open question like that “Do you think other factors that make Jeff could not go out to have lunch with you rather than you thought he did not care about this relationship?”

    B. Core Beliefs
    1. What are core beliefs?
    Core beliefs involve the intermediate beliefs that include attitudes, rules, and assumptions. In other words, core beliefs are the templates that provide rules for our information processing. Core beliefs are all-or-nothing statements that are typically rigid, global, and overgeneralized views about the self, others, absolute truths, and how the world “works.”Dr. V suggests that core beliefs fit into one of three categories – helplessness, worthlessness, and un-lovability. Clients may have negative core beliefs that fall into only one category or have core beliefs that span multiple categories. In addition to these three categories, Dr. V states that core beliefs are typically expressed through at least one of three lenses: self, other people, and the world. There are six key aspects of core beliefs. First, core beliefs most likely developed during childhood into adolescence due to significant life events and people and biological vulnerability but can also develop during adulthood. Second, negative core beliefs develop over time across multiple events through a lens that recognizes only supportive information and disregards contrary information (or distorted contrary information to be supportive). Third, as noted earlier, core beliefs fit into one of three categories: helplessness, worthlessness, and un-lovability. Fourth, negative core beliefs are self-perpetuating. Fifth, negative core beliefs can be modified and replaced by more accurate/ adaptive core beliefs. Sixth, positive core beliefs often get overlooked due to presenting distress.

    2. What are the therapeutic gains that come from modifying core beliefs?
    Not all negative core beliefs are worth exploring. It is not possible or practical to fully reduce the believability of a core belief to nothing. However, modifying the core beliefs will be helpful because when you change your core beliefs, you will have a new and objective view of something or a problem happening in your life. Changing our core beliefs help us in decision making that maybe more easier and more evidence. As discussed earlier, core beliefs influence the development of our attitudes, rules and assumptions. Our beliefs can hold us hostage, which creates a constant cycle of worry. So, if we know how to modify core beliefs, we will have a greater awareness of what we believe in. We have more positive core beliefs than negative core beliefs. We also have happier than distress, and more hope than hopeless.

    Reply

    • Lina Boothby-Zapata
      Mar 05, 2021 @ 21:12:47

      Hi Yhen

      I found very interesting your comments about what any other techniques can be applied for Mark. This is because you tried to look into the type of questions carefully. I didn’t realize it and this is a contribution to my thoughts. I see that you referred to the personal internal/external, permanent stable/unstable and pervasive general/specific and then came out with the question “Do you think other factors that make Jeff could not go out to have lunch with you rather than you thought he did not care about this relationship?” I think another way of seeing your thoughts is that because Mark has a tendency of “personalizing” every situation that is not what was expected of him then, the clinician should do an effort of creating the opportunity to detach this individual, Mark from personal reasons and guide him to examine external explanations to the situation.

      Reply

    • Christina DeMalia
      Mar 06, 2021 @ 14:09:35

      Hi Yen,

      I really like the way you explained the power core beliefs can have over an individual. The idea that they can hold us hostage in a constant negative cycle really gets at how much our core beliefs influence us and why negative core beliefs are so important to change. As we’ve seen with Mark, if you have a strong core belief, you’ll always notice and hold onto evidence that supports it, while ignoring any amount of evidence that could contradict it. By doing this, a person continues to focus on things that reinforce their negative core belief, strengthening it and making it even more deeply ingrained. In that way, it really is like a vicious cycle that can be hard to break out of, especially without the guidance of therapy. However it does give me a lot of hope to know that we are aware of the power of core beliefs, and that we have ways to go about modifying them. Just like negative core beliefs can form a downward spiral, modifying them to positive ones seems like it can create an upward spiral. When an individual starts paying less attention to evidence for the negative belief and more attention to the evidence for the positive one, it can create continuous progress for the person to a better mindset.

      Reply

  14. Abby Robinson
    Mar 04, 2021 @ 11:03:26

    [Automatic Thoughts] – MDD-11:
    1.At first, when Dr. V asked Mark for possible alternative explanations as to why his friend couldn’t go out to lunch, Mark seemed still down and negatively effected by the situation. After talking through it, and collaboratively coming up with a list with Dr. V, Mark seemed more aware that there are many other possibilities as to why his friend couldn’t make it. I think that collaboration in this task was necessary because at first Mark could only come up with a few things that were possible, but Dr. V was able to help and collaborate with him which then Mark could go off of to come up with new possibilities on his own- maybe he had a deadline, maybe he already ate, maybe he had a bad start to his day, etc. This is helpful to modifying Mark’s negative automatic thoughts because originally Mark’s only thinking was that his friend didn’t want anything to do with him. But, after collaboration he seemed to switch gears and say that there are many other possibilities to this situation that don’t even involve Mark. Then Mark starts to say that he feels silly for even thinking the original thought and that there are so many other reasons his friend couldn’t go to lunch. This was helpful to Mark because he was able to remove himself from the reason his friend was too busy for lunch, making him feel better.
    2. Mark was able to separate himself from the negative automatic thoughts by listing all the possibilities that his friend may be unable to come to lunch. Dr. V suggested to Mark to think of other possibilities that could create this situation, work aside. Maybe he’s having a bad day, maybe he had an argument with someone, maybe he doesn’t have enough money, etc. These reasons lets Mark think more clearly and set aside the idea of his friend not wanting to be with him. I think this was particularly helpful to Mark because he was able to see some contradictory evidence of his original negative automatic thought; shifting his emotional approach to this situation.
    3. I think another technique that was really helpful to Mark was when Dr. V suggested to think of this situation where one of Mark’s friends was himself and to give some suggestions that way. Mark said his friend Melissa would be a good choice for this. After thinking of Melissa in the same situation, Mark was able give suggestions as to why her friend couldn’t make it to lunch. After doing this, Mark said it was easy to come up with alternative reasons to the original automatic thought. This would be a good exercise for Mark to keep doing because he was able to complete this task easily and being on the “other side” of the situation opened up new alternatives that he was blinded to at first.

    [Core Beliefs]
    1. Core beliefs are the groundwork for how people process and take in and internalize information from situations or events. Usually the individual processes the information and views it as absolutely true, even if it is negative and makes them feel bad. This is how the individual views them self, others and the world. It’s how the individual views situations that shape their responses both behaviorally and emotionally.
    2. Modifying core beliefs helps the individual alleviate some, most or all of their negative emotional suffering. This is important at changing negative automatic thoughts as well because alternating how the individual views themselves or the world will then alter current, relevant situations. This is important to come up with coping mechanisms or modifications to help with future negative events the individual will have to face. There is also therapeutic gain for the therapist as well because the therapist will get a clear understanding of why/how their client thinks and feels about themselves and certain events. This understanding can help the therapist piece together the reasoning for their client’s emotions and behaviors, which can create a better treatment plan.

    Reply

    • Pawel Zawistowski
      Mar 04, 2021 @ 13:39:27

      Abby,
      I agree with your premise that modifying core beliefs can have great therapeutic results that help alleviate the emotional suffering that a person is experiencing because of the held core beliefs. By modifying core beliefs, you will also change the person’s automatic thoughts as distressing encounters unfold. Being able to pinpoint the irrational core beliefs can promote a more adaptive mindset that can have lasting and positive mental health benefits. Additionally, it can improve one’s decision making capabilities.

      Reply

  15. Nicole Giannetto
    Mar 04, 2021 @ 11:37:40

    1)
    Yes, Mark was able to provide realistic possible alternative explanations. He began by outlining evidence that supported his initial thought that, “Jeff doesn’t want to spend time with me.” For non-verbal cues, Mark identified that there was no eye contact. For verbal cues, he identified Jeff stating, “I don’t have time for this.” Mark was then asked to provide the alternative explanations for why Jeff behaved how he did during their interaction. A few ideas were: “Maybe he is legitimately busy.” or , “Maybe he was having a bad day.” These realistic alternative perspectives are helpful for modifying Mark’s negative automatic thought because it focuses him to view a situation in a different lens. By engaging in this activity, it helps Mark to think about not taking experiences so personal, and that other factors may be at play.

    (2)
    The particular technique was especially helpful for Mark was to take this scenario and imagine it was someone else he knows that experienced it, and he would engage them in identifying realistic alternative explanations. So, he imagined that Melissa came home from work upset, stating that a coworker brushed her off when she asked to grab food. Mark started to quickly list off alternative explanations that he would say to Melissa. After doing this, Mark said he felt silly in realizing how much easier it was to offer alternative explanations to someone else then it was to do so for himself. Looking at the situation from a different lens, unrelated to us personally, is what worked well for Mark.

    (3)
    Another Socratic technique that might be effective to help modify Mark’s negative automatic thought would be to utilize thought records. To do thought records, Mark will use this experience as a model, to practice looking at other events, talking about the thoughts and emotions he experienced, and then consider realistic alternative explanations. By working through this initial experience with Jeff, Mark already has a helpful template which will motivate and guide him to work through future experiences that produce negative automatic thoughts.
    [Core Beliefs] – (1) What are core beliefs? (2) What are the therapeutic gains that come from modifying core beliefs?

    4)
    Core beliefs are ideas about oneself and the world, or values they hold to be true. Core beliefs can be negative or positive in their nature, and also may be illogical, however, the individual themselves will still hold these to be true despite contrary evidence.

    5)Through learning to modify core beliefs, the client can more readily use their skill to take on the perspective of other person’s involved. By doing this, the client can offer realistic alternative explanations for why someone behaved how they did. Through perspective taking, the client can also challenge their core beliefs and how they may generalize the world around them.

    Reply

    • Pawel Zawistowski
      Mar 04, 2021 @ 13:34:17

      Nicole,
      I also agree that it is helpful for Mark to process these encounters as when he does, he comes to the realizations that it is not as personal as he makes it out to be. It appears to me that he ruminates about these encounters with his friends and I would imagine it must be emotional exhausting if such little details of every day encounters get a pretty strong reaction out of him.

      Reply

  16. Pawel Zawistowski
    Mar 04, 2021 @ 13:21:57

    Automatic thoughts:
    1.
    Yes, I believe that Mark was able to provide some realistic possible alternative explanations for why Jeff could not make plans with him. Mark was able to lean more towards his initial automatic thoughts as being irrational and even explained that if the shoe was on the other foot then he would also have likely not been able to make plans because of his busy schedule. Additionally, Mark was able to point out that Jeff has made plans with him before which does suggest that he wants to hangout with him. Also, Mark pointed out that Jeff has put in effort towards making plans with him when Jeff suggested that they should hang out at another time which also reinforced a more positive mindset and offset the initial negative automatic thoughts. However, I would like to know why he felt like Jeff would not even look at him and why he felt that Jeff avoided eye contact, and perhaps redirect Mark’s thinking that this is not necessarily indictive of the fact that Jeff does not want to spend time with him. I find it concerning that Mark internalizes and ruminate on small social ques and details of every day social encounters such as making eye contact.
    2.
    Mark did a very good job separating himself from his negative automatic thoughts after the fact. I think this is something that Mark should practice more often so that he can identify these negative automatic thoughts in the moment rather than ruminating about them. He is very successful at processing these occurrences with Dr. V, however, he will have to work on separating himself from his negative automatic thoughts on his own.
    3.
    I think that the Socratic technique that Mark would especially benefit from is viewing the negative core belief on a continuum. I believe that often times Mark gets caught up in the moment and get very overwhelmed emotionally as an encounter unfolds itself, but once he processes the encounter things begin to look not quite as negatively as he first perceived it out to be.

    Core beliefs:
    1.
    Core beliefs are deeply rooted ideas and views that we believe are true about the world based on our past transactions with the environment. They have a strong influence on our perception and interpretation of our encounters with the environment. Additionally, they impact our automatic thoughts as encounters unfold themselves. They shape our belief system and influence our decisions. Also, they are rigid but malleable and can be shaped by significant events in our life.
    2.
    There is a lot of therapeutic gain that can be made by modifying core beliefs. Core beliefs control a person’s mindset and every day experience. By modifying core beliefs, you can also change any negative automatic thoughts that occur during distressing situations. Also, being able to identify irrational thinking can help the individual have a better sense of self and a healthier mindset. It can also help that person develop coping skills during distressing situations because they are able to pinpoint core beliefs that are false. When an individual has an understanding of their core beliefs and are able to identify those false beliefs, they can begin to make progress and make behavioral changes that promote adaptive functioning.

    Reply

    • Alexa Berry
      Mar 06, 2021 @ 19:02:07

      Hi Pawel,

      In your discussion of Mark’s ability to provide alternative explanations, I like how you included a piece about Mark also being able to separate himself from the negative automatic thoughts. In watching the videos of his sessions, it seems that putting himself in other people’s shoes is an effective strategy for challenging automatic thoughts. I’m glad you pointed this out! I agree with your analysis of Mark’s tendency to overanalyze and ruminate on small details, which then leads to his behavioral withdrawal and further depressed feelings. I hadn’t considered having Mark view his negative core belief on a continuum, but your explanation and rationale for this were great!

      Reply

  17. Cailee Norton
    Mar 04, 2021 @ 13:24:58

    Automatic thoughts
    1. I think that Mark was able to provide a good amount of realistic evidence against his automatic thoughts. He realizes that his friend could have been legitimately busy (especially considering the context of the workload of the past few weeks), that if he were in his friends position he wasn’t sure what he would have replied if he had asked him the same question (though this is more hypothetical), that they’ve gone out in the past together numerous times (he called it an unofficial routine), and that he has initiated asking Mark to go out many times as well. For Mark he mentions that he feels almost silly that his reaction was so negative, especially in his casual remark that his friend even popped into his office and said he wanted to go out with him next week. The problem Mark is facing like many with negative automatic thoughts is that it is exactly that: negative. The first though Mark has is that he’s unlikeable (leading to a core belief) when in fact there is much evidence against such a ‘fact.’ Being able to sit with him and show him the evidence really laid out before him provides Mark to see what other explanations can be present when facing a situation similar to this in the future. This provides Mark the positive experience (positive in that he has worked through this automatic thought in a therapy setting with guidance and seen the possible explanations) to challenge these negative automatic thoughts as they arise in the future.
    2. I think Mark was able to separate himself from the automatic thoughts fairly well. He has a lot of conviction that his thoughts in the moment really hold true and have value, when in retrospection he realizes often there are other possible explanations for a situation and there are other ways in which he could have handled a situation and addressed a specific thought. He has insight into thinking that his behavior was silly when looking back, so working to use this thinking during stressful events is what will be best for Mark. By examining an event through a challenging and critical lens, Mark can see another situation in which a person isn’t able to go to lunch in a specific moment as just that, rather than it being an indication of their dislike of him, his unworthiness of friendship, and that he needs to punish himself his plans didn’t go exactly as he had hoped. This technique is beneficial for someone like Mark because he can look at an event critically and examine these negative automatic thoughts as they arise and look at the evidence. This technique provides Mark an opportunity to challenge in the moment and create a more positive experience when something doesn’t go as planned. Showing Mark such tools will definitely help with his personalization issues, and provide a new perspective for him.
    3. I think that examining the evidence is probably the strongest technique for Mark to enlist outside of therapy, however I think assessing the impact of these beliefs could also be very beneficial. Mark really ruminates about negative events he experiences (or events he specifically perceives as negative), so by helping Mark to really examine the impact of holding such beliefs can provide Mark some momentum to really challenge these thoughts and to attempt to gain a new perspective. He knows that the way he looks at stimuli usually leads to his withdrawal and in some cases a type of punishment, so providing the information and really having Mark stop and contemplate what these thoughts are doing for him (or against him in most cases) can provide some foundation for challenging negative automatic thoughts in real time rather than only during therapy. Ultimately the goal is to have Mark function in this way autonomously, and he is showing a lot of insight that this is possible for him.

    Core Beliefs
    1. Core beliefs are the effective templates everyone works from that provide a guide for how we process information from around us. They guide us in many ways as they are a central part to our beings. Core beliefs provide a basis from which our behaviors, thoughts, and emotions can turn maladaptive to our benefit or adaptive. Usually core beliefs develop during our childhood and adolescence from our experiences, and can be somewhat malleable in early life but become sometimes very rigid. Many clinicians use core beliefs and schemas interchangeably, which schemas refer to cognitive structures within our mind that often house core beliefs. Typically core beliefs are all-or-nothing type of statements that can be generalized to just about everything about an individual, others, and even how that person believes the world to work. Three common core beliefs we find in maladaptively functioning individuals is that of helplessness (“I’m fail at everything”), worthlessness (“I’m greatly flawed”), and unlovability (“I’m unlovable/unlikeable”).
    2. Through modifying core beliefs, we can make immense therapeutic gain through the level of distress an individual experiences daily and in the face new stimuli. If we work with a client with strong worthlessness core beliefs, the modification of “I’m a worthless person” to something like “I do have value to others, and sometimes I can see value to some parts of myself” allows for the possibility that maybe that person isn’t worthless. The rigidity of someone believing that they are worthless only sets up that person for negative emotions moving forward. Through modification of such a belief, this provides the opportunity for that belief to be disproven, for them to have value and to be good at things. This provides that individual hope, and while someone with a core belief of worthlessness may be incapable of seeing that when that core belief is present, the modified belief allows for the window of opportunity to really be shown to them and for them to experience life and make behavioral changes to experience it.

    Reply

  18. Christina DeMalia
    Mar 04, 2021 @ 13:46:59

    [Automatic Thoughts]
    (1)
    Mark was able to identify other reasons for his coworker deciding not to go out to eat with him. He was able to look at the evidence contrary to his automatic thought about Jeff not wanting to spend time with him. He recognized that Jeff had gone out to lunch with him several times before, that Jeff had been the one to ask him to lunch many of those times, and that he even came into his office at the end of the day to suggest the go out some time the next week. After realizing this evidence, he was able to form other possible explanations for why Jeff said no to lunch, such as Jeff being busy with work or being too stressed to go out. He also agreed that Jeff may have other life stressors going on that effected his answer. By realizing that there are other possible explanations, Mark can use that to change the automatic thought he had of “Jeff doesn’t want to spend time with me” to something more adaptive like “Jeff had something going on, so he wasn’t able to go out to lunch.” This removes the personalization aspect of Mark’s thinking and would allow him to think of other reasons Jeff may have said no that aren’t related to Mark’s belief of being unlikable.
    (2)
    Mark did very well with separating himself from the situation by imagining his girlfriend was the one who had a similar experience. Where Mark struggled to come up with a couple alternative explanations for himself, he quickly listed off several immediately when he thought about Melissa in that same situation. He mentioned that the person who said no to lunch might not have the money, might have already eaten, etc. The fact that he was able to come up with so many alternative explanations when he imagined someone else in the situation meant that he was able to recognize that all of those could have been explanations for his situation as well. For Mark, it is easier for him to align his explanation with the idea that Jeff doesn’t want to spend time for him, because of the underlying core beliefs he has about himself being unlikable. However, he doesn’t have the belief that Melissa is unlikable, so coming up with examples is much easier. Then applying those examples to his own situation was able to help Mark realize the ways in which his personalization led to worse assumptions.

    (3)
    I would be interested to see how Mark would do with putting the negative core belief on a continuum. He seems to be at the point in his treatment where he knows that there is some evidence against his core belief. Since we has already been able to work on modifying automatic thoughts, he is aware that there is evidence that he is not unlikable. He mentions having the different parts of his brain, the more logical one that knows he has people who like and love him, and then the part that gets stuck in the negative thoughts about himself. By placing the core belief on a continuum, Mark may be able to realize that he doesn’t always believe that he is unlikable. If there are times when he doesn’t believe that thought, it will lessen the strength and power of the core belief.

    [Core Beliefs]
    (1)
    Core beliefs are the schemas that are created by people to understand themselves, the world, or others. They are overgeneralized and global and like automatic thoughts can enter the person’s mind and effect their actions without the person being fully aware. They are usually formed during childhood, and can be supported by events over time. When a core belief is negative, it is usually a biased one and can become self-fulfilling. Negative core beliefs generally fall into three broad categories: helplessness, worthlessness, and unlovability. Core beliefs can be more difficult to change than automatic thoughts because they are so deeply ingrained in the way a person thinks, but they can be changed over time when replaced with more adaptive or positive core beliefs.
    (2)
    Although it takes work and time to build up to modifying core beliefs, it does seem like the most essential part of making real change through therapy. As Mark has shown with his progress, the more a person can change the negative thoughts they have about themselves, others, and the world, the more their daily functioning improves. Understanding and modifying automatic thoughts is an important step in that process and can help the individual start to improve and feel better. However, even if a client changes some automatic thoughts, they can still be weighed down by negative overarching core beliefs. Mark may be able to change “Jeff doesn’t want to spend time with me,” to “Jeff was busy and probably would have spent time with me if he could have.” However, if Mark still believes that in general he is unlikable, he is likely to continue to struggle with the feelings of depression that brought him to therapy. By changing a core belief from a negative one closer to a positive one, a person can shift the way they view things and process them. If Mark is able to change his core belief of unlikability to believing he is a likable person who people enjoy spending time with, he is far less likely to have those negative automatic thoughts. Instead of personalizing when someone can’t make plans, he will think of more reasonable logical explanations. This will help him from ruminating and entering a downward spiral like he typically does.
    Core beliefs are at the very center of maladaptive thoughts and behaviors in the lens of CBT. Maladaptive thoughts lead to emotions with lead to behaviors. Those thoughts, emotions, and behaviors all effect each other in a dynamic way, and can build upon each other. Therefore, getting to the root of the problems by changing core beliefs, a client is likely to see a change not only in the way they think, but how they feel and how they act as well.

    Reply

    • Anne Marie Lemieux
      Mar 07, 2021 @ 17:55:01

      Christina, I think you make an important point about core beliefs being the root of the problem. Even if a person becomes aware of negative automatic thoughts if negative core beliefs aren’t addressed, they will continue to slide back and not make long term change. I liked that you noted that the goal is to improve daily living or functioning. It gets at the heart of how significant an impact negative core beliefs can have on a persons everyday life. Not only does it make it very challenging to overcome distress. In Mark’s case he is creating the distress because of his skewed perceptions linked to his negative core beliefs.

      Reply

  19. Alexa Berry
    Mar 04, 2021 @ 14:10:51

    Mark provided multiple possible alternative explanations to challenge his automatic thought that Jeff did not want to spend time with him, such as Jeff was legitimately busy and had some kind of deadline or work to get done, he might not have had time to go out of the office and could have had lunch in the office. He also provided contradictory evidence that they have gone out to eat before multiple times and Jeff asked him to do something the following week. This process was helpful for Mark because he was able to use alternative explanations as a source to depersonalize the effects of a perceived rejection. He was able to put himself in Jeff’s shoes and see that although Jeff may unavailable for him in that moment, it was not due to anything he had inherently done to cause this. In other words, Mark was able to externalize these reasons and take the blame off of himself, since personalizing is a persistent pattern in Mark’s depressive thoughts. If a situation like this were to present itself again, it is likely Mark would have an easier time providing possible alternative explanations to view the situation more accurately. This exercise was definitely beneficial for challenging his automatic thoughts, especially in the sense that he recalled Jeff had asked him to spend time together. This was interesting because there was clear evidence against his automatic thoughts, but Mark was so upset by initial perceived rejection that he did not remember this detail until walking back through how he was feeling following this interaction.
    Although this exercise ended up working out for Mark, I would be interested in seeing him use a different Socratic technique. In this case, Mark’s automatic thought about his interaction with Jeff ended up being an inaccurate perception of the events that occurred. If Mark were to end up in a situation where someone truly did not want to spend time with him, I would be interested to see how he would react to and process this. In anticipation of this, I would like to see Mark participate in the Socratic technique of decatastrophizing perceived negative outcomes. So, if Jeff did not want to spend time with him, what could he do to cope with this? Another socratic technique I would be interested to see Mark use in this situation is to assess the impact of believing the negative automatic thought. As previously mentioned, Mark tends to personalize which leads to withdrawal. Mark appears to have a good understanding of the cognitive behavioral model and is actively involved in his sessions, so I believe he is at the point where he can examine his overall behavioral pattern of withdrawal that results from his thoughts. As stated in the text, this can be a helpful approach for clients who are especially motivated and receptive to CBT interventions, which Mark is.
    Core beliefs are a person’s most central ideas about themselves. Core beliefs develop from an early age and are global, rigid, and overgeneralized. Individuals can have either positive or negative core beliefs about the self. An example of a positive core belief a person may have is “I am worthwhile”, while in contrast another individual may have the negative core belief “I am worthless”. Most people have positive and realistic core beliefs, and negative core beliefs may only surface during a period of psychological distress. While core beliefs are central to the self, people can also have core beliefs about other people and the world such as “people cannot be trusted”.
    It is important to treat belief modification early on in therapy because once patients change their beliefs, they are less likely to process events in a maladaptive way (i.e. a client who interprets positive events that go against a negative core belief as luck or a mistake will be able to interpret these events accurately). In modifying core beliefs, patients are able to adopt new core beliefs that are more adaptive. A major benefit of changing negative core beliefs is it has the potential to change the way a client views themselves, their interactions with others, and/or the way they view the world. In doing this, an effective modification of negative core belief can diminish overall stress levels as a result of less frequent and intense automatic thoughts that stem from these negative core beliefs. Changing negative core beliefs can also be beneficial for clients abilities to face future stressors.

    Reply

  20. Carly Moris
    Mar 04, 2021 @ 14:14:37

    Automatic thoughts
    1.
    Mark did a good job providing some realistic possible alternative explanations for why Jeff did not attended lunch with him. While Mark did need a bit of questioning from Dr. V he was able to come up with a few alternative explanations and other situations that contradict his negative automatic thought that Jeff does not want to spend time with him. This info can be helpful in modifying Marks negative automatic thought because it helps to challenge the validity of the thought. After examining the thought, Mark even admitted that he was leaning toward the idea that this thought might not be valid. By coming up with alternative explanations and recognizing that the thought may not be valid; Mark may be able to come up with alternative explanations for situations that are similar to the one with Jeff, that challenge his automatic thought on his own.

    2.
    Mark was able to separate himself relatively easily from his negative automatic thoughts. This technique was helpful for Mark because he was able to recognize that he has a harder time being objective with himself. It took him a bit of time and prompting from Dr. V to come up with alternative explanations for the situation with himself and Jeff. However, when Dr. V ask Mark what he would say to his girlfriend in a similar situation he was able to come up with a number of explanations quite quickly. By separating himself from his thoughts Mark was also able to admit that he was leaning toward the idea that these thoughts may not be valid, and that he may be catastrophizing them more when it comes to himself. This is an important step in modifying these type of negative automatic thoughts.

    3.
    In this session it seems that a number of Socratic techniques were used including examining the evidence, exploring possible alternatives, and separating self from thought. First Dr. V helped Mark go over the evidence for and against his automatic thought that Jeff doesn’t want to spend time with him. Then they came up with alternative explanations for why Jeff didn’t go to lunch. By going through the evidence for and against this thought and coming up with alternative explanations Mark was able to remember that Jeff stopped by at the end of the day to ask if he wanted to do something next week. Mark was able to recognize that he was so caught up in the initial rejection that he ignored the fact that Jeff came to him later. This seemed like a particularly helpful recognition for Mark, that he gets caught up in negative events and can end up ignoring the positive, or info that contradicts the negative. Another Socratic technique that I think may be helpful in modifying Mark’s negative automatic thoughts is to shift attributional bias. Mark seems to internalize the cause of events and it may be helpful to break down how much he thinks he internalizes the cause for an event, vs how much the event called for it. Mark internalized why Jeff couldn’t go to lunch, when external factors probably played more of a role. Mark also viewed this event as something that was permanent. That because Jeff couldn’t go to lunch this time he no longer wanted to spend time with Mark. When this was more likely an unstable event and that Jeff will likely want to spend time with him in the future. I think that going over these two dimensions and what marks personal and permanent attributions were then, and what they are now or what the situation called for may be helpful.

    Core beliefs
    1.
    Core beliefs are an individual’s most fundamental level of belief, and they act as a guide for processing information. They are the way in which an individual understands themselves, the world, and others. Certain core beliefs may operate under specific circumstances, while others may be activated most of the time. Core beliefs generally develop during childhood into early adolescence, and are influenced by an individuals life events, as well as their biological predispositions. These beliefs are generally global, rigid, and over generalized. They tend to be so intrinsic to the individual that they do not question the validity of their core beliefs and instead regard them as absolute facts. Individuals tend to have a bias toward information that confirms their core beliefs, while disregarding information that contradicts them. There are three categories of negative core beliefs: helplessness, worthlessness, and unlovable. These core beliefs can cause cognitive distortions which are negatively biased patterns of thinking or patterns of negative automatic thoughts, because as previously stated negative automatic thoughts stem from core beliefs.

    2.
    There are a number of therapeutic gains that can come from modifying an individuals core beliefs. Core beliefs can effect how an individual sees themselves themselves, the world, and others. So by modifying these core beliefs we can help our clients have a more adaptive view of themselves, the world, and others. Modifying core beliefs can also help reduce the number of negative automatic thoughts an individual experiences, as automatic thoughts stem from core beliefs. Modifying a clients core beliefs can also help them deal with future stressors. They will be better able to identify and modify negative automatic thoughts when they occur, without the help of a counselor.

    Reply

    • Connor Belland
      Mar 06, 2021 @ 16:50:24

      Hi Carly, Thanks for your post! The way you explained core beliefs really helped me to understand it better. It is interesting to understand for both the client and clinician what specific situations or events cause and shape a persons core beliefs and to see which core beliefs are sort of always apparent on the daily for a client. It is also interesting that people believe that their core beliefs are an absolute fact when really they could be totally wrong but they have believed it for so long that they don’t know any other way.

      Reply

  21. Zoe DiPinto
    Mar 04, 2021 @ 15:05:51

    1. The client did provide some realistic alternative explanations to his perspective of an event. He identified that his co-worker friend may have been genuinely overwhelmed instead of purposefully dismissive. This information is helpful because the client was then able to target this previous thought: “he doesn’t want to spend time with me” as an automatic thought. The identification of the automatic thought gave room for the client to slow down and explore the evidence to validate or invalidate his thoughts.
    2. The client was asked to assume his experience had happened to his partner. Then, he was asked to offer her input on the matter. He easily rattled off 4-5 different explanations as to why the excuse of the friend was not a direct reflection of the friend’s idea of her. He was then able to explore why it was difficult for him to let himself off the hook while giving an adaptive realistic perspective to someone else.
    3. Another socratic technique that may have helped would be to have Mark explore the worst case scenario of what it would mean if his friend didn’t want to hang out with him at that moment. This would possibly allow Mark to decatastrophize and realize that his entire relationship with his friend doesn’t have to be in jeopardy even if his friend didn’t want to eat lunch with him that day.

    1. Core beliefs are internal rules and schemas about how the work works and how the self fits into the world. They are developed through childhood as a result of interactions with significant individuals, significant life events, and genetic vulnerability. Negative core beliefs will often fall into one of three categories; helplessness, worthlessness, or unlovability. Core beliefs will often drive self-image and fuel automatic thoughts.
    2. There may be many positive effects from modifying core beliefs. Some of these therapeutic effects may be impacting how the individual sees value in themself and the world. This may increase recognition of automatic thoughts and ability of seeing alternative perspectives when interacting with people and places.

    Reply

    • Maya Lopez
      Mar 04, 2021 @ 18:27:56

      Hey Zoe,

      I agree, it was remarkable how easily Mark thought of different examples when he was the one offering advice to Melissa and the fact that he thought of 4-5 including ones that he didn’t provide for himself. This technique worked very well for him because he then saw the discrepancy between his automatic negative thoughts and the regular thoughts he had regarding his advice. I also love the idea to use decatastrophizing techniques to help him see that his worth and friendship do not have to be on the line when his friend rejects lunch.

      Reply

    • Brianna Walls
      Mar 05, 2021 @ 16:11:59

      Hi Zoe! I like your idea of another Socratic technique. I think it would be really helpful for Mark to think about the worst-case scenario of what it would mean if his friend Jeff didn’t want to hang out with him at that moment. I think it would give Mark a chance to reflect on his thoughts and why it bothers him so much that Jeff didn’t want to go to lunch with Mark that day. Further, I think Mark will realize how outrageous his thoughts are and just because Jeff denied going to lunch with him this one time does not put their friendship in jeopardy.

      Reply

  22. Maya Lopez
    Mar 04, 2021 @ 15:30:32

    (1) Did the client provide some realistic possible alternative explanations? How would this information be helpful in modifying his own negative automatic thought?

    The client did have some realistic alternative evidence such as Jeff being busy, having to meet deadlines, maybe he needs to eat a quick lunch. Mark also reiterated that perhaps it’s not about him perhaps it really is just because Jeff couldn’t spare the time that day. As Dr. V pointed out maybe he didn’t have the energy to go out or had a stressful long day himself, and Mark seemed to nod along to this. It is helpful he is beginning to see alternative explanations and not stuck in tunnel vision that the only reason jeff didn’t want to go was because of Mark himself which perpetuates his core belief of his unlikability. The more rational evidence he can give towards alternative explanations the more likely he will be able to do that in a behavioral experiment and will ultimately change his negative automatic thought.

    (2) The client was able to separate himself from his negative automatic thoughts relatively easily. What made this particular technique especially helpful for this client?

    I was surprised how easy it seemed for Mark to separate himself when using melissas’ perspective. When he was asked what he would say to her given her boss not wanting to eat lunch with her, he quickly came up with multiple reasons and some different ones than the ones he offered for himself. The reasons were: maybe they don’t have the time, money, busy, maybe they already ate. This technique was very helpful to him and I think it can be a lot easier to be nicer to others than it is to be nice to ourselves.

    (3) Is there another Socratic technique that might be effective in modifying the client’s negative automatic thought?

    Another Socratic technique that could be used would be to examine the advantages and disadvantages of believing the thought. Mark might say that his rumination on how jeff doesn’t like him lead him to overlook the positive thing he said at the end of the day which was that he would like to get lunch another day. Thus believing this thought was a disadvantage to how he was feeling.

    (1) What are core beliefs?

    Core beliefs are very strict, absolutist, views or thoughts that are global and affect how other thoughts are processed. They are the core from which other thoughts about oneself stem from and are hard to change because they are the framework. An example of one would be “I am lovable” and therefore that person attributes others’ actions and their own thoughts to feed into that core belief such as “this person did me a favor because I am lovable”.

    (2) What are the therapeutic gains that come from modifying core beliefs?

    The therapeutic gains that come from modifying core beliefs are that clients will feel less distress and that they have control over their negative automatic thoughts. It also helps them deal with future stressors by applying the adaptive skills learned in therapy. Overall clients with healthier core beliefs will tend to view the world differently, in more adaptive happier ways.

    Reply

    • Zoe DiPinto
      Mar 04, 2021 @ 17:11:24

      Hi Maya!

      I like your idea of using the socratic method of exploring advantages and disadvantages of believing the automatic thought. After watching the lecture videos, I can see theoretically how this socratic technique can be beneficial to a client. However, I am concerned that using this method will come across as condescending to the client. Asking why they would believe that thought if it is hurting them seems to be putting the clinician in an offensive position. Perhaps there are better ways to phrase the question, but I can see clients being annoyed at this tactic and think “I dont WANT to believe it, but I do.” The client thinking this seems to decrease their sense of agency. If the intervention is phrased as a challenge, I would be worried that a client may lose their sense of autonomy over what they believe.

      Reply

    • Brianna Walls
      Mar 05, 2021 @ 17:47:05

      Hi Maya! I really liked your Socratic technique. I really think that Mark would benefit from examining the advantages and disadvantages of believing his specific thought. Mark would benefit from this technique because he will hopefully realize that his thought that Jeff doesn’t like him is ridiculous and so out of proportion because he will realize that at the end of the day Jeff asked if they could go out to lunch a different day.

      Reply

    • Anne Marie Lemieux
      Mar 07, 2021 @ 17:40:41

      Maya, I think you make a good point about core beliefs being at the core of who someone is. I think it is especially hard to change core beliefs. Clients have been building skewed evidence to support their negative core beliefs for a very long time. Core beliefs are powerful but can be changed through CBT interventions.

      Reply

  23. Brianna Walls
    Mar 04, 2021 @ 15:35:24

    1. Mark was able to come up with some realistic possible alternative explanations such as “Jeff could have actually been busy” and how Jeff did offer to go out to lunch with him a different day. This information would be helpful in modifying his own negative automatic thoughts because Mark is able to really think about the situation as a whole. For instance, if Jeff didn’t like Mark why would he offer to go to lunch with him on a different day? Also, Mark can relate to Jeff, Jeff could have just been very busy with work and had a deadline coming up. Mark is always talking about how work is stressful and that he needs to make his deadlines, so what if Jeff was just trying to meet a deadline for work?
    2. Mark was able to separate himself from his negative automatic thoughts fairly easily. I believe what helped Mark make this particular technique helpful to him was how he was very open to talking to Dr. V about his negative automatic thoughts and by separating himself from them he was able to see them from a different perspective or lens sort of speak. Mark realized that his negative automatic thoughts were very unrealistic when he did this. I think then is when he was able to see the other side to his negative automatic thoughts such as “Jeff was probably just busy with work” instead of “Jeff doesn’t like me.”
    3. Another Socratic technique that might be effective in modifying Mark’s negative automatic thoughts is to assess the impacts of believing that negative automatic thought. For instance, the therapist will ask the client what they think the outcome would be if they believed this automatic thought and then asking the client what they think the outcome would be if they didn’t believe it. This may guide Mark in the right direction in trying to understand his negative automatic thoughts a little more and to reveal the distress this automatic thought is providing him.
    1. Core beliefs are defined as all or nothing statements that are very ridged, global, and overgeneralized. They are views about the self, others, and how society or the “world” works. They are templates that provide us rules for our information processing. In other words, a core belief maybe “I am unlovable” this statement is a deeply held assumption about the self and it is firmly embedded in one’s thinking and they significantly shape one’s reality and behaviors. Another example of a core belief might be “the world is dangerous.” This is a held assumption about the world and how one views it. Further, there are three categories of core beliefs, helplessness, worthlessness, and unlovability. Core beliefs are typically developed during childhood into adolescence. However, they can be modified or replaced by more accurate/adaptive core beliefs.
    2. There are a few therapeutic gains that come from modifying core beliefs. One of the most obvious is reducing one’s current distress, but it will also help as an “immunization” to resist future stressors, meaning that by modifying one’s core beliefs now they will learn how to do this in the future on their own and they will have little to no distress in the future. Another therapeutic gain that comes from modifying core beliefs is during therapy the therapist and client will uncover positive/adaptive core beliefs that will help the client cope now and in the future. They can be uncovered and strengthened all while working on negative core beliefs. Lastly, once the therapist and client have a comprehensive understanding of their core beliefs, associated negative automatic thoughts, and reinforcing behaviors this will help with treatment and with interventions.

    Reply

    • Tim Cody
      Mar 06, 2021 @ 00:50:54

      Hi Brianna,

      I like what you say about assessing the impact of believing the negative automatic thoughts. Ideally, this may help them see reason in their negative thoughts, but sometimes these negative automatic thoughts are justified. if they still believe them to be true, how should the therapist go about assessing the potential outcome? Even if they are not true, but the client is resistant to believing the alternative, what should the therapist do? I would suggest continuing to assess the outcome of both believing and not believing the negative automatic thought, and continue to dig into finding the future outcome. Hopefully the client will see what is right for them. If not, perhaps a different Socratic technique will help as well.

      Reply

  24. Tim Cody
    Mar 04, 2021 @ 16:01:29

    [Automatic Thoughts]
    (1) One of Mark’s main negative automatic thoughts is “Jeff doesn’t like me and doesn’t want to be my friend.” He usually has these thoughts when he has plans for lunch with him and his friend has to cancel. His automatic thought jumps to a more inclined solution that does not benefit Mark’s mental health or depression. However, he was able to come up with some realistic alternative solutions. His friend could actually be busy and he may only have time for a quick lunch instead of a longer sit-down meal. He also suggested that there was another time when his friend came to him at and asked him to get together next week. This is evidence against Mark’s automatic thoughts. Sometimes stepping back and viewing other alternative explanations can help Mark to not get entangled by his negative automatic thoughts.
    (2) When Mark is able to separate himself from his negative thoughts, he is able to look at things from a different point of view. People with depression and who experience negative automatic thoughts usually are egocentric and only are able to look at things from their own perspective. When Mark can separate himself from his negative automatic thoughts, he able to see alternative explanations as to why his friend cannot meet with him.
    (3) Another Socratic technique is assessing the impact of believing the negative thought. This helps the client’s distress and consequences in believing their certainty of the negative automatic thought. This can also help the client to associate the thought with the negative emotion or feeling that is coupled with it. They can then assess the potential outcome of what would happen if the negative thought were not true, if that makes a difference in their mental health, and replace it with new thoughts that are true.
    [Core Beliefs] –
    (1) Core beliefs represent the “core” of the cognitive disturbance. These beliefs form in early childhood and are based upon our past experiences. They are global, rigid, and overgeneralized beliefs that are often regarded as absolute truths. The older we get, the less we are able to internalize our core beliefs and the less we believe them to be true.
    (2) The therapeutic gains that come from modifying core beliefs because the negative automatic thoughts that are often entangled with one’s core beliefs. If one is to come to terms with their realistic, positive core beliefs, then they can have a more adaptive approach to their therapy. Modifying these beliefs is no easy task, though. It involves identifying the false belief and driving thoughts and emotions that are associated, using psychoeducation to modify them, and put the beliefs into action and behavior.

    Reply

    • Zoe DiPinto
      Mar 04, 2021 @ 17:02:30

      Hey Tim, you make a great point that if Mark separates himself from his automatic thoughts, he is more likely to see alternative perspectives. This makes me wonder about a person’s ability to see other perspectives. I wonder if some individuals are inherently better at seeing other perspectives than others. I believe symptoms of depression and anxiety contribute to a decreased ability to see other perspectives. However, I wonder if some individuals are better at seeing other perspectives (whether it be from nature or nurture) and that is naturally defending them against rumination. Perhaps an ability to see other perspectives is part of a persons personality?

      Reply

      • Tim Cody
        Mar 06, 2021 @ 00:41:18

        Hi Zoe,

        Thanks for you comments, I wonder if there is a combination of the two. Perhaps people naturally have this ability to see things from other’s perspective, but they learn to hone this ability overtime, even from a young age. I remember learning a few things about egocentrism in Professor Kuersten-Hogan’s Developmental Psychology Class. Infants are able to see what other’s are doing and looking at through gaze following. If they can follow what they are looking at, then they are able to see things from other’s perspective. The infants may have been conditioned to see things in this new way, but they had the capability to do so. Theory of mind psychologists would also say that toddlers at around 2-years-old can begin to explain how other’s behave based off of their desires.

        Reply

  25. Connor Belland
    Mar 05, 2021 @ 14:05:07

    Hi Tim, I really like the way you said how Mark usually jumps to conclusions or the more inclined solution that doesn’t benefit him. This seems to be a common theme with Mark as he always seems to go right to the worst case scenario thinking when he experiences any sort of rejection from the people in his life even if it is perfectly warranted.

    Reply

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Adam M. Volungis, PhD, LMHC

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