Topic 7: Automatic Thoughts & Core Beliefs {by 3/11}

[Automatic Thoughts] – Complete your own Negative Automatic Thought Record. (1) Did the NATR help you “see” the relationship between event, negative automatic thoughts, emotions, behaviors, and outcomes?  Explain.  (2) What did you find the most helpful in completing the AFTER portion of the NATR?  For example, was a particular Socratic technique or developing an alternative thought helpful?

 

[Core Beliefs] – Watch MDD-15: Core Beliefs – Identifying – Downward-Arrow Technique. Practice a Downward-Arrow Technique on yourself (or try with a trusted friend or family member).  Answer the following: (1) Even though you probably already knew what core belief you were working towards (admittedly, this can be an awkward technique to do on yourself), did you have any emotional or cognitive reaction afterwards? (2) Was there any particular question or approach that you found more helpful (or less helpful) than others?

 

Your original post should be posted by the beginning of class 3/11.  Have your two replies posted no later than 3/13.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

72 Comments (+add yours?)

  1. Beth Martin
    Mar 06, 2021 @ 05:31:28

    Automatic thoughts:

    1) I believe that completing the NATR did help me see the relationships between an event, my negative automatic thoughts, emotional responses/behaviors and the outcomes. While I’ve been trying to become more self-aware of my emotional responses recently, I have often struggled to go further back than the emotion itself. The NATR helped massively with this. Writing down everything from start to finish forced me to think about why an event was triggering a particular negative emotional response in me, and it’s the thoughts surrounding it. Previously, when looking at the course of things retroactively, I’ve gotten stuck on the emotion and its consequential behaviors, and been unable to take that further step back to find the negative automatic thought. I was also able to see that my emotions clearly influence my behavior (as they’re not behaviors I typically engage in when I’m happier etc.!), and further build a link between my emotions and outcomes. The NATR helped further in providing a bit of evidence for future, catastrophizing, me, in that seeing my negative automatic thoughts and the outcomes don’t necessarily align.

    2) The after portion of the NATR was particularly helpful in helping me depersonalize and look at things more objectively. I used the Socratic technique of questioning what I’d say to a loved one if they held the same negative automatic thought I did. I tend to be a fairly harsh critic of myself, and do not always realise that I’m holding myself to a ridiculous standard, so being able to work through my negative automatic thought as if it wasn’t me having it gave me awareness. I also found the after portion great for helping me practice future responses; I’m a planner and I like rehearsing things, so thinking deeply about an alternative response and how I’d go about overcoming my negative automatic thoughts helped it sink in.

    Core Beliefs:

    1) I think that I definitely had a “oh!” moment when I had finished going through the Downward-Arrow technique. The particular core belief I was working towards is one that I’m aware of and am working on, but I wasn’t aware that it was also affecting me in this particular area. My cognitive response to this was along the lines of “well, I guess I’m not actually as on top of this as I thought”, and I think my emotional reaction of disappointment/surprise was more linked to this, rather than the technique/core belief itself.

    2) It sounds trite, but I really found the “why” and emotion questions Dr. V used in the video helpful to ask myself. They often seem overarching, but the general “and what are you thinking about this right now” really force me to think (shockingly). Additionally, forcing myself to think about what that particular belief meant to me in regards to who I was, was particularly helpful in making sure I didn’t dodge around that avenue of questioning. It’s a question that leads to a lot more, and realizing emotional responses to those lead-on questions helped me continue further down the technique. I didn’t see anything in the video that I used to guide me as particularly less helpful than any other approach, but I can certainly foresee approaches that would be met with resistance if a client isn’t ready. The “what does that mean about you as a person?” approach in particular – it worked really well for Mark (and me!), but I can definitely see a reluctant client saying “that I suck” and shutting it down. But I suppose that just enforces how important it is to make sure that your client is ready to proceed!

    Reply

    • Abby Robinson
      Mar 08, 2021 @ 22:41:24

      Hi Beth!
      I also found that depersonalizing the situation helped me figure out that the chain of events could stem from so many other options/reasons than just me. I think that taking myself out of the equation made it easier for me to think of possibilities for such events to occur and that I am probably not the reason, even though I feel like I am. I also hold my self to a totally different standard and self criticize! I think for me, this is why I can have a strong reactions to certain events and don’t know why- until I back track to my thoughts about the event which help! Being able to back track from emotion to thought helps me understand why I am reaction in a certain way or why the emotion is so strong.
      See you in class!!

      Reply

    • Althea Hermitt- Mcpherson
      Mar 09, 2021 @ 12:19:54

      Hi Beth, I also felt like becoming aware of my emotional responses and physiological arousal is helpful in that it allows us to not get stuck on emotions but we can see past the emotions and assess the underlining issues which is the Core belief and associated automatic thoughts. The NATR is a really helpful tool, putting it on paper and going through each aspect of the situation brought everything into perspective. You are absolutely spot on when you say that we tend to get stuck on emotions and their consequential behaviors. When in the situation we also are unable to take that further step back to find the negative automatic thought or the core belief that’s contributing to our heightened emotions. I agree that the NATR helps to provide a bit of evidence for future situations when we catastrophize instead of examining the evidence. Doing this exercise also had me thinking about how easy it is to allow emotions to override our life if we are not able to put a brake on these thoughts and modify these core beliefs.

      Reply

    • Connor Belland
      Mar 12, 2021 @ 12:58:59

      Hi Beth, I like how you said when you were doing the downward arrow technique you kind of had an “oh” moment as you were going through the process. I sort of had a similar experience when I did it but mine was a “wow” moment. Like I knew what direction we were headed in and somewhat knew what the core belief was going to be, but when it was finally realized and said allowed it was still a little surprising to say it out loud.

      Reply

  2. Cassandra Miller
    Mar 08, 2021 @ 19:53:47

    1.
    I found the NATR to be quite helpful in regards to spotting connections between event, negative automatic thoughts, emotions, behaviors, and outcomes. After filling this out it became quite obvious that each variable significantly influenced the other. For example, my discomfort due to the provoking event caused me to express negative automatic thoughts such as: I would never get passed it, I would never get a break, and it’s just going to get worse. I did find a cognitive distortion in these thoughts in regard to the thought that I will never get passed it, which I only rated as a 6 for believability. However, I did find the believability for the other thoughts to be quite strong, due to this event being a significant struggle I have been dealing with for a long time. The associating emotions strongly reflected these negative thoughts as I expressed sadness, anger, anxiety, and stress; these were all rated considerably high as well. Furthermore, these negative thoughts and emotions caused me to ruminate on what I can’t currently control and to think very far ahead in the future and make negative predictions in regards to the event and possible outcomes. It also caused me to lose motivation in completing my schoolwork, which I had previously been focusing on. Finally, the behavioral outcome of this event was that I remained upset and focused more on my discomfort than anything else, leading me to further procrastinate my schoolwork. This loss of focus only increased my feelings of stress as I noticed the amount of time I was falling behind. As observed in the “before” section of my NATR my cognitive distortions, provoked my feelings, which in turn provoked my behavioral outcomes. In short, these negative automatic thoughts created a cycle of stress and rumination for me, which only increased the magnitude of my original problem.

    I found the Socratic technique (2) to be helpful in the sense that it allowed me to come up with coping strategies for the worst-case scenario, as well as opened up my mind to thinking about the best possible case scenario. However, I do feel that the alternative thought was useful to incorporate into this reflection, since I had been given the opportunity to think through my problem and was then able to consider a more reasonable alternative thought than I would have previously. Thus, I think both strategies go hand in hand because the Socratic techniques help to provide evidence to create a more believable alternative thought. When I went through coping strategies for the event and the possibility of it getting worse, I began to realize all of the resources I actually had at my disposal. Unfortunately, my particular event is unpredictable, but there are steps I can take to make it less overwhelming for me for the future, as well as short term solutions if it becomes too overpowering in the moment. Thus, after considering the worst-case scenario, best case scenario, and coping options I was able to develop the following alternative thought: “whatever comes my way, I have the resources and am prepared for it.” This alternative thought left me feeling more empowered and helped me acknowledge the inner strength that I do possess, instead of being left to feel as though I was in a helpless state. In turn, I felt more hopeful which decreased my feelings of stress and increased my feelings of relief/calm.

    2.
    I did have a strong emotional and cognitive reaction after identifying the core belief which seemed to relate the most to helplessness. My thoughts allowed me to acknowledge where these negative automatic thought patterns stemmed from, but I also combatted these thoughts with more evidence-based ones; regarding how I’ve been successful handling similar situations in the past. In addition, I have evidence to prove that this issue is not always present in my life, I just don’t have 100% clarification of when it will be there and when it won’t, which leaves me in a sort of “gray zone”. This lack of black and white (valid vs invalid) solutions causes me to feel overwhelmed and very negative regarding the issue and the possible future repercussions of it. The processing that I did while completing the Downward-Arrow Worksheet allowed me to understand that there are elements to this issue that are out of my control, but there are many things that are within it (including how I choose to think about it). Thus, I need to think in a grey-area kind of way to match the grey-area issue that is bothering me. If I attempt to think so rigidly (black and white), it will only further support this core belief and inspire further negative automatic thoughts. Furthermore, the additional distress that this core belief causes only makes things worse for me in the long run because stress does not help any situation.

    I found validating the core belief to be quite helpful as it allowed me to consider the areas where evidence does not support this belief. I also found evaluating the amount of distress it is causing me to be helpful, as it reinforced the need for core belief modification. Overall, I found all of these questions to be particularly helpful, as they really helped me process my relationship with this core belief.

    Reply

    • Abby Robinson
      Mar 08, 2021 @ 22:56:03

      Hi Cassie!
      I, too, realized that these factors (event, thought, emotion, behavior) have a big influence on each other. But I didn’t really notice it until I had to break down each one separately. I think because the process is usually so quick and intense it’s easy to get caught up in the emotion or behavior of the situation, the stimulus and thought kind of get left behind as I tend to ruminate on the intense emotion or behavior since the feeling is so “fresh”. Breaking down the whole thing thoughtout the NATR helped me realize how much influence there is between all those factors and to change the NAT each one of those factors needs to be addressed.
      See you in class!!

      Reply

    • Althea Hermitt- Mcpherson
      Mar 09, 2021 @ 12:34:18

      Hi Cassandra, I too experience that strong emotional and OMG moment after identifying the core belief which seemed to relate to my negative automatic thought. I went further in thinking about what specific situations in my past that lead me to harbor these thoughts and core belief which opened up a whole can a worms.
      But as you said the processing of completing the Downward-Arrow Worksheet allowed a greater understanding that there are elements to this issue that are out of your control. I also like that you identified the ones that are within your control and how you can use this to modify your thoughts to alleviate the distress.

      Reply

    • Tayler Weathers
      Mar 09, 2021 @ 13:45:26

      Hi Cassie! It’s interesting that you found the best/worst case scenario so useful. Obviously you didn’t put the negative automatic thought here (nor did I) but I wonder if it’s a difference between internalizing attribution or externalizing attribution. For example, I know mine was a personalization thought, so I wonder if that somewhat dictates why I found the evidence for/against technique most useful (like Mark, actually!). How can we look at the type of thought to pick a method?

      Reply

    • Michelle McClure
      Mar 10, 2021 @ 21:15:50

      Hi Cassandra,
      I just wanted to let you know how brave I think you are for admitting to what your negative core belief was. I did not actually label mine just said that it is strong and deeply held. I guess it would just be to personal to write, in part, in part I find myself trying to figure out which one it actually is as I am torn between two. Maybe its both, I really do not know. I lean toward one slightly more then the other but I really struggle with actually naming my negative core belief. I think it’s amazing that you not only recognize yours, but you were willing to share it with the class in writing. I have no doubt you will continue to make progress when working on this personally because once you know what you are working on, well that is a huge part of being able to work on it affectively. I hope you have an amazing weekend.

      Reply

  3. Althea Hermitt- Mcpherson
    Mar 09, 2021 @ 12:01:36

    Automatic Thoughts] – Complete your own Negative Automatic Thought Record. (1) Did the NATR help you “see” the relationship between events, negative automatic thoughts, emotions, behaviors, and outcomes? Explain. (2) What did you find the most helpful in completing the AFTER portion of the NATR? For example, was a particular Socratic technique or developing an alternative thought helpful?
    1. In completing my very own NATR I was able to shift my emotions and behaviors quickly instead of getting bogged down by my negative automatic thought. My specific negative automatic thoughts lead to me feeling angry, sad, and disappointed. My body sensation was tight muscles, a pounding heart, rapid breathing, and a churning stomach, my behavioral response is that I became anxious and worried and the outcome was that I ruminated about it for a while because I was hyper-focused on the outcome of the situation. The NATR shows how quickly you can spiral because of your thoughts especially if there is an inability to put the brakes on those emotions.
    2. When I completed the After Portion it made me more aware of why I had those physiological and emotional responses because I was able to separate the event, negative automatic thought, emotion/ body sensation, behavioral response, and outcome, instead of just being focused on the event and the emotions. By separating myself from the negative automatic thought I was able to think about what I would tell my sister if she had a similar experience. I was able to come up with several alternative explanations. This lessened my emotions and body sensation and I was able to identify and label my emotions and physiological arousals and focus on whether or not they are accurate or are they just a response to a distorted way of thinking as a result of negative core beliefs. The alternative outcome is that next time I will pay more attention to my emotions and physiological arousal and attend to them right away to come up with alternative explanations or separate myself from these negative automatic thoughts. It did help me to see the relationship between negative automatic thoughts, emotions, behavior, and outcomes.

    [Core Beliefs] – Watch MDD-15: Core Beliefs – Identifying – Downward-Arrow Technique. Practice a Downward-Arrow Technique on yourself (or try with a trusted friend or family member). Answer the following: (1) Even though you probably already knew what core belief you were working towards (admittedly, this can be an awkward technique to do on yourself), did you have any emotional or cognitive reaction afterward? (2) Was there any particular question or approach that you found more helpful (or less helpful) than others?

    1. Identifying the core belief was a bit difficult for me, the probing questions were hard. The question, If what you say is true, what does that mean about you was eye-opening. Getting to the core of those automatic thoughts can be painful because it now gives you more insights into why you think the way you do. The way Mark was challenged by asking these tough questions was hard to watch in the video because it was obvious it hit home and was really difficult for Mark to accept and take in. It was also painful for me to accept and wrap my mind around the fact that I do have those negative core beliefs and what that might mean for me being constantly triggered by these patterns of thinking.

    2. I found that completing the flow chart made me more aware of my core belief which could be helpful in ascertaining therapeutic relevance by tracking and eventually modifying negative core beliefs that are distressing. I felt like the question if that’s true so what is helpful in decatastrophizing the situation and for that reason I think it is helpful as it brings you to the worst-case scenario and helps you to see that what you’re thinking is not that bad.

    Reply

    • Tayler Weathers
      Mar 09, 2021 @ 13:45:15

      Hi Althea! I think you nailed it when you said “The NATR shows how quickly you can spiral because of your thoughts especially if there is an inability to put the brakes on those emotions.” That is exactly my experience – the NATR was good because it allowed me to evaluate the thoughts rather than just accept them as “real” and reply to them (which is spiraling). Stopping that process and seeing where the negative responses to the negative automatic thought come in were a big part of the NATR’s “wow” moment for me.

      Reply

  4. Tayler Weathers
    Mar 09, 2021 @ 13:41:11

    [Automatic Thoughts] 1. Yes, the NATR did help “see” the relationship, because I could track how one small thought caused a physical reaction caused my behavior in subsequent situations. It changed how I behaved not only that day but in similar situations in the future – anxiety that I might not have tracked before and only felt as “today is not the day for this.” The NATR gave me some perspective on and a record of the behavior to refer back to. 2. I thought the evidence for/against was really useful because it let me see how much I was weighing one piece of insignificant evidence against a lot of pieces of significant evidence. Alternative thought was kind of useful, but it ended up being the evidence against too (I thought of alternatives that made more sense than the one I had come up with). Making a list of alternative behavioral responses was the most helpful, so I can respond differently in the future.

    [Core Beliefs] 1. I did have a general idea of what I was working towards, but the phrasing kind of surprised me. I had an idea of the “issue at stake” but not necessarily the “negative manifestation” that I had in the back of my mind. I had more of a cognitive reaction I think, since I worked through some of it with my therapist previously, so it was more surprising to have that piece of it. For me, the “so what” question wasn’t as useful, it was more “what is so bad about that?” and “What is the worst part about it?” that elicited more of a reaction/thought. I also think that the questions to evaluate the Core Belief were useful, because it was one thing to be like “okay, we hit it. Are we done?” and another to evaluate what the thought actually means in a practical sense.

    Reply

    • Beth Martin
      Mar 10, 2021 @ 23:42:27

      Hi Tayler,

      I found the weighing of evidence really helpful too! I know we’re very often tempted to completely ignore information that doesn’t support our own opinions, so having to write said information down made it easier for me to realise what I was rejecting. It’s great that you were able to recognize that the vague “so what?” questions weren’t working as well for you as you’d have liked, and you made changes. It sounds like the changes made it easier for you to get to the root cause!

      Thanks for posting,
      Beth

      Reply

  5. Lilly Brochu
    Mar 09, 2021 @ 21:31:33

    [Automatic Thoughts] –

    (1) Before completing the NATR, I thought that it looked really overwhelming. However, as I was going through it, it was so much easier to complete than I thought. By focusing on each part one by one, it made the process feel less overwhelming. The NATR was really helpful for me to see my own thought pattern and how it affects my emotions, behaviors, and outcomes. I chose a particular event that has triggered a lot of intense negative thoughts and emotions for me for a while, and the thought record was a visual representation that showed me that there is no *valid* evidence as to why this thought should be ruminated on. Moreover, rating the level of believability and intensity of the emotions and physical sensations was also helpful to really understand what and how my body was feeling as well as what can be done (in a healthy way) to relieve icky emotions and sensations. Overall, I felt as though the NATR was an excellent tool to show the “big picture” of my automatic thought(s), and helped me re-frame my thoughts in a less negative way.

    (2) Examining the evidence, listing alternative explanations, and giving advice to a close friend or family member about the same situation were the most helpful Socratic techniques for me. I felt this way because these techniques are direct, and are realistic ways of evaluating and understanding one’s own negative automatic thought(s). It was easier for me to list reasons why my negative automatic thought was false rather than why it was true, which I thought was surprising to see. Also, writing out alternative explanations was a good way of seeing how other things I am experiencing in my life affect my automatic thoughts and how I act on them. Lastly, I felt very hypocritical when I practiced giving advice to a friend or family member because I can never follow my own advice (even if I know it is correct). With this Socratic technique in particular, it was clear to me that my thought was completely invalid and that it was doing me more harm than good.

    [Core Beliefs] –

    (1) The Downward-Arrow technique is helpful because it challenges you to assess your negative automatic thought until you get all the way down to the very core of it. After finishing the technique, I was not extremely surprised because it has been a belief about myself that I have had since I was young. This process still left me feeling uncomfortable, but also a sense of accomplishment that I was able to narrow down my thoughts and emotions to the cause of the negative automatic thought. The biggest take away from this technique was that it really made me wonder where this core belief about myself derived from, and who or what experiences in my life have played a role in the development and maintenance of it.

    2) When I was completing the Downward-Arrow technique, I tried answering each question without any hesitation. I found that using a “stream of consciousness” approach was helpful in answering each question. Any thought that popped into my head immediately following the question is what what I jotted down. I thought that the questions were conducted in way that flowed nicely, and seemed to be very helpful in leading Mark and myself towards the underlying negative core belief we hold about ourselves. Overall, the toughest question to answer for me was, “If what you say is really bad, what is the worse part about it?”. It was difficult to really pinpoint the specific reason when there were several that I could come up with. This technique challenges you to think about yourself and your thoughts on a deeper level, and I can see how it can be really helpful for clients struggling with anxiety or depression. It was very eye-opening to see how many layers we create *unknowingly* that make it difficult for us to understand and challenge the core of our negatively held beliefs that may result in maladaptive coping or functioning.

    Reply

    • Lina Boothby-Zapata
      Mar 09, 2021 @ 22:31:50

      [Automatic Thoughts]

      1. It was interesting to see how the NATR break down one situation step by step between; event, negative automatic thoughts, emotions, behaviors, and outcomes. It provides the opportunity to analyze the situation from an objective perspective. When I did the exercise with two different situations, I found that it helped me differentiate between behavioral response and outcome. These two moments can be seen as once, the same way that sometimes clients can’t perceive the difference between thoughts and feelings. It is interesting to talk about the outcome of the situations because it is related to the consequences of the client’s actions/behaviors. Getting the client to appreciate the consequences of his actions can motivate the client to extinguish the behavior. Another point that I struggled with was identifying emotions, and table 7.3 Negative emotions help me find the feelings that I had.

      2. Doing the second part, “AFTER” For the Socratic Technique, I realize that no all techniques are appropriate to explore with the client. It is important as a counselor to think about the client’s situation and then decide which to apply. I used Socratic techniques; to examine the evidence, explore possible alternative explanations, and separate yourself from the negative Automatic Thought. I think, that the decatastrophize perceived negative outcomes questions might be problematic for clients with suicidal ideation. What could happen if we help the client recreate his death plan? I am concern that the client could be acting out.

      The NATR second part was important because looking at the evidence helps the client to identify the accurate interpretation and the negative connotation and negative emotions of the situation. When the client realizes that there are more realistic explanations besides the interpretation and connotation that the client is attributing, the negative content in terms of cognition and emotions that the situation lost the weight and emotional connotation.

      [Core Beliefs]

      1. After I did the downward-arrow Worksheet exercise, I found it interesting because it helps the client identify his core beliefs, thinking about his major fear or the worst-case scenario. It is an exercise that definitely pushes a little bit of the client to obtain these thoughts that probably have been unnoticed for a while, thus built a positive rapport with the client is fundamental.

      2. When I did the Downward Arrow Technique, I struggled a little bit to answer the question, “If this is true, what does that mean about you?” But I answer the question I clicked my brain with the rest of the steps, it went straight down the pipe until I obtain my core belief. On the other hand, I felt a little pressure on my chest, and I felt mentally tired. I also was glad that I could have an insight moment. I think more exercises are necessary to do to identify the subtype of the core belief.

      Reply

      • Maya Lopez
        Mar 10, 2021 @ 10:25:41

        Hey Lina,

        I liked the step-by-step approach the NATR gives because as you said it does allow us to analyze each step of the cognitive process and see how they affect our behaviors. I also thought “Getting the client to appreciate the consequences of his actions can motivate the client to extinguish the behavior.” was a great point to make because the NATR does instill responsibility that our thoughts affect our behaviors which affect the outcome and we are partially responsible for any negative consequences that occur but it may motivate us to change as well. You also raise a good point with the suicidal clients, I hadn’t considered that. I agree the downward arrow technique does push the client a bit and may feel intrusive so it should be done when a good therapeutic rapport has been established. It does feel mentally tiring to think okay well what DOES it mean to me? They are complex questions for sure.

        Reply

    • Maya Lopez
      Mar 10, 2021 @ 10:09:57

      Hey Lilly,

      I agree the sheet did look very overwhelming at first but I liked how each box told you exactly what to think about and write down. It was an easy process to do once I started going and showed me as you said, there is no “valid” evidence supporting the negative thought and that I have the power to change the thought and overall my behaviors because sometimes it feels like outcomes just occur and there’s nothing we can do to change them but we help contribute to our own feelings and outcomes.
      I think you said it perfectly, finding the core belief did feel uncomfortable yet I did feel accomplished that I was able to use the technique properly, and I too wondered where the belief stemmed from although I have a good idea. Overall I agree the technique seems like a great way to get clients to think more critically about personal beliefs that may be suppressed.

      Reply

    • Pawel Zawistowski
      Mar 10, 2021 @ 23:19:31

      Lilly,
      I also agree that at first the NATR can be overwhelming. But once you start doing it, each part of it makes sense. Additionally, I think by completing this exercise and practicing it multiple times the process will become a natural habit and we would get better in identifying the thoughts, emotions, and behaviors associated with events and we would improve on finding alternative ways to deal with stressful situations on our own.

      Reply

      • Lilly Brochu
        Mar 11, 2021 @ 08:46:26

        Hi Pawel,

        I completely agree! Once clients (or myself) were to complete this process multiple times, I think it would become much easier to understand why and in what contexts the negative automatic thoughts occur. Identifying where the thoughts come from are the first step in changing how we respond to them, and allows the client to grow and work towards more adaptive responses, behaviors, and their overall psychological well-being and functioning.

        Reply

    • Yen Pham
      Mar 11, 2021 @ 06:46:17

      Hi Lily,
      Thanks for your posting!
      I also find it helpful to use the Down- Arrow Technique because it allows us to go deeper and have a broader view of our core beliefs. I also have the same experience with you because after completing this technique I found myself having core beliefs from a very young age. This technique is a great opportunity to think more about where this belief comes from and who it is influenced by. Taking time and reflecting on what we believe, we will realize how great influence of core beliefs in our life. I asked myself why at that time I had such unreasonable beliefs:)

      Reply

      • Lilly Brochu
        Mar 11, 2021 @ 08:24:01

        Hi Yen!

        I’m glad we shared a similar experience. ☺️ After doing the NATR, it really did make me feel a bit silly as well to have those thoughts when they were unreasonable and invalid overall. I find it interesting how the negative automatic thoughts we have are derived from a deeper, more rigid belief that we have created at some point in our lives that have just stuck with us. It is very interesting to see how that one thought is related to a deeper belief and how it affects our behaviors and their outcomes as well (for better or worse).

        Reply

    • Tim Cody
      Mar 12, 2021 @ 16:11:49

      Hi Lilly,
      I found that the NATR was a helpful tool for analyzing my negative thoughts. I agree with you that it helped me to tie my thoughts towards both an event that may have triggered it, and the emotions, behaviors, and outcomes that follow. Analyzing the outcome in particular is something I tend to overlook because I tend not to associated the event that follows with the negative thoughts I fleetingly had. This helped lead me to healthily cope and intervene with these thoughts with the corresponding Socratic technique (in this case, providing an alternative thought.

      Reply

    • Carly Moris
      Mar 13, 2021 @ 16:26:26

      Hi Lilly!

      I agree with you that answering the question “if what you say is bad what is the worse part about it?” Can be very difficult because it does challenge you to think about yourself on a deeper level. I know I also had the issue of thinking about multiple worse parts. At first instead of identifying the worse part, I made a list of a bunch of bad or worse things about by original thought I was working from. When reflecting on this assignment I found that a few of the the things I wrote down were related to each other and my negative core belief, while a few others weren’t really valid or as relevant. They were bad options that I came up with but they didn’t have as emotional as a reaction as some of the others, that I ultimately ended up continuing to question for the downward arrow exercise. I think that making a long list was at first a way for me to avoid having to admit and examine my actual worse part of the thought. I think that maybe sometimes it is easier for us to come up with bad options we may not as fully believe because they are safer for us to admit to ourselves? That we may not even realize we are doing it until later, because I didn’t realize that i did this until I was looking over my notes to answer this blog post. This is probably going to be similar for our future clients, especially individuals who are not used to examining their own thoughts. When we start questioning them they may come up with a few worse parts, but only one or two of these ideas may be connected to their negative core belief. I think this is probably why it is so important to watch a clients emotional reactions during these exercises, because the ideas they come up with that elicit the most emotions are most likely to be the ones connected to their negative core belief.

      Reply

  6. Maya Lopez
    Mar 10, 2021 @ 09:38:20

    (1) Did the NATR help you “see” the relationship between events, negative automatic thoughts, emotions, behaviors, and outcomes? Explain.

    The NATR definitely helped me see the causal relationship between my thoughts, behaviors, and then the outcome that occurred. By having to slow down and write down what I was feeling and analyze it also helped decrease my distress in the moment. I found that putting on paper what was in my head took the power away from it and made it easier to realize this is irrational and not true which then made me feel better.

    (2) What did you find the most helpful in completing the AFTER portion of the NATR? For example, was a particular Socratic technique or developing an alternative thought helpful?

    I used the technique where I tried to think about what I would tell a friend who was having these negative automatic thoughts and I was surprised that I am much more forgiving and empathetic towards a friend than I am to myself. I was able to externalize the problem for a friend whereas I internalize it. I think that is the core feature of that technique. It was helpful for thinking of an alternative way to see the issue and then trying to apply what I would tell a friend to myself and if I couldn’t I’d try to think about “why” it can’t apply to myself.

    (1) Even though you probably already knew what core belief you were working towards (admittedly, this can be an awkward technique to do on yourself), did you have any emotional or cognitive reaction afterward?

    Afterward, I was thinking that I have thought this before and sorta knew what the core belief would be. I was feeling a bit relieved to have it down in writing but also a little confused about where to stop and slightly sad that I would have a core belief like that.

    (2) Was there any particular question or approach that you found more helpful (or less helpful) than others?

    I found the NATR to be more helpful because it made me analyze in the moment my thoughts and feelings which helped me see how they contributed to my actions which then perpetuated my thoughts and feelings and reinforced them more. It allowed me to see an overall view of the interactions. As for the downward arrow technique, the question, “if that’s true, what does that mean?” was more helpful for me because it forced me to think about scenarios in which okay my fears are true, now what and what does that mean about me?

    Reply

    • Beth Martin
      Mar 10, 2021 @ 23:44:42

      Hi Maya!

      I found it really helpful to take a step back and apply the situation to someone else too! I had a very similar conversation with myself, along the lines of “why is it okay for someone else to do, but not me?” too! It made me realise that I had a core belief impacting me a lot more than I thought it was, and it’s cool to see how each particular “homework” exercise leads nicely into another one. It’s nice to be able to put pieces together and imagine how they’d work in a therapy session now.

      Thanks for posting,
      Beth

      Reply

    • Zoe DiPinto
      Mar 11, 2021 @ 12:35:20

      Hi Maya!

      You had a great point that the NATR makes the client “slow down.” I’m finding that this is a common theme in a lot of CBT practices. I also found it very beneficial to physically write down and organize what is a thought, emotion, behavior, and outcome that I was experiencing. In my mind, I discovered that my tendency was to clump emotions, behaviors, and outcomes into one category that seemed to be a muddled “results from the automatic thought.” I believe I am getting the hang of slowing down my internal processes to explore internal interactions, but still need practice on slowing down the interaction internal processes have on external outcomes.

      Reply

  7. Anna Lindgren
    Mar 10, 2021 @ 13:41:27

    [Automatic Thoughts]
    1. This was my first time filling out a negative automatic thought record and I found it very helpful in connecting the dots between the event, negative automatic thoughts, emotions, behaviors, and outcomes. I had to work backward from the negative feeling I experienced because at the moment I was focused on how I was feeling but avoided digging into why I was feeling that way. Upon reflection, and using the NATR, I was able to pinpoint what thoughts the event brought up and how those contributed to my negative emotions, subsequent behaviors, and outcomes.

    2. Going through the process of providing evidence for and against the negative automatic thought was extremely helpful because I realized through this exercise that it’s a thought that has been popping up for me a lot recently and having the evidence against it will help me the next time that I notice the negative automatic thought. I also found it helpful to come up with an alternative thought to try and modify the negative automatic thought moving forward.

    [Core Beliefs]
    1. In doing the downward arrow technique and uncovering my negative core belief, I did have a strong emotional and cognitive response. Emotionally, I felt sad, maybe even disappointed that I have this negative view of myself, while cognitively I was already able to recognize the negative core belief’s invalidity. Seeing it written down and confronting the core belief was difficult, but because I had an emotional reaction to it, I knew that I was touching on something that rang true for me. And yet, cognitively, I could look at the statement and recognize that it isn’t valid. I empathized with Mark in the video when he was acknowledging his core belief and yet already providing evidence against it because I found myself having a similar reaction.

    2. I think the question that really hit home for me was “If what you say is true, what does that say about you?” The wording of this question is so direct that it made my core belief much clearer. However, I don’t know if I would start with that question when doing this technique with a client. Since it is a narrower question, I would probably use it as a third or fourth question to really try and pinpoint the core belief and use broader questions first like “If that’s true, so what?” or “What is so bad about …?”.

    Reply

    • Michelle McClure
      Mar 10, 2021 @ 21:25:39

      Hi Anna. I just wanted to tell you I appreciated your honesty about having a strong emotional reaction and a strong cognitive reaction while going through the downward arrow technique. I also found myself having strong emotional reactions and very interesting cognitive thinking that surprised me a little. The most powerful question for me was also asking, if what you say is true, what does that mean about you. The other powerful question for me personally was, if what you say is really bad, what is the worst part about it. I feel like personally I still have some work to do with my negative core beliefs. I did find by doing this with another person, that was much easier and I understood the concepts better when I was able to take a step back from the activity and use it more objectively and less personally. I hope you have an amazing weekend.

      Reply

    • Brianna Walls
      Mar 10, 2021 @ 21:47:30

      Hi Anna! I too had an emotional and cognitive response. I didn’t think I would have an emotional response, I just thought I would have a cognitive one. I too felt disappointed and sad about this automatic negative thought I had. I was pretty bummed about it, but as I sat there and went through the exercise I was able to have a positive cognitive response. I was able to recognize that this thought I was having was invalid and I didn’t have any evidence to back it up which made me feel better emotionally. Thank you for sharing your experience!

      Reply

    • Anne Marie Lemieux
      Mar 13, 2021 @ 21:38:07

      Hi Anna, Thank you for your candor. I also felt that the questioning of “If what you say is true, what does that say about you?” is very direct. I think that the therapeutic rapport plus having a supportive tone and body language could go a long way in making a client feel safe to explore the question. I think when we reflect on our own without that, it can feel harsh.

      Reply

    • Laura Wheeler
      Apr 15, 2021 @ 23:16:51

      Hi Anna. I really appreciate your honesty in expressing how you felt during the process of the downward arrow technique and confronting your negative automatic thoughts and core belief. I think you worded it very nicely and in a way that I felt I could relate to. While our cognitive thoughts can identify the invalidity of the thought, its still sad to challenge and think about. I am hopeful that you were able to work through that sadness some more and feel a little better about the thoughts you were having. In regard to the downward arrow, I had the same experience- asking those “why” or “so what” questions to yourself are uncomfortable and difficult.

      Reply

  8. Connor Belland
    Mar 10, 2021 @ 19:35:22

    1. The NATR definitely helped me to see the connection between an event happening and the negative automatic associated with it and the emotions that followed. For me it was an upcoming event that I was stressed about so I had some anxious emotions and writing it all down on the NATR helped me to visualize the connection between the initial thought that caused the emotions and the behavior that came out of it.
    2.The after portion of the NATR was helpful to me as a way of sort of rationalizing the though better. After some time has passed, and the negative emotions associated with the negative automatic thought have passed with it, looking back on it, it is easy that the negative thought was irrational or not very valid. Reasoning out the cause of the thought along with trying to view the thought from a different perspective really helped to see that maybe the thought wasn’t as realistic as the emotions felt that came along with it. I had already relaxed from having the previous negative automatic thought but filling out the after portion helped me to break it down even more and relax even more.

    3. I did the downward arrow technique on my mom, so going into it initially I did not know what the core belief was right away. It became clearer after the first couple questions but I was surprised that she actually realized and said what the true core belief was she was having. She was also surprised when she realized it. It also took a little bit longer and extra digging to get down to what the core belief was and became somewhat difficult for her to differentiate the thought from the core belief.

    4. It was slightly difficult to eventually realize what the true core belief was so I had to try switching up my questioning as I went. I started with the “what would be so bad about that” and that got me a little further but eventually I shifted more to “why” questions such as “why would that be so bad” or “why do you think you feel that way” and by then I had realized what the core belief was, but she hadn’t said it yet so I sort of challenged her and said “So do you think maybe (blank) is the core belief you are having” and thankfully I was right and she was in agreement but still a little surprised that this was really what she was thinking.

    Reply

    • Elizabeth Baker
      Mar 10, 2021 @ 19:58:36

      Hello Connor,

      It is good to hear that the NATR helped with further analyzing your negative automatic thought even after it was invalidated. I think it is a great habit to further analyze negative automatic thoughts even after you (or the client) have moved on from them, just to make sure the thought is thoroughly examined. Practicing this habit may influence the response in situations that may raise this same automatic thought. That is, if you (or a client) encounter an experience that raises the negative automatic thought, you (or the client) have a firm foundation (evidence) that invalidates the thought or you (or the client) will not be as affected by the negative thought and will still respond adaptively in this distressing situation.
      Also, it is so amazing that you had a successful outcome from trying this technique with family, as you got a first-hand experience on how this technique would be used with future clients. It is so interesting that changing the W’s of the sentence (i.e., from what to why) can produce such different responses from others and help with their processing of such core beliefs. Great work!

      Reply

  9. Elizabeth Baker
    Mar 10, 2021 @ 19:44:17

    [Automatic Thoughts]
    1) The NATR did help me see the connection between my negative automatic thoughts and behavioral response, and how they influence one another. I realize that my initial negative automatic thoughts before engaging in specific tasks affected my motivation and interest in completing the task (e.g., talking with friends, completing homework, reading, etc.). This decrease in motivation and interest to complete the task caused more negative automatic thoughts to develop. This made me either take more time to complete the task as I dreaded working on the task and kept distracting myself, or made me completely withdraw from completing the task. Understanding this helped me push aside my negative automatic thoughts and understand the value in the task, or more enjoy the task as I tried to “live in the moment” instead of thinking of past and future negative consequences. This allowed me to be more engaged in various tasks and complete them more efficiently.

    2) After understanding how my negative automatic thoughts were influencing my behavior when completing tasks, I tried to separate myself from the negative automatic thought(s) and tried to examine the evidence for and against the negative automatic thought(s). Separating myself from the negative automatic thought helped me become more understanding and aware of the negative emotions that accompanied the thoughts, and allowed me to become more motivated to complete some tasks (e.g., schoolwork) without being as distracted and influenced by the negative thoughts and emotions. Examining the evidence for and against the negative automatic thought helped me identify reasons for the negative thought and develop strategies to address these reasonings (e.g., studying more, reading/viewing outside resources). This technique also helped me separate myself from my automatic thoughts and allowed me to fully enjoy the task instead of letting my concerns keep me from fulfilling the task with my full potential.

    [Core Beliefs]
    1) Analyzing my core belief definitely brought up some negative feelings that I have tried pushing aside when specific situations reminded me of this core belief. It made me think of times that validated this core belief, and kind of started the rumination process as I applied this core belief to semi-current situations. I definitely felt like I needed to take a break or jot down what I was feeling and then come up with explanations as to why I was feeling upset. I was able to break myself out of my rumination as I started analyzing evidence against my core belief, but it seemed that evidence that validated the negative core belief was much easier to focus on.

    2) Aside from the Downward-Arrow Worksheet, I took a look at the Core Belief Flowchart Domain Questions Worksheet and I think this one was helpful in analyzing as well as modifying my selected core belief. With that worksheet, I was able to look at more specific aspects of my life (both significant individuals and significant experiences) that helped me further examine the source of this core belief and evidence that invalidated the core belief. This worksheet provided a bunch of specific questions that were geared towards past and current events and coping habits that have influenced my negative core belief. It was very interesting to analyze such specific aspects of my current and past experiences to further process why I have developed this negative core belief, and experiences and coping habits that have developed to decrease the accompanying distress and modify the core belief.

    Reply

    • Brianna Walls
      Mar 10, 2021 @ 21:05:26

      Hi Elizabeth! I can relate, my initial negative automatic thoughts affect my motivation before engaging in specific tasks and because I lose the motivation to perform these tasks I then start to experience more negative automatic thoughts. Ughh! I liked how you said, “live in the moment.” This may help me too when I’m stuck reminiscing on the past and/or future and their negative consequences. Hopefully, I too will become more engaged when performing certain tasks after experience a negative automatic thought.

      Reply

    • Yen Pham
      Mar 11, 2021 @ 07:00:40

      Hi Elizabeth,
      Thank you for your posting!
      I like the way you discuss methods that help you correct your negative thoughts automatically. The way you look at the evidence of your negative automatic thoughts and detach yourself from it is a great way. I’m glad you’ve found the source of these negative thoughts: making changes to get more motivated to fully enjoy the task instead of letting your concerns keep you from fulfilling the task with my full potential.

      Reply

  10. Brianna Walls
    Mar 10, 2021 @ 20:56:02

    Automatic thoughts
    1. The NATR helped me significantly in “seeing” the relationship between the event, negative automatic thoughts, emotions, behaviors, and outcomes. For instance, it was very helpful to see each broken down separately and then to look at them all as a whole. Further, the NATR helped me slow down and look at the situation as a whole which in return caused my distress to be weakened. By sitting there and taking the time to write everything down it gave me the chance to really think about the situation and why I was feeling this way because of it. Also by rating the believability of each automatic thought I had made me realize “wow, this is ridiculous, why am I thinking like this right now, I have no evidence.” This was also helpful in reducing my distress in the current moment and then, therefore, changed how I reacted and the outcome.
    2. Examining the evidence and developing an alternative thought were the most helpful in completing the after portion of the NATR. For instance, when I would start to have a negative thought I would ask myself “what is the evidence to back this statement up?” Most of the time I couldn’t come up with any evidence which made me realize “wow this thought probably isn’t true.” I would then try to come up with an alternative thought instead of the negative one I was having. This was very helpful because I was able to come up with a few and this gave me hope that the negative thoughts I was having are not true and that once I sat back and thought for a little it wasn’t hard to get rid of them and replace them with something more realistic.
    Core beliefs
    I did have an emotional and cognitive reaction after identifying a certain core belief. One automatic thought that I seem to have often is “I am helpless.” I took this automatic thought of mine and filled out the downward arrow worksheet. The first question I asked myself was “If this is true, so what?” It was extremely hard for me to come up with an answer to this question so I moved on to another one, “What is so bad about being helpless?” This question made me process the thought a little more and deeper. Once I thought about this automatic thought a little more and answered more of the questions I realized that I have a strong core belief of being helpless to myself, not others. Overall this technique really challenges you and it is very helpful.

    Reply

    • Pawel Zawistowski
      Mar 10, 2021 @ 23:28:29

      Brianna,
      I think it is interesting in the way that you used the downward technique to uncover that you are helpless to yourself but not to others. I am a bit curious to know if this information is useful for you to know and if this is something you sort of felt before using this technique. I had a very different experience using this technique and I uncovered something very different. I think it is neat that this technique is unique to the individual and event.

      Reply

    • Zoe DiPinto
      Mar 11, 2021 @ 12:42:28

      Hi Brianna,

      I agree with Pawel! I think it is very interesting that you used the downward arrow technique to discover that you have an internal voice telling you that you may be helpless rather than a fear of others perceiving you as helpless. I wonder if a distinction between an internal voice and an external voice is something that happens often when uncovering core beliefs. As a concept, it makes sense that care beliefs are more likely to be self-perpetuating rather than fueled by others. This could increase the client’s senses of autonomy when they discover they have the power to change the internal voice instead of trying to change other people’s perspectives of them.

      Reply

    • Anne Marie Lemieux
      Mar 13, 2021 @ 21:49:10

      Hi Brianna, I think it is so amazing that we can have completely untrue automatic thoughts that feel so true but are based on no evidence. I also found the process helpful of reminding myself to look for clues to support my thinking verses just reacting in an emotional way. Not only becoming cognizant of the thinking but then creating replacement thoughts that are more adaptive definitely takes practice. I think that until the core belief is identified and shifted, those automatic thoughts act like weeds that keep popping up. Thank you for your insight.

      Reply

  11. Michelle McClure
    Mar 10, 2021 @ 21:08:50

    1. Automatic thoughts
    I thought this was an interesting activity. I found writing down my negative automatic thought was a little uncomfortable and seeing them written down was interesting. I found that despite the objective lens that I was trying to look at this with my levels of belief were still quite high I could see how the negative automatic thought had an effect on my behavior and even though it did not lead to a negative consequence it did lead to an interesting discussion later. I found looking for evidence that supports my thoughts was easier than finding evidence against but ironically I could find more evidence against then for when it was all said and done. I found that the Socratic techniques that were the most helpful for me was examining the evidence, as I had so much more evidence against and I appreciate the logic of that personally, I also liked the impact of believing the automatic negative thought because not much good would come from that and it really just causes me a lot of unnecessary stress and worry which doesn’t need to be there.

    2. Core beliefs
    I found this to be really difficult. I watched the MMD-15, I watched the lecture videos, I read the book chapters, I still found this to be difficult. Maybe I have a deeply held negative core belief, most likely that could be the case. I did make some interesting discoveries and my answers to the questions I was asking myself went into some unexpected directions. I tried doing the down ward arrow technique on someone else. That was much easier. I really liked the question, if what you say is really bad, what is the worst part about it? I found for myself and for the other person I worked with on this that question brought up a lot of emotions. Another question that worked really well with the person I was doing this with was, if what you say is true, what does that mean about you? I managed to get the person I was working with to get to his core belief of unworthiness. It took a lot of asking and re-asking questions to get him to admit to that core belief.

    Reply

    • nicole.giannetto
      Mar 11, 2021 @ 18:01:04

      Hi Michelle! My process was similar to yours in the way that it was uncomfortable filling out the columns, but once it was completed it was interesting to observe how everything connected. I also feel that a lot of people may also have the same experience that you did when you found it easier to find evidence supporting your negative automatic thought. I think that’s why it can be challenging to even acknowledge that we have these thoughts in the first place because they seem so logical in our minds!

      Reply

  12. Pawel Zawistowski
    Mar 10, 2021 @ 23:15:40

    Automatic thoughts

    1. The NATR did help me see the relationship between an event, the negative automatic thoughts, emotions, behavioral response, and outcomes associated with the event. The NATR is a helpful tool that allows you to separate each event and reflect on how our body may respond to the event, the feelings and negative automatic thoughts that are triggered, and the behavioral response to the event. I think that it is an effective strategy to understand oneself and how we interpret these events as well as how they make us feel and react. The NATR can be very useful in therapy in identifying irrational and maladaptive patterns. I felt that in my case I was able to observe the event in greater detail and reflect on things that are easy to be overlooked such as bodily reaction to the event. I noticed that I was very upset and stressed out by a friend who did not respect my time and effort. By observing this event with the use of NATR I was able to come to the conclusion that such things are not worth getting upset about because it is not within my control to have people appreciate my efforts. Additionally, there can be a multitude of reasons for why my friend acted the way they did. By doing this exercise, I was also able to think about the thinking pattern that occurs during certain situations, how I interpret these events, and the resulting behavior that comes afterwards.
    2. What I found the most helpful in the AFTER portion of the NATR is finding alternative thoughts. By changing my thoughts, everything else sort of falls into place because my thoughts also influence my emotional and behavioral response. The Socratic technique that I found most helpful was (4) “What is the outcome of believing your thought? What could be the outcome of changing your thought?” I found that piece most helpful to my event because it helped me come to the realization that my event was not as serious as I was making it out to be, and it had too much influence on how I felt and was not worth the stress that the event was causing.

    Core beliefs

    1. I think that in my case the response I had was mostly a cognitive one and not so much emotional. However, if I was to apply the downward-arrow technique more recently to the event it would have a greater emotional response on me. I think that this technique is a good coping technique to use to restructure some of those negative automatic thoughts and also get an understanding of our core beliefs.
    2. The approach that I find helpful in using the downward arrow technique to get at those automatic thoughts and uncover core beliefs is by asking questions that makes the individual reflect on how they perceive the situation, how they feel about it, and what it means to them. This allows the individual to process and verbalize their core beliefs and negative automatic thoughts. Also, I think there is great clinical utility in having the individual verbalize those negative automatic thoughts and core beliefs because it helps that individual realize that once they speak it into existence it may sort of sound silly. Using this method has great cognitive restructuring potential because it helps the client identify irrational and maladaptive patterns.

    Reply

    • Anna Lindgren
      Mar 12, 2021 @ 10:35:14

      Hi Pawel,

      It can be really hard when we feel like we’re putting more into a friendship than others are. While we can’t control other’s behavior, we can control our boundaries with others (something I’m working on!) so that we don’t feel drained by a relationship. It also sounds like the Socratic technique you tried let you gain some perspective on the event and reduce the amount of stress it was causing you. Thank you for sharing!

      Anna

      Reply

  13. Yen Pham
    Mar 11, 2021 @ 06:11:47

    Automatic Thoughts

    (1) When I have completed the NART, I see there is a relationship between event, negative automatic thoughts, emotions, behaviors, and outcomes. My negative automatic thinking about an event has put me in an unsettled, unhappy and disappointed emotion. My body sensation gets of pain and fatigue. (2) I have realized that a particular Socratic technique or developing an alternative thought was helpful in my case. I think the NATR is so helpful for me because this process helps me develop my own version of self-assessment in identifying my own automatic thoughts and sets the stage for eventual evaluation and modification of negative automatic thoughts. But, to be honest, it is uncomfortable to write down a negative thought automatically because when I look back I feel embarrassed about my thoughts at that moment. However, if I often keep the act of writing down negative automatic thoughts and visually seeing the words. I stimulate my own evaluation process of my thinking patterns (e.g., “Why did I think that? It makes no sense. Is there another explanation for what happened other than . . . ?” What is the outcome of believing that [negative thought]?”

    Core Beliefs

    (1) It is important to aware an event in a particular context, but this perception is not always true because it is influenced by emotions. These emotions in somehow will impact our core beliefs, Thus, for my own opinion, I think emotions (e.g. sad, happy, disappointed) have been a big hindrance to me to modify my core beliefs. (2) I think the Downward-Arrow Technique: Digging Deeper for Core Beliefs and the table 8.3 – Core Belief Flowchart Domain Questions Worksheet are so helpful. In particular, with the table 8.3 it provides a list of each domain to assess and associated questions, including space to record relevant client information such as: category and lens, significant individuals, significant life events, recent contributing stressors, temperament and coping skills, contributing sociocultural factors, and relevant activities or life accomplishments. Additionally, I think the tracking core beliefs are so helpful too. I like some questions as “Do you think you a have rule in your mind about? Do you find that these types of thoughts about… have patterns that come from a deeper source? I wonder if these thoughts about… come from a fundamental belief?” These questions really touch to my thoughts and beliefs. If I take more time to think and challenge what I believe and how it affects my life. I believe that I will find the answer for myself to modify my negative core beliefs which should not be there.

    Reply

    • Cassandra Miller
      Mar 12, 2021 @ 17:16:48

      Hi Yen,

      Thank you for your honesty when describing the process of recording a negative automatic thought. Personally, I felt embarrassed as well, but also quite struck by the fact that I expressed this thought so deeply. When writing down these negative automatic thoughts it’s almost like you are admitting to yourself the actual extent of the negativity of it, which in turn makes it feel silly; causing you to wonder why this idea was so exaggerated in your mind in the first place. I wonder if this confliction occurred for you too? I also agree with you when you said that writing down these negative automatic thoughts really gives you the opportunity to process them as you are forced to consider where the roots of these thoughts stem from and what factors may have led you to come up with them.

      Reply

    • Lina Boothby-Zapata
      Mar 13, 2021 @ 15:15:09

      Hi Yen
      Thank you so much to share your experience. When I was reading your post and I have to say that I had a very similar experience. I had a difficult situation and my thoughts were all cognitive distortions until a “family member not knowing about the exercise” asked me but what is the evidence that you are using to think like that. Then, I went to do the NATR and I realized that all these negative automatic thoughts were commanded by a core belief. This was an aha moment for me. In general, what I really like about the NATR is that helps the client to break down the experience or situation and really look into what happened; the exercise of separating; automatic thoughts, emotions, behavioral response, and the outcome is really important to facilitate to the client because the client will have the opportunity of a new understanding of the situation. Furthermore, the Counselor could guide the client to identify the Core Beliefs that are expressed as Automatic Thoughts in the NATR.

      Reply

  14. Abby Robinson
    Mar 11, 2021 @ 10:48:07

    Automatic thoughts
    1. I definitely think the NATR helped me see the relationship between event, emotions, behaviors and outcomes. I think that because NATs happen so quickly and produce a strong emotion that I put the event and thought to the side and focus on the present feeling and what happened because of it. But I think that the record was a good way to track it from the start and see where this intense emotion stems from. Then I was able to address the NAT and think, “okay, I’m feeling this way because X happened and I had a strong emotional reaction to it” and then so on.
    2. I found the best technique for me to use for the after portion was de-personalization technique as well as explore possible alternative explanations where I would take myself out of the equation and put another friend in my place and think what would I say to them in this situation. I was able to come up with a solid list of possible explanations, outcomes, or reasons when I wasn’t involved in the event. This made my original process seem not logical and I was able to think about things that I wasn’t the reason for this event/outcome.
    Core Beliefs MDD 15
    1. I tried the downward arrow in myself, my initial reaction was that I had to get a bit into some intense negative emotions that I didn’t realize were even part of this NAT and core belief. I think because the core belief is something that I just assumed I didn’t pair it with such negative emotion. Though, after getting through the deep part of it then going forward with the questions of “If this is true, then so what?” or “what is the worst part of this”.
    2. I think the downward arrow technique was an intense but helpful process. I think that it was like a soft wake up call in that I realized the core belief, and also the process on how to get there. Ask the questions “so what is the worst part” “And if this is true, so what?” I found to also be intense but, in reality, I was able to answer and realize that although I thought this NAT, it’s pretty illogical.

    Reply

    • Cailee Norton
      Mar 11, 2021 @ 12:01:24

      Abby,
      I totally understand what you mean about a soft wakeup call in relation between your core belief and your NAT. For me I called it an aha moment and I saw the connections being made and how it really impacts my daily life. One way I conceptualized this process was like the automatic thoughts and core beliefs are like powerlines. The core belief acts as the power source that influences the automatic thoughts. While we know that we get power, we sometimes don’t think of or even acknowledge the power source. However, when we examine the power source we see exactly how it brings us power. In this case the downward arrow technique acts like lines from the power to the power source and really makes it clear for us how our core beliefs directly relate to our thoughts. Great job!!

      Reply

    • Nicole Giannetto
      Mar 11, 2021 @ 18:05:08

      Hi Abby! I agree that visualizing the process of our negative automatic thoughts through filling out the NATR made it helpful to better understand how the process works. Like you said, these NATs happen so quickly, which makes it hard to break down the mechanics of it, but this record allows us to do that which I liked. It connects the dots and can provide us with insight into things we didn’t know or elaborate on things we had some insight on but had not yet grasped the full scope of its influence/purpose.

      Reply

  15. Christina DeMalia
    Mar 11, 2021 @ 11:27:25

    (1)
    I was definitely surprised to see how my negative automatic thoughts connected so much to my emotions, behaviors and outcomes. I have always been slightly aware that when it comes to my health, I have been pessimistic, but hadn’t been aware of how often I have negative automatic thoughts like “I’ll never be healthy,” or “This doctor will never take me seriously.” Even worse, I realized that by having these thoughts, I was creating anxiety, worry, stress, and frustration that wasn’t helpful at all. I had spent a whole day leading up to an important appointment focused on those thoughts, that I was causing my own negative emotions of anger and frustration over something that hadn’t even happened yet. Because of those overwhelming emotions, I couldn’t focus on work, fell behind on things I needed to get done, and spent the whole day overthinking all of the possible negative outcomes of the appointment. The outcome of this was creating even more stress by falling behind, then being mad at myself once I realized that I was causing even more problems for myself by focusing on the negative thoughts and emotions. I also realized that since my current issue was dangerously high blood pressure, stressing myself out more was probably worsening my health concerns even more, creating a cycle that was not only mentally unhealthy but physically unhealthy. I think that if it wasn’t for us going over the NATR this week, I wouldn’t have taken the time to realize just how much my thoughts were negatively effecting my emotions, behaviors, and outcomes. I was having these negative automatic thoughts before the event, the doctor’s appointment, even happened. This meant that most of the negative effects were based on something that hadn’t happened yet and may not have happened at all. By doing this exercise in the moment, I was able to realize that trying to modify the thoughts could be extremely helpful.

    (2)
    What I found most useful in the after portion of the NATR was the evidence for and against the thought, as well as the best, worst, and most realistic scenarios. The “evidence for” list was so much longer than the evidence against list because of over a decade of experience with doctors being unable to help with my health issues, as well as diagnoses for things that have no cure. For that reason, I knew that in some ways the thoughts I was having were valid. Despite them being valid, the way in which I respond to them is not helpful, and in fact seems harmful. The evidence for helped me validate where the thoughts were coming from. The worst, best, and most realistic scenario helped me to look at how I would cope not matter what the situation was. I rated the worst case scenario as much more likely than the best case scenario (6 vs 2) but rated the most realistic scenario as a 9. My worst case scenario – being given the wrong treatment that could lead to more damage- was so high because of the number of times it had happened previously. The best case scenario – all of my specialists working together to come up with a helpful plan – was rated so low because it has never happened yet. My most realistic scenario of the doctors doing the bare minimum and not doing harm but likely not helping much was the most realistic based on previous experience. However, I realized by thinking about all three scenarios that I could control how I approach it. Even in the worse case scenario, I realized I could advocate for myself and do my own research, being actively involved to avoid mistakes previous doctors had made. Once I realized that I couldn’t control which outcome would happen, but I could control my role in it, I felt a huge reduction in the anxiety it was causing.

    [Core Beliefs]
    (1)
    I didn’t notice too much of an emotional response to the downward arrow technique because I worked towards a core belief I have been aware of and tried working on before. However I did have a significant cognitive reaction to this once I realized that the core belief I worked towards was so deeply ingrained. Even though I didn’t continue with an exercise to write out the historical events leading to that belief, I began to think about them as I did the activity. I realized how back to my earliest memories I could see where that core belief started forming. I also started to think about the evidence for and against the core belief I established. I found it really interesting that logically I knew there was a lot of evidence against it, and only a small amount of evidence for it. Despite knowing that, I still emotionally believe the core belief much more than an alternative one.

    (2)
    One of the most difficult parts I found on using this technique on myself was trying to make sure the core belief was invalid. The Socratic technique of separating self from the negative core belief was most helpful for this weird situation of trying to use the technique on myself. If I removed myself from the situation and imagined being a therapist talking to someone with the same thoughts as myself, I would be able to recognize them as invalid. However, when I actually looked at myself in the situation, it was hard to identify a core belief as invalid, because obviously it wouldn’t be a core belief if I haven’t believed it strongly for a long time. It felt a little silly that I can know how to help others identify and modify core beliefs, but struggle in admitting when one of my own core beliefs might not be valid. However, this also helped me to realize how difficult of a process modifying core beliefs can be, and why it is important to slowly build up to that over many therapy sessions with thorough psychoeducation.

    Reply

    • Cailee Norton
      Mar 11, 2021 @ 12:04:36

      Christina,

      I think that you thinking about the sources of your core beliefs is an excellent way to conceptualize them and how they became so ingrained. For me I had somewhat of an emotional reaction to the technique, so I wasn’t able to think about this part. AS a clinician, I realize that this part is really important in showing our clients where these things stem from, and how they develop. This acts as a psychoeducation in core beliefs, while applying it to our client. I think it sounds like you did a great job working through this technique and acknowledging the challenges of sitting in both the clinician and the client seats in terms of validating and invalidating a core belief.

      Reply

    • Lina Boothby-Zapata
      Mar 13, 2021 @ 15:33:02

      Hi Christina,

      I had a similar situation with the Downward–Arrow Technique, in terms of looking for childhood experiences that have a connection with my core belief. What I realized with these two exercises. NATR and the Downward Arrow Technique is that two different situations were commanded by one core belief, I didn’t see the association until I looked at both exercises. Then, I began to look into my childhood experiences and I could identify a significant experience that relates to this core belief. I think this Down-Arrow Technique, as Dr. V said needs to go after the NATR, I think this is more about “kind of digging” and helping the client to identify the core belief and also helping the counselor to identify if this is a core belief that is necessary to modify. I also think that the two questions about what does that means about you? And how much distress this core belief is causing is fundamental for this technique.

      Reply

  16. Cailee Norton
    Mar 11, 2021 @ 11:56:45

    Automatic Thoughts
    1. I feel like the NATR definitely helped me to put my thought into perspective and I was really able to challenge it rather than accepting it. When you think something I think it is in a totally different space and we weigh it differently than if we see it in front of us and on paper. My event has been stressing me out to the extreme for the past few weeks, and while I didn’t think the event was taking a toll on my mental health more than your average daily stress, I realized I was having more body sensations than I had thought. For me the NATR was able to point out a lot of areas I had glossed over in my head, as well as connected some of the physical sensations to the emotions and thoughts I was having. With the way the NATR flows you really find yourself like “oh, yeah that makes sense” and everything really leads together to slowly break down your original negative automatic thought. By the end of it you do feel better and see how such a thought has wide reaching implications, and how proper addressing of these thoughts as they are occurring (and before they just ruminate in your head for weeks like mine have) can really stop a lot of unnecessary stress.
    2. For me I felt like laying out the evidence was a very useful Socratic technique. Ultimately I didn’t have but one point for evidence (and it wasn’t a good point), and several points for evidence against my thought. This for me made me question why I would choose to believe something with little “fact” to it, when I have so much evidence against it. I think that understanding how science is so fact based and really uses a lot of research and experimentation, that I was able to believe the evidence against the thought more easily, but I think that this is definitely something that can be useful to clients. Another Socratic technique I found particularly useful was what I would tell my friends/family if they had a similar thought. I know I’m really critical of myself, and I’m definitely working on this as it can be really detrimental to many aspects of my health, but when it’s my friends/family they’re on a pedestal and I’m able to conceptualize a much more realistic (if not simply more optimistic) outlook on the situation. While I may not be able to give definitive positive feedback, I can see the possible outcomes going positively and the automatic thought not being a factor really. Unfortunately this is something I don’t do for myself, but thinking about my thought for someone else helps me to see why that thought shouldn’t be weighing on me so heavily.

    Core Beliefs
    1. I think that I had an idea of what my core belief was, but I didn’t really realize how it largely impacted me and how it influences my thoughts. I feel like I had both an emotional and a cognitive response to this “discovery.” I know that this is something I struggle with, however realizing how deep set it is was kind of upsetting in a way. I also cognitively was able to see the link between the negative automatic thoughts and my core beliefs. Being able to stop and talk through the steps with my partner really put it into perspective of the steps that my core beliefs take to influence the thoughts I have and why I feel perpetually stuck.
    2. I think that the question “if what you say is really bad, what is the worst part about it” was something that my partner asked me that I felt overwhelmed by. Really the thought is bad, but realizing that the worst part meant x, y, and z was a lot to take in and that’s where in my mind I felt that aha moment and saw the connections. I had some awareness of these beliefs, but to see how they manifest themselves was difficult to see. Another question I think that really hit home the impact was when my partner asked me if the core belief caused me significant stress. Again, an aha moment made me realize how much I did to try to defeat the core belief but being superhuman is unachievable and stresses me out more (thus repeating the cycle of my core belief being ‘right’ in my mind’). The experience was humbling and while I feel that I have some good awareness of myself and my emotions/thoughts, I didn’t realize the expansiveness of this core belief and how it influences much of my life and the decisions/approaches I make.

    Reply

    • Alexa Berry
      Mar 13, 2021 @ 19:57:53

      Hi Cailee,

      I like how in your response you acknowledged that you had been having more bodily sensations related to stress than you were aware of. I thought this was really interesting and it made me take a different perspective-some clients may be more or less aware of their bodily sensations associated with distress while others are more focused on the emotions. Personally, I tend to focus more on bodily sensations when I am stressed and engage in body scanning which can heighten these feelings. I actually had an opposite discovery from you and uncovered thoughts/emotions associated with my bodily sensations, rather than the other way around. I appreciated what you shared about your experience with these automatic thoughts and core belief exercises! I know it can be weird to do these exercises on yourself and then share that, but your ideas helped me see some perspectives I hadn’t experienced myself.

      Reply

  17. Zoe DiPinto
    Mar 11, 2021 @ 12:20:20

    I was pleasantly surprised at the effectiveness of the NATR. To begin, I had a decent understanding of the relationship between the event, thought, and emotional outcome. I knew that an automatic thought was making me feel negatively about myself in comparison to a family member. However, the NATR took it a step further when asking me to separate the emotions I felt from the behaviors I was doing and the overall outcome. This allowed me to further examine my external impact on what I have been doing instead of being focused on what was going inside my head.
    I went through the socratic techniques and initially felt worse because I was trying to believe my new thought, but couldn’t. I filled out “alternative explanations” and it felt like I was just making excuses. This made me more sad and frustrated that my believability scores were so low, even though I used the socratic techniques to understand the realistic scenario is one that I should not feel bad about. I believe it was the technique of uncovering the worst/best case scenario that led me to discover that at the root of my worries, I’m homesick. My internal attributions of not being good enough to maintain my family’s attention shifted to blaming the external situation of the pandemic that is keeping me away from them in the first place. I let go of my self-blame and frustration and allowed myself to shift my perspective from “me vs them” to “us vs situation.”

    The downward arrow technique was difficult to implement on myself. I do not think I identify with core beliefs such as “I am worthless” or “I am unlikeable/ unloveable” so I explored some new possibilities. I examined my anxiety around tendencies to play it safe and easily fear for my life. I landed on the core belief of “nothing I do matters, so I don’t matter.” In this process I wrote down phrases like “I’m afraid of dying.” The most helpful question to get to the point was asking myself “If you were dead, so what?” which led me to say “everything would be fine without me” and “I don’t matter.” I do not believe this core belief is very strong, so it did not elicit a strong emotional response. However, it is clear that this need to be needed is a driving force in many contexts in which I feel anxious.

    Reply

    • Christina DeMalia
      Mar 11, 2021 @ 20:48:37

      Hi Zoe,

      Its exciting to see that the these exercises seemed to have a real impact on you. As much as we may sometimes know what are automatic thoughts are, we may not always fully understand where they’re coming from. It seems like you were able to tunnel down until you realized where the thought came from, which allowed you to better understand that it was external rather than internal issues leading to the problem. I also am a huge fan of the mindset of differentiating between “me vs them” and “us vs the problem” and I think its awesome how you were able to make this shift as a result of using this technique. Lastly, I found it really interesting how you adapted the downward arrow technique to fit your situation. Obviously with a client, we wouldn’t use this unless we were fairly certain there was a negative core belief present. However, the way you translated the exercise to fit with a behavior/mindset of yours showed how Socratic questioning can be useful in a number of different ways.

      Reply

  18. Carly Moris
    Mar 11, 2021 @ 13:02:04

    1. The NATR did help me to see the relationship between the event and my negative automatic thoughts, emotions, behaviors, and the outcome. This is a negative automatic thought I have been trying to work on for awhile, though before this I never really thought about it in terms of the CBT model and as a negative automatic thought. Normally it would be awhile after the event and I would be trying to figure out why I was so angry/upset. I would be able to tell what event/person had upset me but I would struggle at identifying the specific thoughts behind it. Even when I did identify the thoughts a lot of times the strong emotions would prevent me from really confronting them; and even when I did recognize the thought was inaccurate toward the event/person I would still feel a bit upset or resentful. It was usually talking to other people about it that helped. Though this time when I started feeling strong emotions related to this person I started filling out the NATR. I started by writing down my emotions, then my negative automatic thoughts, then the event. I think that recording the NATR kind of interrupted my behavioral response because as I rated the believability of each thought I already found myself challenging how much I actually believed that thought. By the time I finished this exercise I felt better about the situations and didn’t preform my usual behavioral response. In similar situations in the past I would normally go workout for awhile before talking to someone about the event. But this time filling out the before and after of the NATR seemed to be the behavior. Though I did end up talking to my mom about the emotions and thoughts as well because she was in the kitchen as I was filling the NATR and she wanted to know more about it and how I was feeling, especially since she knows that the event is usually a distressing event for me. Though filling out the NATR helped me organize and break down my thoughts and emotions and it made me realize that there were multiple thoughts stemming from this event which contributed to a number of emotions. That I was feeling more emotions than anger and resentment. By breaking the emotions and thoughts down it helped me confront them individually and realize that some thoughts had more validity than others. It also made me realize that one of the first/main thoughts that contributed to the anger was the least valid and that there where some other thoughts involved.

    2. As I mentioned before I ended up talking to my mother between filling out the before and after sections of the NATR. She knew I was upset about the event and wanted to talk to me about it and then the thoughts and emotions I wrote down in the before section when I explained what I was doing. She actually ended up asking me questions very similar to some Socratic techniques, though she was much more direct and challenging. Being this blunt and challenging would probably be off putting to clients, but considering she is my mom and we have a good relationship it was rather helpful. For example similar to asking what is the evidence that supports your thought, she asked me if I really believed X and why, and actually brought up evidence that did not support the thought as we talked. This means that I had already processed some of the event before I completed the after part and I think it made it easier to go though some of the Socratic techniques because from talking I already realized that my negative automatic thoughts about the event were not entirely valid. Though the Socratic techniques I found most helpful were: what is the evidence that supports your thought, is there another explanation for what happened, what is the outcome of believing your thought and what could come from changing your thought, and also doing a version of the responsibility pie chart. I think the hardest one for me to work though was “what is the outcome of believing your thought and what could come from changing your thought”, because this forced me to realize that the thought really will lead to an outcome that I don’t want and that changing it will help lead to a better one. But that this change is also way easier said then done. Because right now I know I need to change this thought process if I want to improve my relationship with the person involved, but part of me is still resentful.
    3.
    I already had a good idea of one of my main negative core beliefs before working on this assignment. I have dealt with a number of negative events related to it in the past, and it has caused some/been related to some issues in some of my interpersonal relationships. I did actually go to therapy for this for awhile. Though unfortunately she wasn’t a CBT therapist and while we talked about how I felt and how to improve my relationships, we never talked about negative automatic thoughts or core beliefs. Also while I have been aware of this negative core belief I have never really examined it working backwards from a negative automatic thought. Especially in regards to the negative automatic thought I chose, because this thought stemmed from an event involving a person that I know is in large part responsible for why I have this negative core belief. I ended up working on this technique by myself because there wasn’t anyone I was comfortable doing this technique with. But I definitely went through a range of emotions while I was doing it and I felt a lot of old anger, resentment, and sadness resurface. Especially in regards to the individual related to this thought and I had to make sure I stayed focused on questioning my thoughts instead of ruminating on my emotions. I also found when I started feeling very emotional I would get up from my desk walk around and maybe even start to do something else before I stoped myself and asked why I was trying to avoid this assignment. While I have been aware of this core belief it is definitely still hard for me to really confront it, especially since I’ve noticed that quarantine and being isolated had made me feel worse about it.

    4.
    The question I started with that I found helpful was to ask myself “if what you say is bad what is the worse part about it?” This question brought up a number of emotions for me but it also definitely got to an underlying belief. From there I asked myself more “if that is true what does that mean about you questions” and like I mentioned previously if I found myself trying to avoid the assignment I would stop try to ask myself why, and what about that point in the process or what thought made me want to stop working on this.

    Reply

    • Cassandra Miller
      Mar 12, 2021 @ 17:27:51

      Hi Carly,

      I really liked your response to the fourth part of the question. I think this question is really helpful when understanding the root of a negative automatic thought, or in other words the underlying core belief. This helps an individual focus less on the overall thought and more on the parts that one believes are valid. In addition, the second part to your question is very important because it allows you to derive meaning from the valid parts of the thought and relate them to how you feel about yourself (pulling in emotions). I think you are brave to say that this part was hard and often made you want to take breaks from this assignment, as it can be difficult to fully admit to yourself these deep-rooted self-perceptions (I had the same struggle, as I felt uncomfortable coming face to face with these beliefs).

      Reply

      • Carly Moris
        Mar 13, 2021 @ 15:33:45

        Hi Cassandra!
        First off all I appreciate you saying that, I was a bit nervous about how much to say or share about completing this assignment. I think that is one of the main reasons Dr. V has us completing these exercises ourselves. Because they may sound straight forward in class, but its a lot more complicated to complete yourself. This assignment definitely ended up being harder and more emotionally taxing than I was expecting. Even though in the end I feel like it helped me process some things. Even though these assignments can be uncomfortable for us, it helps us recognize that they are likely to make our clients uncomfortable as well. This understanding can help us empathize and be genuine with clients when talking about and going through these techniques with them. I also think that writing about our experience was important because it can be uncomfortable figuring out what and how much we should write about for this blog post, and our future clients are likely to feel similar reservations about how much they should share about their experience with these techniques.

        Reply

  19. Laura
    Mar 11, 2021 @ 13:39:56

    [Automatic Thoughts] – Complete your own Negative Automatic Thought Record. (1) Did the NATR help you “see” the relationship between event, negative automatic thoughts, emotions, behaviors, and outcomes? Explain. (2) What did you find the most helpful in completing the AFTER portion of the NATR? For example, was a particular Socratic technique or developing an alternative thought helpful?

    In completing my own NATR, I did notice patterns after the fact. I found that there was a repeated relationship between certain events that were similar to one another and the same negative automatic thought that went along with those events. I found that insistence where negative automatic thoughts came into play had consistently less positive emotions, though even without noticing these patterns in the moments, I was able to maintain acceptable outcomes and did not have any significant behavior changes. In completing the after portion of the NATR I focused most on how I would respond to friends or family who were experiencing the same or similar negative automatic thoughts. I discovered that I was equally understanding and empathetic of the thoughts towards myself and others but was able to more rationally explain the lack of validity of the thoughts when it came to others. In regard to myself, I was able to come up with more seemingly logical reasons as to why my negative automatic thoughts were valid- though I could still empathize with why those feelings were unfortunate or emotionally draining.

    [Core Beliefs] – Watch MDD-15: Core Beliefs – Identifying – Downward-Arrow Technique. Practice a Downward-Arrow Technique on yourself (or try with a trusted friend or family member). Answer the following: (1) Even though you probably already knew what core belief you were working towards (admittedly, this can be an awkward technique to do on yourself), did you have any emotional or cognitive reaction afterwards? (2) Was there any particular question or approach that you found more helpful (or less helpful) than others?

    I found this exercise particularly interesting because despite knowing the core belief I was going to unveil; I was slightly surprised to see the impact it has- I guess I thought I was more self-aware and able to avoid these kinds of things impacting areas of my life. I don’t think I necessarily had an emotional response, but I definitely had a cognitive reaction. It was undoubtedly most impactful for me to ask myself the “so what” questions. In watching the video, when Mark was asked a question regarding his feelings of unlikability, and when Dr. V asked him essentially “so what? So what if they don’t like you?” Mark didn’t really have much of a response other than to say it was hurtful, which I thought was disappointing- in watching that, I wanted more of a response. With that said, when I practiced this myself- I reacted similarly to Mark. I kept trying to think logically and determine exactly why x potential thing mattered, and most of the responses I came up with were emotional and not as important as I might have previously thought. While the experience was surprising, it was also really helpful because I was able to step back and gain some understanding about what responses I have that are purely emotional, and then how to think through those emotions to weed out what might not be so important or what I can modify.

    Reply

    • Elizabeth Baker
      Mar 13, 2021 @ 20:12:57

      Hello Laura,

      I enjoyed reading your post! It sounds like you had a more positive reaction to these exercises, especially with the core beliefs exercise. It is interesting to see your more positive response to this exercise as I had a more negative reaction, even though the core belief I decided to work on was not something that I have newly identified. It is also great that you try to stay self-aware about thoughts and/or behaviors that may affect your adaptive functioning, and I think, and as you have realized as well, practicing these behaviors of analyzing thoughts and emotions and how they intervene with your motivation and completion of various daily tasks have great benefits. Even you have identified and are trying to modify a negative core belief, there are still negative automatic thoughts that appear from core beliefs and situations that validate these negative core beliefs. It is also great that you keep an aware, understanding, and logical state of mind when you encounter these negative automatic thoughts and core beliefs.

      Reply

    • Alexa Berry
      Mar 13, 2021 @ 20:28:50

      Hi Laura,

      It seems like most people had some success with the “how would you respond to a friend/family member with this automatic thought”. In your response, I thought it was interesting that you were empathic towards yourself, but more rational towards others. I think I’ve heard of more instances where people are neither empathic or rational towards themselves, so I wonder where this difference comes from. In regards to your experience with core belief work, I also was surprised in uncovering the widespread impact my core belief had. This made it easier to understand why uncovering and working on core beliefs can be difficult for some clients, especially in the case of uncovering a negative core belief.

      Reply

  20. Anne Marie Lemieux
    Mar 11, 2021 @ 15:06:42

    I believe that I am pretty good at being able to see the relationship between an event, a negative automatic thought, and responses. I am also older and that skill has developed over time. Even still, the NATR definitely helped me to be more aware of my emotional and physiological responses. Similar to Mark’s statement on the video. Knowing something intellectually is not the same as experiencing it emotionally. Prior to utilizing the worksheet I was able to identify when I was experiencing negative thinking. However, it was generally cognitive reflection. I often tuned out my body’s responses. I can now recognize that I frequently clench my jaw as a reaction to a strong emotion. In addition, I keep a lot of tension in my shoulders. In being better able to identify my emotions and rate the intensity, I was able to implement coping strategies (behaviors) which in turn improved the outcome. One of the most helpful Socratic techniques for me was contemplating how I would respond to someone else experiencing the same thing. Recognizing that I may have more empathy towards someone else, allowed me to recognize that I may have been holding myself to a higher standard than necessary.

    The Down-Arrow Technique is new to me and I found it a little challenging to do by myself. However, there was some benefit in being able to reflect and search deeper for insight into negative automatic thoughts. It allowed me to recognize that for the most part I am not managing any core beliefs that are causing significant distress. I have more control in my life than I recognized in my younger years. It also allowed me to recognize when negative automatic thoughts begin to spiral down, it could be stemming from an old belief. It also made me more cognizant to check for evidence when I have had strong emotional responses to events. I think utilizing worksheets is a great tool to use to genuinely recognize and modify core beliefs at an emotional level. It also forces you to look at yourself with more objectivity.

    Reply

    • Anna Lindgren
      Mar 12, 2021 @ 10:45:47

      Hi Anne Marie,

      Thank you for sharing! It really is incredible how it’s so much easier for many of us to be more understanding of others’ negative thoughts than our own. I think that the Socratic technique of separating the thought from the self is so helpful for that reason. It’s a good way of understanding that not all of our thoughts are true or helpful without placing blame on ourselves for having them.

      Reply

  21. Nicole Giannetto
    Mar 11, 2021 @ 15:07:28

    [Negative Automatic Thought Record]
    (1)
    Completing the NATR helped me to visualize the relationships between the event, negative automatic thoughts, emotions, behaviors, and outcomes. I find that visualizing thoughts or experiences is helpful for me to better understand the process of events from start to finish. One example I used was from an experience that occurred at my job. I work in an inpatient setting, and there are instances where restraints may occur. Prior to starting the job, all staff complete CPI training. This week I was part of a code team that had to respond and was tasked with assisting in a restraint. As it was my first time engaging in this, I was very nervous, but wanted to stay calm for the patient’s sake. My negative automatic thought was, “I am not going to be good at this”. Emotionally, I felt scared, nervous, and a bit excited. Physiologically I felt my heart racing and probably a bit sweaty. I found it helpful to fill in the NATR with this experience, and I found it acted as type of debriefing session that I could have with myself to process the event, thoughts, emotions, behaviors, and outcomes.
    One alternative thought I had regarding one specific experience I noted was to consider how my coworkers were feeling when given their specific task in this situation. I was able to put myself in their perspective and understand how that must have also been nerve racking for them. One socratic technique that I found to be helpful was decatastrophizing the situation. Let’s say something happened, I know I would still have support from my coworkers who were there. Regardless of the outcome, this would be a learning experience, and it felt good to think of it in this positive way. Thinking of this after the fact made me feel reassured and I’ll work to remember that in future situations. Overall, these techniques helped to ground myself after this experience, and hopefully will prepare me for future experiences whether at work or in other situations.

    [Core Beliefs]
    (1)
    After this activity, cognitively, I was fairly accurate on my initial assumption about what the core belief was going to be. Emotionally, it felt like a relief to finish the process, because it can feel difficult and heavy during it. Afterwards, you feel a mix of an “ah ha” moment followed by a sense of relief. Despite the relief, there is still some anxiety with now figuring out the next steps of how to decide if this core belief should be modified and how to do that. One question I liked was asking, “So what?”. It’s simple and to the point. I might modify it depending on the client to make it more emotional/less direct if they appear to be more sensitive to questioning. This question gets the ball rolling and helps to make it clearer about whether you’ve reached a core belief or need to keep going.

    Reply

    • Christina DeMalia
      Mar 11, 2021 @ 21:01:41

      Hi Nicole,

      Although restraints are never a good thing, it seems like it was really helpful that you experienced your first one while also having this exercise nearby to complete. I worked in a residential setting where I was probably in well over 100 restraints over the years I worked there. I definitely remember those feelings of self doubt and thinking that I wasn’t capable of doing that when I first had to assist in restraints. In a way, I think it is completely normal that no one feels fully confident or comfortable in their first restraints because of how stressful and traumatic the experience can be for every person involved. However, as you pointed out, the best thing you can do is remain calm for the patient’s sake. Letting negative thoughts about your capabilities during a restraint take control could possibly make the situation worse, so it sounds like you made the best call by remembering that you had been trained and that you had your coworkers there for support. I have always felt like staff should go through a debriefing process after being in a restraint, and although the NATR may not be exactly the right fit, I do wonder if some of the techniques used for the NATR could be useful for a debriefing process for staff.

      Reply

  22. Alexa Berry
    Mar 11, 2021 @ 16:04:43

    1. I found the negative automatic thought record helpful for tracking the connection between a specific event, automatic thoughts, and emotional/behavioral outcomes. However, this exercise was overall not very eye opening for me because I tend to naturally be very aware of my negative automatic thoughts. If anything, I think writing it down is the most beneficial part because if I were to reflect on this experience, I know exactly what happened in the event and what I can target for change, whereas if I didn’t record it, I could distort what had happened in the moment. Perhaps if I had experienced negative automatic thoughts, I was not already aware of, the automatic thought record would have been more of a significant experience for me.
    In contrast, I found the after portion to be much more useful of an intervention. Being aware of negative automatic thoughts is only one step of modifying them. Because of this, I thought the after portion was very beneficial in forcing me to view this event through a different lens. To elaborate, even though I was aware of the negative automatic thoughts I had because they are recurring, going back and applying a Socratic technique for after helped me assess my outcomes and what I could do differently. Additionally, the after portion helped me realize that despite the fact I am aware of my negative automatic thoughts, I tend to not feel differently about them after the event has passed, and hold on to these emotions and have a hard time thinking of alternative behavioral responses. I also struggled with providing evidence that contradicts my thoughts, although I am sure there is some that exists. This helped me see that when I have strong emotional responses to an event I tend to hold on to how I felt about this, and have difficulties viewing it any other way than how I think it occurred.

    2. Interestingly, I did not know what core belief I was working towards when participating in the downward arrow technique. Through learning about core beliefs, I had a difficult time trying to identify what some of my “undesirable” core beliefs are. When I finally identified a core belief that is decently significant in my life, my cognitive reaction was kind of “how did I not realize this before” since it seemed very obvious afterwards. Emotionally, I felt mixed emotions because I was happy to be able to be more self-aware, but a bit disappointed because I realized how this core belief has contributed to my behavior/thoughts/emotions in ways I wish it hadn’t.
    Some questions I found to be helpful during this exercise were from the section on asking the client the meaning of their negative automatic thought. In reviewing some of these questions, after identifying the core belief, it aided in my ability to see how my core belief resulted in automatic thoughts across various parts of my life. Generally, it seemed like the part about automatic thoughts in the downward arrow technique was the most useful part of the core belief exercise.

    Reply

    • Tim Cody
      Mar 12, 2021 @ 16:03:38

      Hi Alexa,
      I liked your comments about negative automatic thoughts. I too felt that I knew the thoughts I experienced very well, but writing them down was a significant way in which I could further analyze them. I also found the “After” section to be a significant way in which to work through interventions, particularly through Socratic Techniques. If I did not write it down in the NATR, I may not have analyzed my negative automatic thoughts as thoroughly, and they could have continued to affect me.

      Reply

  23. Tim Cody
    Mar 11, 2021 @ 16:08:13

    [Automatic Thoughts]

    (1) The NATR helped me to realize where my thoughts were coming from. There are times when I do not think I am good enough to be in the position that I am in. I often feel like I am kidding myself with graduate school and whether or not this is the right choice for me. I found that connecting the automatic thought to a specific event was a good way for me to hone my negative emotions and thoughts and help me realize why I had them in that particular instance. Connecting the thought to the event helped me to even see more clearly the emotions, behaviors, and outcome that followed the thought, even in terms of rating the believability and intensity. I also feel like the NATR will lead to a profound and thorough intervention, particularly when completing the AFTER portion.

    (2) I found developing an alternative thought to be the most helpful. Often when I feel like I do not get along with my colleagues, I begin to blame myself and feel like I am not good enough for the position I am in. I found that when I externalize my negative thoughts and place them to a specific event, I was able to cope better and have more positive regard for both myself and others. The alternative explanation I came to was that my colleagues were not trying to step on my toes, that they believe I am good coworker, and that they would like to work alongside me. In the moment, they were simply trying to reach out to students in the same way that I was, but I interpreted it differently in the moment.

    [Core Beliefs]

    (1) As I was going through my original core beliefs through the use of the Downward-Arrow Techniques, I found that there was a shift in my own emotions. When my colleagues may step on my toes and side step me when it comes to working with students, I find myself thinking, “I am not good enough for this position.” However, when I start asking myself the questions, “If this is true, so what?”, it led me down a path to disbelieving this negative thought. I would at first shift my core belief to “I am not good enough to work on a college Campus,” then to “I am not good enough for a real-life job,” then to “I am not good enough for this Graduate Program,” and finally to “I am not a good enough person.” Seeing this cascade downward, it helps motivate me to doing a better job and being more vocal when I have an issue with a colleague. It also helps me realize that I am good at what I do and my cognitive distortion shits to a more positive aspect. In fact, I know through my job and working with students that I am good at what I do and I enjoy working with those around me, it was only in the heat of the moment that I felt this frustration. After coming to terms with this realization, I am more relaxed and positive towards my environment.

    (2) Usually when I assist others with their negative automatic thoughts, I simply disregard them and look to the positives in their life. I found the “If this is true, then so what?” question to be the most helpful. It assisted me into realizing that even if the negative thought leads to negative core beliefs, there is a chance that the client may come to a deeper realization about themselves. The client may even find that the negative thought is not true because they have a profound sense of their own core beliefs. And even if the negative thought is true, it should not have a substantial an effect to shift their own core beliefs.

    Reply

    • Laura Wheeler
      Apr 15, 2021 @ 23:20:54

      Hi Tim. I think it is really impressive that you were so successful in developing an alternative thought that you put into practice and that had such a positive impact! I found that in theory, it wasnt too challenging to think of alternative scenarios, but putting them into practice was more difficult. Given the minimal information about your situation though, it does sound like your alternative thought is valid and your coworkers were probably just trying to be helpful or work with you. I will definitely keep your process in mind when trying to implement something more adaptive myself!

      Reply

  24. Connor Belland
    Mar 12, 2021 @ 13:17:23

    Hi Tim, I find it interesting that you normal try to look at the positives when people tell you their negative thoughts, i do the same thing. It was a bit of a change for me when we have to instead focus deeper on the negative thought, and find the root of it. We are highlighting the negative automatic thought in this case and questioning it until we get to the negative core belief that is causing it.

    Reply

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Adam M. Volungis, PhD, LMHC

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