Topic 7: Core Beliefs {by 10/28}

[Core Beliefs] – Watch MDD-15: Core Beliefs – Identifying – Downward-Arrow Technique. (1) How was the downward-arrow technique effective in leading to the client’s core belief based on his negative automatic thought and considering his background? (2) Based on the client’s core belief and what you know about his negative automatic thoughts, what modification technique(s) would be the most appropriate?

 

[Core Beliefs] – Complete the Downward-Arrow Technique on yourself (if you want, you can start with your negative automatic thought from your NATR).  Answer the following (you can be brief): (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 10/28.  Have your two replies posted no later than 10/30.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

33 Comments (+add yours?)

  1. Kaitlyn Tonkin
    Oct 27, 2021 @ 13:13:03

    Core Beliefs: MDD-15

    1. The downward arrow technique was helpful for Mark to take his negative automatic thought that “Jeff doesn’t like [him]” or more generally that “people don’t like [him]” to get at the core belief that he is unlikable. The downward arrow technique was helpful in getting there because Mark was able to revisit the thought, recall his emotions in the moment, and think about the validity of the thought. The clinician also worked on challenging those thoughts, which was really helpful in getting to the core belief about not being likeable. The questions that the clinician asked were useful because the answers directed the client and clinician towards the core belief. Furthermore, the Downward Arrow Technique provides the client with a safe space to think deeply about their thoughts and emotions. Identifying a core belief can be a very challenging and emotionally charged task, so doing this activity with a therapist is helpful for the client to talk through how they are feeling and thinking, like Mark did in this example.

    2. Just like automatic thoughts, core beliefs can be modified, and often similar techniques are used to modify automatic thoughts and core beliefs. Based on what we know about Mark, I would say that utilizing Socratic techniques to modify his core beliefs would be the most helpful. In particular, examining the evidence might be helpful for Mark. During the downward arrow technique, the clinician did some of the examining the evidence with Mark, so I think it would be helpful to continue to hone in on this technique. Mark also mentions that intellectually, he knows that people like him, but emotionally, he feels otherwise. Examining the evidence might be a useful technique for Mark to modify those emotions as well. Mark also might benefit from looking at the advantages and disadvantages of the core belief. The purpose of this technique is to validate what the client is saying, but emphasize the disadvantages of the core belief. Core beliefs maintain believability because the thoughts and behaviors that come as a result can be reinforcing to the individual, so taking the time to analyze the advantages and disadvantages of the core belief can allow clients to understand why it would be beneficial to modify their core beliefs. I think this would be helpful for Mark because he could make a tangible list that motivates him to make those modifications. It also gives him the opportunity to come up with a new core belief that would be more adaptive for his day-to-day functioning. Similarly, I think that Mark could benefit from a core beliefs flowchart which would facilitate the development of a new core belief. If Mark was able to modify his core belief, he would likely feel a sense of relief and much less distress in his life.

    Core Beliefs – part 2

    1. As said in the question, I already knew the core belief that I have that I can work towards modifying, so it did not come as much of a surprise to me when I was able to come to that conclusion while doing the Downward Arrow Technique. I feel like if I was given this in a therapy session and worked with a therapist to come to the conclusion about a core belief I would have a much different reaction. I imagine I would feel some negative emotions just thinking about the core belief, and maybe even some relief that we were able to figure it out because then change could begin. I feel like the downward arrow technique can be an intense exercise, as seen in the example with Mark.

    2. When going through the Downward Arrow Technique, I found the question “if what you say is true, what does that mean about you?” to be the most useful at identifying my core belief. I feel like the answer to this question will most likely direct the client and clinician towards the core belief the most. For me, my answer to this question was my core belief (although that might be because I have more insight as a psychology student). The question that asks about the worst part about the thought was challenging for me and difficult to come up with an answer, so I would say that was the most unhelpful question. However, that was just my experience and I can imagine that for other individuals it would be a particularly helpful question to get at identifying their core beliefs.

    Reply

    • Frayah Wilkey
      Oct 28, 2021 @ 10:25:22

      Kaitlyn,
      Thanks for your responses! I really liked your explanation for the second part of the prompt where you explained your experience with the technique. I think you bring up a good point about the possible differences between doing it on your own versus in a therapy setting. I agree that my reaction would probably be different too and I hadn’t even considered that.

      Frayah

      Reply

    • Jennifer Vear
      Oct 28, 2021 @ 13:38:29

      Hi Kaitlyn!

      I really liked your answers for the second part of the discussion. I found it interesting that you mentioned you found it difficult to answer “what is the worst part about…” I was able to answer this one, but it makes me intrigued to think about how different situations/experiences and core beliefs could find this question easier or more difficult. As I mentioned in my blog post, I would be really interested to see how this would play out with various clients and various core beliefs. Thank you for your responses!

      – Jenn

      Reply

    • Giana Faia
      Oct 28, 2021 @ 19:23:34

      Hi Kaitlyn,

      I agree that the downward-arrow technique would’ve been more beneficial had it been done in therapy with a therapist rather than us doing it to ourselves. It felt kind of awkward asking ourselves these questions. I think my reaction would have been different and more emotional had it been a therapist asking me these questions. Similar to you, I also found the same question to be the most beneficial because it got to the meaning of what we think it means about ourselves. Thank you for sharing!

      Giana

      Reply

  2. Valerie Graveline
    Oct 27, 2021 @ 14:37:51

    Core Beliefs
    1) The downward-arrow technique was effective in leading Mark to his core belief as it allowed him to identify how he feels emotionally regarding such belief, versus how he feels intellectually. Through this technique, Mark was first able to identify the negative automatic thought of “They (coworkers) don’t want me around”. Next, the clinician asked Mark various questions regarding how if this thought were true, what would this mean to Mark? These questions led Mark to the thoughts that truth in the statement would mean he isn’t a good person. This eventually led to Mark identifying his core belief of “I’m unlikeable”. This technique was especially helpful for Mark as he was able to fully process his emotions surrounding his negative automatic thought and core belief, while comparing the evidence and his believability of each. It was important for Mark to be able to process his emotions as he tends to ruminate and experiences high levels of distress when these thoughts arise. When discussing his believability of the core belief, Mark ultimately acknowledged that the core belief may not be true as he knows there are people who like him, thus, warranting modification of the core belief.

    2) Based on Mark’s core belief being “I’m unlikeable” and his negative automatic thoughts relating to this, I believe that examining the evidence and assessing the impact of believing the core belief would be the most appropriate modification techniques. In the moment during a distressing situation, Mark tends to have intense emotional reactions and high levels of believability in regards to his negative automatic thoughts, such as “They don’t like me” or “They don’t want to be around me”. In sessions, discussing such events also trigger similar emotional reactions as well. With this in mind, it would be important for Mark to examine the evidence of this core belief, such as evaluating how he has gotten lunch with his coworkers before, and does so often. Mark has shown increased ability to recognize the evidence that contradicts his core beliefs, since in session he was able to immediately identify that the core belief may not be completely valid. Similarly, assessing the impact of believing this core belief would prove crucial for Mark as he has a tendency to ruminate on these thoughts. It would be important to highlight the behavioral and emotional outcomes of not believing the thoughts versus believing it, as not believing this thought would lead to less emotional distress for Mark.

    Core Beliefs (pt 2)
    1) The core belief I was working toward is one that I have previously identified and thus, tend to notice when it arises within various negative automatic thoughts. However, whenever I arrive at this core belief I do still have a negative emotional reaction despite my familiarity with it. I think understanding that even though I have already identified this core belief, but still have negative emotional reactions, showcases that such beliefs are so deeply-held and are hard to modify when they have been ingrained in ourselves for so long. Aside from emotional reactions, I do tend to have cognitive reactions that contradict my emotions using evidence against the belief, but I still find it difficult to accept these contradictions despite the evidence presented.

    2) I think the question I found most helpful when thinking about my core belief was “If that were true, what does that mean about you?”. I find this question really provoking as it caused me to feel a lot of negative emotions. However, I believe it’s a very important question that leads to the root of one’s distress surrounding the belief. Answering this question also caused me to immediately compare the belief with evidence against it, as “what it means about me” was something I did not want to believe to be true. Ultimately, I feel as though this question initiates the most emotional reactions and causes the client to really deeply reflect on the belief.

    Reply

    • Morgan Rafferty
      Oct 28, 2021 @ 13:06:34

      Hi Valerie! Super post.
      I really understand your sentiments regarding asking ourselves the question “If this is true, what does that mean about me?” I think it is difficult because it forces us to face the notion of that core belief being true. It feels ugly to face that head on when it is essentially something about ourselves we do not want to be true. Thankfully, we can shift focus to alleviate discomfort by (hopefully) finding evidence against that core belief being 100% true.

      Reply

  3. Jennifer Vear
    Oct 27, 2021 @ 15:30:30

    [Core Beliefs] – P1
    1. By using the downward-arrow technique for Mark’s negative automatic thought of “they don’t want me around,” we were able to figure out that his negative core belief was that he believes he is unlikeable, or unlovable. By asking various questions such as what if that thought was true, so what if it is true, and what does it mean for you personally if it is true, allowed Mark to narrow down where this negative automatic thought seemed to originate from. Considering the fact that this is a pretty common theme for Mark’s feelings and actions and what we have seen so far, it makes a lot of sense that he would hold this type of negative core belief about himself.

    2. I believe that the best way to modify Mark’s core belief of being unlikeable would be to examine the evidence and determine if the negative core belief is valid. This technique would be extremely effective for Mark because he admitted that he felt that these thoughts were mostly true in the moment and emotionally, but intellectually, he knows that it is not true. When faced with future and past situations, it would be most beneficial for Mark to look at evidence that could support and not support his thoughts to help him break down this core belief into a more positive one. For example, Mark knows that he considers George a friend and of course his girlfriend, but it is the situations when his other friends and Jeff bail on him that makes him question these things about himself. However, there are aspects such as when Jeff apologized and offered to go again another time that proved that Jeff did not truly dislike him.

    [Core Beliefs] – P2

    1. I have already worked with negative automatic thoughts and core beliefs on myself in the past. In examining my negative automatic thoughts and core belief now, it was definitely interesting to see where these questions lead me. For my core belief, I was like Mark in that emotionally it feels very true and real, but intellectually there is clear evidence that these thoughts and beliefs are not always true. I could also benefit from examining the evidence when I feel strong emotions and try to break down each thought to help improve and create a new and more positive core belief.

    2. The most helpful technique I found was using the negative automatic thought record to keep track of my negative thoughts and find a common theme among them, or one that was most powerful and consistent. With that thought selected, I found it helpful to question how I felt if it were true and then what that possible truth meant to me as a person. It makes me also think that depending on the type of core belief that one holds, different questions might work better than others. I found that the question asking, “what is so bad about…” did not really seem to apply to my situation and did not help much in narrowing in on my overall core belief. I did think that analyzing the question, “what is the worst part about it” seemed to help. As a future therapist, I believe that it could really help to already have a guess of the client’s core belief in mind, and gauge which questions might work best in leading the client to discovering their true core belief. I would definitely be interested to see which questions work best for various core beliefs.

    Reply

    • Katie O'Brien
      Oct 28, 2021 @ 11:12:17

      Jenn,

      Thanks for sharing your experience, starting with the NATR. Like you said, when I was completing my record, patterns became more obvious to me. Even though I sort of knew them going in, seeing them laid out in the record really hit home what I needed to work on. I think this shows the importance of giving our clients homework and following through on reviewing those assignments – they really aren’t just busy work! The NATR directly led into the downward arrow exercise and let me get more out of it, I think. Good point!

      Katie

      Reply

  4. Lisa Andrianopoulos
    Oct 27, 2021 @ 20:58:20

    When Mark saw Jeff and other colleagues returning from lunch, his automatic thought was that they didn’t want him around. This thought was used to begin the downward arrow technique. By asking Mark questions that really made him think about the meaning and implications of the thought, Mark was able to dig deeper and really get at the core belief that was surrounding it. When the therapist asks Mark what it means about him as a person and what’s the worst part about this, Mark eventually says that his own well-being is tied into being included in things and that there are days that he doubts if people like him. When asked how he felt about what he just said, Mark said it was one of the toughest things he’s said in therapy. General likability was a resounding theme and it made sense when he was asked, “Mark, do people like you or not?” Modification techniques that have already been helpful with Mark in looking at his automatic thoughts can be helpful here. He is already talking about examining the evidence in the video, so this can be expanded on further. Also, it might also be helpful to try to get him to gain some distance from it by again asking him to consider what he’d say to Melissa if she held that core belief.

    When I did the downward arrow technique on myself, I had a lump in my throat at the end. It made me so sad. It sounded silly, but still rang true for me. I know what I have to work on – Wow moment for sure! The question I found most helpful was the second one, if what you say is true, what does that mean about you? This is the one that really helped me get at the core belief. The third one, what is so bad about…?, helped me expand on it. I didn’t find that the last question added much, other than making me a bit more sad…..

    Reply

    • Frayah Wilkey
      Oct 28, 2021 @ 10:07:05

      Lisa,
      Thank you for sharing your thoughts! I felt really moved by your response to the second portion of the posting. I also felt emotional while doing it and wasn’t expecting that reaction. The exercise really draws out vulnerability and can be hard to work through. It sounds like it was helpful for you though and I’m glad that you got something out of it.

      Frayah

      Reply

    • Valerie Graveline
      Oct 28, 2021 @ 12:08:25

      Hi Lisa,

      I appreciate you sharing your experiences of when you utilized the downward-arrow technique on yourself. I agree that the method was very powerful, and it brought on a lot of different emotions for me as well. I also found the most helpful question to be “if what you say is true, what does that mean about you?” when identifying my core belief. I think it’s super important as future clinicians for us to understand how emotionally-intense this exercise can be so that we are aware of how our clients may be feeling while we utilize this technique.

      Valerie

      Reply

  5. Frayah Wilkey
    Oct 28, 2021 @ 00:11:15

    [Core Beliefs] – Part 1
    1. I think that the downward-arrow technique was a great strategy to use with Mark during this session. It was an effective method to use with his initial thought of “he doesn’t want to be around me”. Through Socratic questioning, Mark was able to dig deeper and engaged in metacognition in order to find the root of his negative automatic thoughts. After some time, he was able to recognize and label his core belief of feeling unlikable/unloveable. This session provided him with a safe and collaborative space to explore his thoughts and enhance his understanding of himself. Mark often struggles with his self-esteem it seems so this exercise appeared to be really useful for his treatment.

    2. Based on past sessions with Mark, it seems that examining the evidence of his automatic thoughts is extremely helpful for his progress. As Mark explains the situation and delves deeper, he reveals that he’s gone out with this coworker a dozen times and even stopped in to invite Mark out at the end of the day. Stating this out loud seems to give Mark a lightbulb moment- he realizes the evidence that disputes his thought and he begins to understand the contradiction. Using this technique in the future would be helpful because Mark is good at considering the evidence and attempts objectivity when prompted.

    [Core Beliefs] – Part 2
    1. Using the downward-arrow technique was enlightening and helpful. Many of my core beliefs are rooted in specific events from my childhood so it was emotional to think of. It’s also interesting to consider how events I don’t even think about daily effect me so greatly. I think that doing this mental work is important though, especially for personal growth and learning. It was difficult but not as bad as I thought it would be.

    2. The particular question that I focused on was ‘if that were true, what does that mean about you?’. I found myself thinking really deeply about this and it made me consider my thoughts and behaviors from a completely different perspective. I feel like it’s such a blunt but deep question and deserves quite a bit of thought. One question I didn’t particularly find any of them unhelpful for learning but that one really stood out to me.

    Reply

    • Katie O'Brien
      Oct 28, 2021 @ 11:22:46

      Frayah,

      Thanks for sharing your experience with the downward arrow technique. It also made me a bit emotional to do, too! Like you said, a lot of this comes from our childhoods and still has a big impact on us, whether we are consciously aware of it or not. I think as we become therapists and begin treating clients, it’s so important to keep our own experiences of doing these exercises in mind. It can be easy to get so caught up in explaining the techniques, but we really need to remain sensitive to how personal and difficult it is to be on the receiving end. This stuff can be pretty big for clients and while we can think objectively, considering which category the belief falls into, what techniques to use, etc., to the client, that’s not really their concern. It’s about how it impacts them and their day to day.
      Thanks for your response!

      Katie

      Reply

    • Francesca Bellizzi
      Oct 28, 2021 @ 12:01:51

      Hi Frayah,

      Awesome post all around!

      In response to engaging in this core belief exercise on yourself, know that I had a heavy emotional reaction too. I think sometimes it is really hard for us to revisit negative events and emotional responses when we are on by ourselves because we almost fall down into our own “rabbit hole” of thoughts. I do agree, this exercise is really helpful and mental work is something we should all be doing.

      Thanks for sharing!

      Francesca

      Reply

  6. Sergio Rodriguez
    Oct 28, 2021 @ 10:10:47

    [Core Beliefs] Part 1

    (1) The first essential and helpful element for Mark’s anxiety was the therapist’s explanation that he would challenge him using the “downward-arrow technique.” The technique was effective because it led to Mark’s core belief having his automatic thought: “they didn’t want around” as a starting point. I consider when the therapist asked Mark: “If that’s true, so what?” Mark’s perception took a new direction and made him go deeper on the reasons around why he was feeling or would feel hurt and unwanted if that thought were real. Then Mark verbalized he puts a lot of effort into being liked by people: “I want to be included,” recognizing Mark’s background, it was a significant improvement. Likewise, when the therapist “forced” a Yes or No question, Mark recognized the answer would be no, but he could analyze the context and check real evidence of that belief, he pointed out and made a difference between his emotions and his rational thinking process where he can identify he is not unlikely and identified real evidence even though he does not feel like that.

    (2) Selecting the most appropriate modification could be challenging because it changes from patient to patient. Considering Mark’s background, I’d use “View the Negative Core Belief on a Continuum” . Most negative core beliefs are expressed in extremes and are dichotomous. For Mark, one pole is being unlikeable, and the other is being wanted by people, so he puts a lot of effort to get to the other pole and feels likable and included. This situation sets him up to failure very often because every time he has an interaction where he feels not part of a group or unlikable by a friend, he will come back to his other pole: “people don’t want me around”. Viewing the negative core belief on a continuum will lead Mark to find points where he doesn’t have to necessarily be liked by everyone and find himself in a middle point where some people like him and others don’t. This mindset will moderate his negative automatic thoughts by just being ok (relief) with not being liked by everyone around him.

    [Core Beliefs] – Part 2

    (1) Generally, when I talk to people, and I feel that there is a core belief in the background of something that may be trivial and that the person is simply holding on for reasons that they probably don’t even recognize, I tend to be very confrontational. However, when I tried to put this into practice with myself, I found it difficult, because as I mentioned before, in many occasions, as human beings, we cling to things that we do not even understand the reasons very well. In emotional terms, it was hard for me to feel that I could be wrong about my thoughts. Perhaps this led me to cognitively avoid analyzing in detail why I found it hard to debate my own negative automatic thinking.

    (2) The most effective approach for me was the questions about whether the core belief was relevant or believed because, on many occasions, it can feel very strong but not be cognitively believed at all. For this reason, it may be generating significant discomfort in experiencing it, thinking about it, or trying to modify it anyway. In this sense, I think the main reason I can become more effective is to open myself to the opportunity to question things or thoughts that are ingrained and often “overlooked” but generate significant distress.

    Reply

    • Valerie Graveline
      Oct 28, 2021 @ 12:40:12

      Hi Sergio,

      I also thought it was important when the clinician essentially “forced” a yes or no answer when asking Mark if he believed the core belief of “No one likes me”. This question made Mark evaluate the evidence that supports this core belief in the moment, and allowed for him to realize that it may not be completely valid.
      Aside from this, I thought you made a very good point regarding Mark’s negative automatic thoughts and core beliefs being expressed in extremes. Your explanation that it would be important to help him recognize that he doesn’t necessarily need to be liked by everyone in order to have people who like him is a very important and powerful conclusion that would definitely help him going forward!

      Valerie

      Reply

    • Lisa Andrianopoulos
      Oct 31, 2021 @ 10:09:55

      Hi Sergio,

      Great comment about how Mark’s dichotomous thinking (likable or unlikable) sets him up for failure. It’s almost as if Mark is hunting for proof that validates the unlikable pole. As soon as he gets a hint that someone may not like him, he become’s laser focused on it, ruminates, and he is right there, clinging to that pole. Having him thinking about his likability on a continuum can go a long way.

      Lisa

      Reply

  7. Katie O'Brien
    Oct 28, 2021 @ 11:07:54

    Core Beliefs (1)
    1.) By using the downward arrow technique, Mark was able to move from an automatic thought (Jeff doesn’t want to spend time with me / doesn’t like me) down to his core belief of being unlikable/unlovable. For Mark, the downward arrow technique was helpful because he noted that intellectually, he knows and can acknowledge that those thoughts and beliefs might not be true, but the emotional reaction to them is still intense and hard to dismiss. By using specific questions, such as what it means to Mark if the belief is true, it highlighted the core belief and thus, why these thoughts do have a pretty large emotional impact on Mark. While it did not feel great for Mark to admit to, being aware of this core belief will help him understand where those automatic thoughts and negative feelings come from going forward.
    2.) Like with Mark’s automatic thoughts, it would be helpful to examine the evidence for and against his core beliefs. While he does have very emotional reactions, by looking more logically at the evidence, which he tends to be pretty good at providing, he can try to put the negative emotions to the side and recognize that those bad feelings don’t mean that the core belief is true. Seeing lists side by side is a clearer way for him to evaluate the belief. Similarly, it would be helpful for Mark to evaluate the advantages and disadvantages for continuing to believe that he is unlikable. Mark has good insight into what outcomes his rumination and withdrawal lead to, so looking ahead into the future would help him recognize how helpful it would be to modify that belief versus how unhelpful it would be to keep it.

    Core Beliefs (2)
    1.) One of the struggles I face when dealing with negative automatic thoughts is that ultimately, I cognitively know they aren’t true, but still have the emotional or physiological reaction to them as if they were true. It was helpful to use the downward arrow technique and get to the root of the thoughts, my core belief. Although I sort of had an idea going into it what the belief is, it was still surprising/somewhat emotional to get to that point and doing the exercise gave me good insight into how clients like Mark must feel when doing this technique in therapy.
    2.) Answering the question, “If this core belief is true, what does that mean about me?” was the most helpful for me. It brought up the most unpleasant feelings, but by doing so, highlighted how important the effects of that belief are to me personally. It almost acted as a motivator to modify the belief. As I said, I cognitively know these things aren’t true, so examining it in this way emphasized how negatively I can feel by putting confidence in something I know isn’t even true to begin with.

    Reply

    • Francesca Bellizzi
      Oct 28, 2021 @ 11:56:00

      Hi Katie,

      Great post! I really enjoyed reading your interpretation of how the downward-arrow technique helped Mark. It was nice that you incorporated the fact that Mark knows intellectually that these thoughts/beliefs aren’t true, yet it is the emotional distress that “gets in his way”. I didn’t think to mention and incorporate this when writing my response, so thank you! It definitely provides more depth to the significance of this exercise with him. I also didn’t think to assess the advantages and disadvantages when trying to modify Mark’s core belief, and I agree that it would be beneficial for him.

      Once again, great post and thanks for sharing!!

      Francesca

      Reply

    • Kaitlyn Tonkin
      Oct 29, 2021 @ 11:49:23

      Hi Katie,

      I have the same experience as you where I know my automatic thoughts aren’t true, but emotionally I feel the opposite. This is something that Mark also brought up during the downward arrow technique and I think it is something that often comes up in therapy when working with automatic thoughts and modifying them. I also had the most success with the question that you did as well. I agree that it brought up the most unpleasant feelings, but the answer directed me straight to my core belief, which was really useful.

      I enjoyed reading your responses and seeing the similarities in our answers. Great post as always!

      -Kaitlyn

      Reply

  8. Giana Faia
    Oct 28, 2021 @ 11:41:29

    [Core Beliefs] –
    (1) The downward-arrow technique helped Mark think through his negative automatic thought to reach the core belief that it stems from. Mark and the clinician used this technique by starting with his automatic thought of “they (coworkers) don’t want me around” and eventually narrowing it down to his core belief of “I am unlikable”. By posing the question of “if that’s true, so what?”, in response to Mark’s thoughts, it helped him strip down each layer of his thoughts/ emotions until he reached his core belief. Based on Mark’s previous therapy sessions, we know these thoughts are frequent both in his life and in therapy which is why it was so important to uncover the core belief. Along with this, Mark was able to identify his core belief through the clinicians guidance rather than the clinician telling it to him which made it more effective.

    (2) Based on Mark’s core belief and automatic thoughts, I think examining the evidence would be appropriate for modifying this belief. Examining the evidence is helpful for seeing if the core belief has any validity relating to it, whether it be past or present. As we know, Mark tends to forget evidence that is against his negative automatic thoughts/ core belief, like when he remembered Jeff asking to make a plan for lunch another time. In that situation, examining the evidence helped Mark pick out evidence that did not support his negative automatic thoughts. If Mark is able to uncover evidence that contradicts his core belief, then he can begin to modify it.

    [Core Beliefs] –
    (1) Prior to using the downward-arrow technique on myself, I already knew the core belief I was working toward but it was interesting trying this approach to reach that core belief. I think had this been done in an actual therapy session, I would have had a more emotional reaction but because I was doing it myself, I didn’t have a strong emotional reaction because it wasn’t anything new to me. Cognitively, I know there is more evidence against it than supporting it, but I still tend to ruminate on the minimal evidence that supports it.

    (2) I found the questions “if that’s true, so what?” and “if what you say is true, what does that mean about you?” to be the most helpful. These questions helped me the most with working through my thoughts/emotions. By asking “so what?” It helped remove another layer so I could uncover the actual core belief.

    Reply

    • Sergio Rodriguez
      Oct 28, 2021 @ 15:55:10

      Hi Giana,

      I definitely agree with you that examining the evidence is a crucial strategy to utilize with Mark. As we have seen before, he tends to overlook some facts (evidence) that can help him feel better when he feels that something hurt him. i.e., the situation with his coworker that you mentioned. I also wonder what could be a better way to have Mark, considering his depressive mood, work on paying attention and include those details that could have been seen overlooked multiple times in the past in other situations that affected him and would have helped him to feel better.

      Great post!

      Sergio R

      Reply

  9. Francesca Bellizzi
    Oct 28, 2021 @ 11:51:08

    [Core Beliefs, Mark]

    1. The downward-arrow technique seemed to be highly effective in leading Mark towards identifying his core belief. It started with Mark’s automatic thought that “people don’t want him around” particularly because of a situation where his co-workers came back from lunch – and he was not asked to go. Through Socratic questioning, Mark was able to identify how he was feeling in that moment and answered things like “so what if it is true” to guide him further towards his own core belief. After about 4 or 5 questions, Mark was able to identify his core belief on his own – which is that he is unlikeable. Moreover, Mark was able to logically and realistically process the questions he was asked along with his responses which allowed him the opportunity to reflect on this core belief. It seemed that this moment of reflection allowed him to feel “more comfortable” with the process and gave him a chance to examine his thoughts without the emotional barriers.

    2. To modify Mark’s core belief that he is unlikable, I believe the most appropriate modification techniques to utilize would be to examine the evidence and to utilize other techniques such as a core belief flow chart. From what we’ve seen and talked about previously, examining the evidence has been a highly effective technique to use when challenging and modifying Mark’s automatic thoughts and beliefs. Utilizing other techniques, such as a core belief flow chart, would also be beneficial for Mark as it helps develop a new core belief that is more positive and adaptive. Core belief flow charts tend to incorporate the technique of examining the evidence as the clinician and client walk through situations, automatic thoughts, and emotional and behavioral responses in order to begin to develop a new core belief. This technique could be beneficial for Mark as he is the type of client who genuinely reflects on events, emotions, and thoughts to help him reason in a more adaptive manner.

    [Core Beliefs, Self]

    1. As a full disclaimer, I actually engaged in these identification and modification techniques during my own therapeutic experience when I was younger; however, as time had gone on and new things have developed, I noticed my experiences with these homework assignments had significantly changed. While I went into this exercise already aware of my own core belief that I was working towards, my reactions both emotionally and cognitively were still very impactful. My initial emotional reaction matched directly with my automatic thoughts and core beliefs, and I felt a sense of discomfort come over me. I am lucky enough to have the opportunity to be able to talk this over with someone who knows me and my “struggles” extremely well, and this gave me the chance to reflect on the outcome. While working through the exercise and once I finished, it kind of felt like all of my negative automatic thoughts came rushing to my head; yet, being able to slow down and create a dialogue about what I had just experienced actually helped me modify and challenge these negative reactions with evidence.

    2. Two questions that helped me were “if what you say is really bad, what is the worst part about it?” and “if what you say is true, what does this mean about you?”. These two questions were particularly helpful because they directly bridged the gap between my automatic thought and the core belief that I possess. On the contrary, the question of “if that’s true, so what?” was not as effective in helping me as it actually had quite the opposite effect. When I asked myself this question, I ended up continuing to identify more automatic thoughts and I went into a very negative space emotionally and cognitively. However, despite the extreme emotional discomfort, asking this question first helped narrow down where these automatic thoughts were coming from and helped provide a solid foundation for when I asked myself the two questions that helped me the most.

    Reply

    • Jennifer Vear
      Oct 28, 2021 @ 13:43:19

      Hi Francesca!

      I have also done these identification and modification techniques on myself in the past and to do them again, I also found that I have changed in various areas. For me, my core belief is essentially the same, but for different situations than it was when I was younger. But I would rather have done this with someone else coaching me through while being unaware of what the goal was if that makes sense. I don’t know, I almost feel like it would bring out more genuine responses if I didn’t know that it was going to bring up my core belief. That would be an interesting thing to try and experiment with (knowledge before or knowledge after the exercise). Overall, great job!

      – Jenn

      Reply

    • Lindsay O'Meara
      Oct 30, 2021 @ 19:02:13

      Hi Francesca,

      It is definitely uncomfortable when you come to the realization of a negative core belief. I am so glad you had someone to talk through it with and were able to feel comforted by that. It’s certainly not easy. I agree that the two questions you said helped are really great in digging a little deeper.

      Thanks,
      Lindsay

      Reply

  10. Morgan Rafferty
    Oct 28, 2021 @ 13:02:09

    1.
    Mark was very hurt when Jeff returned to work from lunch with co-workers. Mark had asked Jeff if he would like to join him for lunch. Jeff told Mark that he had other plans. Mark is crushed that Jeff didn’t invite Mark to tag along. He has a lump in his throat talking about it with Dr. V. and describes the painful, sinking feeling this incident created. He reveals his negative automatic thoughts: “I am not worth anything to them”; “They don’t want me around”.
    The downward-arrow technique was very effective in leading to Mark’s core belief: “people don’t want me to be with them”; “I am unlikeable”. One goal of Mark’s session is to determine the roots of this deeply engrained belief.
    2.
    Some modification techniques that would be most appropriate for Mark are:
    *examine the evidence – while it does seem harsh that Jeff and co-workers didn’t invite Mark to join them for lunch, it is helpful for Mark to think about other instances when Jeff (and maybe others) did invite him.
    *separate self from the negative core belief – it would be helpful for Mark to consider how he might react if his girlfriend Melissa were to come home and tell him this scenario happened to her instead. By guiding Mark to see the situation from an outside perspective, it might help shed some light on the incident not being as negative as he perceives it to be.
    1.
    Upon working on the downward-arrow technique on myself, I gained appreciation of the challenge in doing this task. It feels like I exposed the weakest aspect of me and brought it to the surface to examine. My emotional reaction was one of guilt and disappointment in myself. My cognitive reaction was immediate attempts to set forth statements that argue against this negative core belief.
    2.
    I found it helpful to ask myself “how strongly is this core belief believed on a scale of 0-10”? This allowed me to interpret the core belief as something that is not all or nothing. By viewing it on a continuum, I can see there is some truth to the core belief but yet it is not 100% accurate, 100% of the time. This gave me hope that I could work toward diminishing this core belief through changes in my behavior.

    Reply

    • Morgan Rafferty
      Oct 28, 2021 @ 13:13:30

      Francesca,
      I really appreciate your post. How interesting to have worked on this techniques years ago and to now being working on them again. To notice the difference as time has passed makes sense and is interesting for you to experience I am sure.
      Asking ourselves, “if that is true, so what?” does seem like a prompt that could trigger a cascade of additional negative automatic thoughts. For me, if I were to validate a negative core belief and then ask myself, so what? It would conjure up all bad thoughts! The only way I could see this as being helpful is if it used almost as a cathartic exercise. Thinking the worst and then re-examining the validity of the actual core belief (with the hopes it is not valid of course!).

      Reply

    • Sergio Rodriguez
      Oct 28, 2021 @ 16:11:15

      Hi Morgan,

      Thanks for sharing your thoughts! Also, I definitely understand your point, and I share it since sometimes it could be challenging to identify how strong is the core belief. I think this is important in the sense that I can have specific negative automatic thoughts (part of the core belief) and consider they are strongly believed and increase the perceived distress, but when you get a number to recognize how strong on a scale from 0 to 10 and give it a number will be easier to define how to proceed and change.

      Great post!

      Sergio Rodriguez

      Reply

    • Giana Faia
      Oct 28, 2021 @ 19:34:16

      Hi Morgan,

      I agree that examining the evidence would benefit Mark. Mark tends to focus solely on the times that he was turned down or not invited and dismiss the times he was included. However, by examining the evidence, it can help Mark recall the times he was invited by Jeff/ coworkers. Along with this, separating himself from the core belief could also be beneficial especially if it were Melissa experiencing it. By placing a loved one in his situation, it could help him come up with more positive ways to cope/ handle the situation. Thanks for sharing!

      Giana

      Reply

    • Kaitlyn Tonkin
      Oct 29, 2021 @ 11:52:57

      Hi Morgan,

      As I mentioned in my response, I think that examining the evidence would probably be the most beneficial technique for Mark, but I like that you brought up another technique where Mark could separate himself from the core belief. Reframing the situation and imagining that his girlfriend was the one saying it might allow Mark to see that his core belief is invalid and also give him the opportunity to use some of the things he would say to someone else on himself. I think it is also important that Mark does this technique with someone such as Melissa, with who he has a strong relationship, in order to have the most success with this technique.

      Thank you for your great response!

      -Kaitlyn

      Reply

    • Lindsay O'Meara
      Oct 30, 2021 @ 18:59:25

      Hi Morgan,

      I think it’s normal to feel overwhelmed by learning your core belief. It definitely was for me at first. It’s so positive that you immediately worked to change your cognition. With time it gets easier and being aware is the first step!

      Thanks,
      Lindsay

      Reply

  11. Lindsay O'Meara
    Oct 28, 2021 @ 15:00:52

    1. The downward-arrow technique is used to help the client come to the realization of their core belief on their own. This technique helped by identifying a relevant negative automatic thought, in this case it was “They don’t want me around.” Then the client is asked, “If that’s true, so what?” This helps the client to realize that he feels hurt when he feels like he isn’t valued. The questions that were directed towards Mark helped him to realize he feels unlikeable. When processing together, Mark realizes that there is evidence that people do like him.
    2. Based on the client’s core belief and what we know about his negative automatic thoughts, I think that using the Behavioral Experiment Worksheet would help him in modification. Replacing the old core belief with a new one and identifying thoughts that are good indicators of a new core belief would be beneficial for Mark. He already knows that people probably do like him and there is some evidence for that. Strengthening that and moving away from “I’m unlikable” and closer to the new core belief can help him to feel less distressed. Identifying a plan, and having Mark discuss possible setbacks can help him to feel prepared in tackling these beliefs outside of therapy. This process could help Mark to compile more evidence for the thought that he is likeable.

    1. I had identified this core belief earlier but I remember how I felt when I did. I did have an emotional reaction when I led myself to my core belief. It didn’t seem to align with how I tell myself that I feel so it was a little upsetting to realize that it exists.
    2. I have always tried to ask myself, “Would you talk about your friend that way?” when confronting negative automatic thoughts or ultimately core beliefs. The answer has always been no and it has helped me to be nicer to myself.

    Reply

  12. Lisa Andrianopouljos
    Oct 31, 2021 @ 10:01:51

    Hi Lindsay,
    I like the suggestions you have for useful techniques to use with Mark. I particularly like the idea of strengthening the existing evidence that there actually is a lot of people that do like Mark. Yes, he does know that there are people that like him, but he over focuses on what might be even slight evidence to the contrary. Getting Mark to focus on more positive aspects and strengthening his beliefs in them will go a long way in modifying his negative core belief.
    Lisa

    Reply

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Adam M. Volungis, PhD, LMHC

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