Logging cognitions: Not “what” but “when”

@ 2011 Lynn Cummings, http://www.lynncummings.com . All Rights ReservedIn cognitive-behavioral therapy, it’s hard to get clients to write down their automatic thoughts.  It’s easy to forget one’s pen and pad, and easier to feel self-conscious about jotting private thoughts in public. Even those who cope with those obstacles, still often wonder, “What am I supposed to write down?” It’s not that the therapist didn’t explain carefully, or that the client didn’t get the concept. Often, they hesitate because most automatic thoughts are about as profound as, “I wish this place had Wi-Fi.”

As David D. Burns, M.D.’s “downward arrow” exercise shows, thoughts that seem insignificant can grow from deeply-held beliefs. “I wish this place had Wi-Fi,” might imply a deeper fear of, “I can’t get what I need to do this report properly,  which might imply, “My report isn’t going to be good enough for the presentation,” which might imply, “I’m going to be fired.” The chain could lead to a core cognition of, “I’m a total incompetent doomed to financial ruination and abandonment by my family and friends.” A wish for an internet link wouldn’t seem worth reframing, but the fear your life will be ruined certainly does.

Clients can feel more comfortable about noting automatic thoughts if they compare them to sea spume. These tiny bubbles are no more than a few seconds’ worth of salt water and air, but they are created by powerful ocean waves. Those waves are made by winds, which blow because of the atmosphere’s heating and cooling; and by the tides, which are created by the gravitational pull of the moon.   Like automatic thoughts, sea spume is insubstantial froth that links directly back to massive forces.

Thoughts are usually emotionally loaded when they arise at a time of strong emotions. When client’s ask, “What should I write down?” it’s useful to say, “Don’t worry about ‘what’. Think about ‘when’.”

@ 2011-2012 Jonathan Miller All Rights Reserved

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