Continued from Step 1
Printable PDF: Step2
See also: The Decider Skills for Self Help online course
The documents linked from the bottom of each page are intended to be an integral part of this course, and should not be omitted - the worksheet documents are included in the downloadable Steps linked above.
Use the Self Help mp3 downloads to strengthen therapy or as a stand-alone technique.
In Step 1, we looked at vicious cycles and learned how thoughts, feelings and behaviours are linked and each one affects the others.
If we use the depression example from that page, we see that on waking in the morning, 'Dave' had thoughts that included "There's no point", and "I'll only mess up again". If we think those thoughts and believe them, there is every chance that we are going to feel depressed. If we think those thoughts and feel depressed, then it's likely that we would be sorely tempted to pull the covers over our head and stay in bed.
How does doing that affect the way Dave feels and thinks? Hmm. Staying in bed might mean that his thoughts get carried away and he continues to think that way, making him feel even worse, and even more likely to stay in bed. A vicious cycle.
Vicious Cycle of Depression VIDEO
DEPRESSION
Depression can happen to anyone - and does happen to one in four of us over our lifetimes. Different factors that make it more likely to happen, include biological make-up, upbringing, or reaction to life events. What keeps it going though, is how we deal with those things. The way we think and what we do affects the way we feel.
Depression is often accompanied by other feelings such as guilt, shame, anger and anxiety.
Thoughts
People who are depressed tend to think very negatively about themselves, the future and the world around them. It can be like seeing life through "gloomy specs".
- Everything is hopeless - nothing can change
- I'm useless, worthless
- It's all my fault
- The world is a terrible place - everything goes wrong
We can dwell on these thoughts repeatedly, mulling over things, asking ourselves why, thinking regretful things about the past, what we should or shouldn't have done.
Physical Sensations
- Tiredness, fatigue, lethargy
- Difficulty concentrating or remembering
- Sleep changes (sleep more or less)
- Eating changes (eat more or less)
- Lose interest in hobbies, activities, sex
Behaviours
Because of the tiredness, difficulty sleeping and eating, and negative style of thinking, we tend to do less and less. We stop doing the things we used to do and enjoy. It could get so bad that we can't even go to work, or do things at home. We want to stay in bed, or stay at home doing very little. We might isolate ourselves from friends and family.
ANXIETY
Anxiety is the body's way of responding to being in danger. Adrenaline is rushed into our bloodstream to enable us to run away or fight. This happens whether the danger is real, or whether we believe the danger is there when actually there is none. It is the body's alarm and survival mechanism. Primitive man wouldn't have survived for long without this life-saving response.
It works so well, that it often kicks in when it's not needed - when the danger is in our heads rather than in reality. We think we're in danger, so that's enough to trigger the system to go, go, go! People who get anxious tend to get into scanning mode - where they're constantly on the lookout for danger, hyper-alert to any of the signals, and make it more likely that the alarm system will be activated.
Thoughts
- I'm in danger right now
- The worst possible scenario is going to happen
- I won't be able to cope with it
Physical Sensations The Adrenaline Response
When there is real, or we believe there is a real, threat or danger, our bodies' automatic survival mechanism kicks in very quickly. This helps energise us to fight or run away ('fight or flight response'). We will notice lots of physical sensations, which might include:
Behaviours
Vicious Cycle Of Anxiety
Vicious Cycle of Anxiety - video
We all feel anxious some times. A certain amount of anxiety helps us to be more alert and focused. For example just prior to an exam, a few exam nerves have a positive effect - motivating us, helping us focus our thoughts on the job in hand, making us more alert. Too much anxiety, or constantly being anxious, is unhealthy and detrimental to our lives and relationships.
ANGER
Anger is a result of thinking that we have been unfairly treated or disrespected, or that others have broken or fallen short of our rules, standards or expectations, and we won't stand for it.Thinking this way leads us to feel angry, which stimulates the body's adrenaline response which is our body's way of helping us to cope with either fighting, or running away ('fight or flight' response). We respond to those thoughts and feelings, by acting, or feeling an urge to act, in threatening or aggressive ways.
Thoughts
- I'm being treated unfairly
- I'm being disrespected
- They're breaking a rule or standard
- I won't stand for it
Physical Sensations - The Adrenaline Response
When there is real, or we believe there is a real, threat or danger, our bodies' automatic survival mechanism kicks in very quickly. This helps energise us to fight or run away ('fight or flight response'). We will notice lots of physical sensations, which might include:
Behaviours
- staring & facial expression
- aggressive body posture
- attack
- hit out (or urge to hit out)
- argue
- shout
- run or storm away
- don't talk
- sulk
The Angry Cycle
Vicious Cycle Of Anger VIDEO
We all feel angry some times. Some people tend to become angry easily (a "short fuse"), and some have problems controlling their anger. Anger has consequences, and they often involve hurting other people - more usually their feelings, but sometimes physically. Anger can cause problems in our personal lives, and affect work and study. After an angry outburst, we can think very critically of ourselves and our actions, leading us to feel guilty, ashamed and lower our mood, which might result in our withdrawing from others, not wanting to do anything (see depression cycle).
Summary
In CBT, we aim to break those cycles by changing something - what we think or what we do. We might start by looking at what might be easiest to change. Perhaps in this case, it might be easiest to change what we do.
How would Dave, in the first example above, have felt if he had got up anyway, in spite of how he was feeling. Maybe ate some breakfast, had a shower, got dressed, then perhaps went out for a walk. How would that affect his depression? What would that do to the way he was thinking?
It's very likely that his mood would have improved, and that he would have started to think a little more realistically. He might have even enjoyed his day, or got a sense of achievement from having done something.
Emotions: A summary of particular emotions and their associated thoughts, body reactions and behaviours.
If you have a problem other than depression, anxiety or anger, then you can read the information given in these information sheets, and then continue the course:
Specific Anxiety Disorders:
VICIOUS COGS
Have a look at what you've written down on your vicious cycle worksheets of examples of distressing situations (Step 1 practice). What links can you see between what you think and what you do, and how they affect the way you feel?
In order to make effective positive change, it is essential to look at the factors which help to keep the problem going. Once we've identified those factors, we can then target each factor and start to make positive changes.
Using the example of a simple clockwork mechanism, we can see how the smaller cogs keep the large central cog turning. If there's a problem with any of the cogs, then the whole mechanism will grind to a halt.
We can therefore use this process to help us deal with our mental health problem. If our main problem is "anxiety", then we can write "anxiety" inside the large central cog. Then we can identify each factor than helps keep the anxiety going.
In order to reduce and deal with the anxiety, we need to target and make positive helpful changes in each of those smaller cogs.
EXAMPLE COGS
Vicious Cogs Of Anxiety
Vicious Cogs Of Depression
Vicious Cogs Of Anger
You can see more vicious cogs examples on these pages:
Print a blank Cogs PDF and fill in the factors that keep your anger going.
In the next step, you'll be starting to make some changes that will work for you.
Use the Self Help mp3 downloads...
to strengthen therapy or as a stand-alone technique
See also: The Decider Skills for Self Help online course
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