Challenging thinking errors

After you have learned to identify negative thoughts you will need to learn to
change. If you are working with a therapist you will find that he or she uses
questions to help you to challenge your beliefs. She will encourage you to think
through alternatives to your beliefs or responses rather than holding on to your
negative thoughts.
For example, a therapistmight ask a patient who is worried about other people
noticing her eczema:
Counsellor: What is the worst thing that you could imagine if someone was to
see the patches on your arms?
Patient: That they would stare at me and wonder what was wrong with my
skin.
Counsellor: Well, let’s assume that that’s what would happen.Why would that
be such a terrible thing?
Patient: I don’t know, I guess I just hate the idea of people staring atme. Itmakes
me feel uncomfortable, I never know what to do.
Counsellor: Perhaps if we could work on some practical coping strategies
together such asmaking eye contact with the person that is staring, or diverting
your attention to something else, do you think that would be useful?
Patient: Yes, that’s my main problem you see, I never know what to do. If I had
a way to deal with it, then I wouldn’t get so anxious when I thought about it.
In some cases, you may be anxious about certain situations or events but you
may not be sure why this is. By asking questions relating to ‘worst-case scenarios’
you will be challenged to examine your thoughts and apprehensions and these can
then be discussed during the counselling session.
Thought monitoring
As mentioned earlier, it is not situations in and of themselves that are stressful or
depressing, but rather the perception that we have of them. If we learn to firstly
identify negative or erroneous thoughts and then challenge them,we can influence
our interpretation of emotional reactions to various situations. Becoming more
aware of your thoughts can be achieved by recording when you are feeling upset.
For example:
Patient: I am really worried about going shopping for summer clothes, I’m
afraid that the shop assistants will see me and laugh at the lesions on my back
and arms.Counsellor: That sounds like quite an extreme reaction you are expecting. I
wonder why you’re expecting this to happen. Has this ever occurred before?
Patient: Well no, but I just feel that once they take a look at me, they won’t like
me because of the way I look.
Counsellor: I see. Is that the way that you usually decide if you like someone or
not, or whether to talk to them?
Patient: Well no, of course not. But appearance is important.
Counsellor: Sure it’s important, but so are a lot of other things, including how
friendly you are and how you relate to other people. Since you said that you
don’tmake judgements about liking people based on the way that they look, is it
likely that others do the same?
Patient: I guess so.
Counsellor: Also consider this, in all your past experience this extreme reaction
you’re expecting has never happened to you, right? Then howcan you be certain
that people will dislike you because of the appearance of your skin?
Patient: I see your point. Maybe I was exaggerating what I thought their
response to me would be. No one has ever said, ‘I hate you because of your
skin’.
As you can see from this example, the sooner you are able to challenge your
thoughts through questioning, the easier it is to have a less negative and more
rational view of the situation.
Anothermethod that youmay use, either on your own orwith the help of your
counsellor, to monitor thoughts is through a structured diary called a thought
monitoring sheet. The example belowdescribes theway that a thoughtmonitoring
sheet is used.
(1) Note down the actual or anticipated event that you are anxious or distressed
about and try and rate how strong your emotions are from 0 to 100
per cent.
(2) Write down your thoughts about the situation (no matter how irrational).
Remember what is important here are your thoughts not your emotions.
Once you have written them down rate the extent you believe each thought
from 0 to 100 per cent.
(3) Make a note ofwhat you are feeling andwhat you are doing as a consequence
of the situation.
(4) Now come up with some alternative rational thoughts, and rate the extent to
which you believe each of these from 0 to 100 per cent.
(5) Finally, reassess howmuch you believe your original negative thoughts; also
reassess how you feel from 0 to 100 per cent.

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