Saturday, September 12, 2020

The ABC of thinking equation in Cognitive Behavioural Therapy (CBT)

One of the most useful tools in Cognitive Behavioral Therapy (CBT) is the “ABC of thinking” equation. It helps us to understand why we feel how we feel, react how we react, do what we do, and how we can change that. 

I often get patients to give me a list of their negative reactions to triggers, and apply those variables to the ABC of thinking equation, like in algebra.  It is often very enlightening. 

So like in algebra, if we know A (triggers) and C (reactions), we can work out B (Beliefs, thoughts, fused stories).  This will give us the opportunity to change or defuse from those beliefs, and associated thoughts/stories. 

Triggers (A-Antecedent event) + Beliefs (B-Beliefs) = Reactions (C-Consequence)

When people have a negative reaction to a trigger, the natural tendency is for us to try and change/remove that trigger, avoid the trigger, change/suppress our outward reactions to that trigger. Often this does not work long term as we don’t often have full control of our external environment, and changing those does not change the beliefs that underlie that context.  In actual fact, it often reinforces it.  This strategy represents the external locus of control. 

Alternatively. we can focus on our beliefs/thoughts/stories underlying that context. Same trigger but different beliefs lead to a different reaction.  So if we can change or defuse from our beliefs/thoughts/stories, we can change our reactions to our triggers, and how we feel about them.  This represents the internal locus of control. 

The common unhelpful beliefs, thoughts, and “fused stories” (the B in the equation) are:

I am not good enough.

You can’t trust anybody.

I can’t cope on my own.

Everyone will leave me in the end.

Nobody loves me.

I am all alone.

I am the black sheep. I am too different.  

When someone does something wrong, they need to be punished including me.

Things has to be done properly or not at all.

Why me. Why can’t I have what I want.

Something bad is going to happen to me.

If I fail, I am insignificant. 

Once we are aware of them, we can defuse/detach from them or even change them. Like when we know and understanding how a magic trick is done, the optical illusion has less grip on us. 

Naming them is one strategy and simply state, “Ah Mr Personal Trainer is here” if the feeling of inadequacies pop up for example. Then understand that the feelings of inadequacies is to propel us to take action for self improvement, and not simply to “feel bad” may help with some folks. Feelings are used for both feedback/information, and to propel/take helpful value based actions.  Feelings have both passive and active functions, and when used more mindfully and intentionally, rather than simply reactively, better outcomes may be achieved. 

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