How can I get a handle on the negative thoughts running through my mind constantly

June 21, 2007 10:11 AM

To those who have successfully treated their depression using CBT or are in the process of doing so: How did you/ do you handle the constant barrage of negative thoughts and self evaluations?

I am always comparing myself to others, ruminating on the past and on 'could have been's, beating my self up about missed opportunities and so on. All this not only makes me feel quite depressed but also leaves me feeling very discouraged about my future. I want to change this. For good.

CBT makes a lot of sense to me but I'm finding it very hard to constantly monitor and counter very single thought that I have (It doesn't help that most of my feelings and thoughts about myself at this point are pretty negative).

Solutions like distracting one's self, trying to rationally challenge them work but only temporarily.

What can I do to make the changes in my thinking long lasting? How did you do it?

posted by anonymous to health & fitness (20 comments total)

A strategy that helped me was wearing a rubber band around my wrist. Whenever I would get into a negative thought cycle, I would *snap* the rubber band. This wasn't a self harm thing, just the sensation of the *snap* would make me stop for a moment and pull me out of those thoughts. The rubber band is easy and portable. But any kind of physical sensation / exercise is helpful for getting out of your head. You just have to do something to derail that train of thought, and I find using the same strategy consistently is the best way. Now I just mentally tell myself *stop*, when I start being negative, and it works. I somehow internalized the *snap*, and can do it myself. Yeah, I know this is a little weird... :)
posted by amileighs at 10:24 AM on June 21, 2007

Becoming consciously aware of them is the first step, I think -- so it sounds like you're on the right track.

It may not be necessary to counter every single negative thought that goes through your head (and actually I don't think it's possible). Feeling Good by David Burns, e.g., recommends writing down some typical or particularly painful/problematic negative thoughts and countering them in writing as a better method than merely doing it on the fly and in your head. The same book also recommends classifying the negative thoughts according to certain categories of cognitive distortions -- then you're simply dealing with variations on themes, rather thousands of individual negative thoughts.

Finally, I think it's a matter of practice -- the more you practice, the better at it you get, and the less sway the negative thoughts have over you.

Also, a CBT therapist might be able to help you find some additional strategies.
posted by treepour at 10:29 AM on June 21, 2007

It sounds from your post as if you're trying to handle this yourself. If you are, and if you're having trouble, a few sessions with a CBT therapist might really help you to develop specific strategies that work for you, and solidify any gains you may be making.

Best of luck.
posted by OmieWise at 10:35 AM on June 21, 2007

An excellent therapist I discussed cognitive distortions with me. My 'homework' for lack of a better term, was to familiarize myself with them and when I had irrational or distorted thoughts, list specific points which identified them as one or more of the cognitive distortions. It was a self exercise; she didn't request I show them to her or anything. After a while I didn't have to write them out it didn't mean that the feelings stopped. I was able to have them, but mentally and internally know that something I thought was catastrophizing or fortune telling, etc.
posted by pieoverdone at 10:37 AM on June 21, 2007 [3 favorites]

Keep working at it. For me, constant barrage gets constant mindfulness.

"Hey, look at all these negative thoughts! Where is my body actually? I'm sitting in my office. I can feel a chair below me. It is cold in here. My headache is gone. I'm breathing. Wow, that lightswitch is rusty. There is absolutely nothing going on here that is negative, just these thoughts. It's kind of like a movie or a dream in my head, and I'm making it up and making it bad. But none of it is actually happening right now. Yep, I'm still breathing. This is kind of nice."

Repeat. Especially the part about it being a movie or a dream, because then that includes a ton of thoughts and narratives. And deep breaths, seriously. It takes 4 minutes of deep breathing to feel better so don't get discouraged. You might look into mindfulness meditation, because it can set a baseline for "not feeling bad" and "not obsessing". Then you can remember that feeling throughout the day.
posted by unknowncommand at 10:40 AM on June 21, 2007 [7 favorites]

Don't feel you have to stop and consciously analyze everything you think and feel. That would take forever! The longer you do CBT the more intuitive and natural it becomes. For me it was about five or six sessions before I noticed myself doing it on my own without having to try.

I can't stress enough how crucial to the process of conditioning doing the thought records was. If you're not using the workbook Mind Over Mood I highly recommend that over Feeling Good. If you can't buy it or get it from the library, at least try doing thought records on your own. Try to do at least one per day, or at any time you feel any strong emotion. There are lots of really helpful exercises in Mind Over Mood, but the thought record is the ultimate one.

ALTERNATIVE THOUGHT RECORD [pdf]
(Cognitive Therapy Self-Help Tool)

SITUATION: Describe an event or situation, that occurred within the last few
hours, or days at the most, in which you experienced
emotional distress.

WHEN did it happen?
WHO was involved?
WHERE did it happen?
WHAT happened?

FEELINGS: Describe the feelings that arose at that time. (Remember,
feelings can usually be expressed in one word.) Rate the
intensity of your feelings from 0-100%.

AUTOMATIC THOUGHTS: List one or two of the most intense thoughts
or images that you had at the time of the event.

COGNITIVE TRAPS OR DISTORTIONS: Examine your thoughts and images
to see if there are cognitive distortions (Refer to the Cognitive
Traps thread).

ALTERNATIVE THOUGHT: Describe an alternative, balanced way of thinking
about this event. Notice the cognitive distortions in your
original thinking, and create a new statement that balances
or eliminates those distortions.

Rate the intensity of you feelings now, from 0-100%.

They are not easy. It's really hard to rate feelings by percentage and sometimes it's difficult to pick apart a mood to its component feelings. But with practice you'll start to notice it getting easier and more intuitive. Nowadays I notice my thought pattern go something like this, very quickly, without even trying to steer it: negative thought --> ok, c'mon, be reasonable, what's more likely to be objectively true here? --> briefly, why did I feel that way? --> feel somewhat better even just for knowing I'm being more fair to myself.

Oh, and if you're doing it yourself, DEFINITELY see a pro even just to get on the right track. Doing just 7 weeks with a fantastic therapist was the, THE crucial factor in getting me out of depression. It was a total turnaround for me, and I never believed in talk therapy before due to my terrible "tell me about your childhood" experiences. Before CBT I was plagued with negative thinking and even though I sometimes still have the same doom-filled black-and-white thoughts, I feel in control of them now and I feel stronger for it. If you follow the process and stick with it I promise it will work for you.
posted by loiseau at 10:56 AM on June 21, 2007 [4 favorites]

Oh, I should add that the success of CBT is its structure. You can't really dabble in it. You have to be willing to do the homework and fill out the exercises and not just pass over it. There's a good reason for all the work -- it all leads somewhere. The structure is the way to keep yourself on the right path. It's not at all about distracting yourself or dismissing your feelings straight away. It's all about challenging your automatic assumptions and perceptions. Stick with the program and commit to doing at least a month of it with discipline (a chapter a week is totally doable) and you'll see results.

It's scientific, y'know? It's not just busy work -- it's actually got an entire foundation under it.
posted by loiseau at 11:01 AM on June 21, 2007 [1 favorite]

It sounds like you're having negative thoughts about your tendency to have negative thoughts! :-)

It may help to realize that the doubt you're currently feeling is caused by the same mechanisms that cause you to doubt yourself in other arenas. Do what you can to not get caught up in the same thought patterns here. You don't have to be perfect in this endeavor, just do what you can and forgive yourself for not being able to do more right now.

And it certainly might help to try to focus on one or two areas that are causing you the most stress and work on those for a while; once they're under control, you can move on to other areas. You don't have to fix everything all at once (and, in fact, trying to do so can be counterproductive, because it's such an overwhelming task; better to solidify each small step as you keep progressing forward).
posted by occhiblu at 11:04 AM on June 21, 2007

I agree with pieoverdone. I had a therapist in my college days (I'm all better now thank-you-very-much!) who gave me a print-out of the distortions with examples and it helped me immensely to narrow down all the b.s. I was telling myself. I was a good one for over-generalizing (yeah, my mom said something that hurt so she must totally hate me, blah blah blah...) There is a book called "Rational Emotive Therapy" by Albert Ellis that also helped a great deal. Good luck!
posted by wafaa at 11:06 AM on June 21, 2007

A similar thread - although I never did formal CBT I can't stress enough the fact that perseverance and patience are needed to get anywhere with making a significant and lasting change in your thinking. Change comes over months and years of effort. I can remember so well telling myself for the thousandth time "that isn't happening right now. Don't get mired living in that hypothetical, be here in this moment" and thinking, why do I bother? I'll never think that way. But applying rationality consistently to negative thoughts does change them over time.
posted by nanojath at 11:09 AM on June 21, 2007

Forget about becoming free of self-doubt, because that's not going to happen. Paradoxically, that realization has helped me a lot with my own constant self-critical thoughts. Preventing the thoughts isn't your job; rather, you have the task of keeping them from taking over and crowding everything else out, as amileighs says. I suggest you try every constructive suggestion that you can, even if they sound like they won't work. And know that most of them won't work -- you're just looking for the few that'll do you some good.

One thing that helped me a lot was meditation, if only for the practice it gave me in allowing a thoughts to appear and then watching it flow away without its taking hold. (The idea of clearing your mind of all thoughts isn't realistic, so don't even try.) Breathing, if you really can concentrate on it, definitely will give you an opportunity to break out of bad thoughts. It can help to impose a breathing pattern for when you need to calm yourself, like "breath in for a count of four, hold for four, breath out for a count of four, hold for four" -- google "breathing exercises" for better ones. I also do the thing that unknowncommand suggests: just set my mind to look at my physical surroundings, even if all I'm able to do is go around the room and name each thing I see. The bad thoughts still try to intrude, so I have to keep renewing my concentration. The calming effect can take a few very long minutes.

Exercise can help a great deal. I personally favor things like crunches, which are pretty intense and require me to concentrate on what's happening in my body.

CBT can be very difficult, and it doesn't help that a lot of the literature makes it sound easy. A self-critical person will constantly barrage herself with things relating to the therapy itself: "I shouldn't think this stuff, I should be better at dealing with it, I must be doing something wrong, I should have started working on it a long time ago..." Do try to remind yourself of what your real goal is -- pulling the plug on the persistent doubts, again and again and again. The more you do it, the better you get at it.
posted by wryly at 11:37 AM on June 21, 2007

One easy trick is to visualize a worrisome or bad message - just one, one simple thought, like my perennial favorite "I don't know what I'm going to do" - visualize it as an object, like a beach ball. Then imagine another, positive alternative thought as an object, like "I am capable of handling my fears" represented as a lawn chair. It sounds silly! Okay, so think back and forth between them. Picture the beach ball, and think about that worrisome thought, then replace it with other thought, and flex on that thought, like you're squeezing a muscle. Interrogate it, think it hard. Change back and forth between the two ideas, gradually devoting less time and focus to the worrisome one, and visually attempting to make it disappear and be replaced by the positive one, the lawn chair, victorious. I call this crossfading. It seems to work well for creating a habitual alternative positive self talk statement for worries or negative thoughts. You'll remember "I am capable of handling my fears" the next time you think "I don't know what I'm going to do."
posted by Ambrosia Voyeur at 11:38 AM on June 21, 2007 [1 favorite]

All of the above is good advice.

The things that specifically helped for me:

• Write it down. Don't think about how to phrase it, or make it more palatable, or soften the thoughts. Just write down verbatim what you are telling yourself. Make it a habit. Every once in awhile when you're feeling okay, sit down and look at them. See if you can focus on the logic flaws (it helps to know the standard cognitive distortion list). This is the best way to keep your head from looping in on itself and driving you nuts.
• Don't fight the thoughts as they happen. This only makes it worse. Simply try to accept that these are thoughts that are happening and that you can let them happen without accepting their premise.

posted by softlord at 11:44 AM on June 21, 2007

I've told this story several times in AskMe before, so forgive the repetition, but it softlord's comment made it pop into my head again. My yoga teacher once recommended that when negative thoughts pop up in one's head, you could simply recognize them, say (silently or out loud) "Thanks for your input," and then carry on with whatever it is the thoughts just told you you couldn't do.

It's a way of combating negativity without getting into an extended internal discussion about it, and of reminding yourself that everything that happens in your head isn't really you, per se.

Maybe you could find one, all-purpose phrase like that? Or just use that one? "I don't actually believe that" or "I appreciate your opinions, but I'm going to do it differently" or "Hmmm, interesting, thanks, but that won't work anymore"?

You can still do the more specific work that softlord and others recommend on top of that, but that might at least get you in the habit of stopping the negative thoughts as they come up without feeling overwhelmed or ill-prepared.
posted by occhiblu at 11:54 AM on June 21, 2007 [4 favorites]

Maybe you could find one, all-purpose phrase like that? Or just use that one? "I don't actually believe that" or "I appreciate your opinions, but I'm going to do it differently" or "Hmmm, interesting, thanks, but that won't work anymore"?

I LOVE that. It's like talking to your 'inner child'.
posted by wafaa at 12:08 PM on June 21, 2007

I just completed six months of that kind of therapy, with a heavy dose of time spent on the cognitive distortions cited by pieoverdone. I also had a great therapist, and I did my homework. It gets a lot easier with time. Now I counter negative thoughts with a simple mental phrase: "bullshit". And that works for me. I haven't felt this good since I was 12. Hang in there, anonymous, time is on your side.
posted by theinsectsarewaiting at 12:35 PM on June 21, 2007 [2 favorites]

Someone once suggested I imagine a big 'stop' sign, whilst saying 'stop' to myself which amused me, and that helped break some of the tension. Affirmations are also useful; looking at yourself in the mirror and vocalising your self-worth. I did a lot of exercises and homework by myself but found dealing with the constant barrage of self-induced negativity overwhelming and depressing. Partnering with a therapist and doing some of the work together proved very effective and I now have a radically different outlook on life. Good luck!
posted by poissonrouge at 1:20 PM on June 21, 2007

I've been there anonymous, and a lot of what has been mentioned here is exactly what has helped me get better or at least learn to cope the best way I can. I nth the concept of committing time and care to addressing your problems, and of trying to be an "impartial spectator" of your thoughts.

I'll toss in a couple more thoughts:

- Accepting that I didn't need to fight my anxious feelings or feel shame about them did a tremendous amount in easing my anxiety about them. It actually felt much better to counter them or to move around them. Like I was giving myself a break so I could move on with feeling better.

- I got to the point where I realized that I had done a lot of work on my thoughts/anxiety/OCD, and that it was very, very hard to make it all "stick". So, I chose the meds route with my docs' help. This helped bring the shizz going on in my head down to a level that I could do the work and actually make some progress. It has been a godsend, and made all the difference for my progress. YMMV.

Good luck, anon, you're heading in a very positive direction!
posted by lucyleaf at 8:29 PM on June 21, 2007

I've been 'in' CBT twice in the last year or so and I'd agree with many of the posts above. Stuff I found personally helpful was the weekly 'homework' I got. Each week my therapist would get me to either work on one of the specific forms of negative thoughts I'd have, and deconstruct it, or to focus on how I responded to individual thoughts.

Looking back what this helped me to do was two main things: understand a range of specific issues from a new, alternative point of view that did not include beating myself up, and learn to make new, more conscious responses to each one. But the important thing was that all of this did NOT involve tracking and individually responding to every thought that entered my head. You can't do that, as you'll get too involved in the 'meta' of life to actually engage in anything any more!

But doing my homework, and repeating exercises every day and week, was a critical part of this. I think analysing each main issue in depth allowed me to develop awareness of when each one would arise, whilst practising new responses helped to make these a more automatic reaction so that the 'beating up' stuff happened less and less.

I don't think that you simply stop having negative thoughts - they're too deeply a part of who we all are. But remember that just because you have thoughts doesn't mean that you have to take ownership of them. Learning to recognise them 'in the distance' and respond in new ways has helped me to stop reinforcing negative thoughts, so they have largely lost their power over me.

Stick with the CBT (with a therapist - I can't emphasise how inportant it is not to do this on your own) and engage with it as fully as you can. The repetition will become habit over time (weeks, not months) and you'll realise one morning that everything has changed for the better.

Enjoy that morning - I'm sure you'll get there.
posted by dowcrag at 1:42 AM on June 22, 2007

Good advice above. Sorry if I repeat some of it. Sometimes I ramble on.

If I have particularly insistent upsetting thoughts, then sometimes only distraction will help. This is a temporary fix, but that's OK, because the thoughts pass, the mood passes, and then other less extreme remedies will help. In other words, I use distraction to 'get over the hump' sometimes.

Remember the mind-body connection. If you take good care of yourself, your bad thoughts will probably be less insistent. See past threads on depression here. Exercise, good diet, good sleep, lots of daylight, omega-3 oils can all help. Meds can help.

Completely relaxing can be helpful. Some thoughts can make me tense. Relaxing the body can help break the cycle. If you're familiar with the 'body scan', it's like that. Just 'look' in your body for tense muscles and discomforts, and relax them.

Meditation can be helpful. You can learn to be more in the present moment, rather than obsessing about past mistakes or future disasters. Also meditation can help you be more objective about your thoughts. You can see how your mind is always 'going', and yet the content isn't really very interesting. In meditation, I've learned to see a lot of thoughts just as clouds passing through the sky (sorry if that's overly poetic, that's really the image I have...) and that it's pointless to get too involved in them. They just obscure the sky.

I read recently about an OCD treatment that had patients completely divorce themselves from the content of their thoughts (what their obsessions were about). Then eventually the feelings would fade. I try to do a bit of the same thing: realize that there's a mood going on, and that some thought has attached itself to it, and that the thought itself is not really important.

When I recognize some thought, then sometimes I just say 'no' to it. Not as in 'no it's not true', but a 'no' that just dismisses the question. Sometimes this works, sometimes I have to repeat it a bunch of times as the thought comes back. Sometimes it doesn't work. I don't really actively dispute the thought, I'd rather not get that involved with it, but that's just my method. Yours might be different.

Sometimes I'll just try to accept the thought. People don't find me attractive? OK, that's not so bad. This thunderstorm is going to dig big ruts in my driveway. OK, I won't like that, but it's happened before, and I can fix it (with a lot of grumbling). I'm out of work and I might never be able to get a job again? OK, I don't like that, but at least I'm not Kurt Vonnegut (dead, that is). In other words, disempower the thought by acceptance. The thing the thought is about is usually not as bad as the feelings it is causing.

I could go on and on, but I gotta go fix breakfast now.
posted by DarkForest at 5:57 AM on June 22, 2007