In Cognitive Behavioural Therapy; Negative Automatic Thoughts (‘NATs’) are a type of thinking that exists within a more obvious stream of thoughts. They are brief and tend to appear suddenly, and can occur in verbal and/or visual form. NATs are usually accepted as true, without contemplation or appraisal. Thoughts related to personal problems are connected to particular emotions, depending on their content and meaning; and individuals are often more aware of these emotions than the NAT causing them.
When continuing unchecked; this process can make improvement very difficult. However, with a little guidance, one can become mindful of their own personal thinking patterns; and it has been shown that the identification and evaluation of NATs usually leads to a positive shift in mood and greater mental health.
There are various techniques currently used in cognitive behavioural therapy that are designed to aid in the identifying and evaluating process of NATs. An experienced therapist will employ one or all of these to help the client understand how their thinking has developed. These concepts can be hard to grasp at first, but really can be quite easily understood with a little further explanation. If you would like to know more, please contact me to arrange a free consultation and we can explorein greater detail how Cognitive Behavioural Therapy may be able to assist with various behavioural and emotional difficulties. Sessions for CBT are available in my all my practice locations, including in North London in Highgate.
By following certain lines of questioning, a great deal of information about the client’s NATs can be quickly uncovered. Such questions might include the following:
‘What is the evidence that supports this idea?’
‘What is the evidence against this idea?’
‘Is there an alternative explanation?’
‘What is the worst that could happen?’
‘Could I live through it?
‘What is the best that could happen?’
‘What is the most realistic outcome?’
The intention is simply to guide individuals in the recognition and refutation of unhealthy thought processes, and toward a more rational, healthier perspective. The goal of this type of questioning is to have clients reflect upon and sort out all the presented material, rendering them more likely to recall and employ it in their day to day life.
By using this technique, cognitive behavioural therapists teach clients how to assess their negative automatic thoughts as merely premises, which are meant to be tested, for once one realises that their automatic thoughts are not accurate, they are free to construct more stable and adaptive appraisals. Equally, the testing of assumptions may help create new solutions if the process corroborates one’s original perception of an event.
Clients may also be helped to use ‘imagery’ to discover their thinking patterns as many people experience automatic thoughts not only as unspoken words in their mind but also in the form of mental pictures or images. In order to teach clients how to recognise and intervene with their distressing images, the therapist attempts either to elicit a spontaneous image a client has had or to induce an image in session.
Other techniques include ‘Self-Monitoring’ which is one of the most fundamental and necessary aspects of CBT. It is used both for assessment as well as a treatment approach. As an assessment, monitoring ascertains the context and content of thoughts, behaviours, and emotions and tracks changes or growth in these areas.
As a treatment, it helps the individual become aware of patterns and offers a framework both to pinpoint problematic emotions and to distance oneself from them (in order to assess them in an unbiased manner). The fundamental task of monitoring is that each instance that the individual experiences a strong emotion, he or she must document specifics concerning the time, place and context (i.e. the triggering event), the strength and extent of the experience, and the thoughts, sensations and reactions that occurred (i.e. coping strategies used).
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