Transcription:
Breaking the Cycle of Negative Thoughts: Cognitive Behavioral Therapy, Part 2

Bill Klaproth: Welcome to part two of this two-part podcast and how to change those negative thoughts in your head by using cognitive behavioral therapy or CBT.

Bill Klaproth (host): In part one, we learned about CBT and when depressed or anxious, most of our thinking is generally negative.

Bill Klaproth: And how we constantly beat ourselves up through what is known as ant or automatic negative thoughts. And then we covered thought records and how do I identify this negative pattern of thinking, which can be so damaging to our lives. And then we learned how to overcome it with a balanced counter statement.

Bill Klaproth (host): In part two, we will go deeper on this and cover other things. As we talk with Ted Vander, Clute, a psychotherapist at Morin health psychiatry. Uh, U C S F health clinic

Bill: This is the healing podcast brought to you by Marin health. I'm bill Claro, Ted. In part one, we were covering thought records. How to identify those negative thoughts in your head. Can you give us an example of what a thought record.

Ted Vander Clute: I'll be glad to give an example about a patient I'll call Greg who suffers from depression. Greg has the core negative beliefs that he's not good enough. And he's a failure. When I asked for evidence to support these beliefs, Greg revealed that his father had repeatedly called him a good for nothing failure.

He also brought up how his high school girlfriend. I had broken up with him years ago.

When I asked him about this and probe, for more information, it turned out his father was a depressed volatile man who suffered from addiction. I explained to Greg that depressed people can be irrationally hard on themselves. And others. Well, addicts often project blame rather than looking at themselves.

Thus the fact that Greg's father passed this negative judgment on him is not good evidence. That it's true. It is good evidence that Greg's father was depressed and had an addiction problem, but it's not good evidence that Greg is not good enough or that he's a failure.

As for the high school breakup. It turned out the girlfriend would be attending college on the other side of the country. And didn't think a long distance relationship would work Neither situation had anything to do with Greg's inherent value. Depress people often ignore the evidence against their negative thought and may need the help of a trained therapist to unearth it.

That's cuz we're so focused on the evidence to support our negative thoughts. So we can't even see the evidence against it. Questions about academic professional and personal accomplishments. Usually reveal strengths that a person may have overlooked or discount. In Greg's case after dropping outta high school, he went back to college and ended up graduating near the top of his class.

Later, he wisely left a career that did not suit him. And he found one that did rising to the position of manager. We also found that Greg was reliable in his relationships with his friends and his spouse. However, he has difficulty standing up for himself and asserting his needs in interpersonal relationships.

Over time, Greg was able to modify the thought pattern telling himself I have persistently and successfully pursued my goals, which is a true statement. I'm a dependable partner and friend. Also a true statement and I'm learning to assert my needs in relationships. So he replaces distorted unhelpful thought with an accurate, helpful thought.

And again, to reinforce these balanced, realistic thoughts, Greg will need to repeat them daily until they become a habit.

Bill: Wow, what a great story. Thank you for sharing that with us. When you were talking about discounting, the positive predict and the future and mind reading, it seems like Greg had fallen into some of those.

He thought, eh, my girlfriend thinks I'm an idiot. Well, that wasn't the case. He was mind reading. Right. And here it was that she was going to school in another area of the country. So that's a great example. And of course the upbringing as well. So thank you for that. And thank you for sharing how to change these thoughts.

I imagine. It probably sounds easier than it is, but there is a path forward to change these negative thought patterns. So let me ask you about this, Ted. I've heard about the Socratic method and thinking in shades of gray. Can you explain those to us? What are those.

Ted Vander Clute: Well, I use this technique when I'm doing a thought record, when people are depressed, they think in rigid all or nothing, black and white terms.

As an example of his perceived inadequacy. Greg mentioned that he'd been late for work. When I asked him for specifics on this, he said he'd been late twice, once by 10 minutes and another by 20 minutes, I then asked him how many years he had been at his job. He told me 15 years. I said. So you've been working at your job for 15 years and you have been late two times.

How often have your coworkers been late? It turned out that many of Greg's coworkers were late much more often than he was sometimes by 30, 45 or even 60 minutes through this process. Greg began to see that being late twice in 15 years, hardly made him not good enough for a failure.

Bill: Wow. Okay. Is that thinking in shades of gray?

Is that what that is? Yes. So how about the double standard or what would you say to a friend technique? Can you explain that to

Ted Vander Clute: us? Yeah. Depressed people are often very self critical and they treat themselves more harshly than they would a loved one or a good friend. I had Greg named someone he really values and asked how he would react to that person.

If that person said that they were a failure for being late to work twice in 15 years, Greg thought about it and admitted that he would say that's perfectly normal we usually treat people that we care Much better than we treat ourselves. Again, Part of overcoming depression is learning to treat ourselves with compassion.

Bill Klaproth (host): So then I asked you earlier about the cognitive aspects of CBT. What is the behavioral aspects of CBT then?

Ted Vander Clute: Well, in just the same way that the cognitive part says that our thoughts affect our mood and our mood in turn affects our thoughts, but the behavior aspect, we look at how our behavior affects our mood and conversely, how our mood affects our behavior.

When depressed people tend to isolate and cut themselves off from the support of friends and loved ones and are therefore much more susceptible to the distortion and negativity of depressed thinking. Imagine you don't go out with your friends on a Saturday night, you stay home, but you get stuck in your thoughts.

I'm not good enough. I'm a loser. You end up feeling worse. You're more likely to isolate. Additionally depressed people tend to forgo healthy, pleasurable activities. They may stop exercising, eat poorly and over-indulge in drugs or alcohol. These behaviors increase depression and make people feel worse about themselves.

It's essential to reduce or eliminate unhealthy behaviors and increase healthy activities. Exercising, maintaining a balanced diet. Doing things you enjoy and spending time with supportive people, all improve our mood and boost self-esteem goals are best accomplished by setting realistic, measurable weekly.

Goals. For example, if the larger goal is to improve your marriage, a weekly goal might be to plan a date night or have dinner at the table. Instead of in front of the TV. The most pleasurable activities are often ones that are meaningful and reflect our core values and another way to feel good about yourself and your life.

It's to practice gratitude, focusing on what we have instead of what we don't have such as good help a job. A place to live friends and family creative talent in the natural beauty that surrounds us opening up to the gifts in our lives can lead to more positive thoughts

Bill: and moved. Yeah. How true is that?

We all need that vitamin G right? Uh, of gratitude. Vitamin of gratitude. Wow. That's really powerful. This has really been a great conversation, Ted, and hopefully we've. Opening some eyes and helping some people out. One other question about Greg and thank you for sharing his story. You have to become self aware at some point.

Like I need help. Something's not right here. What I've been thinking or doing my whole life. How did Greg come to see you? What made him go? You know what I need help. I need to get some professional help. What is usually that, is it a low point in somebody's life or did they read something or do they hear about something?

What causes people to come to you like Greg?

Ted Vander Clute: Well, people can come for a variety of reasons. Sometimes they've had a pivotal event in their life. Say a divorce. The death of a loved one. They've come down with a medical illness or some combination of all three.

Or a person might just realize, I feel lousy and I'm sick and tired of this. And I'm hoping that going to therapy is going to help. And I'm going to give it a try. Because if I don't do anything. I'm going to keep feeling as badly as I do.

Bill: I would imagine you often get comments from the people you help after you help them and you help them improve their life and improve the quality of their.

Not only mentally, but also physically too. If they cut out some of the bad behaviors, the smoking, the eating bad, the not exercising, the not socializing. I bet they come to you and say, gosh, I wish I knew about this or did this years ago. Is that

Ted Vander Clute: true? Absolutely true. And in some cases, in the best cases, After doing a thought record, somebody cuts through a barrier that they've been holding up in front of themselves for their whole lives.

So I've had people at age 50 60 saying, oh my God, it's like a cloud has lifted. I feel better about myself. And I feel better about my life. And in some cases, people. We're so low, they wanted to end their lives and they have now a renewed reason to stay alive and enjoy life. And that's quite satisfying.

Bill: That is absolutely the best Ted. This has been fabulous. Thank you so much for your time. Is there anything you'd like to

add at all?

Ted Vander Clute: I just want to say that depression and anxiety and the distorted thought patterns that they can create can be overcome. The good news is that by identifying challenging and changing cognitive distortions and unhealthy behaviors, we can find a way to joy and fulfillment and find happiness in our lives.

Bill: Uh, that is such a great statement. I love that depression and anxiety and distorted thought pattern. Can be overcome. So that is so true. And we hope anybody listening to this that is struggling with this will seek help and find help and live a better quality of life. Ted, thank you again so much for your time.

This has really been informative and insightful. Thank you

Ted Vander Clute: again. It's my pleasure bill. And thank you for giving me the opportunity to talk with you.

Bill: And once again, that's Ted Vander Clete and to learn more, please visit my Marin health.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.

This is the healing podcast brought you by Marin health. I'm bill Claro. Thanks for listening.