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Cognitive Diary Example

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The following is an example to help learn how to identify and change irrational thinking. It is best to read the articles defining the irrational styles of thinking prior to trying to identifying the styles in the example. It uses the format of the CBT Tools for Healthy Living app. Read: Understanding and Using the Cognitive Diary.

Too Depressed to Call

EVENT: My friend has left several messages for me about going to lunch.

EMOTIONS: overwhelmed, embarrassed, unworthy

DISTRESS RATING: 8—high level of distress

THOUGHTS: “My depression is so bad I just don't feel like being social. But I should call my friend. She will think I am a horrible person for not returning her call. I am so lazy and weak that I can't do a simple thing like calling my friend.”

CAN YOU IDENTIFY THE IRRATIONAL THINKING IN THIS EXAMPLE? There are at least 3 irrational beliefs.

HOW CAN YOU CHANGE THE THINKING? What is another way of thinking about the situation that won't cause the feelings of being overwhelmed, embarrassed, and unworthy?

The CBT Tools for Healthy Living app helps you to determine some ways to challenge the irrational thinking. Once you have done that, it is important to read the rational challenges frequently until they automatically come to mind rather than the irrational thinking.

ANSWER:
Some of her emotional response may be due to the depression she is experiencing. However, the idea is to address the irrational thinking in this situation so that it doesn't add to the emotional burden she is already carrying because of the depression.

Irrational Beliefs:
1) Shoulds. This person is placing a demand on herself regarding making the phone call. With most "shoulds" we need to determine whether we WANT to do them or whether they are unnecessary demands. In this case, even thinking about the phone call as a desire rather than a demand can relieve some burden. Instead of thinking she "should" call her friend which only makes her feel worse she can think "I would like to call my friend."

By thinking of it as a desire instead of a demand it allows her then to make a decision that is not connected to feeling overwhelmed by the obligation. When a person is overwhelmed they are less likely to see alternative possibilities.

2) Negative Labeling of Self. The statements that she is "lazy", "weak", and her friend will think she is "horrible" indicates that she is negatively labeling herself due to her depression. Having a depressive illness is enough of a burden without also feeling self-blame about having the symptoms. Clinical depression causes fatigue, lack of interest in usual activities, and a tendency to isolate. Not wanting to socialize is common for people who are severely depressed. It is NOT due to being lazy, weak, or bad in any way.

However, this negative labeling of herself will only make her feel worse. If she has depression AND feels bad about herself, she will only feel more incapable and hopeless about the depression. By recognizing the depression as an illness that is not her fault she can remove her self from the downward spiral of increasingly negative emotions.

3) Mind-Reading Others. She believes that her friend will think negatively of her as well. This belief is common for people who have negative thoughts about themselves. They frequently believe that others will think the same way about them.

However, this is her friend. It is also possible that her friend understands the depression she is experiencing and is calling her out of concern rather than trying to place a demand on her. With mind-reading it is helpful to recognize that there are other possible views of the situation.

How Can This Thinking Be Changed?
“I would like to call my friend but it is too much for me right now. I am not a weak or bad person--I have a depressive illness that makes it difficult to do even simple things. My friend cares about me and is not likely to think negatively of me. Even though I can't call her right now maybe there is something that wouldn't be as difficult. Maybe I could email her and let her know that right now isn't a good time but I'll call her when it is."

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