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More PsychNotes: Cognitive Behavioral Therapy (CBT)

October 4, 2017       

When You have Negative Thoughts about Your Thoughts
by Monica A. Frank, PhD

Have patience with all things, but, first of all with yourself. St. Francis de Sales

Many times when I'm teaching a client about cognitive therapy and how thoughts can contribute to or exacerbate problems, they become highly critical of their thoughts. In an effort to feel better, they begin to punish themselves for certain thoughts: “That's stupid! I shouldn't think that way!” or “It should be simple to control my thoughts—what's wrong with me?”

One particularly difficult area is when the “thought-stopping” technique is used. This technique literally has a person tell themselves firmly “Stop it!” When a person does so it becomes easy to add a judgment: “Stop it! I'm so weak I can't even stop these thoughts.”

Although the purpose of cognitive therapy is to learn how to change thinking, punishing oneself about the thoughts can make the therapy less effective and may even worsen the problem. Research shows that these thoughts about your thoughts need to be addressed as they can interfere with effective reduction in symptoms.

For example, when researchers studied those with chronic pain who were using cognitive therapy, they found the pain was worse when a person was self-critical of their thoughts (Yoshida et al., 2012; also see Psychnote: It's Not What You Think But How You Think That Affects Chronic Pain). So although cognitive therapy can help reduce the experience of pain, the negative thoughts about the thought process can make it worse.

The idea behind cognitive therapy and symptom reduction is to learn to recognize inaccurate or irrational thoughts that increase symptoms. By doing so, ways to challenge or replace the thoughts can be identified and applied.

However, this needs to be a gentle process. For some, even the term “irrational” which is meant to be a neutral description can be a trigger for punishment: “I'm irrational—I can't think straight!” But there is a difference between describing a thought as irrational and depicting the self as irrational. Almost all of us have irrational thoughts at times but that doesn't mean we are irrational people. Learning to recognize an irrational thought allows us to talk ourselves through the situation.

One of the best techniques for someone who has a difficult time being gentle with him or herself is developing a mindful attitude. The mindful approach to thoughts is to examine them without judgment. Then a person can determine appropriate replacement thoughts or to just let the thought go. The "Understanding Mindfulness" series, particularly Step 4—Mindfulness and Cognitive Restructuring can help you learn this approach.

Yoshida, T., Molton, I.R., Jensen, M.P, Nakamura, T., Arimura, T., Kubo, C., and Hosoi, M. (2012). Cognitions, Metacognitions, and Chronic Pain. Rehabilitation Psychology, 57, 207–213. DOI: 10.1037/a0028903

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