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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 COGNITIVE DIARY CBT SELF-HELP app. Read: Understanding and Using the Cognitive Diary.

Insomnia: Worrying About Not Sleeping

EVENT: Lying in bed thinking about not being able to sleep

EMOTIONS: worried, distressed, agitated

DISTRESS RATING: 8--High level of distress

THOUGHTS: "I need to sleep. I've got a lot of things to do tomorrow including my presentation and I'm not going to function well if I don't sleep. People will think I'm incompetent. If I don't start getting better sleep I might even lose my job. I am such an unlucky person that this happens right before an important meeting.”

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 worry, distress, and agitation?

The Cognitive Diary CBT Self-Help 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:

Irrational Beliefs:
1) Catastrophizing. One of the most common causes of insomnia is worry. In many cases of insomnia people also have the specific worry about not being able to sleep and catastrophize about what might happen if they can't sleep. This person believes that he has to get a good night's sleep or he will function poorly at work which could cause bad things to happen. Then, because he is worrying about not sleeping he becomes more distressed and agitated. Such emotions are arousing and will have the effect of interfering with sleep. As a result, he is in a negative cycle of worry which causes emotions that will only make the situation worse.

The only way he will be able to get good rest is to break this cycle. To do so, he needs to first stop the catastrophizing. He needs to remind himself that it's not likely to be as bad as he fears and that worrying about it only makes it worse. He then needs to focus on creating a more relaxed state. One way to do both is to mindfully focus on his breathing. As he focuses on his breathing and a worry intrudes he can gently refocus back to his breathing. By giving his attention to his breathing rather than the worry, his body is likely to relax and he has a higher chance of falling asleep.

2) Mind-reading Others. Part of his catastrophizing is believing that he knows what others will think. Often, with lack of sleep, the symptoms are felt strongly by the individual but others might not even notice them. People are often able to function well enough when the circumstances call for it. In particular, when he feels the demand of his presentation he will probably feel the same arousing emotions that interfered with his sleep. Only in this case the arousal can help him overcome the sleep deprivation.

In addition, if others do notice anything, they are not likely to change their opinion of him just because he's not up to par. Typically, people will dismiss information that doesn't conform to an already formed opinion. So the likelihood that others will think he is incompetent is not very high.

3) External Control Fallacy. When he says that he is unlucky, he is saying the situation is not under his control and he can't do anything about it. However, there are some things he can do and recognizing his ability to change the situation allows him to take actions that could help.

How Can This Thinking Be Changed?
"I've functioned on little sleep before--the adrenaline will kick in when I need it. And I'm a valued employee so my fear of being fired is silly--people know I'm competent. And luck has nothing to do with this because I'm creating the insomnia with my worrying. Instead of worrying I'm going to focus on my breathing and relaxing my body. I can even use a relaxation audio. Whether or not I get enough sleep, I will still benefit from the relaxation."

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