Understanding the Links between Thoughts, Feelings & Behaviours
On the first page, we looked at vicious cycles and learned how thoughts,
feelings and behaviours are linked and each one affects the others.
If we use the depression example from that page, we see that on waking in the
morning, 'Dave' had thoughts that included "There's no point", and "I'll only
mess up again". If we think those thoughts and believe them, there is
every chance that we are going to feel depressed. If we think those
thoughts and feel depressed, then it's likely that we would be sorely tempted to
pull the covers over our head and stay in bed.
How does doing that affect the way Dave feels and thinks? Hmm.
Staying in bed might mean that his thoughts get carried away and he continues to
think that way, making him feel even worse, and even more likely to stay in bed.
A vicious cycle.
Depression
Depression can happen to anyone - and does happen to one in four
of us over our lifetimes. Different factors that make it more likely to
happen, include biological make-up, upbringing, or reaction to life events.
What keeps it going though, is how we deal with those things. The way we
think and what we do affects the way we feel. Depression is often accompanied by
other feelings such as guilt, shame, anger and anxiety.
Thoughts
People who are
depressed tend to think very negatively about themselves, the future and the
world around them.
It can be like seeing life through "gloomy specs".
Everything
is hopeless - nothing can change
I'm useless,
worthless
It's all my
fault
The world is
a terrible place - everything goes wrong
We can dwell on these thoughts repeatedly,
mulling over things, asking ourselves why, thinking regretful things about the
past, what we should or shouldn't have done.
Physical Sensations
Tiredness, fatigue, lethargy
Difficulty concentrating or remembering
Sleep changes (sleep more or less)
Eating changes (eat more or less)
Lose interest in hobbies, activities, sex
Behaviours
Because of the
tiredness, difficulty sleeping and eating, and negative style of thinking, we
tend to do less and less. We stop doing the things we used to do and
enjoy. It could get so bad that we can't even go to work, or do things at
home. We want to stay in bed, or stay at home doing very little. We
might isolate ourselves from friends and family.
Anxiety
What is Anxiety?
Anxiety
is the body's way of responding to being in danger. Adrenaline is rushed
into our bloodstream to enable us to run away or fight. This happens
whether the danger is real, or whether we believe the danger is there when
actually there is none. It is the body's alarm and survival mechanism.
Primitive man wouldn't have survived for long without this life-saving response.
It works so well, that it often kicks in when it's not needed - when the danger
is in our heads rather than in reality. We think we're in danger, so
that's enough to trigger the system to go, go, go! People who get anxious
tend to get into scanning mode - where they're constantly on the lookout for
danger, hyper-alert to any of the signals, and make it more likely that the
alarm system will be activated.
Thoughts
that often occur:
I'm in
danger right now
The worst
possible scenario is going to happen
I won't be
able to cope with it
Physical Sensations
- The Adrenaline Response
When
there is real, or we believe there is a real, threat or danger, our bodies'
automatic survival mechanism kicks in very quickly. This helps energise us
to fight or run away ('fight or flight response'). We will notice lots of
physical sensations, which might include:
Heart racing -
This helps to take the blood to where it is most needed – his legs so that he
can run faster (flight);
his arms so that he can hit out
(FIGHT);
his lungs to increase his stamina. At the same time blood is taken from the
places it is not needed for example fingers, toes and skin. These changes
cause tingling coldness and numbness.
Breathing gets faster- This helps the bloodstream to carry oxygen to the arms, legs and lungs.
This will give him more power. The side effects may include chest pain,
breathlessness and a choking feeling. As there is a slight drop in the
blood and oxygen being sent to the brain he may feel dizzy or light headed, he
may experienceblurred vision.
Muscles
tense and prepare - The large
skeletal muscles tense and create power, this may cause pain, aching and
shaking.
Sweating -
Sweating helps to cool the muscles and the body. It helps to
stop them from overheating. Sweating can also make us more slippery to
our enemies!
Pupils
dilate -
This lets more light into his eyes so his overall vision
improves. Side effects may include sensitivity to light or spots before his
eyes.
Digestive system slows down - These are not
important while in danger and so are slowed down then the saved energy goes to
where it is most needed. Side effects may include nausea, butterflies and a
dry mouth.
More
alert - He
will be concentrating on looking for danger, much less able to concentrate on
anything else. He will be waiting for something to happen. This is the basis
of the way we worry.
Behaviours
might include:
Avoiding
people or places
Not going
out
Going to
certain places at certain times, e.g. shopping at smaller shops, at less busy
times
Only going
with someone else
Escape,
leave early
Go to the
feared situation, but use coping behaviours to get you through: examples
include: self talk, holding a drink, smoking more, fiddling with clothes or
handbag, avoiding eye contact with others, having an escape plan, medication.
These are called 'safety behaviours'.
Safety
behaviours can also help to keep your anxiety going. Whilst you depend on
them to help you cope, you don't get to find out that without them, the anxiety
would reduce and go away on it's own.
Whilst avoiding people or
situations might help you feel better at that time, it doesn't make your anxiety
any better over a longer period. If you're frightened that your anxiety
will make you pass out or vomit in the supermarket aisle, you won't find out
that won't actually happen, because you don't go. So the belief that it
will happen remains, along with the anxiety.
Vicious
Cycle of Anxiety
We all feel anxious some times. A certain
amount of anxiety helps us to be more alert and focused. For example just
prior to an exam, a few exam nerves have a positive effect - motivating us,
helping us focus our thoughts on the job in hand, making us more alert.
Too much anxiety, or constantly being anxious, is unhealthy and detrimental to
our lives and relationships.
Anger
What is Anger?
Anger
is a result of thinking that we have been unfairly treated or disrespected,
or that others have broken or fallen short of our rules, standards or
expectations, and we won't stand for it.
Thinking this way
leads us to feel angry, which stimulates the body's adrenaline response which isourbody's
way of helping us to cope with either fighting, or running away ('fight or
flight' response). We
respond to those thoughts and feelings, by acting, or feeling an urge to act, in
threatening or aggressive ways.
Thoughts
that often occur:
I'm being treated unfairly
I'm being disrespected
They're breaking a rule or standard
I won't stand for it
Physical Sensations
-
The Adrenaline Response
When
there is real, or we believe there is a real, threat or danger, our bodies'
automatic survival mechanism kicks in very quickly. This helps energise us
to fight or run away ('fight or flight response'). We will notice lots of
physical sensations, which might include:
heart
racing or pounding - enabling good blood supply around our bodies
breathing quickly - allowing more oxygen around the body
tense
muscles - a state of readiness to fight or flee
shaking
hot,
sweating
light-headed
stomach churning or butterflies
fist
or teeth clenching
Behaviours
might include:
staring & facial expression
aggressive body posture
attack
hit
out (or urge to hit out)
argue
shout
run
or storm away
don't
talk
sulk
The Angry
Cycle
We all feel angry some times. Some people
tend to become angry easily (a "short fuse"), and some have problems controlling
their anger. Anger has consequences, and they often involve hurting other
people - more usually their feelings, but sometimes physically. Anger can
cause problems in our personal lives, and affect work and study. After an
angry outburst, we can think very critically of ourselves and our actions,
leading us to feel guilty, ashamed and lower our mood, which might result in our
withdrawing from others, not wanting to do anything (see depression cycle).
Summary
In CBT, we aim to break those cycles by changing something - what we think or
what we do. We might start by looking at what might be easiest to change.
Perhaps in this case, it might be easiest to change what we do.
How would Dave, in the first example above, have felt if he had got up anyway, in spite of how he was
feeling. Maybe ate some breakfast, had a shower, got dressed, then perhaps
went out for
a walk. How would that affect his depression? What would that do to
the way he was thinking?
It's very likely that his mood would have improved, and that he would have
started to think a little more realistically. He might have even enjoyed
his day, or got a sense of achievement from having done
something.
Have a look at what you've written down on
your sheets of several examples of
distressing situations (Step 1 practice). What links can you see between
what you think and what you do, and how they affect the way you feel.
In the next step, you'll be starting to make
some changes that will work for you.
