How to Use This Book

This book is designed to be used in a number of different ways. You may use it to gain knowledge about emotional states and how we differentiate them in CBT or you may wish to use it for personal development, studies or to support your therapeutic work. The next eight chapters look at the eight unhealthy negative emotions and their healthy versions. The final chapter briefly explains the two main theories in CBT.

Each chapter contains an introduction to the title emotion and a checklist of triggers. A set of illustrations of both unhealthy and healthy cognitive consequences and action tendencies helps you identify the emotion. A guide for instigating emotional change then follows.

Each emotional pair is illustrated to show its cognitive consequences (how you think) and its action tendencies (what you feel like doing). You can compare and contrast the cognitive consequences and the action tendencies of anxiety and concern, for example. By looking at the illustrations and captions in each of the eight chapters on Emotions you can understand or become aware of your emotional state and whether it is healthy or unhealthy.

There are two ways of using this book if you wish to change your emotional state.

You may choose ‘General Change’ or ‘Philosophical Change’.

General Change helps you work out for yourself how to modify your assumptions and behaviours by learning about the unhealthy and healthy negative emotions and their cognitive consequences and action tendencies. General Change does not deal with the underlying belief systems that provoke the cognitive consequences and action tendencies. If you wish to change the beliefs that trigger the cognitive consequences and action tendencies, then you should choose the philosophical route and learn how to do that.

Philosophical Change is a more directive approach focusing you on identifying your unhealthy beliefs. It teaches you how to dispute them, work out their healthy counterparts and dispute them too. Disputing is a key skill in Philosophical Change. Disputing involves questioning the reality, sense and helpfulness of your beliefs.

This is done in order to help you understand the healthy solution to solving the problem. You will see, from the example later on in this chapter, the disputation questions to ask. Finally, Philosophical Change involves implementing the healthy solutions to your problem by thinking and acting in accordance with your healthy beliefs.

General Change helps you to manage your emotions and symptoms whereas Philosophical Change helps you to get better in the long term. It enables you to face what you are most disturbing yourself about and then develop a healthy rational response to it. You learn a philosophy that you can then generalise to other areas of your life. Below are two examples that demonstrate the difference between General Change and Philosophical Change.

Example 1: Dealing with the problem of rejection.

In General Change, you will realistically understand that you might not get rejected. You will focus on the likelihood of getting rejected and work out that, in reality, you may or may not get rejected.

Philosophical Change starts by pushing the button – it assumes rejection will happen to you and then helps you work out the unhealthy belief you hold about being rejected. It focuses you on facing the possibility of rejection rather than focusing you on the likelihood of rejection.

Example 2: Dealing with anxiety about dying in an aeroplane incident.

In General Change you will realise that flying is a safe mode of transport, disasters are rare and that the odds are stacked strongly in your favour. The likelihood of arriving safely at your destination is almost, but not quite, certain.

With Philosophical Change you will face the reality that risk exists, no matter how improbable. It helps you accept and develop a healthy attitude to adverse possibilities and uncertainty.

If you choose General Change but find yourself thinking ‘Yes, but?’ then the Philosophical Change method is for you.

We prefer Philosophical Change because it focuses on the most disturbing aspect of any problem first.

General Change has five steps

STEP 1 Choose a typical example of your emotional problem.
STEP 2 Identify your cognitive consequences and action tendencies that relate to your unhealthy negative emotion. Write them in your own words, using the illustrations as a guide. Make sure that they are specific to your example.
STEP 3 Repeat the above, this time identifying your cognitive consequences and action tendencies that relate to the healthy negative emotion.
STEP 4 Commit to thinking and behaving in accordance with the cognitive consequences and action tendencies of the healthy negative emotion.
STEP 5 Repeat, Repeat, Repeat in a consistent and forceful manner until your new thinking and your new behaviour become second nature.

Example of General Change – Presentation Anxiety
1 You have identified that you feel anxious about doing a presentation.
2 One of the cognitive consequences of anxiety is ‘You create an even more negative threat in your mind’, so you might write, ‘I think the presentation will go badly and I will end up losing my job’. One of the action tendencies of anxiety is ‘You seek reassurance’ so you might write, ‘I keep wanting to ask and ask my colleagues to tell me that all will be fine.’
3 Now look at the cognitive consequences and action tendencies for the healthy negative emotion of concern. One of the cognitive consequences of concern is ‘You do not create an even more negative threat in your mind.’ You might write, ‘I hope all will be fine and it’s unlikely that I will lose my job if it doesn’t go well.’
One of the action tendencies of concern is to ‘Deal with the threat constructively.’ So you might write, ‘I will not seek constant reassurance.’
4 Commit to thinking and behaving in accordance with the cognitive consequences and action tendencies of the healthy negative emotion.
5 Repeat, Repeat, Repeat in a consistent and forceful manner until your new thinking and your new behaviour become second nature.

Having followed through to the last step, you should begin to think healthy thoughts when you think about your presentation and you should stop yourself from seeking reassurance.

Philosophical Change has five steps

STEP 1 Identify your unhealthy belief by:
a. Choosing a typical example of your emotional problem.
b. Using the Common (Emotion) Triggers table as a reference to pinpoint what you are feeling most disturbed about.
c. Express your answer to (b) in the form of a ‘MUST’.
d. Identify the three derivative beliefs. (Awfulising, Low Frustration Tolerance and Damning). You may have all three derivatives or any combination of the three. You should imagine yourself in the trigger situation when identifying the derivative beliefs.
STEP 2 Dispute your unhealthy belief.
The unhealthy belief is made up of the rigid demand and its derivatives. The disputing questions below are used on all of them.
a. Are they realistic or not and why?
b. Do they make sense or not and why?
c. Do they lead to helpful or unhelpful outcomes for me, and why?
STEP 3 Identify your healthy belief.
This is done by rewriting the unhealthy belief into its healthy version. The healthy version of the rigid demand is called a preference belief. Three balanced beliefs are derived from the preference belief. (Anti-awfulising, High Frustration Tolerance and Unconditional Acceptance of Self or Other.)
STEP 4 Dispute your healthy belief.
The healthy belief is made up of the preference belief and its derivatives. The disputing questions below are used on all of them.
a. Are they realistic or not and why?
b. Do they make sense or not and why?
c. Do they lead to helpful or unhelpful outcomes for me, and why?
STEP 5 Strengthen your healthy belief and weaken your unhealthy belief.
A number of cognitive and behavioural assignments are suggested in each chapter.

Example of Philosophical Change – Presentation Anxiety
1 You have identified the following belief that triggers Presentation Anxiety:
My colleagues must not judge me negatively if I appear nervous. It would:
  • be awful if they did.
  • be unbearable if they did.
  • prove I’m worthless if they did.
2 The unhealthy beliefs (Rigid demand, Awfulising, Low Frustration Tolerance) are each disputed by asking the following:
a. Are they realistic or not and why?
b. Do they make sense or not and why?
c. Do they lead to helpful or unhelpful outcomes for me, and why?
3 Identify the healthy belief. The unhealthy belief is rewritten into its healthy version below:
I’d prefer that my colleagues did not judge me negatively if I appear nervous but that does not mean that it absolutely must not happen. If they judged me negatively it would:
  • be bad but not awful.
  • be difficult but not unbearable.
  • not mean that I am worthless. I am a fallible human being and my worth does not depend on whether my colleagues judge me negatively or not.
4 The healthy belief is disputed by asking the following questions about the preference belief and its derivatives:
a. Are they realistic or not and why?
b. Do they make sense or not and why?
c. Do they lead to helpful or unhelpful outcomes for me, and why?
5 Strengthen your healthy belief and weaken your unhealthy belief, by reciting the healthy belief whilst imagining yourself looking nervous in front of your colleagues. Also, behave in accordance with healthy action tendencies such as not seeking reassurance and not avoiding presentations.

We believe that making a philosophical shift is a more effective way of getting better in the long term because you will be working on the auto pilot that provokes your unhealthy emotions, thoughts and tendencies to behave, i.e. your beliefs.

You will be able to generalise what you have learnt to other areas of your life too, as you will have learnt a philosophy for healthy living.

Whichever route of change you choose – General or Philosophical Change – you will enable yourself to make helpful positive changes to your well-being. Beginning to recognise how your thoughts impact on your life experience is empowering.

Choosing General Change will enable you to figure out for yourself how you need to think and what you need to do to manage your emotions more healthily.

Philosophical Change takes more time and focus and will enable you to change underlying unhealthy beliefs to more healthy counterparts. On achieving this specific change you can then go on to generalise this healthy way of thinking and apply it to other areas in your life.

However you choose to use this book, we hope that you find it helpful.

Humour

We have used humour in some of the illustrations to help you remember some of the points and also because we believe in taking things seriously but not too seriously. Indeed, psychological health has been summarised by this philosophy by many great thinkers. But remember to put the emphasis on not taking things too seriously. It shouldn’t be interpreted as ‘it doesn’t matter to me’.

Using humour is about demonstrating how unhealthy and irrational our thoughts and behaviours can be. It is not about poking fun at anyone. No one is perfect and a key aspect of CBT is about accepting ourselves unconditionally as fallible human beings who can at times think and act in unhealthy ways. Accepting this fact helps us to move forward.

Illustration Conventions

We have used the standard illustration conventions for this book.

Cognitive consequences are illustrated using ‘thought’ bubbles.

Action tendencies are illustrated, where relevant, with ‘speech’ bubbles.

The original inspiration for the illustrated figures came from two boys from a little village called Samode, Rajastan, India. At the time, Patrick (the illustrator) was sketching a street view of the village. Patrick says:

These two young boys, one about 8 and the other perhaps 10 or 11, were curious about me. Their faces showed (I thought) rather conflicting emotions. On one side, friendly curiosity and on the other, disapproval: ‘What was this foreigner doing on our patch?’

This was fairly rural India and I don’t suppose they saw many Westerners. I thought that this image of these two boys might just fit with the premise of this book, that one’s emotions can lead one in different directions, healthy or unhealthy. My original intention was to have the boys in every illustration but it became rapidly clear that such a concept would be nigh on impossible to continue over such a broad swathe of emotions. However, they do appear here and there and they have been my starting point for many of the images. These boys will be young men now … 

A Final Note Before You Get Started

This book has been written to help you gain insight about emotions and understand how to change the unhealthy negative ones by working on the unhealthy beliefs that provoke them. We recommend professional intervention if your emotional state is so overwhelming that working on them on your own proves to be too much for you. You will find additional information for seeking professional help at the end of the book.