I have seen quite a lot of people coming into Evolve with certain thought patterns that are focused around issues or things that are happening to them in their lives currently. With anxiety especially, our thoughts can be very focused on the “What if’s” - What if x happens, what if I can’t do x, what if I don’t get x, what if I can’t see x. What we are doing is creating and analysing potential problems that could emerge. I say “could emerge” due to the fact that all our potential problems/issues that we can create have a percentage chance of happening, even if they are sub one percent chances.
In CBT what we try to do with these thought patterns is to look at them realistically, logically and the evidence supporting them. This is the challenging aspect of CBT where we challenge the thoughts emerging to see the validity held within them. This helps clients filter out the very unlikely thoughts (0-5% chance of happening) and focus on the issues or problems that have a higher probability of happening.
The next step or working in tandem with the CBT challenging would be the cognitive restructuring interventions which are also part of CBT. In relation to future thoughts, we start trying to shift our perspective or analysing to the “What then”. When an intrusive thought emerges stating “What if x happens?” and it causes anxiety, the CBT therapist might ask the question “What would you do if x happens?” The subtle shift here is to start focusing on solutions to the potential problems/issues that might emerge rather than staying fixated or worrying about the potential problem/issue.
An example - “What if I have a panic attack at the work party?” - Through challenging and examination we collaboratively have come to a 15-20% percent chance of this happening. It has happened a few times before in public and there is more stress on a work event to go and talk to others. The shift in questioning is to then ask the client “What would you do if you felt a panic attack coming on or started having one?”, “Are there any things you can do for yourself if you do notice this happening?”. The idea of the “What then” is not to take away the problem from happening, but to better equip the client with tools to help themselves if it does happen. In this scenario a client might answer “I could pretend to have a phone call and leave”, “I could go get a drink”, “I know a friend who will be there, I could talk to them” or “If the panic attack does come on, then I will have to sit down and wait for it to pass using breathing exercises or other techniques that I have found helped.
The goal here is to have a plan in place or come up with solutions to the potential problems/issues that we could foresee happening in the future. When we change the “what ifs” to the “What thens” we start to restructure our perception to be more solution focused than problem focused.
I hope this was of help to people and provided some insight into how a CBT therapist might work. If you have any questions please feel free to contact us on our email below:
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