Part 6: Cognitive Restructuring to Change Your Thinking

What is Cognitive Restructuring: Working with Thoughts that Aren’t Working for You

Having learned to check in with your mood and identify automatic thoughts, you probably feel more grounded in your emotions, not being carried away by them as often. This chapter is devoted to helping you make big changes in your thoughts, feelings, and behaviors from that new, grounded place.

The skill we’ll be working on here is called cognitive restructuring. Cognitive restructuring refers to the act of identifying ineffective patterns in thinking, and changing them to be more effective. More effective can mean triggering less negative emotion, seeing things more clearly, or enabling more skillful behavior. Cognitive restructuring builds on your ability to accurately recognize automatic thoughts and feelings.

Oftentimes, when we first introduce people to cognitive restructuring in a cognitive-behavioral therapy session, they assume it has something to do with the power of positive thinking, that theory that putting a positive spin on negative situations leads to happiness. The reality is that we find in our work with our CBT clients that extremely positive thinking can be just as ineffective as extremely negative thinking. Being certain that you’re going to do poorly on a first date can cause the date to go poorly for sure. But assuming a date will go well no matter what might cause you to be less concerned about how you interact with your date, also resulting in the date going poorly.

Cognitive restructuring is not about flipping to the positive extreme. There’s a term for that: it’s called denial, and it’s not a terribly effective coping tool. Cognitive restructuring is concerned with developing a more sophisticated viewpoint that considers both positive and negative perspectives. The result is being able to adopt a thought that triggers less negative emotion and is more effective at helping you achieve your aims.

Sometimes, you may feel an immediate positive shift in your mood having restructured a dysfunctional thought. Other times, you may have to rehearse a new way of thinking about a challenging situation before it starts to sink in and influence your feelings. Our CBT clients often find that with consistent practice in CBT therapy, cognitive restructuring happens automatically, without any extra effort on their part.

Steps for Cognitive Restructuring

Step 1: Record the situation, thoughts, and feelings on your cognitive restructuring thought record (below). Just as instructed in the last chapter, choose a situation that triggered negative thoughts and feelings and break it into its component parts. What is important in cognitive restructuring is that you identify as many thoughts associated with the negative emotion(s) as possible. Don’t just stop at one thought.

Step 2: Pick one automatic thought from the list you created, the one that feels most responsible for your negative emotion. Focus on the thought that seems to be associated with the most distress. If that’s difficult to determine, it may be helpful to identify the strongest emotion and then figure out which thought provokes the majority of that emotion. For instance, in a situation in which you feel anger, sadness, and disappointment, if anger is the strongest emotion, find the thought that feels like it’s the one that generates the most anger. Before you proceed to the next step, make sure you’ve transformed your thought into a statement. Here are some examples:

Automatic thought: “What if I fail the exam?” Transformed into a statement: “I will fail the exam.”

Automatic thought: “Oh crap!” Transformed into a statement: “I really messed up big time.”

Automatic thought: (an image of not being able to get through a sentence without stuttering). Transformed into a statement: “I will stutter, and they’ll think I’m a fool.”

Now you can move on to step three.

Step 3: Develop different points of view about the situation. Think about the situation and the automatic thought from as many angles as you need in order to start to think and feel differently. There are countless ways to do this, but here, it’s better to work smart, not hard. There are several probing questions you can ask yourself that are bound to help you discover new perspectives on the situation:

1. What is the effect of believing this thought? What would happen if I didn’t believe this thought?

Answering these questions forces us to face the consequences of having a particular thought and pragmatically determine whether the thought is helpful or not. Take the following scenario as an example: You are up for a promotion at work but find out that another co-worker was picked over you.

Disappointment is a natural response to this, but if you have the thought, “I’ll never be able to get ahead,” how does this thought actually function in your life? Probably, it causes you to feel worse, turning disappointment into depression or despair. It probably also saps you of your energy and confidence, making it harder to do well at your job and other areas of your life. In this way, the thought functions as a self-fulfilling prophecy. The more you ruminate on the thought, the worse you feel and the worse your work performance will be, making it less likely to be chosen for a promotion next time.

Now, what would be the effect of not believing this? Well, for one, you might feel disappointment but not despair. You would probably recover more quickly and be more likely to strategize ways you could improve your performance to receive that promotion in the future. And you would also probably feel better in general. Having compared the effect of believing the automatic thought with not believing it, you can determine whether or not it’s really working for you. If it’s not helpful, then continue to look at the situation from different angles by continuing to answer the questions below.

2. What is the evidence supporting this thought? What is the evidence against this thought?

These questions help you determine the accuracy of your automatic thought. If the thought is inaccurate, you’re working with bad information and are thus unable to make good decisions about how to proceed. Using the same example of getting passed over for a promotion, the evidence for the thought “I’ll never be able to get ahead” is:

• I worked hard for this promotion.

• I believe I am a lot more qualified than the person who received it.

• This promotion was the only way for me to get ahead.

• I’m a total failure.

• If I can’t get this promotion, I won’t get any other promotion.

• My boss hates me.

By considering only these ideas, it’s not surprising that you would come to the conclusion that you’ll never be able to get ahead. It’s probably the case that there is more to the story, though. Now, let’s answer the second part: What is the evidence against this thought? Just be prepared that this question may be harder to answer than the first question because we might not be used to venturing outside of our normal thinking patterns.

• I don’t need a promotion to get ahead because I can get ahead in other ways, such as taking on increased responsibility.

• Just because I didn’t get a promotion now doesn’t mean I can’t get one in the future when I’ll have more experience.

• I’m good at what I do, so I’m bound to get a promotion, if not here, at another company.

• This is just one setback. I will have lots of opportunities for advancement throughout my career.

• I can figure out what I was lacking this time to bolster that part of my resume and experience, so I’m prepared the next time around.

Notice these thoughts are not 100% positive. What they are is effective in making this situation seem, though disappointing, manageable. Sometimes, when you find it hard to come up with evidence against your automatic thought, you can look over the ‘evidence for’ list and see if there are any logical fallacies or half-truths there.

The thought “I don’t need a promotion to get ahead because I can get ahead in other ways…” is the counterpoint to the thought “There was no other way to get ahead…” Pretend you’re a defense attorney when you’re answering this second part of the question, and try to pick apart the ‘evidence for’ list. Would that piece of evidence hold up in court, or does it seem flimsy? By deliberately reviewing the evidence for and the evidence against the thought, you’re able to consider the matter in a more thoughtful, intentional way and determine where the quality evidence actually lies.

3. Is there an alternative explanation?

Asking yourself if there’s an alternative explanation challenges you to consider possibilities you probably had not previously. In other words, answering this question forces us to realize that our automatic thought is merely an assumption and that we should give it the same weight as we would any other assumption or guess.

Let’s use a different example this time. Yvette has been feeling sad because her friend, Annika “never” texts her, and Yvette has thoughts that she “always is the one to text first.” Yvette has the automatic thought, “Annika doesn’t really like me that much. She just responds to be polite.” Yvette might be totally right, but without evidence, this thought is nothing more than an assumption. Identifying a list of alternative explanations might help her consider other possibilities and loosen her grip on this assumption:

• Maybe she just doesn’t like texting.

• Maybe she’s just very busy.

• Maybe Annika feels like she would bother Yvette to text out of the blue. (This is actually pretty common).

• Maybe she’s socially anxious, so she waits for Yvette to text first.

• Maybe texting isn’t that important to her.

• Maybe she’s gotten used to relying on Yvette to text first because she usually does.

• Maybe she’s trying to cut down on her screen time.

Some of these explanations might be more plausible than others, but the fact is that without any evidence, you have little reason to believe your assumption over any one of these other explanations. By considering different explanations for a challenging problem, you open the door to new possibilities and can more effectively navigate the situation and problem-solve. You also end up withdrawing some of your investment in the automatic thought, helping you feel better about the event and improve your mood.

4. What’s the worst that could happen? Would I survive it? What’s the best that could happen? What’s most likely?

In situations in which you fear a certain future outcome (think anxiety-provoking situations), it’s helpful to identify the whole range of possibilities. Ordinarily, when we’re anxious about something, we fixate on the worst possible outcome. The reality is that the worst outcome is usually not the likely outcome, so we overwhelm ourselves with negative emotions needlessly.

Let’s start with the first question: What is the worst that could happen? Here is where you actually flesh out in detail what you’re afraid will transpire. Using the texting example from question 3, let’s imagine Yvette was considering confronting Annika to ask why she doesn’t text. Thinking about this conversation, Yvette might have written down the following worst-case scenario:

Annika will be angry with me for bringing this up, say that she never liked me, and tell me never to talk to her again.

This is a fully fleshed out worst-case scenario. Sometimes, people aren’t specific in their answer to this question. Consider the following examples:

              It will be bad.
              I’ll be nervous.
              It won’t go well.

What’s missing in these examples is the detail. What will happen that will be “bad?” What will “It won’t go well” look like? When developing the worst-case scenario, you should have a detailed idea in your mind of what will go wrong. But you’re not done yet. After you identify the worst-case scenario, ask yourself the following questions about it:

Would I survive it?
              What could I do to cope with it if it did happen?
              How would I feel a week later? A month later? A year?
              If I looked back at this from the future, why might I think it was actually good for me?

Going through these additional questions will help put the worst-case scenario into perspective and make it feel more manageable. Let’s see how Yvette might have answered these questions:

It would feel miserable, but I would definitely survive it. If it did happen, I could reach out to another friend or my sister for support and momentary distraction. A week later, I’d probably still feel pretty sad about it, but it would feel more manageable. A month later, I would be disappointed when I thought about it, but I probably wouldn’t think about it that much. A year later, I would have moved on. It might actually be good for me because if she really reacted this cruelly, I wouldn’t want her or anyone like her as a friend anyway.

Next, identify the best-case scenario. Just like the worst-case, the best-case scenario usually isn’t the most likely. Unlike the worst-case scenario though, the best-case often doesn’t get much airtime in our minds. When we’re anxious, it’s much easier to consider everything that might go wrong rather than everything that might go right. To get perspective, it’s necessary to stretch our minds a little and consider the full spectrum of possibilities. Here’s an example:

Annika will be very understanding and tell me she didn’t text me first because she was afraid she would bother me, but now that she knows better, she’ll text more often. Then, because of this conversation, we’ll feel closer and be better friends in the future.

Totally possible, but definitely the best case. Finally, having re-calibrated by considering both the best- and worst-case scenarios, it’s time to answer the final question: What is most likely to happen? There are a number of ways of coming to that answer. One way is to find something halfway between the best and worst cases. Another, and probably a more effective way, is to consider as much evidence as you can and come to an educated guess. That might sound like this:

Honestly, I don’t know why Annika doesn’t text first, but if I bring it up, she’ll probably be understanding as she usually is. That’s one of the reasons I’m friends with her. She’ll also probably be more mindful of texting me more frequently in the future because deep down, I know she really does like me because we usually have a pretty good time together.

Having identified the most likely scenario, you may feel some of your anxiety lift. You will also probably be better able to imagine and plan for the actual situation.

5. If my friend _________________ were in this situation, what would I tell them?

Have you ever noticed how easy it is to give advice or support to someone else, but you come up short when trying to access that wellspring of wisdom when you need it yourself? Sometimes, situations feel a lot worse because we’re unable to get out of our own heads. This probing question is a handy way of allowing us to depersonalize it, meaning remove all our own biases about the situation and to see it more clearly. The way to do it is to pick one of your actual friends and think about how you might respond if they came to you for advice. Let’s consider the following situation:

Donovan has been lending his sister money since she lost her job several months ago. Initially, he thought it was a one-time loan, but his sister keeps coming back to him for more, and he’s concerned she isn’t even trying that hard to find a job. Since he’s been lending her money, he’s had to make some significant cuts in his spending. Donovan wants to tell her he can’t afford to give her any more, but he feels guilty when he thinks about saying no next time. He’s afraid he’ll ruin their relationship if he does.

For Donovan, this feels like an intractable situation with no solution. To answer this probing question, he chooses his friend Debra and imagines she told him the same exact story. He finds it easier to encourage Debra to do the right thing:

Debra, you’re not responsible for your sister. She’s an adult, and while it’s good of you to help her, she is responsible for solving her own problems. You might actually be more helpful to her if you offer support in different ways, like helping her find a job or apply for unemployment. She’ll probably be disappointed, but if she cares about you, she’ll understand.

Notice this answer isn’t just sugarcoating the problem or dismissing the possibility of a negative outcome with blithe platitudes. It’s an actual attempt to solve the problem at hand. You might notice that this answer seems to draw from the answers to some of the other probing questions in this thought record. I find this question is most helpful after answering as many of the other questions as are relevant to the situation at hand. That way, you can consider all of the various perspectives you’ve been developing and then boil it all down into some good advice.

6. What can I do about this?

We save this question for last because we usually come up with the best action plan after I’ve mulled over the situation from a number of different angles and feel I have the clearest sense of what’s actually going on. Sometimes, even in really unpleasant circumstances, asking yourself what can be done helps to change your mindset from being a passive victim of circumstance to being an active player who can shape the course of events.

Ask yourself: How might I be able to effectively deal with this situation? What are the ways I can influence the others involved in order to change things? How can I use the adversity to at least partly work in my favor? By shifting your orientation to the problem and positioning yourself to proactively work with it, you might feel increased confidence. You’ll also turn your mind from ruminating on negative automatic thoughts to identifying ways to succeed. The less time you spend on unhelpful thinking, the better you’ll feel, and the more you’ll be able to handle adversity. There are two steps to answering this probing question:

1. Brainstorm possible solutions
2. Identify the most effective solutions and implement them.

Let’s use this example: Ayala sent out a report with a significant error to the board members of the company where she works. Her boss met with her privately and in the heat of the moment, told Ayala she better “shape up” or she’d “be toast.” Afterward, Ayala was understandably shaken. She sat down once she was feeling a little calmer and brainstormed things she could do about this event. The rules for brainstorming are: 1. Write out as many solutions as possible, no matter how harebrained they seem, and 2. Don’t edit or consider the effectiveness of any solution until you’ve finished the list. This is the brainstorming list Ayala came up with:

1. Use this as an excuse to more actively look for a job more aligned with my career goals.
2. Win the lottery and quit.
3. Apologize sincerely to the boss and ask what steps she would recommend in remedying the problem.
4. Create a system that will keep this from happening again and present it to the boss.
5. Reach out to some of the board members to explain what happened from my perspective rather than let them jump to their own conclusions.
6. Blame another co-worker.
7. See this situation as a sign I might need to apply more effort in double-checking my work.
8. Once the boss has cooled off, make the case using this event as evidence that I could use more help in the office.
9. Accept that everyone makes mistakes and do my best to learn from this one.

As is evident from this list, Ayala did not hold back. Some of these ideas are pretty unwise. Blaming her co-workers for her mistakes or hoping that she wins the lottery are not the wisest ways of managing this challenge. By giving herself permission to consider all options, though, she was able to come up with solutions she would have otherwise discounted immediately, such as deciding to look for a better job.

After brainstorming, she ruled out the unfeasible ideas and decided to create a system for double-checking her work in the future. Ayala also decided now was as good a time as any to start exploring career options she was more excited about. At the end of the exercise, Ayala noticed she was focused more on ideas about what she could do rather than the image of her boss’s face chewing her out. Consequently, Ayala felt a lot better about the situation.

To reiterate, answering this probing question generally works best after you’ve answered some of the other questions on the thought record. Its aim is to redirect your thoughts from those of helplessness, hopelessness, or victimization to thoughts of confidence and empowerment. You may find that you feel a lot better after your problem-solving session, and as an added bonus, you’ll have an action plan to begin solving the problem.

Step 4: Craft an alternative response. Having answered a few of these questions, you may find that you already feel better. To get the most benefit, though, challenge yourself to create one statement that encapsulates the answers to the probing questions, or at least the most powerful components of them. We call this the alternative response. You can bring to mind this alternative response whenever the old automatic thought occurs to you. Although it’s hard to replace thoughts, allowing the new alternative response to coexist with the old automatic thought can do a lot to lighten your mood and help you get back on track.

It can help to write down and place this alternative response wherever you need it. Have it pop up as a reminder on your phone before meetings. Set it as your desktop background. Write it on a Post-it and put it on the refrigerator door. Whatever system you devise, the more you think about your alternative response, the more it will occur to you naturally, you’ll believe it more, and you’ll feel better when you bring it to mind.

The more of these thought records you complete using cognitive restructuring, the easier they will become. After some practice, you should be able to construct an alternative response in the moment without having to write out a thought record.

Completing a thought record using cognitive restructuring to develop an alternative response is one of the most powerful ways of addressing thoughts, feelings, and behaviors in cognitive behavioral therapy, so it’s important that you practice this skill as much as you can until it feels natural. Many of our CBT therapy clients never move beyond cognitive restructuring because it addresses all of their needs, so you’ll also likely benefit from spending more time on this skill. Our recommendation is that you complete a thought record with cognitive restructuring every day for at least a week before moving to the next module. With time, you’ll find you naturally engage in this investigative process mentally whenever you meet with a challenging situation.

CBT For Anxiety Disorders: A Practitioner Book. Wiley-Blackwell: Hoboken, New Jersey. – Simoris, G., Hofmann, S.G. (2013).

Cognitive Behavior Therapy, Second Edition: Basics and Beyond. The Guilford Press: New York. – Beck, J.S. (2011).

Cognitive therapy techniques: A practitioner's guide (2nd ed.). Guilford Press. Leahy, R. L. (2018).