Recording the results of therapy is important, but not so easy to do. I do not keep a diary and too often I rely on my memory to notice what is going on. The problem, here, is that I can fool myself very easily. My memory does not provide an accurate record of what happens. In my search for meaning, I am adept at moulding the facts to my own convenience or ‘truths’.
For this reason, it is handy to write things down. If you are not keen, like me, then simply use Post-Its to record the headline facts.
AN EXPERIMENT: remember something specific that happened yesterday – whether a good or bad experience.
Use a Post-It or piece of paper to recall:
What happened – in one line.
The emotion(s) you felt at the time. Use the Subjective Unit of Discomfort (SUD) to ‘measure’ the emotion. Give each one a rating from 1 – 10. Zero, for example, would mean no emotion, so 1 is the smallest experience of the emotion and a SUD of 10 is the emotion at the strongest you can recall. You could score anywhere between 1 and 10.
The situation. What were you doing when you started to feeling the emotion? Who were you with? What time of day was it and where were you? In general terms, what was the focus of your thoughts at the time? Only put down the general topic here (e.g. `Thinking about how difficult life is‘).
What precisely was going through your mind should go in the next column.
The automatic thought(s). What thoughts were running through your mind at the time you started to feel bad? Try to record them as accurately as possible, word for word. Some of your thoughts may take the form of images in your mind’s eye, rather than words. Write down exactly what the image was, just as you saw it.
Preferred managing strategies: Notice any strategies you use to avoid or side-step the discomfort. You may notice ‘favourite’ strategies for doing this, e.g. complaining about some-one else in your life.
Associated feelings: thoughts can make us feel bad and commonly generate anxiety, sadness, depression, hopelessness, guilty and anger. What feeling was around on this occasion?
Instead of being overwhelmed by these feelings, you can learn to use them as a cue for action.
AFTER THE EXPERIMENT
Return to your brief note after a few days. How do you recall the event now? Do you review the facts, thoughts and feelings in a different way, now?
Are you becoming more sensitive to changes in your feelings and the thoughts that spark them off.
You may well find that the same thoughts occur again and again.
Ask yourself what you understood was going on it that situation, as described. What does it tell you about yourself, your situation, your future? Can you identify a changing meaning associated with the event? You may be able to challenge it the old meaning or even the new one.
EXPERIMENT: PART TWO
As you become more fluent with spotting and recording a negative thought give it a rating out of 7 according to how far you believe it. This is called the Validity of Cognition (VoC) scale. It’s similar to the Subjective Unit of Discomfort (SUD) in that it is a rough-and-ready measure of the certainty of your belief (rather than feeling and sensation); where 1 is I really do not believe this at all …… and 7 is I really believe this entirely.
Notice that it is possible you will find yourself making excuses not to record, for reasons I have mentioned. This may be because you have hit on something important, so be extra vigilant and make yourself write a summary down.
You could divert yourself with a distraction exercise if you want to but ignoring a thought will not make it go away.
| What do you feel? How bad is it (0-10)? The SUD||What were you doing and with whom?||What were your thoughts? How far do you believe each one (1 – 7)?|
As your record grows, you are likely to see patterns in your thoughts and actions. At this point, you can consider some antidotes.
Can you change the situation you are in? That can change our thinking patterns.
Can you observe your mood – practise ‘just noticing’ (3rd para down) – to observe the impact on your mood. Add in the small, safe experiment of ‘affirmation’ of yourself, e.g. say: “even though I am feeling [this mood – name it specifically], I can still deeply and completely accept myself”. When you repeat this affirmation in your head what changes arise in your thought pattern? ….. even if only to laugh at ourselves!! That’s a difference.
Can you be objective enough to seek out some evidence that supports a negative thought? Often there can be some sound reason for holding it. However, follow this up with finding evidence that runs counter to the negative thought. There is usually something to be found to contradict any one thought we are having. Note all of them down.
When you look at all the information, and initiate some controlled breathing: what is the ‘balanced’ view that emerges?
What impact can these experiments and reflections have on your own Stroke Economy?
Consider: what something a little bit different might I do to re-consider this belief – and my actions – just a little bit differently.