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20 July 2023

Understanding Negative Self-Talk

Negative thinking or as some call it, negative self-talk, “stinkin’ thinkin’,” is an all too common threat to individuals with a substance use disorder. Such thinking can seriously jeopardize the ability to change one’s substance using behavior by sabotaging change efforts with doubts about one’s ability to change and the resulting fear of failure. Counselors employing Rational Emotive Behavior Therapy (REBT) can teach clients whose negative self-talk presents roadblocks to change by helping them identify and then dismantle these barriers.

 

Albert Ellis, the founder of REBT, developed the “A-B-C” approach to counseling individuals whose negative self-talk impedes their movement towards desired change goals. In this approach to cognitive behavior therapy (CBT), the “A” stands for an activating event that precedes some consequence like a negative emotion or untoward behavior, the “C” in this model. The “B” represents the belief one holds and uses to interpret this activating event (A) that results in the consequence (C). The beauty of this model is its simplicity in pointing out that it is not the event that causes one’s emotional upset but what one tells oneself about the event that is the source of the distress.

In short, the model moves the focus of change from an external locus of control—something over which the client has no control—to an internal locus of control where the likelihood of change is something the client can affect. Once aware of the “A” interpreted by “B” results in “C” view of negative emotions, clients can then dispute, what Ellis referred to as “D” in his model, these irrational beliefs and replace them with new effective rational beliefs, “E” in his model. 

 

Teaching clients to challenge irrational beliefs can involve a variety of techniques and strategies. One of which is cognitive restructuring. This is a therapeutic technique used to challenge and change irrational or negative thought patterns. It involves identifying and examining the underlying beliefs and assumptions that contribute to these thoughts and replacing them with more rational and positive ones. This process often involves questioning the evidence and logic behind the irrational beliefs and finding alternative, more realistic interpretations of the situation when the belief fails to stand up to such scrutiny. It aims to help individuals develop healthier and more adaptive ways of thinking, which can lead to improved emotional well-being and behavior.

 

Let's say someone holds the belief that they are a failure because they made a mistake at work. They believe this causes them to feel anxious and depressed. Through cognitive restructuring, they can challenge and replace this irrational belief with a more rational and helpful one.

First, they would identify the negative thought or belief, which in this case is “I am a failure.” Then, they would examine the evidence for and against this belief. They might realize that they have had many successes in their career and that this one mistake does not define their entire worth or competence.

 

Next, they would generate alternative, more rational thoughts or beliefs. For example, they could replace “I am a failure” with “I made a mistake, but I am capable and have learned from it. I can improve and do better in the future.”

 

Finally, they would practice and reinforce these new thoughts or beliefs through repetition and positive self-talk. Over time, this cognitive restructuring process can help them develop a more balanced and realistic perspective, leading to improved emotional well-being.

 

Another useful technique for disputing irrational beliefs is the “downward arrow technique,” sometimes called the vertical interviewing technique. This technique is a cognitive therapy technique used to identify and challenge irrational beliefs. Although developed for use in Beck’s Cognitive Therapy, it is equally useful when employing Rational Emotive Behavior Therapy (REBT). It involves asking a series of “why” questions to explore the underlying beliefs and assumptions that lead to negative thoughts or behaviors. Some thoughts on employing this technique include:

 

·      Identify a negative thought or behavior: Start by identifying a negative thought or behavior that you want to explore further. It could be something like “I'm not good enough” or “I always mess things up.”

·      Ask “why” questions: Once you have identified the negative thought or behavior, ask yourself why you believe it or why you engage in that behavior. For example, if your negative thought is “I'm not good enough,” you might ask yourself, “Why do I believe that?” or “Why do I think I'm not good enough?”

·      Explore underlying beliefs: As you ask yourself these “why” questions, pay attention to the underlying beliefs and assumptions that come up. Often deeply ingrained, these beliefs may not be immediately obvious. For example, you might uncover beliefs like “I have to be perfect to be worthy” or “I'm not lovable unless I achieve certain things.”

·      Challenge the beliefs: Once you have identified the underlying beliefs, challenge them by asking yourself if they are rational or if there is evidence to support them. For example, if your belief is “I have to be perfect to be worthy,” ask yourself if that belief is realistic or if there are examples in your life where you have felt worthy despite not being perfect.

·      NOTE: Uncover or “exposing” underlying or “core beliefs” that give rise to negative self-talk may require several successive questions such as: “and if this is true, what does that mean?” or “and your proof of this is?” Such questions often generate yet additional beliefs to which additional “why” questions or others as just cited can ultimately result in identifying one or two “core beliefs.” These core beliefs, like those noted in the previous bullet, tend to generate all the negative self-talk reported by clients. Identifying and then effectively disputing them can result in significant improvements for your client.

·      Replace with rational beliefs: Finally, replace the irrational beliefs with more rational and positive ones. For example, if your belief is “I have to be perfect to be worthy,” you could replace it with “I am worthy just as I am, flaws and all” or, “I may not be perfect but when I am not, I learn from my mistakes.”

 

Remember, the downward arrow technique is a tool to help you identify and challenge irrational beliefs. It may take time and practice to fully uncover and dispute these beliefs, but it can be a powerful tool for personal growth and self-improvement.

 

As noted above, there are many techniques and strategies used by cognitively oriented practitioners when assisting clients. Many of these are particularly useful when working with individuals with a substance use disorder. For mor on cognitive techniques and resources, visit https://positivepsychology.com/cbt-cognitive-behavioral-therapy-techniques-worksheets/