CBT Thought Record Diary: How to recognise and reframe your intrusive negative thoughts?
Cognitive Behaviour Therapy (CBT) explained
In a nutshell, Cognitive Behavioural Therapy, or CBT as it’s commonly known, is a talking therapy that can help us change our behavioural responses to instinctive yet unhelpful thought patterns. CBT is based on the premise that in every situation our thoughts, feelings, behaviours and physical symptoms all interact with each other, and with the situation itself. One small shift in one of these areas can change the outcome of what we’re facing in life.
A CBT Thought Record is a helpful first step to understanding the patterns of our thinking and in this blog I will walk you through the model and process. There is a free downloadable PDF Thought Record template that you can print and use at home. May it bring lots of calmness to your thoughts, and a sense of mastery over the way you are reacting to the challenges in your life!
Hi, I’m Karin. I work as a Coach & Psychotherapist. As we engage with CBT and create our own Thought Record some of the thinking patterns and styles we might encounter can be challenging. I invite you to approach it with gentleness and kindness towards yourself, knowing that as you gain more insight and more autonomy over your thoughts even greater compassion and tenderness is often the result.
Let’s start at the beginning
What is Cognitive Behaviour Therapy (CBT) ?
Dr. Aaron T. Beck is the original founder of CBT and he first published his methodology on cognitive therapy in 1967. So it’s been alive as a therapy for some years now. His thinking was developed from the groundwork of many notable behaviour therapists including Pavlov, Watson and Weeks, and the work on cognition in psychotherapy by Alfred Adler. Beck synergised much of the thinking and theory into what is recognised today as Cognitive Behavioural Therapy.
Cognitive refers to what we think, and how our thoughts affect our mood and behaviours.
Behavioural refers to what we do, and in particular how our actions maintain a particular problem or keep us inside a repeating loop of negative mood.
Therapy in this context refers to what we come to understand, heal and transform using techniques and strategies to change for the better.
CBT recognises that our thoughts, emotions, physical sensations and patterns of behaviour are all interconnected. When we have unhelpful unconscious or automatic irrational or distorted thinking that can lead to anxiety, overwhelm, distressing emotions, worry and rumination or depression, CBT can help us to unravel the connections between our thoughts and our behaviour, and invite new ways of responding.
Here’s a simple example of how in the same situation just a simple difference in thought can lead to a completely different outcome.
Imagine you’re walking down the street and you pass by a friend, perhaps you even bump into them and they just walk on by, paying you no attention as they go.
An instinctive thought might be “That’s so rude, they didn’t even acknowledge me… Who do they think they are? Well that’s not OK, how dare they treat me like that! Or have I done something wrong, and are they upset with me?”
Feelings of confusion might arise, then feelings of insecurity might start to bubble up, physical sensations of constricted breathing, a tightness in the stomach, feeling teary with an impulse to protect our stomach or close over our solar plexus.
The behavioural response is a desire to close off to protect ourselves. To withdraw and to avoid contact, not decide not to initiate with a phone call or a text perhaps until they make the first move, all the time worrying if we have done something wrong and if they are angry with us.
Let’s take the exact same situation with a different thought. What if the thinking is “Gosh, that’s not like them, I hope they’re OK, I wonder if something has happened to upset them, maybe they’ve got a lot going on, I wonder if there’s anything they need…?”
The feelings and sensations arising might be those of concern and kindness, warmth and closeness, curiosity and care. Our heart feels soft, and our arms feel like wanting to embrace them. We rush a little to get home soon, so we can get in touch.
The resulting behaviour: when we have finished our shopping the instinct is to reach out, perhaps we text or call or send a card checking in to see if they are OK.
We can see that either behaviour can be possible or likely and how two completely different outcomes stem from two completely different initiating thoughts. See how we broke the internal experience up into different categories: our thoughts, physical sensations, emotions/feelings and our behavioural response.
Fundamentally CBT practitioners believe that when you change your thoughts, you impact your body and emotions, and therefore are able to respond differently to a situation in a way that is more conducive and helpful to the desired outcome.
Here’s how that interconnectedness is understood in practice:
How our thinking relates to our emotions and behaviour in CBT
We experience automatic (negative) thoughts in response to situations and events, which in turn lead to unhelpful emotional and behavioural responses. Today let’s look at the role our thoughts and internal dialogue (especially our stubborn inner critic!) play in how we feel and behave. Getting a deeper understanding of this can help us avoid downward spirals and getting trapped in overthinking and distorted cognitive thought patterns that can feel so real, but aren’t based on facts.
We will learn to recognise when these habitual and often unnoticed patterns, otherwise known as cognitive distortions, and limiting beliefs come into play.
It’s natural to experience exaggerated or irrational negative thought patterns that can lead us to believe things that aren't necessarily true, I’m sure we’ve all been there. Let’s take a funny example like Santa Claus! Didn’t we all believe in him once upon a time?? We’re talking more serious stuff here, like the thoughts of going to be fired when asked to see the boss, or being certain our partner has an affair when he doesn’t pick up the phone. It can feel incredibly real and is most definitely unpleasant, but despite it feeling like reality with all the heightened emotions that go with this kind of thinking, at times we have simply distorted reality (at times based on previous trauma) and need to re-order our thinking and make new sense of it.
It is important to recognise that all cognitive distortions:
Are habitual patterns of thinking or beliefs;
Are false, inaccurate, and often exaggerated catastrophic thoughts;
Manifest themselves as negative emotions or feelings;
May increase anxiety and depression.
One strategy that CBT helps us to deploy is to create a little healthy distance between our sense of Self and the thoughts that we have. It allows us to start to cultivate a wiser, more compassionate self-witness or observer to our thoughts, rather than being unwittingly led astray by the unhelpful thoughts themselves. Once we are aware of the thinking that is present, we can offer a kind of dispassionate commentary on those thoughts (words that comes from our wiser, less critical, more adult self). This is a good first step to freeing ourselves from being quite so reactive.
So for example instead of letting your head tell you “I am such an idiot”, with CBT we might replace it with “my anxiety is telling me that everyone thought I was such an idiot while I did that presentation”. Can you feel the difference? With the second statement we are no longer identifying with the thought (“I am…”) and instead can make some sense of where that thought might be coming from and also give it a more confined specific context, rather than the exaggerated all pervasive “I am an idiot” statement. Now of course, ideally we’d like to get to a point where we don’t walk around calling ourselves an idiot at all, but it’s a first step in the right direction.
Let’s see how we can begin to unpick some of our thoughts using the CBT Thought Record Diary to deepen our awareness.
Now, let’s get to work 😊.
Download your free CBT Thought Record diary template straight away:
Download your free pdf template / worksheet of a CBT Thought Record by submitting your details above.
Using a CBT Thought Record Diary to track and challenge our unhelpful (and at times distorted and irrational) thought patterns.
A Thought Record or Thought Diary is commonly used as a starting point in CBT to help us find some of the unconscious links between our thinking and responses in certain situations. As we go through the process it invites us to question the validity of negative or unhelpful thinking and to seek evidence to the contrary. We go one step further and formulate what new thinking we would like to replace the old thinking with, creating a kind of blueprint that we can follow when old patterns occur. Doing this repeatedly builds new connections between the thoughts and behaviour and allows us to find some liberation.
“Successful therapy will educate you to understand and become aware of your distorted thinking, and how to challenge its effects. Frequent negative automatic thoughts reveal your core beliefs.”
- Aaron Beck, Founder of CBT -
How to fill the CBT Thought Record
CBT Thought Record to challenge our thinking errors
Before we begin it’s helpful to note that a good time to complete a CBT Thought Record is relatively quickly after we notice a change in your mood or sensation as this will often be the first indicator that a change in thinking has occurred that we might be unaware of. It will be easier to work with a ‘live’ situation as it’s happening, rather than trying to remember what you were thinking and feeling in a situation from the distant past. So, let’s get going, our first point of call is to identify a situation to work with.
Situation (life situation, relationships, practical problems and/or challenges):
For example being called in to see our boss and getting panicky, waking up feeling anxious, doing a presentation for a big group of people and thinking you made a fool of ourselves, an argument with our partner, a disturbing phone call with a parent, visiting friends and going quiet in front of everyone etc.
Answer the following questions: What were you doing? Who were you with? When was it? Where were you?
Physical Reactions (altered physical feelings/symptoms in the body):
Next we explore what is going on in the body. For example a headache, butterflies in tummy, sweaty, restless, can’t think clearly (brain fog), increased heart rate / palpitations, chest pain, shortness of breath, muscle tension, feeling sick, nausea or abdominal distress, numbing, tingling, chills or hot flushes, dizzy / unsteady, trembling / shaking, dry mouth, memory difficulty, sensitivity to sound and noise, red face, lack of concentration, etc.
Check in with your physical reactions and name all the sensations you are aware of in your body. It’s important that these are descriptions of sensations rather than labels of emotions which we will get to next. Don’t worry too much if you note things down in the ‘wrong’ column, to begin with it’s great to have a curiosity about your inner experiences, and to try and develop the vocabulary as to what is going on.
Emotions (altered feelings/emotions):
Now we begin to explore the emotional landscape which may be a little harder to get to for some people, but you can make your best guess. For example resentful, anxious, angry, low, hurt, irritable, worried, rejected, confused, sad, relieved, relaxed, insecure, happy, excited, guilty, ashamed, disappointed, overwhelmed, fed-up, responsible, apprehensive, hopeful, stressed, embarrassed, disgusted, defensive, panicky etc.
Have a look at this extraordinary blog about getting to know your feelings better, and finding the right words to express them to others:
In the CBT Thought Record, describe each mood in one word and rate the intensity of each on a scale from 0 to 100%. Zero meaning not disturbed at all, hundred meaning as disturbed as can ever possibly be.
Behaviours (altered behaviour or different ways of acting compared to usual):
When we are at the mercy of distorted thinking in uncomfortable situations we can often act in ways that we aren’t proud of, and it can be easy to judge ourselves for that. Again I plead some compassion, this is a journey and process and the wheels of positive change are always greased by kindness. If you’d like some explanation or reassurance as to where some of these less than ‘adult’ behaviours might be coming from you might like to look back to the blog I wrote on the Parent Adult Child Model of Transactional Analysis.
When we get to this part of the CBT Thought Record we are looking to describe our reaction / our actions in this situation.
For example I went quiet in front of everyone, I kissed him back even though I did not want to, I shouted at my daughter, I people pleased, I left, I drank a lot of alcohol, I said things I did not mean, I stayed in bed the whole day, I ate sugary things, I postponed what I needed to do, I worked late, I hang up the phone mid conversation, I cried, sat at desk at work but did nothing.
Let’s keep going with examples of behavioural reactions: Comfort eating. Slamming doors. Driving dangerously. Withdrawing from social situations. Shutting down. Not answering phone or text messages. Avoiding conflict or not confronting situations to share how you really feel. You get the gist yes?
When we understand the context, our feelings and physical sensations we can begin to lift the lid a little on the thoughts occurring underneath this all. So, looking at our thoughts is our next step!
Thoughts (altered thinking):
Negative Automatic Thoughts (NATs) are thoughts that pop into our minds and which are negative, disturbing, dysfunctional and unhelpful. They seem to come into our head unbidden and seemingly outside of our control. It’s crucial to identify, challenge and transform these negative thinking patterns as we have seen above, they influence our mood, behaviours and the outcome of situations.
For example “Why can’t I do this, others seem to pull this off so easily?”, “I’m stupid”, “He’s going to leave me”, “They think I am fat or ugly”, “I am no good at this”, “I’m going to be fired”, “I cannot cope with the stress at work”, “She will yell at me and we’re going to have an argument”.
Often our negative thoughts have an underlying common thread. Like a pattern that is the foundation of the myriad of thoughts that spiral out. These are called limiting core beliefs or negative cognitions. Examples of limiting core beliefs are “I am not good enough”, “I’m a failure” or “It’s my fault”. It goes a bit beyond the scope of this already long blog to delve into the reason for those. But for now, know that they are not part of your fundamental nature, and thinking these thoughts can be unlearned and changed into a kinder pattern of self-talk.
To get to the bottom of the thoughts that are going through your head, answer the following questions in your journal: What was going through my mind before I started feeling this way? What does this situation say about me, my life, my future? What am I afraid of that might happen? What is worst thing that could happen if this is true? What does this mean about what the other person(s) thinks or feels about me?
As you explore this please be honest yet gentle with yourself, this is not about arming your internal critic with more ammunition but rather finding a way to get beneath the surface thinking to the core of what is needed.
For those who think in visual images:
As an additional column, feel free to add visual representations of what you are experiencing. Some people’s minds communicate with words (thoughts), others are more visual (and show images in front of their mind’s eye). It’s like you can see what it feels like.
Examples are “at the bottom of a dark pit”, “in the corner of a black room without windows”, “like a fire burning through my entire stomach”, “as if a dagger was wedged inside my heart”, “as if someone was choking me”, “it feels like there is a huge rock pushing down on my chest”.
Answer the following question: What images (or visually descriptive sentences) appear in relation to this situation?
If this is you, I strongly encourage you to draw the images that come up for you, and if you want, bring them to therapy. Magic happens when we start to relate to our inner world and become truly curious to the expressions of our deeper self!
Download your free CBT Thought Record diary template straight away:
Here’s where we begin to shift our perspective from a curious enquiry of what is present, to a balanced assessment of the available evidence.
Evidence / Proof against Negative Automated Thoughts
In order to change our Negative Automatic Thoughts, we need to look for evidence of the opposite being true. Is there really evidence that our thoughts are correct? If you were the defence lawyer in a court of law, and you had to give proof that your thoughts are not true, what would you say? Maybe your thoughts are assumptions, and feel very real, but aren’t actually factually true. This is very often the case.
For example, instead of thinking “I can’t cope with my workload, I am useless”, examples of more balanced thoughts might be “Many of my colleagues are stressed, it is not just me”. “I have had demanding jobs before and managed well”. “My team is understaffed, the problem is not with me but with the amount of work on my plate”. “My role description and responsibilities are not clear”.
Can you feel the calm these more balanced thoughts bring?
Questions to help find evidence that does not support your Negative Automatic Thoughts:
Have I ever had any experiences that show that this thought is not completely true all the time?
If my best friend or someone I loved had this thought, what would I tell them?
If my best friend or someone who loves me knew I was thinking this thought, what would they say to me? What evidence would they point out to me that would suggest that my thoughts were not 100% true?
When I am not feeling this way, do I think about this type of situation any differently? How?
When I have felt this way in the past, what did I think about that helped me feel better?
Have I been in this type of situation before? What happened? Is there anything different between this situation and previous ones? What have I learned from previous experiences that could help me now?
Are there any small things that contradict my thoughts that I might be discounting as not important?
Five years from now, if I look back at this situation, will I look at it any differently? Will I focus on any different parts of my experience?
Are there any strengths or positives in me or the situation that I am ignoring?
Am I jumping to any conclusions that are not completely justified by the evidence?
Am I blaming myself for something over which I do not have complete control?
How to transform automatic unhelpful and even irrational or distorted thoughts into alternative balanced thoughts
We’ve arrived at the final column of the CBT Thought Record and this is where we can offer some creative, balanced and alternative thinking to resource ourselves for the future.
Let’s take a real life example to work through this part of the process. We’re going to re-word the irrational, distorted, unhelpful automatic negative thoughts into more kinder and supportive self-talk. Imagine a young woman, we’ll call her Sarah, she believes that whenever she gets into a romantic relationship that her partner will always eventually leave her and she will end up alone. She has deep feelings and beliefs around unworthiness and not belonging.
When she finds herself in an argument with her partner her thoughts go straight to “they are going to leave me”, combined with feelings of panic and anxiety. Her body tenses up, heartbeat increases, and a knot forms in the pit of her stomach. She responds with a reactive, clingy and rather desperate attempt to make things better, by trying to get a cuddle or ask for reassurances.
When we look at this pattern through the lens of The Parent-Adult-Child Model from Transactional Analysis we can see that Sarah, instead of responding from a place of a well-regulated adult who might have resources to de-escalate a fraught situation and resolve conflict, instead has awakened her inner abandoned child. Perhaps she learnt in childhood that she always needed to appease her parents in order to feel safe and loved, and this life script is playing out again utterly unconsciously.
A more helpful new belief for Sarah to start to introduce might be something like “I am just as worthy of being loved as everyone else. I am safe in relationships”. By turning towards her wounded inner child and not abandoning herself in these moments she can start to re-parent herself. With practice these new thinking patterns become more and more believable, not just at the level of our thinking, but deep in our bones at a somatic and emotional level too.
Questions to help arrive at alternative or balanced thinking:
Based on the evidence I have listed in the CBT Thought Record, is there an alternative way of thinking about or understanding this situation?
Write one sentence that summarises all the evidence that supports my Negative Automatic Thought and all the evidence that does not support my Negative Automatic Thought. Does combining the two summary statements with the word “and” create a balanced thought that takes into account all the information I have gathered?
If someone I cared about was in this situation, had these thoughts, and had this information available, what would be my advice to them? How would I suggest that they understand the situation?
If my Negative Automatic Thought is true, what is the worst outcome? If my Negative Automatic Thought is true, what is the best outcome? If my Negative Automatic Thought is true, what is the most realistic outcome?
Can someone I trust think of any other way of understanding this situation?
Enjoy going out into the world and look for evidence or experiences that support your new belief. Come up with activities and experiments to test your new more balanced thought. And enjoy your newly found freedom!
Before you go, quickly download your own free template for journalling, and make peace with those invasive thoughts in your head today:
Healing the root of our intrusive, negative or even distorted thoughts
In a deeper therapeutic piece of work, in a one-on-one setting, we would look at the root of your Negative Automatic Thoughts (NATs). These are often based on previous real life experiences, likely based in childhood, where you came to certain conclusions, started to believe things about yourself, based on what happened to you back then. CBT Thought Records help to identify these thoughts and core beliefs, and to transform the way we think. CBT in my opinion does not eradicate the root of these automatic negative thoughts and thinking errors. For that, a deeper piece of therapeutic healing and inner child work is needed.
I’m hoping this has given you a thorough yet easy to follow step by step guide to completing a CBT Thought Record and that through beginning this inquiry you can start the journey of unravelling some of those unhelpful patterns of thinking that might leave you feeling less than peaceful.
If you would like to explore how therapy can help you reach some of the underlying core beliefs and gently work towards healing those, please do get in touch for a no obligation free discovery call to find out more.
Karin Peeters - Coach & Psychotherapist
Sources and CBT book recommendations, with gratitude:
Centre for Cognitive Therapy, Newport Beach, C.A.
Mind Over Mood by Dennis Greenberger and Christine A. Padesky. The Guilford Press.
The CBT Workbook by Dr Stephanie Fitzgerald.