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Pre-read week 3
What is this week’s tool?
We are continuing to focus on tools to manage our thoughts. This week we are including several tools for dealing with unhelpful thinking, including:
Acceptance (from DBT and ACT)
Cognitive Defusion (from ACT)
Overview of how to use all the tools to navigate thoughts
Why use these tools?
You may have noticed in your home practice last week that some of the thoughts that come up during your scheduled worry time may not be suitable for cognitive restructuring. Perhaps you could not find an alternative way to approach your thoughts, or you were unable to replace them with more balanced ones. These “resistant” thoughts might be better suited for some of the tools we are exploring this week, as they allow us to approach and move forward with thoughts that are true or unchangeable.
How do I use these tools?
Schedule some specific times, at least 2 or 3 times a week, to practice these tools in mental flexibility. This is similar to the worry/rumination/unhelpful thinking time we learned and practiced last week, but we will instead focus on dealing with “resistant” thoughts using our alternative tools of acceptance and cognitive defusion.
Notice in your daily life when a bothersome or unhelpful thought arises. Take a moment to acknowledge that a part of you is bringing up that thought for a reason—it’s trying to be helpful. Then write the thought down to address during your scheduled mental flexibility time.
The flowchart below will help us decide when to use which tool(s).8
Wellbeing Tip:
The above flowchart does not need to be followed exactly. In fact, you can apply multiple tools at once if it suits you! In almost every situation, there is a way in which our thinking could be made more balanced (i.e. could benefit from cognitive restructuring), there are some parts of the situation that are within our control i.e. could benefit from problem-solving), and there are some parts of the situation that are unchangeable (i.e. need to be accepted). If you look at the examples earlier in this pre-read, you will see that the sample adaptive responses often combine multiple tools.
8 Similar processes have been used in various versions of CBT, but this particular flowchart is from Mo Gawdat, a former systems engineer and tech executive who has written about happiness and AI risk!
Some of these tools fit better for certain situations or people, and none of them are a panacea. So, having all of them in your toolkit will maximize your flexibility and enable you to apply whichever works best at any given moment.
Let’s start with “I have a thought”:
Is the thought true?
No, definitely not Amazing! Cross it out and move on.
Yes, it is an indisputable fact Move on to b.
Maybe (it’s an opinion or an unknown) As you have practiced last week, use the cognitive restructuring worksheet to come up with a more balanced, but still believable, thought. If you need a refresher on using the tool, review this example. Whenever your unhelpful thought arises in the future, remind yourself of the new and improved alternative thought.
Can I do something to fix the problem or improve the situation surrounding this factual thought? Is the problem worth solving?
Yes Try problem solving! Using SMART goal-setting from Week 2, plan out when to take your first step to address this situation/problem. If you are uncertain how to solve it, your first goal is to gather information on how you might solve it. Put your first step on your calendar or to-do list if you find that helps you let go of thinking about it. We will come back to problem- solving strategies in Week 8 when we focus on taking action and conducting behavioral experiments.
No (or yes, but I don’t want to) Move on to c.
Acknowledge that this is the unfortunate state of reality at this moment.
Consider ways that you can still live as good a life as possible given the circumstances. See this worksheet on practicing radical acceptance for some reflection exercises that may help you move towards acceptance of reality.
The thought may continue to bother you. It's the nature of the mind to continue generating thoughts, and in some cases, trying to change a thought can get us even more stuck, especially if we are prone to rumination.
Fighting against a thought too hard can sometimes cause it to fight back. If you notice this happening, you can try cognitive defusion techniques, which allow the thought to be present without you being immersed in it (i.e. “fused”).
Here is a written explanation of cognitive defusion. Defusion doesn’t try to change the thought, but instead tries to reduce its power over our attention and behavior. Cognitive defusion understands that generating more helpful thoughts is only one useful approach, not your only option.
Optional Resources
Explanation of cognitive defusion with several exercises (video, 20 min)
An alternative version of worry time without cognitive restructuring (handout, 1 page)
Difference between cognitive defusion and cognitive restructuring (handout, 2 pages)
9 Shared courtesy of Dr. Hannah Boettcher, an EA-aligned therapist.
Thinking Time Record
Copy the thinking time record template for each day you complete thinking time. When needed, use the worksheets and resources linked above for the corresponding tool; this template is just for recording the “final result” of using the tool. In the “helpful response” column, write the result of whatever tool you used (restructuring, problem-solving, acceptance, defusion, etc.).
Here’s an example of a completed form:
Thought
My colleagues thought that I was weak and shameful when I teared up during that meeting.
Restructuring
Prob. solving
Acceptance
Defusion
Let go
Some people might have been uncomfortable, but they probably understood that everyone gets emotional at times. My colleagues care about me and they know I do good work.
I’m unlikeable.
Restructuring
Prob. solving
Acceptance
Defusion
Let go
[Sang it in a silly voice, which helped me see how untrue and extreme my self-view is. I was able to laugh at myself in a good-natured way.]
I’m unlikeable.
Restructuring
Prob. solving
Acceptance
Defusion
Let go
It’s okay to feel grief. This is going to be hard. I know that I can make a worthwhile life after she is gone because most people deal with losing a parent and can still find happiness. I will lean on my friends and talk to those who have lost a parent, if they are open to talking about it, to help me process.
I’m at a higher risk for cancer.
Restructuring Prob. solving Acceptance Defusion
Let go
Made an appointment to see an oncologist to help me understand my risk and what I can do to lower it.
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