Need help using the techniques in "When Panic Attacks by Dr.Burns" (CBT)

[Epson]

Hello guys, I was hoping you could help me out with a problem. Now, before I ask my question I’d like to insist that those who answer my question have read the book, When Panic Attacks by David Burns, or have done CBT using that book. Of course, if you feel that you’d like to contribute anyway, feel free to.

I’ve read Feeling Good and it’s helped me immensely. It was like a kick to my belly. It pretty much awoke me from a looonngggg period of (four years?) of misery and bleakness. I won’t go into that now, but I decided to go and buy “When Panic Attacks” based on the successes I had with the author’s previous work.

I have a specific question however. I’m just wondering how often, and how exactly are you supposed to fill out the “Daily Mood Log.” The way the Daily Mood Log works is you write down a specific event (e.g., a social situation) that caused you anxious or depressed feelings. And you write down all the negative thoughts that went through your mind as this event unfolded.

Generally, the next step is to replace each negative thought with a positive thought that is 100% valid, and that will put the negative thought to rest for good. The meat and potatoes of the system is trying to put a lie to that negative thought so you experience a change in feeling on the gut, emotional level. The way you do that is choosing from the 40 or so cognitive/exposure/hidden emotional techniques that are available (you do about 15 at a time), until you finally put the negative thought to complete rest (hence the corresponding feeling).

So…My question is: How often are you supposed to fill out a daily mood log? Supposing you have multiple negative thoughts, that you have to cycle through a bunch of the techniques, can’t tackling even a single event/adversity at a time take an entire week to complete?

I was under the impression that you should do the Daily Mood Log once a day, for at least 30 minutes a day but I don’t think that’s possible. Maybe the 30 minutes a day involves all the different techniques you try out. Since you’ve already fleshed out all your negative thoughts, and they are on paper infront of you anyway right?

So for example on Monday I would fill out the daily mood log, “Studying my book on memory” would be the event. Then I’d write down the array of negative thoughts. And I try out 4-5 tecniques that day. The next day I might try another 5, none of them working. And so on and so forth until I get a breakthrough on Thursday. And THEN I write another daily mood log? Is that how it works? I can't imagine writing a moodlog EVERYDAY, because you need time to use all the different techniques to silent each negative thought.

How do I keep from relapsing? Say, I don’t feel anxiety anymore when I start studying, but how do I maintain this? Do I just keep the techniques that worked for me and mentally rehearse them in my mind, or on a sheet of paper or what?

I hope this post wasn’t too long and confusing!

Thanks.

 

[David Baxter PhD]

Re: Need help using the techniques in "When Panic Attacks by Dr.Burns" (CBT)

First, it needn't take 30 minutes a day or any specific length of time per day... it will take as long as it takes.

Second, yes you can do more than one per day. The recommendation is to do at least one per day in order to to practice the techniques so that you have the skills when you need them.

Third, the idea is to:

1. identify the automatic thoughts and self-talk that accompanies your negative feelings
2. try to challenge those automatic thoughts by identifying potential types of what Burns calls "Twisted Thinking" and/or by looking for alternative interpretations of what has upset you
3. if you can identify distorted thinking, then try to identify more rational self-talk to correct the cognitive distortions

I think it's important to understand that it is not necessarily the case that all of your negative feelings are wrong, or invalid, or the result of distorted thinking. For example, you may feel angry and hurt by something another person says to you or does. It is possible that you are reacting too personally and that there are other interpretations of what that person said that would mean there was no intent to hurt and that you need not feel upset (or as upset) by what just happened. Or... you may go through the cognitive challenges and having considered all the evidence conlcude that in fact that person did mean to be rude or dismissive or hurtful. If so, your anger and hurt feelings are appropriate. (Now what you do with those feelings, how or whether you express them, and what you do about that person is of course another matter and a matter of choice.)

So the point is to challenge the automatic thoughts, to determine whether they are distorted or excessive or the result of a misinterpretation, being aware that if you suffer from depression or anxiety and realted conditions that there is a high probability that at least some of your self-talk is distorted - but not necessarily to dismiss what you are thinking and feeling entirely.

 

[Epson]

Re: Need help using the techniques in "When Panic Attacks by Dr.Burns" (CBT)

Thank you for your input David! One of my concerns is that I don't have enough "material" to be able to fillout a daily mood log on a daily basis. Should I do practice ones when I've run out of current material?

My second concern is that I'm required to fill out at least once a day (I guess this in itself can be put in my daily mood log). See because I'm worried that a few of the problems I have will take more than one day to solve so I'm afraid that I won't be able to meet the requirement of filling one daily mood log a day. So for example, I have a huge problem with procrastination. Say I tried 10 techniques today. A few of the techniques like the "pleasure prediction sheet" will take more than one day to complete. The next day, I finish the pleasure prediction sheet and a few other techniques that I find effective in shutting down the negative thoughts. So everything has gone well, except that I didn't fill out a daily mood log that day. Do you see what I'm getting at? Is that the proper way to do this, or should I always fill out a daily mood log regardless? Because I can see some problems taking even a week to resolve.

 

[David Baxter PhD]

Re: Need help using the techniques in "When Panic Attacks by Dr.Burns" (CBT)

Do it in stages.

Stage 1
Start by just identifying the thoughts, self-talk that go along with a negative feeling. To begin with, leave it at that. Don't try to do anything else. Just do that daily.

Stage 2
Then, once you have that part down, start trying to identify the thinking errors (what type of cognitive distortion are you or might you be engaging in?). Practice those two things until you feel comfortable doing them.

Stage 3
Now start challenging the automatic thoughts.

That way, it's not so overwhelming and less likely to create more anxiety, which in turn is less likely to result in procrastination.

 

[Banned]

Re: Need help using the techniques in "When Panic Attacks by Dr.Burns" (CBT)

Epson,

I've done mood logs as well based on Dr. Burns' books and also found them to be immensely helpful. Dr. Baxter has summed up the process perfectly (of course!) and the only thing I would add to what he's said is to not put so much pressure on yourself to do them "properly" or "right" or "for at least 30 minutes" that you start to buckle under the stress of doing them. The fact that you're doing them is going to call attention to your distorted thoughts...so don't make each mood log into a Master's thesis...because as Dr. Baxter said...that'll just feed the anxiety and turn into you not wanting to do them at all. You can pick away at them...do a bit...think about it, etc...it's for your own benefit so as long as you are seeing what you need to see, it's hard to do them "wrong"...if that makes sense.

I commend you for taking such action independently...it took a massive kick in my pants to get me to do them...but once I did, I found the more often I did them, the more helpful they were, and the easier and more natural they became.