Recognizing Negative Automatic Thoughts

Goal

To recognize negative automatic thoughts about diabetes management.

In the second lesson, we talked about the relationship between thoughts, symptoms, and behaviors. Now, we are going to circle back to that to focus on how to change negative automatic thoughts. These thoughts can be thought of as the way we talk to ourselves, the language we use in our internal conversation.

Unfortunately, it is common for people to use negative language in their internal conversations. Generally, these negative thoughts fall into one of ten types. We will look at them in chunks, with examples from Daniel and Jo.

1. Overgeneralization: making a general conclusion based on one piece of evidence.
   1. a. Daniel gets a high glucose reading and thinks “I will never get my numbers under control.”
2. Filtering: Focusing on negative events, and ignoring positive events, or information that contradicts the negative outlook.
   1. Jo has done really well at following her diet plan all week, but at a work party, she eats more dessert than she should. Later, she reflects on her dessert choices and thinks, “I always fail at sticking to my plan, this is pretty hopeless.”
3. All or nothing thinking: Thinking that there are only two extremes, with no middle ground.
   1. Daniel is in a rush in the morning and doesn’t eat breakfast, so his numbers are off throughout the day. He thinks “Well, I’ve already screwed up, no point in continuing to try at this point.”
4. Personalizing: Taking responsibility for something that is not your fault.
   1. Jo is at her doctor’s appointment, but because the office is behind schedule, she does not get answers to all of her questions. When she leaves, she thinks, “Wow, I can’t even ask questions correctly. I don’t do any of this right.”
5. Catastrophizing: Expecting that the worst will happen.
   1. Daniel is preparing for vacation with his family. He decides not to make a plan to manage his diabetes while on the trip, because, “It’s not like I’ll stick to it at all anyway, because there won’t be any healthy food on the trip.”
6. Emotional reasoning: Mistaking how you feel about a situation with how the situation really is.
   1. Jo weighs herself after a couple weeks of working out daily, only to find that her weight has not changed. She feels like nothing she’s doing is working and thinks, “I shouldn’t keep trying, because nothing is changing.”
7. Mind reading: Thinking you know how another person thinks or feels about you without checking evidence from their actions.
   1. Daniel’s doctor is very rushed during his next appointment. Daniel thinks, “She must not like me because I’m not doing good enough at managing my diabetes.”
8. Fortune Telling Error: Anticipating negative outcomes and then thinking your anticipation is fact.
   1. Right after Jo was diagnosed with diabetes, her thoughts were often along the lines of “There’s no point in trying to get this under control because I’m going to fail.”
9. Should statements: Using the words “should” or “must” can set up unrealistic expectations and difficult rules to stick to.
   1. Right after Daniel was diagnosed he thought, “I should never eat desserts again.”
10. Magnification/Minimization: Emphasizing the impact of negative events, while downplaying the importance of positive events
    1. Jo overemphasizes the times that her numbers are too high and ignores the more frequent times that she is able to keep her numbers under control.

Your Turn:

On a piece of paper, or in the Diabetes Forum, keep a record of your thoughts for the next week, before going to the next lesson. When you notice a negative thought, note what activity brought it on, and the time of day. In the next lesson, we’ll work on reframing those thoughts. As you go, ask yourself “What is going through my mind right now?” and “What is it about this situation that is upsetting me?”