Feeling Good: Overcome Depression and Anxiety with Proven Techniques

by David D. Burns

The first principle of cognitive therapy is that all your moods are created by your “cognitions,” or thoughts. A cognition refers to the way you look at things—your perceptions, mental attitudes, and beliefs. It includes the way you interpret things—what you say about something or someone to yourself. You feel the way you do right now because of the thoughts you are thinking at this moment.

The moment you have a certain thought and believe it, you will experience an immediate emotional response. Your thought actually creates the emotion.

The second principle is that when you are feeling depressed, your thoughts are dominated by a pervasive negativity.

When you are depressed, you possess the remarkable ability to believe, and to get the people around you to believe, things which have no basis in reality.

When you are depressed, you wear a pair of eyeglasses with special lenses that filter out anything positive. All that you allow to enter your conscious mind is negative. Because you are not aware of this “filtering process,” you conclude that everything is negative. The technical name for this process is “selective abstraction.” It is a bad habit

that can cause you to suffer much needless anguish.

If your perceptions make no sense, the feelings they create will be as absurd as the images reflected in the trick mirrors at an amusement park.

Your thoughts create your emotions; therefore, your emotions cannot prove that your thoughts are accurate.

He measured himself by the way others looked at him and by what he had achieved. If his cravings for approval and accomplishment were not satisfied, Eric sensed he would be nothing because there would be no true support from within.

First, you cannot earn worth through what you do. Achievements can bring you satisfaction but not happiness. Self-worth based on accomplishments is a “pseudo-esteem,” not the genuine thing!

In practical terms the study indicated that during periods of depression you lose some of your capacity for clear thinking; you have trouble putting things into proper perspective. Negative events grow in importance until they dominate your entire reality—and you can’t really tell that what is happening is distorted. It all seems very real to you.

a. Train yourself to recognize and write down the self-critical thoughts as they go through your mind; b. Learn why these thoughts are distorted; and c. Practice talking back to them so as to develop a more realistic self-evaluation system.

Start by writing down your automatic thoughts and rational responses for fifteen minutes every day for two weeks and see the effect this has on your mood, as measured by the Burns Depression Checklist.

A second method which can be very useful involves monitoring your negative thoughts with a wrist counter. You can buy one at a sporting-goods store or a golf shop; it looks like a wristwatch, is inexpensive, and every time you push the button, the number changes on the dial. Click the button each time a negative thought about yourself crosses your mind; be on the constant alert for such thoughts. At the end of the day, note your daily total score and write it down in a log book.

most everyone has plenty of room for improvement. The meaningful question is not “Am I a good or bad mother?” but rather “What are my relative skills and weaknesses, and what can I do to improve?”

a human life is an ongoing process that involves a constantly changing physical body as well as an enormous number of rapidly changing thoughts, feelings, and behaviors. Your life therefore is an evolving experience, a continual flow. You are not a thing; that’s why any label is constricting, highly inaccurate, and global. Abstract labels such as “worthless” or “inferior” communicate nothing and mean nothing.

Your feelings do not determine your worth, simply your relative state of comfort or discomfort. Rotten, miserable internal states do not prove that you are a rotten, worthless person, merely that you think you are; because you are in a temporarily depressed mood, you are thinking illogically and unreasonably about yourself.

“Then how can I develop a sense of self-esteem?” you may ask. The answer is—you don’t have to! You don’t have to do anything especially worthy to create or deserve self-esteem; all you have to do is turn off that critical, haranguing, inner voice. Why? Because that critical inner voice is wrong! Your internal self-abuse springs from illogical, distorted thinking. Your sense of worthlessness is not based on truth, it is just the abscess which lies at the core of depressive illness.

So remember three crucial steps when you are upset: 1. Zero in on those automatic negative thoughts and write them down. Don’t let them buzz around in your head; snare them on paper! 2. Read over the list of ten cognitive distortions. Learn precisely how you are twisting things and blowing them out of proportion.

3. Substitute a more objective thought that puts the lie to the one which made you look down on yourself. As you do this, you’ll begin to feel better. You’ll be boosting your self-esteem, and your sense of worth...

One of the most destructive aspects of depression is the way it paralyzes your willpower. In its mildest form you may simply procrastinate about doing a few odious chores. As your lack of motivation intensifies, virtually any activity appears so difficult that you become overwhelmed by the urge to do nothing. Because you accomplish very little, you feel worse and worse. Not only do you cut yourself off from your normal sources of stimulation and pleasure, but your lack of productivity aggravates your self-hatred, resulting in further isolation and incapacitation.

Your inactivity will be all the more frustrating if you once took pride in the energy you had for life.

In my practice I find that the great majority of the depressed patients referred to me improve substantially if they try to help themselves. Sometimes it hardly seems to matter what you do as long as you do something with the attitude of self-help.

But the perplexing question is the same—why do we frequently behave in ways that are not in our self-interest?

The thoughts on this patient’s mind are negative; he says to himself, “There’s no point in doing anything because I am a born loser and so I’m bound to fail.” Such a thought sounds very convincing when you are depressed, immobilizing you and making you feel inadequate, overwhelmed, self-hating, and helpless. You then take these negative emotions as proof that your pessimistic attitudes are valid, and you begin to change your approach to life. Because you are convinced you will botch up anything, you don’t even try; you stay in bed instead.

You may refuse to answer the phone for fear of hearing bad news; life becomes a treadmill of boredom, apprehension, and misery. This vicious cycle can go on indefinitely unless you know how to beat it.

all emotional change is ultimately brought about by cognitions; changing your behavior will help you feel better about yourself if it exerts a positive influence on the way you are thinking.

You may assume you must do everything at once instead of breaking each job down into small, discrete, manageable units which you can complete one step at a time.

You might also inadvertently distract yourself from the task at hand by obsessing about endless other things you haven’t gotten around to doing yet.

The problem is compounded when you label yourself “a procrastinator” or “a lazy person.” This causes you to see your lack of effective action as the “real you” so that you automatically expect little or nothing from yourself.

You defeat yourself with inappropriate goals and standards. You will settle for nothing short of a magnificent performance in anything

you do, so you frequently end up having to settle for just that—nothing.

A second mind-set that contributes to the fear of defeat is when you evaluate your performance exclusively on the outcome regardless of your individual effort.

It was a great personal victory when I learned to evaluate my work based on the process rather than on the product.

Because of your lack of confidence, success may seem even more risky than failure because you are certain it is based on chance. Therefore, you are convinced you couldn’t keep it up, and you feel your accomplishments will falsely raise the expectations of others.

You may also fear success because you anticipate that people will make even greater demands on you. Because you are convinced you must and can’t meet their expectations, success would put you into a dangerous and impossible situation. Therefore, you try to maintain control by avoiding any commitment or involvement.

You feel under intense pressure to perform—generated from within and without. This happens when you try

to motivate yourself with moralistic “shoulds” and “oughts.” You tell yourself, “I should do this” and “I have to do that.” Then you feel obliged, burdened, tense, resentful, and guilty.

Low Frustration Tolerance. You assume that you should be able to solve your problems and reach your goals rapidly and easily, so you go into a frenzied state of panic and rage when life presents you with obstacles. Rather than persist patiently over a period of time, you may retaliate against the “unfairness” of it all when things get tough, so you give up completely. I also call this the “entitlement syndrome”

Your frustration results from your habit of comparing reality with an ideal in your head. When the two don’t match, you condemn reality. It doesn’t occur to you that it might be infinitely easier simply to change your expectations than to bend and twist reality.

If you do nothing, you will become preoccupied with the flood of negative, destructive thoughts. If you do something, you will be temporarily distracted from that internal dialogue of self-denigration.

What is even more important, the sense of mastery you will experience will disprove many of the distorted thoughts that slowed you down in the first place.

Not only are you depressed and alone but you treat yourself in a way that can only inflict pain. Would you treat someone else in such a sadistic manner?

The moment she gets into bed, she becomes despondent, yet claims it is beyond her control to get out of bed. As Annette recorded her automatic thoughts one Sunday evening (Figure 5–4), it became obvious what her problems were: She was waiting around until she felt the desire, interest, and energy to do something; she was assuming that there was no point in doing anything since she was alone; and she was persecuting and insulting herself because of her inactivity.

you’re the only person in the world who can effectively persecute yourself.

Little Steps for Little Feet. A simple and obvious self-activation method involves learning to break any proposed task down into its tiny component parts. This will combat your tendency to overwhelm yourself by dwelling on all the things you have to do.

If you translate shoulds into wants, you will be treating yourself with a sense of respect. This will produce a feeling of freedom of choice and personal dignity. You will find that a reward system works better and lasts longer than a whip. Ask yourself, “What do I want to do? What course of action would be to my best advantage?” I think you will find that this way of looking at things will enhance your motivation.

Any time you feel shoved, whether by someone’s hand actually on your chest or by someone trying to boss you around, you will naturally tighten up and resist so as to maintain your equilibrium and balance. You will attempt to exert your self-control and preserve your dignity by refusing to do the thing that you are being pushed to do. The paradox is that you often end up hurting yourself. It can be very confusing when someone obnoxiously insists you do something that actually would be to your advantage. This puts you in a “can’t win” situation because if you refuse to do what the person tells you, you end up defeating yourself just in order to spite him or her. In contrast, if you do what the person tells you to do, you feel bad. Because you gave in to those pushy demands, you get the feeling the individual controlled you, and this robs you of self-respect. No one likes to be coerced.

Mary admitted that doing things might help her feel better, but this would mean giving in to her mother, who kept telling her to get off her duff and do something. The harder Mom pushed, the more stubbornly Mary resisted.

It is an unfortunate fact of human nature that it can be extremely difficult to do something when you sense you are being forced into it.