Feeling Good: Overcome Depression and Anxiety with Proven Techniques

by David D. Burns

the depressed individual sees himself as a “loser,” as an inadequate person doomed to frustration, deprivation, humiliation, and failure.

the depressed person thinks in idiosyncratic and negative ways about himself, his environment, and his future. The pessimistic mental set affects his mood, his motivation, and his relationships with others, and leads to the full spectrum of psychological and physical symptoms typical of depression.

A cognition is a thought or perception. In other words, your cognitions are the way you are thinking about things at any moment, including this very moment. These thoughts scroll across your mind automatically and often have a huge impact on how you feel.

your thoughts create your feelings.

your feelings result from the messages you give yourself. In fact, your thoughts often have much more to do with how you feel than what is actually happening in your life.

Nearly two thousand years ago the Greek philosopher, Epictctus, stated that people are disturbed “not by things, but by the views we take of them.”

In the Book of Proverbs (23: 7) in the Old Testament you can find this passage: “For as he think...

“...s within himself, so he is.”

And even Shakespeare expressed a similar idea when he said: “for there is nothing either good or bad, but thinking makes it so” (Hamlet, Act 2, Scene 2).

“...s it so.” (Hamlet, Act 2, Scene 2)

bad things do happen, and life beats up on most of us at times. Many people do experience catastrophic losses and confront devastating personal problems. Our genes, hormones, and childhood experiences probably do have an impact on how we think and feel. And other people can be annoying, cruel, or thoughtless. But all these theories about the causes of our bad moods have the tendency to make us victims—because we think the causes result from something beyond our control.

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

The third principle is of substantial philosophical and therapeutic importance. Our research has documented that the negative thoughts which cause your emotional turmoil nearly always contain gross distortions. Although these thoughts appear valid, you will learn that they are irrational or just plain wrong, and that twisted thinking is a major cause of your suffering.

Depression is not an emotional disorder at all! The sudden change in the way you feel is of no more causal relevance than a runny nose is when you have a cold. Every bad feeling you have is the result of your distorted negative thinking. Illogical pessimistic attitudes play the central role in the development and continuation of all your symptoms.

Every time you feel depressed about something, try to identify a corresponding negative thought you had just prior to and during the depression. Because these thoughts have actually created your bad mood, by learning to restructure them, you can change your mood.

Your emotions result entirely from the way you look at things. It is an obvious neurological fact that before you can experience any event, you must process it with your mind and give it meaning. You must understand what is happening to you before you can feel it.

All-or-Nothing Thinking.

“This refers to your tendency to evaluate your personal qualities in extreme, black-or-white categories. All-or-nothing thinking forms the basis for perfectionism. It causes you to fear any mistake or imperfection because you will then see yourself as a complete loser, and you will feel inadequate and worthless. If you try to force your experiences into absolute categories, you will be constantly depressed because your perceptions will not conform to reality. You will set yourself up for discrediting yourself endlessly because whatever you do will never measure up to your exaggerated expectations.”

Overgeneralization.

“You arbitrarily conclude that one thing that happened to you once will occur over and over again” “The pain of rejection is generated almost entirely from overgeneralization.”

Mental Filter.

“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.”

Disqualifying the Positive.

“Disqualifying the positive is one of the most destructive forms of cognitive distortion.” “You don’t just ignore positive experiences, you cleverly and swiftly turn them into their nightmarish opposite.” “The price you pay for this tendency is intense misery and an inability to appreciate the good things that happen.”

Jumping to Conclusions.

“You arbitrarily jump to a negative conclusion that is not justified by the facts of the situation. Two examples of this are “mind reading” and “the fortune teller error.”” “MIND READING: You make the assumption that other people are looking down on you, and you’re so convinced about this that you don’t even bother to check it out.””This self-defeating behavior pattern may act as a self-fulfilling prophecy and set up a negative interaction in a relationship when none exists in the first place.” “THE FORTUNE TELLER ERROR: It’s as if you had a crystal ball that foretold only misery for you. You imagine that something bad is about to happen, and you take this prediction as a fact even though it is unrealistic.”

Magnification and Minimization.

“Magnification commonly occurs when you look at your own errors, fears, or imperfections and exaggerate their importance”This has also been called “catas-trophizing” because you turn commonplace negative events into nightmarish monsters.” “When you think about your strengths, you may do the opposite—look through the wrong end of the binoculars so that things look small and unimportant. If you magnify your imperfections and minimize your good points, you’re guaranteed to feel inferior.”

Emotional Reasoning.

“You take your emotions as evidence for the truth.” “This kind of reasoning is misleading because your feelings reflect your thoughts and beliefs. If they are distorted—as is quite often the case—your emotions will have no validity.” “Because things feel so negative to you, you assume they truly are. It doesn’t occur to you to challenge the validity of the perceptions that create your feelings.”

Should Statements.

“You try to motivate yourself by saying, “I should do this” or “I must do that.” These statements cause you to feel pressured and resentful. Paradoxically, you end up feeling apathetic and unmotivated. Albert Ellis calls this “musturbation.” I call it the “shouldy” approach to life.” “When the reality of your own behavior falls short of your standards, your shoulds and shouldn’ts create self-loathing, shame, and guilt. When the all-too-human performance of other people falls short of your expectations, as will inevitably happen from time to time, you’ll feel bitter and self-righteous.”

Labeling and Mislabeling.

“Personal labeling means creating a completely negative self-image based on your errors. It is an extreme form of overgeneralization. The philosophy behind it is “The measure of a man is the mistakes he makes.”” “Labeling yourself is not only self-defeating, it is irrational. Your self cannot be equated with any one thing you do. Your life is a complex and ever-changing flow of thoughts, emotions, and actions.” “When you label other people, you will invariably generate hostility.” “Mislabeling involves describing an event with words that are inaccurate and emotionally heavily loaded.”

Personalization.

“This distortion is the mother of guilt! You assume responsibility for a negative event when there is no basis for doing so. You arbitrarily conclude that what happened was your fault or reflects your inadequacy, even when you were not responsible for it.” “Personalization causes you to feel crippling guilt. You suffer from a paralyzing and burdensome sense of responsibility that forces you to carry the whole world on your shoulders. You have confused influence with control over others.”

Even though your depressing thoughts may be distorted, they nevertheless create a powerful illusion of truth. Let me expose the basis for the deception in blunt terms—your feelings are not facts! In fact, your feelings, per se, don’t even count—except as a mirror of the way you are thinking.

“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. But these abnormal emotions feel just as valid and realistic as the genuine feelings created by undistorted thoughts, so you automatically attribute truth to them. This is why depression is such a powerful form of mental black magic.”

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

Most psychotherapists today share the conviction that becoming more aware of your feelings and expressing them more openly represent emotional maturity. The implication is that your feelings represent a higher reality, a personal integrity, a truth beyond question. My position is quite different. Your feelings, per se, are not necessarily special at all. In fact, to the extent that your negative emotions are based on mental distortions—as is all too often the case—they can hardly be viewed as desirable.

“Do I mean you should get rid of all emotions? Do I want you to turn into a robot? No. I want to teach you to avoid painful feelings based on mental distortions, because they are neither valid nor desirable. I believe that once you have learned how to perceive life more realistically you will experience an enhanced emotional life with a greater appreciation for genuine sadness—which lacks distortion—as well as joy.”

The great majority of depressed individuals are in fact very much loved, but it doesn’t help one bit because self-love and self-esteem are missing. At the bottom line, only your own sense of self-worth determines how you feel.

Unless you substantially reverse your self-defeating thinking and behavior patterns, you are likely to slip back again into depression.

Pinpointing the nature or origin of your problem may give you insight, but usually fails to change the way you act. That is not surprising. You have been practicing for years and years the bad mental habits that helped create your low self-esteem. It will take systematic and ongoing effort to turn the problem around.

Since ventilation of emotions and insight—the two staples of the standard psychotherapeutic diet—won’t help, what will? As a cognitive therapist, I have three aims in dealing with your sense of worthlessness: a rapid and decisive transformation in the way you think, feel, and behave. These results will be brought about in a systematic training program that employs simple concrete methods you can apply on a daily basis. If you are willing to commit some regular time and effort to this program, you can expect success proportionate to the effort you put in. Are you willing?

Specific Methods for Boosting Self-Esteem

Talk Back to That Internal Critic!

“A sense of worthlessness is created by your internal self-critical dialogue.” “In order to overcome this bad mental habit, three steps are necessary: 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.

“triple-column technique.”

“One effective method for accomplishing this is the “triple-column technique.” Simply draw two lines down the center of a piece of paper to divide it into thirds. Label the left-hand column “Automatic Thoughts (Self-Criticism),” the middle column “Cognitive Distortion,” and the right-hand column “Rational Response (Self-Defense).” In the left-hand column write down all those hurtful self-criticisms you make when you are feeling worthless and down on yourself. Then, using the list of ten cognitive distortions, see if you can identify the thinking errors in each of your negative automatic thoughts. You are now ready for the crucial step in mood transformation—substituting a more rational, less upsetting thought in the right-hand column. You do not try to cheer yourself up by rationalizing or saying things you do not believe are objectively valid. Instead, try to recognize the truth. If what you write down in the Rational Response column is not convincing and realistic, it won’t help you one bit. Make sure you believe in your rebuttal to self-criticism. This rational response can take into account what was illogical and erroneous about your self-critical automatic thought.”

The “triple-column technique” can be used to restructure the way you think about yourself when you have goofed up in some way. The aim is to substitute more objective rational thoughts for the illogical, harsh self-criticisms that automatically flood your mind when a negative event occurs.

One note of caution: Do not use words describing your emotional reactions in the Automatic Thought column. Just write the thoughts that created the emotion.

“For example, suppose you notice your car has a flat tire. Don’t write “I feel crappy” because you can’t disprove that with a rational response. The fact is, you do feel crappy. Instead, write down the thoughts that automatically flashed through your mind the moment you saw the tire; for example, “I’m so stupid—I should have gotten a new tire this last month,” or “Oh, hell! This is just my rotten luck!” Then you can substitute rational responses such as “It might have been better to get a new tire, but I’m not stupid and no one can predict the future with certainty.”

It is crucial to write down your automatic thoughts and rational responses; do not try to do the exercise in your head. Writing them down forces you to develop much more objectivity than you could ever achieve by letting responses swirl through your mind. It also helps you locate the mental errors that depress you.

When you are down on yourself, you might find it helpful to ask what you actually mean when you try to define your true identity with a negative label such as “a fool,” “a sham,” “a stupid dope,” etc. Once you begin to pick these destructive labels apart, you will find they are arbitrary and meaningless. They actually cloud the issue, creating confusion and despair. Once rid of them, you can define and cope with any real problems that exist.

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 error is in emotional reasoning. 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!

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 worthlessness (and, of course, your depression) will disappear.

Do-Nothingism:

“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.”

many depressed individuals will go through a phase in which they stubbornly refuse to do anything to help themselves. The moment this crucial motivational problem has been solved, the depression typically begins to diminish.

Hopelessness.

“When you are depressed, you get so frozen in the pain of the present moment that you forget entirely that you ever felt better in the past and find it inconceivable that you might feel more positive in the future. Therefore, any activity will seem pointless because you are absolutely certain your lack of motivation and sense of oppression are unending and irreversible. From this perspective the suggestion that you do something to “help yourself” might sound as ludicrous and insensitive as telling a dying man to cheer up.”

Helplessness.

“You can’t possibly do anything that will make yourself feel better because you are convinced that your moods are caused by factors beyond your control, such as fate, hormone cycles, dietary factors, luck, and other people’s evaluations of you.”

Overwhelming Yourself.

“There are several ways you may overwhelm yourself into doing nothing. You may magnify a task to the degree that it seems impossible to tackle. 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. To illustrate how irrational this is, imagine that every time you sat down to eat, you thought about all the food you would have to eat during your lifetime. Just imagine for a moment that all piled up in front of you are tons of meat, vegetables, ice cream, and thousands of gallons of fluids! And you have to eat every bit of this food before you die! Now, suppose that before every meal you said to yourself, “This meal is just a drop in the bucket. How can I ever get all that food eaten? There’s just no point in eating one pitiful hamburger tonight.” You’d feel so nauseated and overwhelmed your appetite would vanish and your stomach would turn into a knot. When you think about all the things you are putting off, you do this very same thing without being aware of it.”

Jumping to Conclusions.

“You sense that it’s not within your power to take effective action that will result in satisfaction because you are in the habit of saying, “I can’t,” or “I would but …” Thus when I suggested that a depressed woman bake an apple pie, she responded, “I can’t cook anymore.” What she really meant to say was, “I have the feeling I wouldn’t enjoy cooking and it seems like it would be awfully difficult.” When she tested these assumptions by attempting to bake a pie, she found it surprisingly satisfying and not at all difficult.”

Self-labeling.

“The more you procrastinate, the more you condemn yourself as inferior. This saps your self-confidence further. 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.”