How many times have you heard yourself say, “I can’t?”

Everyone has these moments. Problems can seem too intricate to solve, and challenges can appear too difficult to face. For people living with PTSD, there is an additional piece that will easily make anything seem impossible: negative thinking.

Negative thinking is choosing to have thoughts that discount any positive, hopeful, or desirable outcome. These negative thoughts often arise out of cognitive distortions. You can use your knowledge of cognitive distortion to better understand the types of negative thinking you engage in. For example, it is easy to have a distorted response to criticism. If my employer tells me that I’ve done something on a project incorrectly, I could turn that into thinking that the entire project is ruined. This distortion is called “all-or-nothing,” the belief that it all must be done correctly or none of it is right.

It is after the distortion that the negative thoughts kick in:

“It’s ruined, and I’ve failed, and I can’t do anything to fix it.”  

These thoughts bring with them feelings of helplessness, self-hatred, shame, frustration–all emotions that will lead only to morenegative thinking:

“I can’t fix it, I’m helpless, I don’t do anything right, and this is never going to change for me. I can’t.”

Negative thinking is a learned behavior. We aren’t born with it; we cultivate it over time. The bad news is, you’re probably pretty good at it: most people with mental health issues are. The good news is, you can learn a new behavior. You can teach yourself to utilize neutral thinking and to apply positive (forward-moving) action.

Notice that we don’t use “positive thinking” as the opposite of “negative thinking.” Why? Because we want to understand that our thoughts are essentially neutral; they do not automatically have an emotion. We assign an emotion. This notion is a fundamental principle of Cognitive Behavioral Therapy (CBT), and it remains a useful concept regardless of one’s opinions regarding CBT therapy.

The goal is to get to an action. When we tell ourselves “I can’t,” we grind to a halt. We become stuck in whatever the problem is. If we don’t change the negative thinking, we will eventually drift into negative action: procrastination, avoidance, self-sabotage, lashing out, self-harm, even developing addiction problems or causing irreparable harm to others.

However, when we learn to create neutral thought, we can then apply positive actions: problem-solving, challenging, and acceptance. We can move forward.

How?

Step 1: Recognize the distortion
Step 2: Name the distortion
Step 3: Challenge the negative thought
Step 4: Create a neutral thought
Step 5: Problem-solve
Step 6: Create positive action using acceptance

You will apply three therapeutic steps when managing a cognitive distortion: recognize, name, and challenge. These steps are taken from CBT, and are part of the larger seven-column thought record process. Simply put, you must recognize that you are distorting the issue, name the distortion type, and then challenge how true it may or may not be, using evidence to support your viewpoint.

Sample situation: Jane’s boss sends a completed project back to her, asking for an adjustment to one section and complimenting the other four sections and the work overall. Jane later tells her friend that she “completely ruined” a project at work. Jane shares that she is afraid to fix it because she will make it worse.

Step 1: Recognize the distortion. 
Jane’s friend points out that it was only a section that received criticism, not the entire project, and this helps Jane see the distortion. Often, when we are first learning to see our distortions, we need help from an outsider: a friend, a therapist, a poster on a message board–you can even have your own “outside” eye by writing down your thoughts and then reading them. This is one of the strengths of a place like MyPTSD. We are often better at seeing other peoples’ distortions than our own. Eventually you will become attuned to your habitual distortions and you will be able to recognize them easily.

Jane sees that her friend is correct and recognizes the distortion. At this point, whether or not Jane is ultimately right about the project being completely ruined isn’t relevant. All she needs to do is recognize that she has gone from one from one thing wrong to all things wrong.

Step 2: Name the distortion
Next, Jane will name which distortion she is using. Think of this piece as being able to put a name to a symptom. Initially, she might need to go and look at a list of distortions to figure it out, but after a bit of practice at naming distortions it becomes almost automatic and naturally follows the recognition phase of our process. Jane names this distortion “all or nothing.”

Notice: by introducing these two new cognitive–that is to say, thought-based–steps, Jane has stopped the downward spiral of distortion. Instead of having already moved on to believing she can’t do anything about her situation and engaging in negative action, she is slowing herself down enough to examine her situation.

It is very important that you give yourself permission to go slowly, step-by-step. You still do not have to think a different thought–nowhere in here has Jane actually changed her mind concerning her belief that it’s all ruined. She is simply not following that belief into the greater negative thoughts and actions that would normally follow her initial, reactive belief.

Step 3: Challenge the negative thought

CBT uses the concept of evidence. What evidence do you have that a particular thought is true?

Sometimes, this is where the cognitive distortion “bubble” bursts quickly. It can be immediately obvious that there is no evidence to support the thinking. Sometimes, we can try and provide evidence but will notice that the evidence isn’t proof-based: it’s based in emotional reasoning. In other words, we will notice that we are thinking with our feelings instead of thinking with our thoughts.

Jane could try and say that the evidence for the whole project being ruined comes from the last time she made a mistake and everything turned out poorly, but that’s not strong proof, because that was a prior situation, and this is a current one. There is no way to know that the same situation will repeat. She could try and say the evidence is that she always fails at fixing things. This assertion is merely using an emotion–despair–to construct a reason, but it’s not proof. It is a feeling.

Whenever you think the words “always,” “never,” and “last time,” you can be fairly certain that you are using emotional reasoning. Factual absolute statements are very rare.

Jane notices her “always” and “last time” phrases and sees that she is engaging in emotional reasoning.

She decides to list the evidence for and evidence against her prediction that the project is ruined.

Evidence that it is completely ruined:

  • The project is not acceptable in its current form, so right now, it is completely unacceptable according to the boss. It needs fixing.

Evidence that it is not completely ruined:

  • the boss gave a compliment on the quality of the project overall.
  • a portion of something is not the whole of something.
  • the project was returned to Jane for fixing, which indicates a degree of confidence her boss has in her ability to do the job.

Jane now understands that there is little to no proof for her initial distortion; the fact that she made one mistake does not automatically predict that she will or has ruined the entire project. It might have taken her less than a minute, or it might have taken her a half-hour with pencil and paper, but she has gotten herself to this revelation.

What now? 

Traditional CBT would suggest that Jane move to the next step of the thought record, which would be creating “balanced” thought. But this will not actually support the problem-solving she needs to do in the here and now; it is a part of the CBT process designed to ultimately get at your core beliefs around the distorted thought. Creating a full thought record is good mental-health work to do, but will not help Jane find a way to get to work on the project, because even though Jane has recognized, named, and challenged her distortion, she still quite likely believes in it.

Jane is struggling with the difference between “knowing” and knowing. In dealing with all mental health issues, there are things that the sufferer is taught about their condition. These are the things we “know,” the facts that we have memorized and even accept as true. But “knowing” how to address a cognitive distortion does not lead to believing that it is rooted in something negative that was instilled in a persons core beliefs as a result of their trauma. It takes a long time to get to believing–knowing–that these things aren’t true: in Jane’s case, that she is not always doing things wrong. That particular core belief will need to be challenged many, many times before she begins to believe that it isn’t true. Right now, Jane is at only one of those times. However, the more often she completes this process, the more she chips away at the larger, deeper anxieties hiding in her core beliefs. The first, small chip she can make is in creating a neutral thought to replace the negative thought.

Step 4: Creating neutral thought
Instead of a more nuanced “balanced” thought, let’s just get Jane to what I will call neutral thought. 
Neutral thought is, in a way, the thought itself without any feeling (or editorializing) applied. Remember, thoughts do not come automatically tied to feelings. Thoughts exist on their own. We add meaning to them, and when we do so, we often add emotion or judgement.

Negative Thought
Jane ruined a project and will only make it worse if she tries to fix it.

Neutral Thought
Jane wrote a report; 80% was as requested, 20% was not. She has been tasked with correcting that remaining 20%.

Now, Jane is clear on the neutral facts of the situation, and she can apply problem solving techniques to find a new, positive action. And this step may strike you as obvious, but it is the most critical aspect to addressing negative thought. Until the negative is re-framed as neutral, it will linger and either grow stronger or balloon out into other situations.

Practicing neutral thought can sometimes seem like adopting an almost robotic view of the world, but I assure you it is not. Neutral thought is what will ultimately provide the gateway to positive action.

Remember: most negative thinking will arise from a cognitive distortion. That cognitive distortion will be the result of a problem or challenge you encounter. Practice applying these first four steps to the negative thoughts you encounter when facing a problem or challenge. Steps one through four, taken alone, represent the tools you need to do something called re-framing. Re-framing is a common therapeutic concept and is useful for anyone working through challenges of perspective. The process of re-framing–moving a thought from one point of view to another–is used for much more than addressing negative thought. However, by learning to apply it swiftly and effectively to negative thought, you will find that other types of re-framing become simple to do as well.

In the second part of this series we will move on to the practical issues of addressing the initial problem. We will apply some problem-solving tools in order to circumvent or reverse that final, negative thought of “I can’t.” We might not arrive at the kind of solution we think we “should” arrive at, but we can absolutely end up somewhere other than “I can’t.” Subsequently, we will finally see how all this preparation will lead to applying a positive action–changing how you think, one step at a time.

Read Part II