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Let's take anxiety or fear. Therapists recognize particular patterns in their patients' thinking that are connected to these feeling states. These patterns typically involve perceptions of threat or danger coupled with a lack of confidence in their ability to handle whatever challenging threats they perceive. In other words, we perceive something bad is about to happen—maybe something specific, like the threat of failing an exam or having a panic attack, or maybe it's just a vague sense of dread or apprehension about some yet unknown future calamity. At the same time, we doubt our ability to manage the threat effectively (“My God, what will I do? I don’t think I can handle it.”).
People with anxiety-related disorders such as panic disorder (PD), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD) tend to be overly sensitive to threatening stimuli or cues. For example, in panic attacks, these cues may involve relatively minor changes in internal bodily sensstions—for instance, sudden lightheadedness, dizziness, or a racing heart. These sensations may be blown out of proportion and taken as signals of an impending catastrophe (having a heart attack, losing control, going crazy). The mind runs out of control imagining the worst possible consequences, exaggerating the threat level to the max. Rather than thinking, “Okay, this is just some light headedness. . . it will soon pass,” the panic attack sufferer thinks, “My God, it’s happening again. This time it's is going to be really bad. Maybe I'm having a heart attack! Oh my God!”
Exaggerated, catastrophizing thoughts induce anxiety, creating more unpleasant physical sensations, which in turn are then exaggerated and catastrophized. Round and round it goes in a vicious cycle of cascading bodily sensations and threatening cognitions, culminating within minutes, seconds even, in a full-blown panic attack. The way to short-circuit these attacks, therapists find, is to help patients learn to tolerate minor changes in bodily sensations without catastrophizing them and to talk calmly to themselves whenever these sensations arise.
Depressing thoughts are like the flip side of anxious thoughts in that they involve looking backwards to past disappointments and failures rather than looking ahead to looming threats. The depressed person is mired in a past filled with self-recriminations and negative self-labels (“I’m just a loser. Why do I always screw up?”) This forward/backward difference is a useful rule of thumb to keep in mind, but it is not a general law. The depressed person also looks ahead to the future, but sees in it a mirror of the past, expecting ever more failures and disappointments. The anxious person may also look backward, recalling fearful experiences that portend future negative events (“What if it happens again? What will happen to me?”)
Angering thoughts revolve around perceptions of unfairness or injustice (“How could he treat me like this?”) coupled with a sense of outrage (“I swear I'm not going to let him get away with this!”).
What are the types of thoughts go bump in your mind? Take a minute to compare your thinking with case examples here from my clinical files of some common thought triggers associated with anxiety, depression, and anger. Becoming better aware of triggering thoughts is the first step toward replacing them with more adaptive, coping thoughts.
Examples of Thought Triggers
Anxious or Fearful Thoughts
Underlying Theme: Perception of threat
Thought Triggers:
- Something bad is going to happen.
- This is going to be awful.
- I won’t be able to handle it this time.
- My God, what if ______?
- I’m going to make a fool of myself.
- I’m just going to lose complete control.
- What if something bad happens and no one’s there to help?
- What if I have a panic attack?
- What if I have a heart attack?
- What if_____?
Depressing Thoughts
Underlying theme: Negative perceptions of oneself, of the world at large, and of the future
Thought Triggers:
- I’m just a screw-up.
- Nothing ever works out for me and it never will.
- What’s wrong with me? Why can’t I be like other people?
- The world sucks and I suck along with it.
- Nobody ever wanted me.
- Why are these things always happening to me?
- Angering thoughts
Angering Thoughts
Underlying Theme: Perceptions of unfairness and injustice
Thought Triggers:
- It’s so unfair and I just can’t take it.
- No one should act that way. It just gets so steamed.
- Why are they treating me like this?
- The world is just unfair and I can’t stand it.
- I’ll show him he can’t treat me like this.
- Damn him and damn them all.
Take a minute to reflect on your own thought triggers. What are the thoughts that bump around in your mind that trigger negative emotions?
© 2015 Jeffrey S. Nevid
