By Dr Steve Last, Edinburgh
The theory of Cognitive Behavioural Therapy, or CBT, is that emotions are closely linked to cognition. Put more simply, CBT says that "the way you think affects the way you feel". People who think anxious thoughts will end up feeling anxious.
As a psychiatrist who uses CBT techniques, a significant proportion of my clients suffer from anxiety. Edinburgh is a beautiful city and a wonderful place to live, but as in any urban enviroment, individuals can start to feel stressed out and anxious. Thus it is important for me to help each client to become familiar with their own ways of thinking, and to help them to identify ways in which their thinking patterns may be contributing to their emotional problems.
A CBT therapist has a term for patterns of thinking that can lead to emotional problems - they are called "Thinking Errors". Many different types of thinking error have been identified over the years, but what follows is a brief summary of those errors that I have seen as a therapist in Edinburgh when working with people suffering from anxiety.
"Catastrophising" is a thinking error frequently found in anxious people. In fact, I'm sure we've all done it ourselves at some point! When someone catastrophises they automatically "assume the worst". A message to call back the boss is taken to mean that you're going to be sacked, a clunking noise in your car means that the engine is about to fall to bits, and a pain in the chest is the beginnings of a heart attack. CBT hypothesises that habitually thinking like this will lead to long-term problems with anxiety.
Another common thinking error seen in people with anxiety is called "Mind-Reading". As the name suggests, a person who's exhibiting this thinking error will believe that they know (absolutely know) what people are thinking about them. This belief will often go contrary to what the other person says and does, and is almost always pessimistic in nature. For instance, if the CBT therapist yawns (heaven forbid!) during a session, the client will know that the CBT therapist is bored or fed up with them - even if the therapist apologises and explains that her young daughter is teething and kept her awake last night. Or if the person gets invited to a dinner party, they will know that they're only invited along to make up the seating numbers. Thinking in this way can make life one long series of possible sleights and put-downs, leading to increased anxiety and excessive monitoring of those around you.
"Crystal-Ball Reading" is a third common thinking error in anxiety. People thinking in this way know what is going to happen in the future. And, lo and behold, it's bad! The bus will definitely be running late, they will definitely fail the interview, and they will absolutely make a fool of themselves at the works party. Not a pleasant way to think. And certainly not a good way to prepare for an interview (or even a party!). CBT encourages people to "keep it real" - there's enough strife out there without looking into the future for extra!
These three thinking errors are those that I've found most frequently in anxious people whilst working as a therapist in Edinburgh, although I doubt that they're exclusive to East Coast Scots!
Dr Steve Last is a Psychiatrist who uses CBT techniques. He is based in Edinburgh. Please visit http://www.drstevelast.co.uk for more information about psychological problems and CBT.
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