UTILITY ANALYSIS OF THOUGHTS & BELIEFS* PLUS COGNITIVE RESTRUCTURING = MORE RATIONAL AND FUNCTIONAL THINKING

David Barnhart, EdD

Emotional and behavioral change begins with improving self-awareness. Self-awareness is a component of emotional intelligence that can be improved through a process of monitoring and analysis. What triggers stress? What are the emotions we feel? What thoughts or beliefs are associated with the trigger? Thoughts include what we remember, what we imagine, what we focus our attention on, and the automatic thoughts that seem to pop into our awareness.

We use a stress log to monitor stress triggers. We use the components of a stress log, triggers, emotions, and thoughts to construct a utility analysis of these thoughts and beliefs. That is, are these thoughts and beliefs useful? Do these thoughts and beliefs help me achieve my desired outcomes? If not, can we generate new thoughts and beliefs that lead to our desired outcomes?

Using the conclusion from step 9 of the Utility Analysis of Thoughts & Beliefs from the International Obsessive Compulsive Disorder Foundation website, we develop a cognitive therapy intervention called “cognitive restructuring” to help modify stress reactions to triggers and to the way triggers are perceived.

Utility Analysis

Choose a thought or belief from your Stress Log.

  1. Write the thought or belief below:
  1. If you experience this thought/accept this belief, how are you likely to feel (e.g., sad, lonely, angry, frustrated, afraid, guilty)?
  1. When you feel this way, how are you likely to behave?
  1. When you behave this way, what is the likely outcome? List any positive things (e.g., companionship, affection, stimulation, recreation, income) that are less likely to occur and any negative things (rejection, conflict, ill health) that are more likely to occur because you engage in this behavior:
  1. Are you satisfied with this outcome? Is this outcome consistent with your life goals?
  1. If you answered no, what outcome would you prefer? List the positive things you want to happen and the negative things you want not to happen:
  1. How would you need to behave in order to increase the likelihood that this outcome will occur?
  1. To make it easier to behave this way, how would you like to feel?
  2. In order to feel this way, what thought would you need to experience or what belief would you need to accept? [Hint: the most useful answer is not necessarily the opposite of what you wrote in step # 1. Useful thoughts and beliefs tend to be balanced and realistic, not simply positive]

*https://iocdf.org/wp-content/uploads/2016/04/14-BTTI-Utility-Analysis.pdf                                                                                  Revised 7-13-08

Cognitive Restructuring

Decades of cognitive behavior therapy inform us that we usually can’t change automatic emotional reactions, thoughts and behaviors without feedback. Here is one of our favorite tools for implementing cognitive change.

We use these steps:

  1. Relabel
    1. This refers to giving the trigger a name.
    2. The name should be specific in order to help our minds discriminate between triggers because we will develop specific ways of thinking (Reframe) in response to different triggers.
  2. Reframe
    1. This refers to the result of our utility analysis above.
    2. The alternative thoughts developed through the utility analysis provide us with a thought tool we can choose to use rather than repeating the automatic thinking that has not been serving a useful purpose.
  3. Redirect
    1. This refers to focusing attention on a valued activity.
    2. We generate alternative behaviors that help us redirect and sustain attention so that we are practicing engagement in the thoughts and behaviors that we value, e.g. spending time with people we love, building a space ship, coloring in a book, going for a run.

Each of the steps is important. When we implement this strategy we are practicing a new way of thinking and behaving so that we are no longer likely to ski down the same old rutted mental pathway that is making us suffer. Practice daily until your new response set becomes automatic.

We believe this will be most successful if you monitor your progress. Keep a daily tally or chart to see how frequently the triggers appear and making sure to go through each step, re-label, reframe, and redirect until your SUD level is consistently at two or below.

Stress Log

Developing the skill of maintaining emotional control in the face of normal, stressful, demanding or even crisis situations begins with a personal assessment. With our clients we recommend utilizing a stress log and a measure of relative stress, subjective units of discomfort (SUD). Follow these steps in creating your personal stress log.

  1. When you notice an increase in your feelings of stress, estimate your stress level and enter a number on a scale from 1 to 10 in the SUD column where 1 represents very little stress and 10 represents as much stress as you could possibly stand.
  1. When you notice an increase in stress write a brief description of the situation (TRIGGER) in which the stress event occurred. Describe what was happening at the time. It could be that what was happening did not seem to directly relate to your feelings of stress, but describe the situation nevertheless.
  1. Now, describe your emotional feeling and write this down in the EMOTION column next to your THOUGHTS. For example, you may have feelings of nervousness, anxiety, disgust, hurt, anger, or dread. You may have complex or contradictory feelings. Record them all. They don’t have to be logical. You may have difficulty coming up with a good word to represent how you feel. Don’t get hung up on this, just start with the relatively easy words like mad, bad, sad and glad. Yes, you can even have discomfort when you are glad.
  1. In the next column record the specific THOUGHTS you were having at the time you felt the stress. If you were not aware of any specific thoughts, write a description of what you may have thought, believed, imagined or focused your attention on. Don’t clean up your internal language when you make the entry (if you are thinking expletives, write them down). Also, if you use extreme descriptions in your thinking or make absolute statements in your thinking, such as, never, always, a million times, etc., don’t edit just write what you thought.
  1. Keep your log for at least several days before the next counseling session and continue throughout counseling. First, this should provide a good baseline assessment of your stress and provide some idea of specific situations, thoughts and events that trigger much of your stress. Next, continuing to record stress will let you see where more work may be done and where progress in stress management is taking place.
Subjective Units of Discomfort (SUD 1-10) Trigger Emotion Thoughts or Beliefs
8 Example: Boss or Teacher Scowls Anxiety, Dread Now what have I done?