One of the most popular sentiments in self-help material is the importance of shifting from a negative or unhealthy mindset to a more positive one. But in practice, what does this mean? How do we release thoughts that are classified as unhealthy? And is replacing them as simple as reciting positive affirmations?
Fortunately, cognitive behavioral therapy (CBT), one of the most popular and research-supported forms of psychotherapy available today, has an answer to these questions. In my years as a cognitive behavioral therapist, as well as a holistic health practitioner and spiritual seeker, I have developed an approach to challenging and replacing unhealthy beliefs that is both simple and effective. I explore it in depth in my new book, Worthy As You Are, and in this article I will review the nuts and bolts of it.
In my experience, one of the most important first steps in releasing and replacing an unhealthy belief is to gain insight into it—to understand where it came from, what it does in our lives, and so on. After identifying a negative thought that appears to be causing suffering and other problems in a client's life, the initial question I use with clients in this process is: What is the story of this thought? In other words, what experiences in your life seem to have inspired it? Where did it come from?
This question helps clients understand where a thought originated. One reason this is important is because in almost every case, the worst thoughts we have about ourselves stem from harmful experiences we had with external forces. Either something was said or done to us that negatively impacted us, we observed something that harmed us, or we reacted to what was said or done to us in a manner that resulted in this thought. Recognizing this can make it possible to distinguish the thought from our inner voice, as well as our deeper, authentic sense of self. Were it not for the harmful experiences we had, this thought would not be there, which means it is possible for it to us to live without it. It's not an inherent part of our lives.
Here's an example of this step of the process via questioning the thought, "I will never be good enough." When someone presents with this thought, which is very common, it usually comes from clearly identifiable sources: a parent who didn't show them much love and had high standards, a failure to live up to an oppressive and unrealistic beauty standard, a history of being told explicitly or implicitly that their worth was based on their achievements, and so on. In fact, this belief is so common and pervasive that challenging it is one of the central themes of Worthy As You Are.
In identifying that this thought originates from external influences, and what those influences in particular were, we set the stage for challenging it and setting it aside. During this time, I will often ask clients to remember their lives before they started thinking this thought, assuming they can, and to reflect on what that time was like for them.
The second question I use with clients in this process is this: What effect does believing or thinking this thought have on you? In other words, how does it influence how you feel, think, and act?
This question helps clients recognize that the thought itself is causing a quantifiable impact in their life. The central premise of cognitive behavioral therapy is that how we think and act affects how we feel. Albert Ellis, a pioneer of cognitive therapy, popularly taught this with an ABC model: when we experience an activating event (A), it is filtered through our beliefs (B), which results in a consequence (C) in how we feel or act. For example, if someone cuts me off in traffic (A), I might assume they are reckless (B), and feel scared or angry (C). In exploring the effects of a thought in someone's life, this question demonstrates the way the past experiences we identified in question one affect present experience, and also how powerful thought can be in shaping feeling, action, and perception of reality in general.
To continue with the example, there are many ways the thought, "I will never be good enough" can impact someone. In terms of how they feel, there will likely be a nagging sense of dissatisfaction with anything they do. Even if they feel good about what they do in the moment, afterward, doubt will likely creep in. They will tend to feel inadequate to some degree in their professional life, relationships, and any significant activity they undertake. If they are an artist, they are likely to constantly feel like their work isn't up to snuff. They may even become super perfectionistic, and many people with this belief are, but in that situation, they never quite measure up—at least at the end of the day.
In terms of how this thought can influence how someone thinks, they are likely to often compare themselves to others. After all, a core belief in their life relates to a measurement of relative worth. Presumably, some people are good enough, while others aren't. They may be highly judgmental, seeing people through the lens of conditional worth, and greater or less than their perception of self. They may also meet challenging opportunities and risks with a deep sense of foreboding, like they may as well not even try to challenge themselves because failure will likely result unless a factor like luck tips the scales in their favor.
Accordingly, the belief that "I will never be good enough" will likely disincline someone from taking risks or seizing bold opportunities, particularly daring to dream and act big in their lives. It also might lead them to choose things that feel safe or average because they may be able to make those things work—or almost do so. For example, a job that doesn't seem too hard, or a relationship that is kind of ho hum yet adequate. This belief can also lead people not to advocate for themselves in the workplace in terms of things like promotions and raises because they feel, deep down, that they don't deserve them. It can lead to them shouldering poor treatment in relationships as well, as they may feel they deserve it. This step in the process can also include reviewing how someone believes this thought has affected them over time, from the catalyzing event until now.
The third question I ask questions is: Why might this thought not be true? What is the fact-based evidence for or against this thought being true?
This is a standard question in cognitive behavioral therapy. It is important to specify that the evidence be fact-based because oftentimes people will be able to come up with reasons an unhealthy thought might be true, but if those aren't rooted in the facts, how relevant are they? Part of the aim of this process is to help instill an everyday approach to thought that is rooted in critical thinking, one that prioritizes facts and accuracy, as that has a tendency over time to help most people find an improvement in their mood given that unhealthy beliefs generally paint a bleaker picture of oneself or reality than the facts do. When considering the fact-based evidence for or against an unhealthy belief, it usually becomes apparent quickly that the belief doesn't hold water, at least not in its extreme form. During this aspect of the questioning, it is important to really see all the flaws in the thought as much as possible, and it is often helpful to recognize that someone would likely not belief this of a loved one in their exact circumstances, even though they believe it of themselves.
Regarding the example thought, "I will never be good enough," we would explore what that even means in practical terms. If it doesn't seem like it is something that can ever be lived up to—like an impossible standard of perfection—we would make a firm note of that. We would also likely recognize all the times in this person's life when they were good enough: when they completed something, succeeded at something, achieved something, survived something, and so on. We would question whether or not the messages that their worth was conditional were ever true or made sense to hold as standards. We would also likely loop in their spiritual beliefs at this point if they have any. For example, if someone theoretically believes that all of life is divine, but they don't see themselves that way, it's important to note that. Why would they be an exception to such a sentiment?
The last question I usually ask is: What would be a healthier thought to think instead (a thought that is fact-oriented, accurate, wise, and compassionate)? And building on that, how might your life change from believing this new thought?
This is also a common practice in cognitive behavioral therapy, and it is important to pick a thought that holds more fact-based water than the prior thought because that will likely make it easier to believe or feel truer, particularly when it is affirmed regularly. I have also found it helpful to select a thought that resonates with our inner knowing and conventional wisdom, which is what I mean by "wise," and one that demonstrates empathy and awareness of context, which is the gist of what I mean by compassion.
In terms of the example thought, we might come up with a thought like, "there are many situations in my life in which I have been good enough, and I affirm that all life is sacred, which includes my own." As this belief is affirmed each day, it can change someone's life in many ways. It is likely to make them feel better about themselves in general, and certainly if they make a mistake or are unsure of their ability to do something. It is likely to make them feel more able to take risks, too, as their worth isn't on the table since they, like all life, are sacred. Over time, this thought has the potential to revolutionize how they think, act, and feel in many areas: it unlocks a plethora of opportunities they would either not have gone for or greatly second guessed before. Someone who holds this belief is far more likely to stand up for themselves too, in a host of circumstances.
This process may seem highly involved, but with practice, it happens quickly and eventually becomes reflexive. Over time, it organically shifts one's thought process to being more compassionate and less tolerant of extremely negative thoughts, and that can profoundly influence well-being. It is like the difference between a finely weeded and cultivated garden and one that is left to its own devices. That is my favorite metaphor for this type of work: inner gardening, and it is at their heart of Worthy As You Are. Sometimes CBT is made to seem kind of sterile or robotic, but I have found it doesn't have to be that way. We can integrate spiritual beliefs like I've done here with processes of questioning thoughts and think about all of this in an organic manner. If you resonated with this approach, I encourage you to check out Worthy As You Are. I explore this topic and others related to establishing well-being far more deeply within it.