Mental Health After Childbirth: Ask the New Dad How He Is Feeling

‘New dads feel it’s not their place to say ‘I’ve got a problem’.

Source: Mental Health Support After Childbirth: Why Asking A New Dad How He Is Feeling Could Help Save His Life | The Huffington Post

 

I was fortunate to be asked to be interviewed for this piece for the Huffington Post.  Hopefully this encourages any new dads out there to get help if they’re feeling low.

Using problem solving to treat depression


Do you ever feel like you just don’t know what to do next? When you’re faced with problem after problem does it ever feel so overwhelming that you become stuck or just give up?

This experience is not uncommon when we are depressed, and particularly when we are a new dad presented with so many new challenges for the first time, even the smallest thing can seem like a big problem. This article shows you how problem solving skills can be learned, quickly enabling you to reduce those feelings of overwhelm or hopelessness. As with all things on this site (and with CBT in general) we pick up skills by doing, so once you have read through this page, follow the step by step instructions to see how problem solving can help you with your current stressors.

Why problem solving works.

Behavioural theories of depression suggest that low mood serves as an emotional signal for us to retreat from an unrewarding or punishing environment so that we can conserve energy until our environment improves. Low mood is not a “bad” emotion as such, in that it actually evolved to serve us when times are difficult. However, whilst retreat and avoidance would have been an effective self-preservation strategy for our pre-historic ancestors when faced with famine, loss or danger, in modern times this strategy can contribute to the maintenance of depression symptoms in that we fail to develop the techniques necessary to resolve the problems that we are faced with.

If problems remain unresolved then this can lead to them becoming more unmanageable than they were in the first place, and strategies other than Avoidance and Retreat fail to develop, thus leading to further low mood and the cycle of depression ensues. This cycle can be interrupted by changing how we respond to challenges by developing Problem Solving skills.

The diagram below shows how depression can be kept going through avoidance and reduced activity.

CBT Problem solving maintenance

Problem solving as a treatment for depression

Problem solving has been established in therapy as a way of dealing with psychological distress since the early seventies and is both an integrated element of treatment models and a treatment in its own right. As a treatment for depression, Problem solving therapy has been shown to be an effective treatment when compared to other therapies and better that waiting list or no treatment at all. There are two main aspects to problem solving – Problem Orientation and Practical Problem Solving. This article is going to teach you the skills of practical problem solving.

P.O.S.T.

Four letters for you to remember.

P.O.S.T letters

P.O.S.T. is very simple but effective way of working with problems. Each of the letters represents one step in moving towards a solution. The letters stand for:

P – Problem
O – Options
S – Solution
T – Test

Problem – The first step in effective problem solving is to clearly define what the problem is. It is not unusual when placed under some degree of pressure for us to exaggerate or distort a particular presenting issue, or to attempt to solve ten problems simultaneously rather than just one, much more manageable one. By defining the problem into one or two clear, explicit statements we are able to maintain focus upon one problem area at a time, thus increasing our chances of finding a useable solution.

Options – Step two is to generate as many potential options or solutions as we can which may remedy our problem. It’s important at this stage to abandon any criticism and judgement as we generate as many potential actions as we can. No idea should be rejected on the grounds of being too silly, too extreme or because we just don’t think that it will work. When we are depressed, our thinking becomes much more rigid and habitual and thus less creative and imaginative. By brainstorming as many wide-ranging problem solving options as we can, we are working to challenge this. We don’t stop at a list of 3 or 4 but instead try keep going until we have around 10 possible options – Remember, at this stage no idea is out of bounds.

Solution – Here, the aim is to select one of the generated options and prepare to test it out so see if it will resolve our problem. Again, in the spirit of opening up our thoughts beyond the habitual thinking patterns characteristic of depression, we want to try not to overthink this part. A simple numbering of the options, from 1 to 10, with 1 being the preferred option, 10 being the least, will help in making our choice. A preferred option might be one that is easiest to implement, be easily accessible or just something that we feel might just sort the problem out. It doesn’t matter what criteria you use to decide upon your solution because if it doesn’t work then we are going to go right back to our list and choose the next option. We either solve the problem or find out one more way how not to solve it. Win/Win.

The second part of “Solution” is to do a quick plan of the steps we need to implement the solution. Again, we do not need to overthink this – we do not need to come up with another list of problems. Just a quick list of steps of what you would do to get this solution into action.

Test – At this stage the chosen option is tested to see if it resolves the defined problem. Just do it. We will look closely at the effects of the solution upon the problem – did it solve it completely or only partially? Did it have no effect at all? Did it make it worse? Whatever the outcome was we can use this information to decide our next steps.

If the solution resolved the problem completely – great stuff, relax and reflect upon how well you did.
If the solution resolved the problem partially – Either do more of the solution or return to the start of P.O.S.T. and redefine the remaining elements of the problem.
If the solution didn’t have any effect on the problem at all – go back to your list of Options and choose the next one on the list.

The diagram below shows POST in action…

Problem solving flow chart

Make sense? Follow the steps below to have a go at practical problem solving yourself.

STEP BY STEP GUIDE TO PROBLEM SOLVING

Step 1 – Problem.

Try to define the problem that you have been faced with. There can be a tendency sometimes to make a problem appear larger than it really is, but by breaking it down to the facts of the problem, we can get a better grip of the task at hand. Here’s an example:

Poorly defined problem:
“Every time I have hold of the baby it cries and my wife looks at me as though I’ve caused it.”

Clearly defined problem:
“To learn how to soothe the baby.”

Poorly defined problem:
“I haven’t slept properly in four days and now my boss has told me I’ve made a mistake in work.”

Clearly defined problem:
“How to get more sleep.”

Get the idea? When we are depressed, we can be prone to all sorts of thinking distortions when initially presented with a problem but by clearly defining the facts of the issue, we can make the problem much more manageable.

Step 2 – Options.

Write down as many options for resolving the problem as possible. No idea is too silly, extreme or otherwise beyond consideration. What we are looking to do here is get the creative parts of the brain going, expanding our thinking beyond our routine thinking habits. Sometimes you just can’t see the wood for the trees. It might feel like a challenge initially but it is good to aim for at least 10 possible options. Here are some examples based upon the problem definitions above…

Problem definition: To learn how to soothe the baby.

Options:

    Give it it’s dummy (pacifier)
    Don’t bother and let my wife do the work
    Read some books about parenting
    Speak to the health visitor
    Ask some other dads about what they do to calm baby
    Ask my own Dad what worked for him
    Make a list of different techniques and test them over the week (cuddles, trip in the pram, feed, etc)
    Ask my wife to show me what she does
    Let the baby cry and hope it grows out of it.
    Quit being a dad altogether and run away with the circus

Problem definition: How to get more sleep.

Options:

    Sleep in the car during my lunchbreak
    Agree to do the nightfeeds on alternate nights with my partner
    Do nothing and hope it improves over time
    Go to bed earlier
    Sleep in in the morning and tell work my alarm didn’t go off
    Forget about sleeping and just drink more coffee
    Ask my boss if I can work from home so I can sleep in during the travel time
    Tell my wife I’m struggling and ask that she does the feeds during the nights when I’m in work
    Learn some sleep hygiene techniques
Step 3 – Solution.

Now, its time to choose just one of the options from our list. As we don’t yet know which of the options will actually solve our problem, it’s helpful to number each of the items based upon how appealing each may be to test out. Rate the easier to implement, or more obviously suitable, solutions with a lower number and the less immediately appealing solutions with a higher number. We are going to test each out based upon this numbering.

For example…

    1. Make a list of different techniques and test them over the week (cuddles, trip in the pram, feed, etc)
    2. Ask my wife to show me what she does
    3. Ask some other dads about what they do to calm baby
    4. Speak to the health visitor
    5. Read some books about parenting
    6. Give it it’s dummy (pacifier)
    7. Ask my own Dad what worked for him
    8. Don’t bother and let my wife do the work
    9. Let the baby cry and hope it grows out of it.
    10. Quit being a dad altogether and run away with the circus

Don’t become too attached to any potential solution – after testing it out, we may find that it was not the right solution for the problem. So long as we become “unstuck” in our problem solving then we are making progress, and that is a good thing as far as our depression is concerned.

Step 4 – Test

At this stage, you will put your first chosen solution into action and evaluate it’s success.

When implementing your chosen solution, again try not to get too caught up in overthinking about it. You’ve evaluated it in step 3 so you’ve already decided it’s the preferred solution over the other available ones. If you find yourself stuck, or overthinking too much, then return to your list and choose the next option down. Remember, it’s taking action that moves us forward.

After you have taken action using your chosen solution, then take a step back and evaluate the effects upon your problem. Ask yourself the following questions…

Did it solve the problem?
If it didn’t solve the problem completely, what effect did it have?
Did the problem improve slightly – Do I need to repeat the solution until the problem resolves completely?
If the solution had no effect, do I need to choose the next option on the list?

Whatever the outcome, try not to evaluate it on an emotional level – this could get us stuck and inactive again. Simply and methodically, return to the P.O.S.T. process and keep going.

Define the Problem, generate Options, choose a Solution, and Test it out. Rinse and repeat.

I’d be really interested in finding out about how these techniques worked for you. You can give me feedback in the comments section below or get in touch on twitter @newdad_depressn. Speak soon.


George Maxwell Therapist 250px

George Maxwell is an Accredited Cognitive Behavioural Therapist and director of Access CBT UK.
He specialises in the treatment of Male depression in the post-natal period but also has extensive skills in working with PTSD, Anxiety disorders, OCD and Panic. If you would like to arrange individual therapy with him (either face to face or via Skype), or would like to receive information and updates relating to New Dad Depression then feel free to contact him at enquiries@accesscbt.co.uk or follow on twitter @newdad_depressn.

 

Disclaimer: Depression in New Dads takes no liability for consequences of using materials on this site. In the event of crisis, a suitably trained mental health practitioner should be consulted.

No Hormones – No problem? Male PND Myths dispelled

When I started working on this site I, somewhat naively, thought that it would be greeted with open arms as a positive offering to men who are struggling with depression after becoming a new dad. But, as with anything in this life, things are a little more complicated…

For reasons that will become apparent, the first draft of this article was a ranting, passive-aggressive self-justification piece aimed at one particular misinformed fellow who implied that I was out to “mislead” men. It wasn’t fit for publication. It did however set the scene for addressing some of the misconceptions and myths which surround the phenomenon of Male post-natal (or post-partum) depression. I hope you like it.

The story began when my wife sent me a text saying that Male post-natal depression was going to be a topic on The Wright Stuff show. Optimistically and without thinking about it too much, I sent a tweet to the show suggesting that they check out the site:

Twitter Wright Stuff Male PND

This was the first response…

Twitter Wright Stuff Male PND 2 blurred

“Misleading men?” (Note: This is where the first draft of the article explored in depth the anger and other unpleasant emotions that I experienced in relation to our tweeter’s over-confident assertion that I am out to mislead. Whilst it would have made a good academic paper for a psychodynamic therapy training course, it definitely wouldn’t do much to further the cause of Male PND, so I’ll spare you the details (and expletives)).

I read on…

Twitter Wright Stuff Male PND 3 blurred

This is one of the first things that we hear people say when they compare female PND to male – “Isn’t it caused by hormones, and if men arent’t actually carrying the baby, then how could it apply to them?” Except, only 10% to 15% of women develop post-natal depression. If hormonal changes were the cause of PND, and all women experience the same hormonal changes, then we would expect all women to develop PND. They don’t. Therefore, it is widely accepted that there are other factors involved.

The following list (accredited to Beyond Blue) details many, but not all, of the other factors which can contribute to the development of post-natal depression. As we can see, many of these factors can effect men as well as women – no biochemical changes necessary!

• Personal or family history of mental health problems or current mental health problems
• Pregnancy, labour or delivery complications
• Perinatal loss, e.g., miscarriage, stillbirth or termination
• Current or past history of physical, psychological, or sexual abuse
• Anxious or perfectionist personality
• Lack of support from family and friends
• Stressful life events (e.g., moving house)
• Continuing lack of sleep or rest
• Unplanned pregnancy
• Having multiples (e.g. twins or triplets)
• Severe baby blues after the birth
• Premature baby
• Difficulties with breastfeeding
• A baby that is difficult to settle
• Partner experiencing perinatal depression or anxiety

So, to really labour my point, and with reference to the original tweet – Post Natal Depression isn’t something that just “effects women biochemically.” This is an unhelpful myth that perpetuates the notion that depression is all in the head, rather than it being the consequence of multiple interacting biological, psychological and social factors, many of which can be acted upon (with appropriate support) to reduce distress.

I’m sorry that our tweeter feels that men will be ridiculed for “latching on” to a biochemical explanation for their depression symptoms. I don’t know if it’s true that men will be ridiculed or not, but there is evidence to suggest that men do also experience changes in hormones throughout the pregnancy and post-natal period. Testosterone, Oestrogen, Cortisol, Vasopressin and Prolactin have all been identified as being hormones which change in Men during the period, and changes in each have all been suggested to underlie a part the experience of Post-natal depression symptoms in men. Personally, I’m not the worlds biggest advocate of a purely biochemical (sometimes called the bio-medical model) explanation for depression, instead believing it be an interplay between biopsychosocial factors, but with reference to the tweeters concerns about ridicule, if someone has a physical issue which is beyond their control (i.e., hormonal changes) then surely they are less likely to be ridiculed for something than if it was something that was potentially within their control (i.e., a skill deficit or difficulty coping). Just my view.

Next…

Twitter Wright Stuff Male PND 4 blurred

I’ve heard this one before too.

Except, the UK guidelines for the treatment of Post-natal Depression and for the treatment of Depression are essentially the same. Here are the NICE guidelines for the treatment of post-natal depression:

Managing a new episode in the postnatal period

How should I manage a new episode of depression in the postnatal period?

• For women in the postnatal period who are not breastfeeding, manage as for depression in the general population. See the CKS topic on Depression.

For women in the postnatal period who are breastfeeding:

• Involve the woman, and her family where appropriate, in all decisions about treatment (see Making decisions about treatment).

For a breastfeeding woman who develops mild or moderate depression during the postnatal period, and does not have a previous history of depression, consider:

• Self-help strategies, non-directive counselling delivered at home, or brief psychological treatment (see psychological treatments).

For a breastfeeding woman who develops mild depression during the postnatal period and a has a history of severe depression, consider psychological treatments.

• If she declines, or does not respond to psychological treatment, consider seeking specialist advice on the use of antidepressants.

For a breastfeeding woman who develops moderate depression during the postnatal period and has a history of depression, consider:

• Structured psychological therapy specifically for depression (cognitive behavioural therapy [CBT] or interpersonal therapy [IPT]).

• Antidepressant treatment (if the woman has expressed a preference for it and is aware of the risks associated with antidepressant use during breastfeeding). Consider seeking specialist advice.

• Combination treatment (psychological treatment plus an antidepressant) if there is no response, or a limited response, to psychological or drug treatment alone, provided the woman understands the risks associated with the use of antidepressants during breastfeeding. Consider seeking specialist advice.

For a breastfeeding woman who develops severe depression during the postnatal period, consider:
• Structured psychological therapy specifically for depression (CBT or IPT).

• Antidepressant treatment (if the woman has expressed a preference for it and is aware of the risks associated with antidepressant use during breastfeeding). Consider seeking specialist advice.

• Combination treatment (psychological treatment plus an antidepressant) if there is no response, or a limited response to psychological or drug treatment alone, provided the woman understands the risks associated with the use of antidepressants during breastfeeding.

• If the woman requires psychological treatment, ensure that she is seen promptly (ideally, within 1 month of initial assessment, and no longer than 3 months afterwards). If prompt access to psychological therapies is not available, see the section on delivering psychological treatments.

We can see here that psychological treatment (CBT or IPT) is the preferred treatment for Post-Natal Depression in women. Antidepressant medication is considered secondarily.

And here are the NICE treatment guidelines for depression:

For people with mild depression or subthreshold depressive symptoms who request an intervention, consider a period of active monitoring, and:

• Provide information about the nature and course of depression.
• Arrange follow up, normally within 2 weeks (consider contacting the person if they do not attend follow-up appointments).

For people with persistent subthreshold depressive symptoms or mild-to-moderate depression:

• Consider a psychological intervention. This is accessed by referral or self-referral to IAPT (Improving Access to Psychological Therapies). Following assessment, the following interventions may be offered:
• One or more low-intensity psychological interventions or group-based cognitive behavioural therapy (CBT) for people who decline this intervention.
• A group-based peer support programme, either alone or in combination with the above, for people with a chronic physical health problem.

Avoid the routine use of antidepressants, but consider this for people with:
• A history of moderate or severe depression.
• Subthreshold depressive symptoms that have persisted for a long period (typically at least 2 years).
• Mild depression that is complicating the care of a chronic physical health problem.

For people with moderate or severe depression — offer an antidepressant and a high-intensity psychological intervention. Psychological interventions are accessed by referral or self-referral to IAPT. The type of intervention offered will depend on the severity of depression and the presence or absence of a chronic health problem.

We can see that psychological therapies are the preferred treatment, with medication being considered in more severe cases. The treatment for both is the same.

If I was to treat a woman for post-natal depression with CBT, I would be looking to identify patterns of avoidance and reduced activity and support her to modify these. I would teach her how to problem solve current and potential stressors and I would also be interested in understanding how she thinks about herself and her situation, support her to re-evaluate unhelpful thought content and disrupt unhelpful thinking processes such as worry and rumination. But if I was treating a man… Guess what? I would do exactly the same. There may be differences in context and content (just as there are between all individuals who enter therapy) but the actual treatment would be the same.

There is also a good point to be made here to further challenge the biochemical explanation for PND mentioned earlier. NICE recommends psychotherapies as the preferred treatment for depression and post-natal depression, before the introduction of antidepressant medication. This is based upon multiple studies which show that CBT or IPT perform just as well as, or better than, antidepressants in research trials on depression treatment, with fewer side effects. Now, when a therapist sits down with a client, they don’t say, “right, let’s get your hormonal imbalance sorted out.” They instead say, “what would you like to change?” meaning, “how can we change things about you, your relationships, your environment, etc to get you feeling better?” We don’t treat hormones, we treat people. Leaning too much upon a purely biochemical model can leave individuals feeling passive, hopeless and resigned to their sadness, rather than empowering them to take even the smallest action to remedy their situation. Taking action leads to change and the opportunity for recovery.

I’m sure there are many more myths and beliefs that people hold about Male Post-Natal depression and I’m happy to tackle them all if it means that more men will be prepared to get help when they need to. Keep ’em coming.

George Maxwell Therapist 250px

George Maxwell is an Accredited Cognitive Behavioural Therapist and director of Access CBT UK.
He specialises in the treatment of Male depression in the post-natal period but also has extensive skills in working with PTSD, Anxiety disorders, OCD and Panic. If you would like to arrange individual therapy with him (either face to face or via Skype), or would like to receive information and updates relating to New Dad Depression then feel free to contact him at enquiries@accesscbt.co.uk or follow on twitter @newdad_depressn.

 

Disclaimer: Depression in New Dads takes no liability for consequences of using materials on this site. In the event of crisis, a suitably trained mental health practitioner should be consulted.

Really interesting to see that Male PND is beginning to receive some degree of recognition, both medically and in the media. Hopefully, this article and others like it can contribute to some alleviation of the stigma associated with depression (and other mental health issues) which men experience following childbirth. Follow the link to find out more.

Thoughtful man

http://www.telegraph.co.uk/men/health/men-suffer-from-postnatal-depression-study-reveals/

George Maxwell Therapist 250px

George Maxwell is an Accredited Cognitive Behavioural Therapist and director of Access CBT UK.
He specialises in the treatment of Male depression in the post-natal period but also has extensive skills in working with PTSD, Anxiety disorders, OCD and Panic. If you would like to arrange individual therapy with him (either face to face or via Skype), or would like to receive information and updates relating to New Dad Depression then feel free to contact him at enquiries@accesscbt.co.uk or follow on twitter @newdad_depressn.

25 Unhelpful Thinking styles in Depression (and how to challenge them)

 

brain
By George Maxwell

Published on 05/01/2016

I’ve talked elsewhere about how Automatic Negative Thoughts are one of the symptoms of clinical depression, and about how they can maintain a depressive episode. The content of these Automatic Negative Thoughts can be looked at, and challenged, at the level of the individual thought, or collectively as an Unhelpful Thinking Style. This article looks at the different Unhelpful Thinking Styles which can occur within depression and at how becoming aware of them can allow us to alleviate their effects upon our mood.

Unhelpful thinking styles.

When teaching people in CBT how to challenge their negative thinking, I tell them that becoming aware of Unhelpful Thinking styles (sometimes also called Unhelpful thinking habits, cognitive distortions or negative thinking styles) can often be a “quick win” in terms of reducing symptoms of depression. I say this because by simply becoming aware that one is “Mind Reading” for instance, we are able to disengage from and devalue the negative thought which is generating distress quickly, rather than becoming overly embroiled in the “words” of the thought. By familiarising themselves with the different types of negative thinking styles, the client is able to pick up when they are using them, challenge them swiftly, and experience a change in emotional distress or respond in a different way behaviourally.

So, below are 25 different Unhelpful Thinking styles which can occur in depression (or even in anxiety) based thinking. Take a look, see if you notice any that you use yourself, and follow the “Challenge” instructions to get some leverage on them. Use this in conjuction with the information here, and you’ll be on your way to developing the skills to challenge your depressive thinking.

Thinking Style Thought Challenge
Mind reading.
Making the assumption that we know what other people are thinking.
“She thinks I’m useless” How do you know what she thinks? Has she told you? Do you have any evidence for the thought or are you guessing? Are you able to read minds?
All or nothing thinking.
When we think in pure black or white, all or nothing terms, rather than seeing things as a matter of degree.
“I need to get it all right or else I’ve failed” Are things really this black and white? Try to think of things as a matter of degree. Sure, you may not be 100% at something, but does this really mean failure?
Emotional reasoning.
When we base our decision-making upon an emotional state.
“I feel low, it’s going to be a bad day” Mood is variable. There could be a number of reasons as to why you feel a certain way – it doesn’t necessarily say anything about the situation.
Personalising.
This is when we take responsibility for situations which may not have been our fault, rather than taking other factors into account.
“It’s my fault things are going wrong” What else was involved in the situation? Make a list of all of the other factors involved in the task (time, people, resources, etc) and give them a percentage rating for how they influenced the task. Was it as much your fault as you initially thought it was?
Overgeneralising.
This is when we assume one aspect of experience to be characteristic of all other similar experiences.
“Everything is going wrong” Everything? There may be a lot of things that don’t appear to be going so well right now, but are there just one or two things which are ok? Did you manage to raise a smile from your colleague this morning? Did the baby eventually settle to sleep?
Catastrophising.
This is when we treat an otherwise ordinary event as something potentially catastrophic. (Similar to awfulising – see below).
“The baby’s got a cold, they might get really ill and end up in hospital.” Can we really assume that the worst is going to happen based upon this one event? Is it more helpful right now to assume the worst or to see the situation as it really is?
Awfulising.
When we treat minor setbacks and events as being much more negative than they really are.
“This is awful – I can’t get an appointment with the Doctor until 11 O’clock.” Are things really that awful? Is it helpful to think that things are this awful right now? What might be a more realistic way of looking at the situation?
Must, Should, Ought-to Thinking.
Using these thinking styles can put us under undue, unrealistic levels of pressure. Also sometimes called Musterbation.
“A dad should be able to calm down the baby straight away.” Where do these rules come from? What is the effect of them? Do these rules help you right now, or do they put you under even more pressure? Is there a kinder way of thinking about the situation?
Magnification.
This thinking style makes things appear much larger, and much more significant than they truly are, leading to feelings of anxiety or overwhelm.
“I’ve been asked to a meeting with the directors at work – this is massive, I’m not sure I can cope.” Take a step back and try to look at the reality of the situation. Is it really as big an issue as it initially seems or is there another way of looking at it? (e.g., just a gang of suits in a room). What are the costs or benefits to magnifying the situation?
Minimisation.
This is when we take a potentially significant issue or event and distort it into something of low importance or value.
“I don’t need to bother with the mortgage arrears, nothing will happen.” Is this view accurate? Is there any part of this event that I do need to respond to or think about? What are the costs or benefits of viewing this event in this way? Waht is a more realistic or balanced way of thinking about it?
Selective Abstraction (Mental filter).
This is when we knowingly or unknowingly pay attention to things which support our beliefs, despite things which may challenge the belief also being present.
“I know I’m a failure, everywhere I look I can see it.” What is another way of looking at the situation? What evidence is there to support this alternative view? Use a positive data log.
Critical self.
Holding a negative, critical view about yourself.
“I’m a failure.” How does this view serve you? Does it benefit you or does it carry a cost? If it doesn’t help you, then what might be a more helpful or realistic belief to hold about yourself?
Compare and Despair (Negative Comparisons). When we evaluate ourselves, our behaviour and our qualities negatively in comparison to others. “Everybody else is doing fine, I’m not doing well at all.” Even though others may give the impression that they are ok, or doing well, do we really have the full picture? How does comparing yourself to others help? Especially when you are feeling low already?
Fortune Telling (predictive thinking). When we assume that we know what is going to happen in the future. “My partner will get fed up with me and leave.” How certain are you that this is inevitable? Are you able to see into the future? Can you predict the weather for tomorrow, or the lottery numbers for this week? If not, how can you be certain about these other predictions? Is there any way we can test out some of these predictions?
Perfectionist thinking.
When we hold ourselves or others to perfectionist, typically unrealistically so, standards.
“I/Others need to be perfect.” This is a tall order. Is it actually possible to be perfect? How do we know when we have achieved perfection? What are the costs or benefits associated with this expectation? What would be the consequences if I aimed for 90%, or even 80%? What would be the worst thing? How do my expectations of perfection effect my relationships with others?
Validation from others.
This is when we will evaluate ourselves based upon how we feel others view us.
“If she thinks I’m useless, then I must be.” What are the costs and benefits of evaluating ourselves based upon others perceptions? Does this mean that I can only be happy when others are? What are the consequences of this for my depression? How do I know what others think of me anyway(see mind reading)?
Wishful thinking.
When we believe that our situation or experience would be better if certain wishful (not necessarily realistic) conditions were met – wishful thinking can detract from taking action to develop useful coping behaviours.
“I wish I had better parenting skills, then I’d be able to cope.” Wishful thinking can feel nice to indulge in for a while, but how is it going to help you at present? What behaviours would be required if this wishful thinking would become true? How would you behave, think or feel differently? Is there anything you can do today to emulate the behaviours present in your wishful thinking. If not what can you do to do this?
Regretful thinking When we spend time focusing upon a past event, with the belief that our lives would be better if that event hadn’t happened. “If only I hadn’t met my partner that night, then things might be different now.” You’re right, if things had happened differently in the past then no doubt your current situation would be different right now. But how does focusing upon past events change your reality right now? Are there any benefits to thinking about the past in this way? Similarly, what is it costing you to regret the past?
Belief in a just world.
When we believe that the world in and of itself works in a just and fair way, when in fact sometimes bad things happen to good people.
“I come to work on time, do my job, keep my head down – I can’t believe I’ve been overlooked for promotion.” We only have to look at the news on TV to see that the world can sometimes be an unfair, unjust place. Although we expect some degree of fairness, it can be helpful to anticipate alternative outcomes in situations. What is another way of looking at this situation? Is there any action I am prepared to take to remedy this unjust situation? If not, are there any ways I can learn to accept this?
Cognitive Dissonance.
This is when we will rigidly hold onto a belief despite significant evidence to the contrary being available. The more the belief is challenged, the more rigidly we will hold onto it. Can often maintain arguments and disputes.
“I know you’ve been driving for 15 years, but women are still worse drivers than men. Stop, take a minute. Look at the point you are holding on to. Is it accurate? What is the evidence to support your belief and what is the evidence against it? If it’s inaccurate, then what would be the absolute worst thing that would happen if you changed your belief? (e.g., people will think I’m stupid, people will stop listening to me) How likely is it that this worst outcome would happen? (see catastrophising, mindreading).
Low frustration tolerance.
This is when we “just can’t stand” things the way they are and will engage in short term distractions, avoidance or unhelpful behaviours rather that perservere with a more significant task.
“I’ve had a stressful day, I can’t face more stress at home – I’ll need to have a drink before I get there.” What is the worst thing that could happen if you tolerated the presenting issue or situation? Is it truly as intolerable as you think? What are the short and long term consequences of not perservering with the issue? Do they outweigh the short term “fix”?
Can’t live with/without thinking.
This is when we falsely believe that we are unable to live or function without a certain condition being met.
“I can’t live without her.” What is your evidence for this belief? Have you managed to live with similar situations in the past? What other strengths or resources do you have which can enable you cope in this situation?
Cognitive conformity. This is when we adopt the views and beliefs of the company in which we are in, even though they are not necessarily views which we held previously. “Everybody in work thinks my partner should pull her weight more, and I do too.” Try to look at this critically. Has your view changed because of the company you are in? What are the costs and benefits of holding this view for you?
Attribution bias.
This is when we assume that that someone else’s performance in a situation is based upon their personal attributes rather than additional situational factors.
“My partner made a mistake with the baby formula, I can’t believe how stupid she is.” What other factors may have contributed to the outcome? In the example above, the partner may have been overtired, it may be a new formula that she is unfamiliar with or perhaps she was distracted with looking after the baby that she made a mistake. When you notice yourself using the attribution bias, make a list of all other possible factors which may have played a part – is your thought as accurate as you initially believed it to be, or is there a more realistic or balanced thought?
Assumed similarity.
This is when we make the assumption that others will share our views and opinions based upon perceived shared characteristics. When it transpires that this assumption is inaccurate, this can lead to disappointment or low mood.
“He’s a youngish male from Liverpool – I bet he likes Football” (happens to me all the time!) Like many of the other unhelpful thinking styles, and negative automatic thoughts in general, this habit will be activated fleetingly. Allow yourself to notice when you are using this thinking style and then question the validity of the assumption. How could you possibly know much at all about this individual based upon limited information? Ask questions, speak to them. Use the situation as an opportunity to find out more.

Notice any that you use? Are there any Unhelpful thinking styles that you’ve identified in yourself that aren’t included in this list? Either way, I’d really appreciate hearing your views in the comments section below.

 

George Maxwell Therapist 250px

George Maxwell is an Accredited Cognitive Behavioural Therapist and director of Access CBT UK.
He specialises in the treatment of Male depression in the post-natal period but also has extensive skills in working with PTSD, Anxiety disorders, OCD and Panic. If you would like to arrange individual therapy with him (either face to face or via Skype), or would like to receive information and updates relating to New Dad Depression then feel free to contact him at enquiries@accesscbt.co.uk

 

Disclaimer: Depression in New Dads takes no liability for consequences of using materials on this site. In the event of crisis, a suitably trained mental health practitioner should be consulted.