Cognitive Behaviour Therapy. Joseph Avy

these principles and philosophies into a theoretical model helps you to see more easily how feelings, different thoughts, behaviours and events all interact with one another.

      The easiest is the ‘ABC’ model of emotional response.

      A = Activating Event (or trigger)

      B = Belief

      C = Consequences

      The ‘A’ can be:

      Real or imaginary

      The trigger can be an actual event, such as losing someone or something important to you, or an imaginary one. It could also be an inference – a hunch – like imagining that someone is going to reject you before any rejection has taken place.

      External or internal

      External events are things that happen outside of your body, for example: someone's death, being rejected, failing at something or experiencing an accident.

      Internal events are triggers that happen inside your body, for example: your thoughts, images, emotions, fantasies, memories and bodily sensations.

      About the past, present or future

      The event could be something that has happened in the past, something that is happening now or something that could happen in the future.

      Key points to remember:

      • ‘A’ can be an internal past event that was real. For example, losing someone you loved. All past events are internal because they exist in our memories.

      • ‘A’ can be real, future and external. For example, making a speech at your friend's wedding next week.

      • It is not the event itself that provokes your emotions but what you tell yourself or what you infer about it now that provokes your feeling.

      • It's easy to assume that A causes C but that would not be accurate.

      When the trigger happens at ‘A’, you feel, behave, think and experience symptoms. Because this happens quickly, you think ‘A’ causes ‘C’ (the consequences). So you may use expressions like ‘he made me feel angry’, or ‘my job makes me depressed’. It is as if we are not responsible for our own emotions.

      Remember the 100 and 1000 people example earlier?

      What is at the heart of your feelings is the ‘B’ (Belief) between ‘A’ and ‘C’. So it is your belief (evaluation) about the activating event that provokes your emotions, behaviours, thoughts and symptoms.

       Beliefs

      According to the ABC model we can have two types of beliefs: rational and irrational, or healthy and unhealthy.

      1. Healthy beliefs:

      • are flexible;

      • are based on the things that you want, like, desire and prefer;

      • tend to make sense – they are logical and consistent with reality;

      • mean accepting that sometimes you may not get what you want;

      • detach human worth from success or failure;

      • lead to emotional well-being and set you up for goal achievement.

      2. Unhealthy beliefs:

      • are unrealistic;

      • can be self-critical;

      • are not based on acceptance or acknowledgement of reality;

      • do not acknowledge or accept other possibilities (even though reality shows that other possibilities exist);

      • cause a mismatch between internal and external realities;

      • lead to emotional disturbance and set you up for failure and goal sabotage.

      Compare the following statements:

      ‘I would like it to be nice and sunny every day when I wake up but I accept there is a chance that it might not be.’

      ‘The day MUST be nice and sunny when I wake up.’

      The second example is unhealthy and irrational because it is unrealistic. Unhealthy beliefs do not make logical sense. What makes sense is to have a more healthy belief like: ‘I would like the day to be nice and sunny when I wake up, but it doesn't mean that it HAS to be.’

       Healthy negative emotions and self-helping behaviours

      It is easy to understand that if you hold a healthy belief about yourself or about certain things in your life, this will increase your chances of success. However, success is never guaranteed, so if you don't succeed you might feel upset and sad. Having healthy beliefs means that, while you might feel sad or upset if you failed, you would lick your wounds, dust yourself off and focus back on your goal. Instead of feeling guilty you might feel regret and look at ways of improving. Instead of feeling unhealthy anger or rage, you might feel annoyed. You would behave assertively without lashing out in a destructive way or giving up. You would believe that you are not a failure as a human being but rather that you are a fallible human being who is able to learn and improve.

       Unhealthy negative emotions and self-destructive behaviours

      It is not difficult to understand that if you have unhealthy beliefs about yourself and about certain things in your life, your feelings and behaviours are not going to be healthy.

      According to the ABC model, unhealthy beliefs provoke unhealthy, negative emotions and self-damaging or destructive behaviours. Depression, anxiety, guilt and rage are examples of unhealthy negative emotions.

      ANXIETY VS CONCERN

      DEPRESSION VS SADNESS

      ANGER/RAGE VS ANNOYANCE

      HURT VS SORROW

      GUILT VS REMORSE

      SHAME VS REGRET

      UNHEALTHY ENVY VS HEALTHY ENVY

      UNHEALTHY JEALOUSY VS HEALTHY JEALOUSY

      Exercise

      Identify the different emotions in the example below and work out if they are healthy or unhealthy.

      Sam is a 40-year-old man and has been married for three years. He is studying towards some professional qualifications and has to sit his final exams in a couple of months. He is finding it difficult to concentrate when he sits down to revise. He keeps thinking that he will fail and, whenever he tries to revise, he ends up doing other work. When his wife tells him to sit down and get on with it he slams his books shut and shouts at her. After his outburst he ends up begging for forgiveness and thinks that he is a bad person.