Tackling unhelpful thinking
The first step in tackling unhelpful thinking is to catch your unhelpful thoughts. Next time you are feeling anxious… notice what you are thinking, and ask yourself whether those thoughts make you feel better or worse. To help you capture your thoughts it can be useful to keep a thought diary (either on paper, or on your phone/tablet/computer… whatever is easiest for you). Make a note of what your thoughts are, and how they make you feel. Thinking about your thoughts and feelings together can really help you to identify which thoughts are likely to be helpful, and which are not. Once you have identified your unhelpful thoughts, there are a few things you can do to change them.
You already know that thinking unhelpfully can make you feel worse about things. So, take a moment to imagine how you might feel if you changed your thought patterns, and started thinking more helpfully. How do you think you would feel if you were able to tackle those unhelpful thoughts and replace them with more balanced, helpful ones?
The main aim of this section is to give you the tools you need to challenge and replace your unhelpful thoughts.
Step 1: Decide whether helpful or unhelpful
The first step in overcoming unhelpful thoughts is to recognise them. Once you’ve made a note of your thoughts, have a look though them and decide whether they were helpful or unhelpful. Helpful thoughts are those that tend to give you hope, make you feel positive, or suggest some solutions or actions. Unhelpful thoughts are those that make you feel bad, and often don’t offer a way forward.
We all have both helpful and unhelpful thoughts. But by recognising unhelpful thoughts when they occur, we are better placed to do something about them.
Step 2: Challenge your unhelpful thoughts
The next step in is to actively challenge the unhelpful thoughts that you have, by standing back from them and looking at them objectively. Imagine you are a lawyer in a court room. Try to look at the facts of the situation, and ask yourself whether your thought is a true reflection of reality… or where it is distorted or inaccurate in some way. Try to look at the evidence for and against your thoughts. To help with this, there are a number of questions that you might want to ask yourself, depending on the type of unhelpful thoughts you are having (see below).
Step 3: Replace them
Finally, once you have started to challenge you thoughts, the aim is to replace your unhelpful thoughts with more accurate, balanced and helpful ones.
Here are some examples of how this might be done for the different types of unhelpful thoughts:
Catastrophising, black and white thinking, fortune-telling, underestimating ability & emotional reasoning
- Is it really so bad, or are you exaggerating/assuming the worst?
- Are you being fair to yourself?
- Are you underestimating your ability to cope with difficulties and challenges?
- Is this based on facts, or your feelings?
- What is the most likely scenario?
Unhelpful thought: “I just had a call from my midwife. There must be something terribly wrong. I don’t think I can cope with it.”
More balanced thought: “I am assuming the worst-case scenario. It’s more likely the office is calling me to book my next appointment. There is no evidence to suggest there is anything wrong. But even if there was, medicine is amazing these days. While I can’t imagine being able to cope with bad news, I have managed to get through difficult situations in the past, so I’m more resilient than I think I am.”
Mindreading
- Are you jumping to conclusions without all the facts?
- Are you sure this is really true? Where’s the evidence?
- Could there be other explanations for other people’s behaviour?
Unhelpful thoughts: “Noone in my antenatal class has spoken to me. They probably don’t like me.”
More balanced thoughts: “I have no reason to think they don’t like me. I have friends, so I am a likable person. It could be that they are all nervous, as they are about to be parents for the first time – so none of us know what to expect.”
Filtering and setting unrealistic standards
- Are you discounting or overlooking the positives of the situation?
- Are there other more balanced ways of looking at this situation?
- What’s really the worst/best that could happen?
- Where did these expectations come from, and are they realistic?
- What are some things that you have achieved or done well recently?
Unhelpful thought: “I’ll be able to give birth exactly the way I want to – 100% following my birth plan, with little pain, no complications or medical interventions, dim lights, and soft music. If there are any deviations or complications, I’ll feel like I have failed.”
More balanced thought: “I have a birth plan so that my midwives know what my wishes are for the birth. However, childbirth can be unpredictable and doesn’t always go according to plan. Women have babies all the time; some have interventions and others don’t. While I hope I am able to have the baby the way I want to, I have thought about the other possibilities – and feel prepared and confident that whatever happens, I will be able to cope with it.”
While most births don’t have complications, unfortunately some do. And for some women, their expectations of childbirth are wildly different from the reality. Our research shows that having unrealistic expectations of childbirth can lead women to feel anxious, upset and like they failed if their birth experience significantly differs from their plans. As such, rather than having a strict, rigid birth plan, you might find it more helpful to outline your preferences, but allow for some flexibility in how you see your birth going – and think about possible contingencies. Being realistic about the different things that might happen during labour and the birth can help you to feel more confident and better prepared if things need to deviate from your original plan. And remember, there is no right or wrong way to have a baby.
Harsh Critic
- Would I talk to someone I care about this way? What might I say to them if they were in a similar situation?
- Is this way of thinking helpful?
- What would be a more objective or compassionate way of talking to myself or thinking about others?
Unhelpful thought: “There must be something wrong with me – I’m just not enjoying my pregnancy as much as I should.”
More balanced thought: “There is no ‘normal’ way to experience pregnancy. And some aspects of pregnancy are intrinsically unpleasant (like morning sickness). There are no set rules about how I should feel, and many women don’t enjoy being pregnant.”
Emotional reasoning and confusing thoughts with actions
- How many times have I thought/felt _____ and how many times has it come true?
- Am I using emotions too much as a guide?
- What evidence do I have?
- Have I ever thought/felt something bad might happen but it never did?
- What about something bad that happened but I never thought about it?
Unhelpful thought: “I feel so nervous about the ultrasound scan, there must be a reason for it… there must be something wrong with the baby.”
More balanced thought: “I tend to assume the worst is going to happen, and things usually do not turn out badly. I don’t have any evidence that my thoughts will increase the likelihood something bad happening, other than the anxiety I feel.”
NOTE – While many people find thought challenging and balancing really helpful, there is no ‘one size fits all’ for perinatal anxiety. It may not work for everyone, and can be difficult to do at first. We suggest trying this method for at least two weeks to see if you get results. The more effort you put in, the more likely you will see (and feel!) a difference.
