Thought Diary
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. You can download the activity sheet that accompanies this here.
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 at some point. 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. 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, in the light of the evidence you have looking at, 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: “The baby has a rash. 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. Babies get rashes all of the time; and they usually are not serious. At the moment, there is no evidence to suggest there is anything seriously wrong – but I will keep an eye on it to see if anything changes. But even if it was something serious, 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 mum and baby 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 likeable 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: “All the mums on social media seem to be coping really well, just effortlessly getting on with life so soon after having their babies. I feel like such a failure for not being able to cope in the same way.”
More balanced thought: “Social media only shows a snapshot of people’s lives, which is rarely an honest portrayal of reality. Everyone has ups and downs… and it would be impossible to try to live up to those images all of the time. I am not a failure, as I have successfully done several important things today: I’ve fed and clothed my baby, and even manged to get out of the house for a short walk. I am successfully looking after my baby’s needs.”
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 motherhood as much as I should.”
More balanced thought: “There is no ‘normal’ way to experience motherhood. It’s a challenging time – a lot has changed in a relatively short period of time, and it can often take time to bond with the baby. There are no set rules about how I should feel, and many women struggle after having a baby. I need to be kind to myself, and give myself time to get used to everything that has changed.”
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 constantly feel worried that something bad is going to happen to the baby, there must be a reason for it… there must be something wrong.”
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.