TM4T Stress Armoury - Introduction to CBT and DIY CBT

This web-page is intended as a layman's introduction to Cognitive Behaviour Therapy and includes a do-it-yourself set of CBT steps. It is intended to help more experienced teachers to deal with some of the emotional strains of their role: strains which typically sap their time and limit their effectiveness.  It is specifically aimed at teachers dealing with persistent moods of 'anger', 'anxiety' and 'gloom'.  This material is provided in the same spirit as all TM4T stress management guidance: it is aimed at 'managing the middle': the grey area which lies between happy-shiny land (where everything is peachy) and the dark land where burnout beckons. The dark land, we emphasize, is the domain of the health professional. If you believe that you are clinically depressed, or doubt that you are able to manage your dark moods on your own, then don't dither here on the Web: go see your GP pronto.

Introduction - An Example...

Read the brief anecdote below, and consider how you would have felt...

The Queue

I work in a school where students and teachers share the same canteen, eat the same food, and join the same queue. Oh, the queue, the dreaded and hated queue. Parents often passed on complaints from their offspring about spending most of their lunch break queuing for food. The Head, though, was unsympathetic - and strictly egalitarian. Everyone had to queue together. That was the ethos of the school. On this particular day, I was really busy, and really hungry. I'd had to skip breakfast to arrive on time for a coursework moderation meeting, and I was in a hurry to get back to my teaching room to look up a couple of points on the exam-board website... but I had to join the back of the queue.  Then, as I was patiently waiting (well, impatiently waiting, to be  honest) Jason Norman from Year 8 casually walked past me smirking to the front of the queue. I challenged him about his behaviour, and he told me that he had permission from the Head of Games, because the team coach was leaving soon. I may have looked a pillock, but I had done the right thing. I rejoined the queue, and then almost immediately one of my least favourite colleagues - Jon Grimm, Head of Science - ignored the queue and wandered to the front, and he was accompanied by two sixth-formers!!. I could feel the gaze of other students as if they were telepathically questioning whether teachers were allowed to break the rules and get away with it... 'Er.. Mr Grimm' I said 'I was just reminding the students about the queuing rules...'.  Grimm looked at me as if I were quite mad. 'Important meeting' he said 'Can't be late'. He picked up his sandwich and left. I was still queuing and I suspect my face was starting to turn red... and then, with a relentless inevitability, one of the Governors swept into the canteen, didn't even glance at the queue, but walked straight up to the hatch and ordered food. I had a brief mental debate with myself. Then I did nothing.

Now, if you ask 'how would you have felt?' of five teachers, you will probably get ten different answers. Some will suggest that they would have challenged the Governor too, some would assert that they wouldn't have queued in the first place, others would mention feelings of anger, irritation, frustration, amusement, or bored cynicism. The important point is that exactly the same events provoke different feelings in different people - even people who generally share the same ethos and view of the world. The difference is in how each teacher - each person - thinks; in their belief system.

Sometimes, your belief system can make you prone to stress. Queue-jumping, for example, makes some people angry and frustrated; if so, many other things in modern life are also likely to make them angry and frustrated. Of course, those with a different belief system may find queues a breeze but will find other situations stressful.

Negative Thinking

So... a teacher's 'thinking' emerges from how they view things: things to do with themselves, their school, their lives and their future. Inevitably, some of those things will be seen as negative - viewed as threats to a teacher's well-being: a 'threat' in this context includes not just 'physical danger', but moral outrage, financial loss, a sense of uncertainty or failure, or any of a host of other less-than-pleasant outcomes. The queue-jumping in the example above was one of those 'things' - for the narrator, anyway. The key point here is that a teacher will think negatively if they perceive these threats to their well-being.

When a teacher perceives threats, their body reacts automatically. These bodily reactions - changes in the biochemistry -  inevitably affect the way the teacher feels, and how they behave. This is inevitable, but a problem arises if the teacher allows these changes (changes in how they are feeling and how they are acting) to reinforce their negative thoughts. If this happens, a spiral results: more negative thoughts, more physical reactions, more changes in emotion and behaviour, and so on. This loop can of course be entirely out of proportion to the 'threat to well-being' which triggered the negative thoughts in the first place.

The principle here is simple: we can rarely change the threat itself... but we can change the way we think... and if we can change the way we think, we can change the way that we feel and the way that we behave. This applies in all situations, but in the context of work, the idea is that if a teacher can change how they think about themselves - their school, their lives and their future - they will feel better as a result, and achieve more.

So What?

Good question. It's as simple as this: the way you think is reflected in the way you behave. If you are worried about something, it will literally prey on your mind: you will think about it a lot. This can - well, let's be a little more statistically precise - this is more likely to make you anxious and emotionally upset, and no matter how hard you try to keep your personal feelings out of your teaching, this will show in your behaviour. Exactly how it  manifests itself will differ from person to person: you may be more easily irritated, you may become more physically clumsy, you may be absent-minded... These behaviours create a ripple effect: you make odd decisions or silly mistakes, you alienate colleagues or students. You may suffer direct physical effects: disturbed sleep or eating patterns.  At the risk of stating the obvious, this is not conducive to good teaching. Of course, if the negative thoughts and emotions at the root of these behaviours actually relate to your teaching in the first place, you have even more reason to tackle those negative thoughts head-on.

The A-B-C

The key practical application of Cognitive Behavioural Therapy has an ABC mnemonic:

A:    the actual situation or event that causes you to feel upset (the queue, the angry parent, the snooty colleague)

B:    the beliefs or views that you hold about that situation

C:    the consequence - that is the feelings and behavour that result from your beliefs   

The central idea is that there is always something between the A and the C. This may be some moral certainty, some ethical belief, or just some deep-rooted feeling about how things 'ought', 'should' or 'must' be: 'governing bodies should make decisions and stick to them', 'meetings ought to start on time' or 'colleagues must show respect for each other'.

How others behave

Most teachers have pretty clear views about how others should behave, about fairness, and about how they themselves should be treated.  These beliefs are invariably founded in childhood, and sometimes - just sometimes - you may find that the maintenance of too-rigid beliefs is not helpful for an adult.  Why?  Well, the simple fact is that we - 'we' means the adult members of society - are all different. We are too different to have one set of beliefs that apply to everyone. If you find that you are regularly getting upset by others' behaviour, then you may want to reconsider some of your views.

This does not imply that you should stop caring, compromise your principles, or change your own standards. It does imply that you should acknowledge that your own beliefs are not universal, and that you should consider your own best interests by not  becoming upset without good reason.

The Tyranny of Shoulds

Read this anecdote; know anyone like Jon?

The Near Miss

I'd just finished making myself a cup of coffee, when Jon came storming into the staffroom. He didn't even say hello, just started telling me that he'd nearly had an accident in his new car. Someone had pulled out right in front of him, coming out of the hospital car park, and he'd only avoided a collision by slamming on his brakes. Jon recounted it word for word: "I said 'bloody stupid idiot, you nearly hit me, you shouldn't be allowed on drive if you can't watch where you're going'". Jon ranted on and on. His face was getting red as he spoke, he was sweating visibly and his voice was getting louder and higher-pitched. I mumbled some conciliatory agreement and shuffled out towards the faculty. Later in the day another colleague described Jon's arrival in school: they had nearly been run over by Jon in the staff car park as he screeched to a halt, before slamming the car door shut and storming into school. I don't think Jon fully calmed down till mid-afternoon.

The anecdote above illustrates how a belief determines our feelings and behaviours.  Most of us have experienced a near miss while driving, but most of us will respond along the lines of 'wow, that was close' and then forget about it.  Jon's response suggests that he has strong beliefs about how things should be: perhaps he believes that the other person's bad driving was deliberate, personal and malicious; or believes that the other driver's behaviour is representative of a deep malaise in society, or... whatever the reason, it really shouldn't have happened.  If Jon's anger affects his work, or his life in general, he may want to reconsider his beliefs about bad driving: about how other people should behave, about how the world in general should be, and about how he should fit into that world.  It's that 'should' word which represents the problem. There is no problem with expressing a preference: 'I prefer other people to always drive carefully'; the problem arises when the belief is more extreme and less realistic: 'Other drivers should always drive carefully.' The should word is the real tyrant: controlling Jon's behavour and emotions.

The central point is that it is not really other people who upset us: we can do that all on our own. They just sometimes offer us a prompt.

CBT DIY Step 1 - Understanding the Mental Mess (Accept that Events don't cause Emotions)

So... Here is Step 1 and the good news is that you've already started to take it, if you've read and understood the introduction above. Step 1 is to view the world in a non-simplistic way. This means that you don't accept the simple causation shown below...

It is very easy to assume that 'what happens' determines 'how we feel'.  This view is, after all, consistent with a lifetime's experience and seems to be re-inforced every day. The Head gives us less-than-glowing feedback after observing us teach, and we feel low. Cause and effect, obviously, right?  Well, wrong, I'm afraid.  There is a whole hidden clump of thoughts, beliefs and experiences sitting between the 'cause' and the 'effect'.  These will vary from teacher to teacher, may be deeply entrenched and certainly might not always be rational. For example, if you are gloomy after receiving the Head's feedback, your beliefs might include...

- "if I work really hard at something I should get praise and reward"

- "I shouldn't be criticised when it wasn't all my fault"

- "people often don't understand me or what I'm trying to do"

- "everyone should be kind to me; I'm a nice person"

This notion - that our moods and emotions are NOT simply determined by outside events - is really important. Unfortunately, it kind-of complicates things. Instead of a simple cause and effect - where the effects are 'you' and the causes are 'not you', there's a whole kaleidoscope of thoughts, emotions, feelings, beliefs and behaviours to be considered.

So, it doesn't work like this:

In fact, it works more like this:

Things happen, and - depending on what we believe and what we think and how we interpret that event - we feel emotions. You can, of course, see this demonstrated every day. Different people react in different ways to exactly the same event. Next time you are stuck in a traffic jam, discreetly look around you and see what the range of emotions. Some drivers will be tapping their steering wheels in irritation and frustration; others tapping and laughing in time with some banal radio chorus. Of course, the core of human experience is common and shared - we laugh and cry at roughly the same points in the movie; but the extent and intensity of our emotions vary enormously from individual to individual....

 ... and, in fact, things are even more complicated than the diagram above suggests. There are cyclical aspects to this. In the 'Near Miss' example above, colleague Jon was sent into a rage by a careless driver. Few of us actually react so extremely: "Bloody stupid idiot, etc..." ...  unless, of course, we were already angry when the near miss happened.

So: there is a complicated, cyclical relationship between what we feel, what we think, and how we behave, and all three influence the other two...

CBT DIY Step 2 - Over to You (Understand your own thoughts, beliefs, feelings and behaviours)

These diagrams are all very well, of course, but they represent abstractions and generalisations. You need to understand your specific real-life experiences. There is no easy short-cut: you need to work out the links between your own mess of thoughts, beliefs, emotions and behaviours.  To do this, you need to spot times of interest during your day- basically, this means times when you weren't happy with what you did or how you felt - when an event triggered an unwanted emotion or behaviour. For each of these, you need to jot down details, using a log-sheet like this one...

Notes (on the diagram above):

A couple of clarifications:  'How did it look?' means that you should write down how your behaviour would have looked to an entirely uninvolved and objective observer. Sometimes 'What did I do?' is skewed towards  'what you wanted to do' and not towards 'what you actually did'... and sometimes these are very different.

Examples of 'What did I feel? (emotions)' might be 'disappointed, resentful, irritated', while examples of 'What did I feel? (physiological)' might be 'sweating palms, itchy eyes, fast hearbeat').

Of course all these aspects are important, but most important of all are your thoughts - these are likely to reveal and explain exactly why this particular event produced this particular reaction (feelings and behavours).

Download stuff here

So now you have a stack of sheets of paper.

Most people read these pages because they have a messy emotional problem, and you need to start thinking about what that problem is. If you have two (or more) very different problems, then do this twice (or more).  Focus on one specific emotion, or mood, or clump of feelings...

Don't worry or agonise over the details or definitions in your choice - you can change and refine these as you go. In fact, you very probably will adapt and adjust your peception of your problem area as you understand it better.  Now of course, all teachers are different, but there are some recurring issues, and the three we are going to use as examples are:

• Anger

• Anxiety

• Gloom (ie depression, but not clinical depression)

Your issue may well be different, but I hope you can follow the following examples.  You need to collect enough data - using forms like the one shown above - so you have a reasonable understanding of your own feelings and behavour - you need to understand it enough so that it isn't just a 'mental mess' but displays recognisable patterns which make sense to you. You then need to tie down the emotion, or mood, or feeling that you are concerned about: the thing that is soaking up your time and limiting your effectiveness.  Give it a name, and include as many synonyms which seem to fit under the same heading. This is a quite personal labelling, and you should not be restricted by dictionary definitions or nuances of meaning. If it feels the same to you, then that's fine.  Here are three examples (no, you don't have to draw the faces...):

Whatever your personal problem area is, label it and nail it down; similar to the examples above.  Then make a small summary sheet, similar to the example below, showing what actually happens when this particular thing happens (when you get angry, or anxious, or down, or whatever).  Here is a blank example...

... and here are three completed examples, based on our anger-anxiety-gloom scenarios...  These are composites of the observations you recorded on your record sheets above, which should give you an aggregated picture - based on a number of real-life examples - of what actually happens: what you think, what you feel and what you do... You should note that - because these are theoretical examples - the details are pretty vague. You own real-life examples should be much more specific in terms of what you think and what you do (for example, "give loud instructions to students who already know what they are doing" or "pick fault with a student's work when they really needed encouragement"). You may find that, when you start to look at thoughts, physiological feelings and behaviours, as well as emotions, you start to reassign some of the emotional words; for example, you may find that 'impatient' triggers the same kind of thoughts as 'anxious' and fits better under that heading. That's fine - it's really up to you, understanding how your mind works.

Now, it would be perfectly reasonable if you have a question at this stage. The reasonable question would be: 'isn't this an awful lot of work for very little return?' or maybe 'are we really only at Step 2?.  The answers to these questions are important. Firstly: yes, it is quite a bit of work, but it is really worth it. For many teachers, the simple fact of understanding what is going on is valuable in itself. For many of us, the most worrying aspect of our emotional mess is the feeling of being out of control, of not understanding why we are feeling how we are feeling, and of not knowing where our feelings and behaviour are coming from. Well, now you DO  know... You may quite quickly find familiarity with a whole host of feelings which may seem random and irrational. The list can be quite alarming: pounding heart, trembling, shallow breathing, difficulty in breathing, light-headedness, dizziness, shaking voice, sweat,pins & needles, a need to go to the toilet, butterflies in the stomach, a tightness in the chest, a lump in the throat... and in answer to the second question ('is this really only Step 2'), yes it is, but the other Steps are much quicker.

Just for clarity, the diagram below shows how to map your experiences onto your four-part sheet...

The Vicious Circle

At this stage, it's worth revisiting one key point: the cyclical relationship between behaviour and feelings. Make absolutely sure that you understand this point before you consider how to address your particular issues.

Your feelings influence your behaviours, and your behaviours influence your feelngs.  If you are already angry, then you will tend to be more easily irritated; if you are already anxious, you will be more likely to interpret things as threats; if you are already gloomy you will be inclined to view the world in a negative way.

This is the vicious cycle which underpins a lot of our issues. We start off being made angry by a particular event (like Jon in the 'near miss' example) and then are pre-disposed to being made angry for the remainder of the day - and beyond. These persistent states are sometimes called 'moods', which differ from emotions because they are more persistent and less linked to a specific stimulus.  Emotions - specific, event-linked emotions - are a logical and necessary feature of human existence, as shown below...

Stages in a Standard Emotional Response

• 1. Cognitive appraisal: an individual assesses the event, applies his or her beliefs and cues the appropriate emotion.

  2. Physiological changes: the thoughts prompt a reaction involving biological changes such as increased heart rate or pituitary adrenal response.

  3. Action: the individual feels the emotion through the physiological change and chooses (consciously or subconsciously) how to react.

For example: Sammy sees a snake.

• 1. Sammy sees the snake, and sees that it is close enough to harm her. Her conscious brain understands that this may be dangerous.

  2. Sammy's brain subconsciously activates the production of Adrenaline which results in increased heartbeat, dilation of blood vessels etc

  3. Sammy screams and throws a book at the snake.

This is all very well, but there are rarely dangerous snakes in the staffroom. What most of us experience is a maladaptation of this well-developed emotional response. Our bodies' defences are designed to handle one off, discrete, specific dangers - like sabre-toothed tigers. Instead we are faced with repeated or prolonged, subtle and complex threats - like bureaucratic administration tasks, like persistent low-leve disruption, like clumsy bullying management. Our bodies just aren't well-equipped to deal with this, and deploying the standard emotional response (Sammy sees a snake) is counter productive.  It is counter-productive for two reasons:

Firstly, it may result in a sudden involuntary reaction (like yelling at a student who has asked one irrelevant question too many). These are rarely helpful in education.  Secondly, it may not result in a one-off response, instead it may result in a persistent, self-perpetuating mood - the vicious circle described above.  You get angry, and your body responds. You carry on thinking about the event which triggers the anger, and your body tries to maintain its response state. In this state, you are much more likely to get irritated by minor events, and the anger persists.  At the risk of stating the obvious: this is not good for your health.

CBT DIY Step 3 - Ch-Ch-Ch-Changes... (Adapting your behaviour and thoughts to reduce unwanted outcomes)

OK. Step 3 starts with an apology. I am apologising because I personally don't like it when something is being explained to me, and then suddenly the explanation tapers off and it's, like: "well the next step is really up to you" or "the best option will vary from teacher to teacher" or "you will have to choose, according to your situation" or even - worst of all "there is no right answer".

So: sorry, but that's how it is.

On the positive side, however, you do not have to come up with your own solutions: you can choose from a host of well-proven options. 'Well-proven' but unfortunately they are well-proven to work in some situations and not to work in other situations. There is an inevitable need for experimentation here.

So: what are the options? Well, these fall naturally into three groups, shown on the diagram below...  Alternatively, if you're a 'menu' kind of guy, you can review the complete list of techniques in the stress armoury here.

A: (This is included for completeness. because it's not usually a good idea) You can modify the Actual events which trigger the unwanted behaviour. Typically, this means avoiding certain people, places, situations etc.  Now, if this involves not going to the local bakers because the man behind the counter is really, really annoying, that's fine. You can easily find another baker.  However, for a teacher, the events and situations are frequently unavoidable. There is no escape from 9C. Or your head of department.  Or Jason's mum.

B: You can seek to modify the thoughts  which are triggered by events in your life and the underlying Beliefs to which they correspond. There are several avenues to explore here and you should not focus on any single one of them. Browse the stress armoury here and select methods which appeal to you. Try them, and if they don't give you what you need, try others.

Automatic Thoughts - Identification

In all events, you should seek to identify and evaluate your automatic thoughts.  Here's a summary of how to identify these pesky critters.

1. Automatic thoughts are...err, well, automatic; they just pop into your mind in certain situations. You may not be aware of them until you start consciously recording your thoughts. Don't worry about where they come from; they are normal, and natural, and...

2. Automatic thoughts are normal, natural and ...they are frequently negative too. They represent a part of your natural defence mechanism: anticipating and predicting threats to your well-being. You are - in fact anybody is - likely to have some kind of automatic negative thoughts which just jump unbidden into your head. These will be negative thoughts about one of three things: yourself, or the world in general, or the future.

3. Your automatic thoughts are almost invariably plausible.  That does not mean that they are true, accurate, or helpful - just reasonably believable to you. You will find your own automatic thoughts believable. You might not, though, find another person's automatic thoughts believable.  In the 'Near Miss' example above, Jon's automatic thoughts may have been 'people who drive like that are selfish arrogant fools' but you - in the same situation - you may consider that the other driver may have been axious and distracted - he was leaving a hospital car park, after all.  Don't expect your own automatic thoughts, though, to be easy to challenge and discount as Jon's or other other-people's. They have become automatic to you because they are plausible to you.

4. Your automatic thoughts are... err, well, yours; they are personal in a distinctive way - sometimes specific to and allied with your own cultural background, your own childhood experience, your own moral standpoint and ethical values. Sometimes, though, they seem to be almost perversely in opposition to the values that you espouse. Jon, for example (in the Near Miss example above) may be a sensitive, liberal man who sympathises with feminist ideas, but may have savagely misogynistic thoughts if he sees a careless woman driver. These thoughts are likely to be distressing to Jon, and exacerbate his rage and negative feelings.

5. Automatic thoughts tend to be persistent and repetitive. Your thoughts seem to repeat themselves over and over, and - like a stone gathering moss - they gain credibility and strength, possibly developing new variations over time.

Automatic Thoughs - Evaluation, Categorisation and Challenge

Identify your automatic thoughts from your log-sheets. These automatic thoughts are likely to be a mish-mash of facts and opinions, emotions and beliefs. You need to identify your automatic thoughts, separating them from any conscious, logical factual thoughts which you have had.  Then look for examples from any of these standard patterns of flawed and unhelpful thoughts (click here).

C: You can seek to modify the Consequences of your thoughts -  your behaviours. You may feel that this is kind-of avoiding the problem - the problem being in your head, but because behaviours and beliefs influence each other, you can (to some extent) change the way you feel (your attitudes and thoughts) by modifying your behaviours.

You can do this in two ways: you can add in new behaviours - there is a list of well-proven options to choose from. But first, you should start by simply reviewing your existing behaviours listed on your log forms, and sorting out the different types of behaviour, then looking for alternatives.  Here is a list of behaviour patterns to look out for. Click here.

When you have identified things you want to change, well... just change them. Using the magic wand that you can order online from the TM4T shop. Only kidding. We know it isn't easy. But if you want to change you do need to just look at alternatives and start experimenting with options.  Start by looking at these questions:

• • Ask yourself  'What could I have done differently?'. Keep it real and keep it focused on the time when the original behavour occurred.  If you got upset immediately after a difficult lesson, then 'I could have planned a better lesson' isn't what you need in this step (though of course it's a good idea). Better options might be 'I could have jotted down exactly what went wrong and factored that into future lesson plans' or 'I could have opened the window and taken two breaths of cold air' or...

  • Ask yourself  'What might someone else have done in that same situation?'.  Don't choose a saint or a superhero for the 'someone else' but choose some specific persron that you know, who might have handled the situation differently, with different results. You don't have to change your personality here, just try out different behaviours for size.

  • Ask yourself 'How have I have handled situations like that previously?'. Sometimes we deal with things in a particular way, but don't enjoy how it felt. So we stop doing it. If you have previously been successful, ask yourself why things have changed.

    and finally:

• • Ask yourself 'If I could travel back in time, tap myself on the shoulder and give myself advice, what would I tell myself to do?'  The answer to this questions is important. You need to re-cut this answer as 'if I could have just paused and taken a breath, this is what I would have done'. And then next time, of course, you need to do it. It's possible that you can think of two or more alternative ways to change your behaviour - that's great, flexibility is always a good thing.

Plan B

When you have identified your alternative way of behaving in these situations - your Plan B or Plans B & C etc - ask yourself a few more questions to make sure you understand what you are trying to achieve:

• • Would this new way of behaving have made me feel any different? How might it have affected what I thought? Would there be different emotions? Different physiological reactions?  Don't expect miracles here, but do have an ideal of what you are aiming for when you try out your new behaviour.

  • In what ways will this new way of behaving make the situation different? How might the consequences (ie what happens after the situation) be affected?

REBOOTT

Some picky critics may have noticed a problem with the steps above: it does depend on you being able to time travel, tap yourself on the shoulder, and tell yourself what to do. We need an alternative approach, which we call ReBOOT.  This means that - when a problematic situation arises - you do the following:

REsist the urge to REact

Breathe

Observe

Objective

Try out new Techniques

Breaking this down:

1. Resist the urge to react

This means that you pause and tell yourself that you are going to respond to this situation, not react to it.

2. Breathe

Unless there is an immediate threat of physical danger, your next step is to focus on your own breathing. Take at least two deep breaths in and out.

3. Observe

Try to rationally appreciate what is actually happening in the real world, but also observe what is happening in your mind - your feelings, automatic thoughts, physiological reactions, and possibly automatic behaviours. 

4. Objective.

Having acknowledged your own responses, now focus on being absolutely objective.  Do your thoughts represent facts or opinions?  How would an neutral observer interpret the situation?  How would you interpret the situation if you saw someone else in your shoes?  Are there any unhelpful automatic thoughts here?  Are you making a mountain out of a molehill? How important will this situation seem in six months time?

5. Techniques.

OK. Now it's time to try the alternative behaviours you practiced as part C of your Ch-ch-ch-Changes activities above. You can also consider a whole range of activities from the Stress Armoury here.