I’ve lived with general anxiety for as far back as my memory goes. As a writer and stand-up comedian, I have the most trouble fighting against social and performance anxiety on a day-to-day basis, as I conduct interviews and interact with editors during the day and then take the stage at night.
My anxiety most often shows itself in what I call “anxiety hangovers,” when I wake up on the day following a social event or meeting or comedy show feeling horrible about everything I did or said — no matter how fun or successful the event felt the night before.
Everyone thinks you’re egotistical and obnoxious, my inner voice spits at me when I wake up.
You said the exact wrong thing to your friend when she asked for your opinion, because you never think before you open your mouth.
You dominated the dinner conversation. No wonder no one likes you.
You were so embarrassing on stage, of course you aren’t a success.
The mean little voice goes on and on and on.
After big events, like a friend’s wedding or important comedy show, I’ve had panic attacks the following morning: a racing heart, trembling hands, and trouble breathing. On other days, I just can’t concentrate because of the worry and feel mentally paralyzed, and the confidence I need to do my work is sunk.
Where cognitive behavioral therapy comes in
The central idea behind cognitive behavioral therapy (CBT) is extremely simple: If you change the way you think, you can change the way you feel.
But if feeling better and escaping depression and anxiety were that easy, we wouldn’t live in a country where psychological distress is increasing.
While I’ve found that I can’t fully eliminate or “cure” my anxiety (and probably never will), I’ve found a simple five-minute CBT exercise that quiets it down each day. My racing thoughts stop, my foggy brain begins to clear, and my fatigue lifts.
Suddenly, I feel like I can start my day.
Called the triple column technique, which was developed and named by clinical psychiatrist Dr. David D. Burns, all it does is change my mindset. But sometimes, this shift is enough to completely shut my anxiety up for the day. A change in how we think about ourselves is all we really need to find a calmer, happier place.
Recognizing cognitive distortions
In 2014, a friend recommended Burns’ “Feeling Good,” a CBT classic that takes readers step-by-step through recognizing negative self-talk, analyzing it rationally, and replacing it with healthier and more accurate thinking.
(Burns also suggests, for many people living with anxiety and depression, to see their doctor and pair therapy and the appropriate medication if deemed necessary.)
The book made it crystal clear that I wasn’t a secretly bad person and incredible failure who can’t do anything right. I’m just a pretty regular person who has a brain that can distort reality and cause way too much anxiety, stress, and depression.
The first big lesson was to learn the specifics of cognitive distortions — those statements that the little voice makes about who I am and what’s going on in my life.
There are 10 big distortions that can occur:
- All or nothing thinking. When you see things in black and white instead of in shades of gray. Example: I’m a bad person.
- Overgeneralization. When you extend a negative thought so it reaches even further. Example: I never do anything right.
- Mental filter. When you filter out all the good stuff to focus on the bad. Example: I didn’t accomplish anything today.
- Disqualifying the positive. When you believe a good or positive thing “doesn’t count” toward your larger pattern of failure and negativity. Example: I guess I survived the talk — even broken clocks are right twice a day.
- Jumping to conclusions. When you extrapolate an even bigger and broader negative thought from a small negative experience. Example: He said he didn’t want to go out with me. I must be an unlovable person.
- Magnification or minimization. When you exaggerate your own mistakes (or other people’s accomplishments or happiness) while minimizing your own accomplishments and others’ flaws. Example: Everyone saw me mess up at the game, while Susan had a perfect night on the field.
- Emotional reasoning. When you assume your negative feelings reflect the truth. Example: I felt embarrassed, therefore I must have been acting in an embarrassing manner.
- Should statements. When you beat yourself up for not doing things differently. Example: I should’ve kept my mouth shut.
- Labeling and mislabeling. When you use a small negative event or feeling to give yourself a huge, general label. Example: I forgot to do the report. I’m a total idiot.
- Personalization. When you make things personal that aren’t. Example: The dinner party was bad because I was there.
How to use the 5-minute triple column technique
Once you understand the 10 most common cognitive distortions, you can start taking a few minutes a day to complete the triple column exercise.
While you can do it in your head, it works amazingly better if you write it down and get that negative voice out of your head — believe me.
Here’s how you do it:
- Make three columns on a sheet of paper, or open an Excel document or Google Spreadsheet. You can do it anytime you’d like, or just when you’re noticing you’re beating yourself up. I like to write mine in the morning when I’m feeling most anxious, but many people I know write theirs before bed to clear their minds.
- In the first column, write what Burns calls your “automatic thought.” That’s your negative self-talk, that crappy, mean little voice in your head. You can be as brief or detailed as you’d like. Yours might read, My workday was the worst. My presentation bombed, my boss hates me, and I’ll probably get fired.
- Now read your statement (it always looks kind of shocking to see it in print) and look for the cognitive distortions to write in the second column. There may be just one or more than one. In the example we’re using, there are at least four: overgeneralization, all or nothing thinking, mental filter, and jumping to conclusions.
- Finally, in the third column, write your “rational response.” This is when you think logically about what you’re feeling and rewrite your automatic thought. Using our example, you might write, My presentation could’ve gone better, but I’ve had lots of successful presentations in the past and I can learn from this one. My boss was confident enough to have me lead the presentation, and I can talk to her tomorrow about how it could’ve gone better. There’s no evidence at all that this one subpar day at work would get me fired.
You can write as many or as few automatic thoughts as you want. After a good day, you might not have any, and after a big event or conflict, you might have to work through a lot.
I’ve found that after years of doing this, I’m much better at catching my brain in the middle of a distortion and much more comfortable in recognizing that, at best, my negative talk isn’t rational at all. At worst, it’s exaggerated or overdramatic.
And is it proven to work?
A 2012 meta-analysis of 269 studies about CBT found that while this simple talk therapy is most helpful in combination with other treatments, it’s very successful when specifically treating anxiety, anger management, and stress management. Go forth and fill out your triple columns!
Sarah Aswell is a freelance writer who lives in Missoula, Montana, with her husband and two daughters. Her writing has appeared in publications that include The New Yorker, McSweeney’s, National Lampoon, and Reductress. You can reach out to her on Twitter.