Alternative Response Formulation
By now, you are probably an expert on the cross sectional formulation and can probably explain it to your friends, but let’s take another look at it before incorporating the next component. You begin the simple cross sectional formulation by identifying an anxiety provoking event and then noting the interactions of your experiences of anxiety symptoms.
We have found that the cognitive component is heavily weighted such that the way you think about or interpret a situation can perpetuate the anxiety and then trigger other symptoms. We spent a lot of the workshop talking about the impact of automatic and unhelpful thoughts.
You may be asking yourself, so now what? What do I do about it? Remember that we have done 2 activities to address the physical symptoms directly (deep breathing and progressive muscle relaxation) and that by addressing the physical symptoms directly you are freeing up mental energy to address other symptoms.
Also, remember that completing the cross sectional formulation is a tool. It requires that you slow down and detangle the symptoms you are feeling.
Now let’s focus on how to address the thoughts directly through cognitive restructuring. What we mean by cognitive restructuring is to take a different thinking approach to the anxiety provoking situation. This involves purposefully slowing down, challenging your automatic and unhelpful thinking patterns and giving yourself a broader perspective on the situation. This takes time and lots of practice. So be patient with yourself.
Here’s how it works. When you start to notice anxiety, think to yourself: “Stop, pay attention and get perspective.” This means, stop, pay attention to what is going on in your mind and body, and then be intentional about what happens next.
What we want to do here is to slow down the process so that you don’t get caught up in the anxiety and so that you feel more in control. The ultimate goal is for the “stop and pay attention” mantra to become second nature so that you use it even before experiencing anxiety. That is going to take time and lots of practice.
To better understand this “stop and pay attention” mantra, let’s work through an example of alternative responses to anxiety. I want to highlight that when we are doing the alternative response we are not saying “just think positive”, because you have probably heard that before and it’s not that simple. What we are saying is, let's look at the situation from a broader perspective.
For example, using the same anxiety provoking situation of being invited to a party and feeling anxious about going, one of the alternative responses is "I might still have an okay time." It is important to remember that you're probably not going to jump from the thought: "I'm gonna have a terrible time" to the thought: "I'm gonna have a blast." Make sure your alternative thoughts are realistic and believable. Don’t try to just jump to the positive extreme as this would be an example of an unhelpful thinking style of black and white thinking.
You will be filling out an Alternative Response Worksheet which corresponds to an anxiety provoking event that you used as an example earlier. Review the example here.
Now, using the anxiety event from one of your cross sectional formulations, fill out the blank Alternative Response Worksheet here. Click here for a guide if you feel stuck; these questions are intended to guide you to think of alternative responses until they become second nature, which is going to take a lot of time and practice.