Core Beliefs

Automatic thinking is a term that comes up a lot around these parts (parts=this blog) and refers to the self-talk or narrative that folks with depression and anxiety immediately engage in as a response to an activating event or trigger.  Automatic thinking can be the result of a trigger or can act as a trigger for distress.  Many of the clients I work with are often curious about how or why this type of thinking occurs. The primary source of automatic thinking are core beliefs; beliefs that we hold about ourselves, others and/or the world around us.  Individuals who struggle with a mental health issue typically have negative core beliefs that can influence thinking on a variety of events that occur on a day to day basis.

Core beliefs can center around adequacy (“I am worthless”), control (“I cannot be trusted”) or safety (“I cannot protect myself”). Someone who holds the core belief of “I must be perfect” may be prone to polarized thinking (placing events or people in categories of “all good” or “all bad”) which may in turn increase the distress associated with failing and could also influence a reaction to failing that is unhelpful or harmful.

There are many factors that influence core beliefs; one being a biologically based condition like depression.  A person may have a typical family history and childhood  but because of the impact depression has on their mood,  that person may interpret the “stuff” we all go through in ways that are more negative and impactful.  Failing a test or feedback received from a parent may take on a deeper meaning that feeds into the understanding that a  person has about themselves. A child or teen without depression may move on from these events or, perhaps, use these events as motivating factors to improve. A person who struggles with depression or anxiety may view these events as evidence of a fundamental flaw.  This perceived flaw may begin to shape how everything is viewed and can even be predictive.

Another factor involves traumatic events which can range from being embarrassed in front of a classroom by a teacher to events we typically associate with the word trauma like sexual abuse, assault, combat or witnessing the unexpected  death of a loved one.  These events, especially when they are experienced at younger ages, can have a very big influence on core beliefs as survival becomes the driving force in holding onto the belief.  A survivor of sexual abuse may live in a home environment where the belief of “I am not safe” is actually adaptive.  This belief helps to maintain the kind of  vigilance the survivor needs to avoid the trauma.

Once the survivor leaves the home environment the cost-benefit of the belief and the behaviors connected to it shifts. Because of the association the belief has to survival, it may be very difficult for the survivor to consider any other alternative in their thinking.  Imagine living your day to day life in a mine field for the first 12-17 years of your life. Now imagine someone taking you away, placing you in the middle of another field, telling you “there is nothing to worry about now” and even demonstrates this by running through the field carelessly. How easy do you imagine it would be for you to act according to that evidence?

There are several steps to changing core beliefs in therapy, the first one involves actually identifying it.  In CBT, the process to accessing a core belief involves asking a series of repetitive questions around an automatic thought or hypothesis a client has in relation to an activating event or trigger.

T- “So you’re saying that going to the grocery store will probably result in a panic attack.  What would having a panic attack at the store say about you?”

C-“It would be pretty embarrassing.”

T-“So you would feel embarrassed, what would make it embarrassing?”

C-“Everyone would be staring at me….avoiding me.  People who know me might look at me differently.

T-“And what would that say about you?”

C-“That I’m unstable….crazy.”

T-“What would that mean to you?”

C-“That I shouldn’t go to the grocery store.”

T-“And what would that say about you?”

C-“Well… that’s a pretty basic thing…..if I can’t do that then I’m pretty helpless.”

T-“And what would that say about you?”

C-“Just that…I’m helpless.”

T-“So when you think about those three statements “I’m crazy.”, “I’m unstable”, “I’m helpless”, which one makes the most sense to you when you think about having to go shopping?”

This is pretty consistent with how EMDR handles it within its’ protocol; the only difference being that clients are asked to look at the worst image of the event they are working on (usually historical) when coming up with the core belief. If someone is struggling with putting words to the core belief, I’ll provide them with a list that they can either pick from or use as a way to jog their thinking.

Negative core beliefs typically develop during times of high distress when we are less capable of looking at events objectively.  Because they are distressing, we may not revisit them for reasons ranging from discomfort to fear. As a result, the initial understanding or conclusion about the event may not change or be challenged.  Being aware of the core belief(s)  is key to long term sustainable change as it addresses the root cause.  In identifying core beliefs, we become more able to engage in a variety of skills that seek to address the source of the belief in ways that can lead to fundamental shifts in our thinking.