Managing Unhelpful Thoughts


Research has shown that there is a clear relationship between our thoughts, our feelings and our behaviour. We all have worrying or depressing thoughts - it is a normal part of having a human brain.  Sometimes these thoughts can be useful, for example, if you had a job interview, it would be useful for your brain to have the worrying thought of “I might not get the job if I don’t prepare for it”.  This would potentially lead you to spend some time reading about the requirements of the job, which could be helpful. However, if we get trapped in a cycle of having lots of these worrying or depressing thoughts, and we are unable to take action to calm them, it can make us feel very depressed or anxious.

It is normal to feel worried or sad when confronted with a life-changing situation. Research has shown that once we feel unhappy, we tend to view ourselves, others and the world in a more negative way.

It can be helpful to know about common patterns of thinking so that you are better able to recognise when you are beginning to get entangled in a downward spiral of worry and/or sadness. Some of the common thought patterns experienced by people with physical health conditions include:

All or nothing thinking: Viewing situations or events as either black or white. For example, having a condition that cannot be treated may result in beliefs of “I might as well give up if this can’t be treated”. In this case, the diagnosis is being viewed as either “curable or death”, whereas the reality might be months or years.

Filtering: You might select only parts of information which match your current beliefs or mood. For example, you might feel anxious when speaking to a member of your medical team about your care plan. You might focus on negative information about your diagnosis and pay less attention to what really matters to you at that time e.g. spending time with loved ones.

Jumping to conclusions: This involves making assumptions about the future e.g. “my family will not be able to cope without me if anything happened to me”. You might also try to mind-read what others are thinking (based upon their actions) to manage feelings of uncertainty. For example, you might infer that “the results are bad” by a look from your nurse or consultant.

Personalisation: Some people may blame themselves for having a physical health condition. For example, “I am being punished because of all the bad things I have done” or “I have this because I am a smoker/drinker”.

Catastrophising: Assuming the worst outcome will happen and that it is out of your control. This pattern of thinking often includes thoughts of “what if?” e.g. “what if I only have days to live or don’t wake up tomorrow?”.

The ‘shoulds’, ‘woulds’ and ‘coulds’: This might include thoughts of “I should have done more in my life before this”, “I would have been able to look after my family if I didn’t have this diagnosis”.

Unhelpful thoughts are tricky in the sense that they are often:

  • Automatic
  • Require little effort to pop into our head
  • Can spiral out of control especially if we have few distractions
  • Difficult to control
  • Believable

Strategies to help you cope with unhelpful thoughts
Sometimes being aware that you are engaging in unhelpful thinking patterns can aid the process of adopting more helpful ways of thinking. Have another read of the common unhelpful thinking styles provided above – did any of them resonate with you?

We know that our brains are designed to make sense of problems, to understand the “why”, “what” and “how”, and to predict the worst. Trying to control negative thoughts or avoid them can sometimes strengthen this negative experience rather than diminish it. In other words, a thought can almost grow, the more you try to push it away.

Being mindful of your negative thoughts may allow you to make a skilful decision about how best to manage them in that moment. For example, when you notice that you are having a negative thought, you can create a distance from the thought to help you to manage it. Strategies to help you do this may include:

  • Writing your thoughts down on paper to help you view them in a way that is less emotionally intense and overwhelming.
  • Telling yourself “I am having the thought that…” as a way to defuse from the thought.
  • Look at the thought from a different perspective by asking yourself questions such as “what advice would I give a friend who was having this thought?”, “what is the evidence that this thought is true?”, “is it helpful for me to think in this way?”.
  • Using mindfulness exercises to observe your thoughts and notice the feelings that they give rise to in your body.

Neither of the strategies above is better than the other. Being mindful of your negative thoughts and aware of the fact that you have a choice for managing them, can in itself help you start to feel back in control.