1. FEELING MODULE

2. Why people feel bad based on CBT: They have negative self-image They interpret events and experiences in negative ways They have negative views of future. They believe things will never change. And what makes people happy: They have positive self-image They interpret experiences in positive ways They have positive views of future

3. Character Examples Amy is happy person she believes that she is confident, she is aware of her weaknesses and tries to improve them, she has had good experiences from her last relationships, sometimes they did not work but she hopes having a good relationship in future and…………. John is unhappy person, he believes that he is not lucky, the future is dark and……….He has never been good in his relationships and is never going to be …..

4. Advantages of Amy: She feels good about herself, she feels worthy Her interpretation of events is good She is looking forward to more happiness and success

5. Disadvantages of John: He has a negative view of himself His interpretation of events are negative Future is dark for him he does not have any hope It is obvious that John is in risk of depression and anxiety more than Amy

6. In this part Amy and John answer questions about Their failing in exam About relationships with their “difficult” daughter Moving up the corporate ladder

7. Identifying Negative Thoughts and Positive Thoughts Please read the character answers to the questions and identify the negative and positive thoughts, negative and positive views of the future, and negative and positive interpretations of events.

8. Question 1): Have you ever failed your exam? Amy : Yes 2 or 3 times, I was very sad and disappointed at first but I found out that it was because I did not balance my time. I went out too much with my friends and spent plenty of time in the gym. From the beginning of this semester I tried to … John : I am not as smart as I want to be, I failed my exam 2 or 3 times. Sometimes I think that I am not suitable for this course. Sometimes I think about giving up the studying. If it happens again …

9. Question 2): Have you ever had problem in the relationship with your children? Amy: My daughter always talks back. She fights me on everything. But I know she is independent minded. She thinks for herself and won’t fall to peer pressure like the other teens. John: My daughter always talks back. She fights me on everything. She is so disrespectful she is driving me crazy. I don’t know what’s wrong with her.

10. Question 3): How do you foresee your progress at the company? Amy: I will keep on working hard and being a team player. My boss will notice and eventually, I will get that promotion. John: I work hard but I am not sure if anyone notices. Unless I do something drastic it is pointless, I will never get promoted.

11. Their Differences People would rather to be Amy instead of John. It is obvious that John is at risk of being depressed and anxious. Amy is more confident. She carries a more positive view of the future. Most people do not want to feel unhappy and depressed, but sometimes negative thinking becomes a habit. Carrying and holding these negative thought make us more vulnerable to depression, anxiety, and unhappiness.

12. So, Is It My Fault For Feeling Bad? Not at all!! It is not your fault. It depends on many factors, We suggest that you modify these negative feelings. By taking positive steps and improving your skills, you can change your life. CBT can help people cope better with their everyday or more serious problems like abuse, accidents, etc. CBT can help people find a way for best coping with their situation and problems.

13. How Do I Become More Satisfied ? You can change your view about the future and about yourself. CBT suggests that your emotions are strongly influenced by what you think. Negative emotion are caused by thinking negative. Positive emotions are caused by positive thinking.

14. The Two Kinds of Interpretations Say someone is at a party, one of his friend passes and does not say hi to him. Positive Interpretation: She did not see me. If she saw me, she would have come over. Negative Interpretation: She ignored me. She doesn’t like me. It is not the events themselves that trigger the feelings, it is our interpretation of the events that lead to such feelings

15. Example You want to go to a trip with your friends, you get ill How do you feel? What are your thoughts? What are our characters’ feelings and thoughts? Amy: I have not gotten sick for a long time, I am lucky that it happened now not during my trip. I will call my friends and explain them everything. Maybe I can join them later… John: This is the worst thing that could happen. Why am I sick now? I am unlucky all the time..

16. Let’s have some examples that might help show you faulty thinking might be the case.

17. All-or-None Thinking When you see things in only 2 categories such as black or white. Example: You see yourself as a failure if you are not perfect. Example: “Nothing I ever do is right.” Tinnitus example: “If my tinnitus is loud when I wake up in the morning, I know I will have a bad day”

18. Oversimplifying When you interpret one bad event as a pattern that never changes. Example: You get on the wrong train one time and think, “I’ll never learn how to use the subway.” Tinnitus example: “I was awake all night from my tinnitus. This will happen every night.”

19. Focusing on the Wrong Details When you pick out a single detail and focus on it. You don’t think about more positive details. Example: “I got a 60% on my math homework. I’m a terrible student.” Tinnitus example: “Tinnitus made it hard to enjoy dinner with a friend.”

20. Jumping to Conclusions When you think of an event as being unpleasant while there are no facts to support it. You assume that you know what someone else is thinking or assume things will turn out badly. Example: “If I go to that party, I don’t know anyone and will not have fun.” Tinnitus example: “My tinnitus kept me awake last night. Today I met a friend for coffee. I was really tired and didn’t talk much. I bet he thought I was boring.”

21. Overestimating When you think things are more important than what they really are (such as a mistake, event, or someone else’s success). Example: “I forgot to shake my bosses hand!” Tinnitus example: “My tinnitus makes me moody. No one wants to be around me.”

22. When you think things are less important than what they really are (such as your success or someone else’s faults). Example: “So I got a promotion. It’s not a big deal.” Tinnitus example: “I know I learned how to get sleep even though my tinnitus is loud. I also started using soothing sound for my tinnitus at work. Even so, I’ll never learn to deal with my tinnitus.” Underestimating

23. Assuming the Worst When you think something is much worse that it really is. Example: “She turned me down when I asked her to go on a date with me. Holy Crap!!! She will tell everyone.” Tinnitus example: “I’m going to become deaf from my tinnitus.”

24. Emotional Thoughts When you think that your emotions show the way things really are. You might think, “I feel it, so it must be true.” Example: “I feel like I’m the only one who cleans up around here so you must not be helping.” Tinnitus example: “I feel like no one knows what I am going through with my tinnitus. I feel all alone.”

25. “Should” statements When you say “should” and “shouldn’t” to try to get yourself to do hard tasks. These statements make you feel guilty. Also included are these statements with the words “must” and “ought”. Example: “I should be eating healthier and stop eating food I like.” Tinnitus example: “I should not have to deal with tinnitus during the best years of my life.”

26. Labeling Attaching a bad label to yourself or others Example: “He lost his keys. He’s so stupid.” Tinnitus example: “I can’t deal with my tinnitus, so I’m a weak person.”

27. Making Things Personal You see yourself as the cause of negative events when your are not actually responsible. You ignore other details. Example: “My doctor was not nice to me because I was sick.” Tinnitus example: “My tinnitus made it hard for me to enjoy the picnic. I caused everyone else to have a bad time, too.”

28. Blaming You blame others for your problems. You may also blame yourself for other people’s problems. Example: “I didn’t get the job because you didn’t call to give me a pep talk before my meeting.” Tinnitus example: “My tinnitus wouldn’t be such a problem if my wife was more supportive.”

29. As You Have Seen We have different ways of thinking about events. Different thoughts lead to different feelings, which lead to us to act differently.

30. CBT: Cognitive Behavior Therapy We can illustrate CBT with a simple diagram Event Thought Feeling Behavior Events trigger our thoughts which produce our feelings which determine our behaviors

31. Example You have tried very hard to get that promotion at work but it was given to someone else. You think “all that hard work was for nothing”. You feel depressed Because you feel depressed, you put in less of an effort. Your performance declines. You might not even apply for the next position that opens up.

32. How Thoughts Lead to Different Behaviors Thoughts: I did not try very hard, I am a loser and nobody respects me at work and…. Feelings: depression, anxious, shame Behavior: does the minimal amount of work required, not friendly coworkers OR Thoughts: I will be more prepared next time, other applicants didn’t get it either Feelings: a bit of sadness, determined Behavior: put in more time at work, come up with helpful ideas

33. As Shown: Some thoughts trigger negative feelings and some trigger positive feelings. Many of us would consider not getting that promotion as horrible. Trying to handle this situation may cause positive responses (determined, leading to try more in future) or negative responses (self-loathing, fear, avoidance). Response to any event can be either positive (useful) or negative (not useful or even harmful)

34. No matter how long or short the event is, it can trigger strong emotions. Good or bad.

35. How Thoughts Influence Feelings I Think Therefore I feel I will never be happy again Hopeless Life is not worth living Suicidal I am going crazy Frightened, panicky I can’t do this alone Anxious, dependent I’ve done this before, Hopeful, energized I can do it again Nobody is perfect Relieved, less pressured I didn’t give up, at least I tried Proud, happy No one cares about me Rejected, lonely

36. We often believe that we know what other people are thinking. We have to remember that people think and see things differently than we do. In fact, we have to identify our thoughts and then examine the facts. If I believe something is true it doesn’t mean it is true. Thoughts are hypotheses, descriptions or even speculations. They can be either false or true. Many people who are depressed, anxious, or angry treat their thoughts as if they were facts.

37. This is an example that shows how the same event can lead to different thoughts, feelings, and behaviors EVENT THOUGHT FEELING BEHAVIOR Hear the window rattling Someone is breaking into my house Anxious Lock the door, call police Hear the window rattling It is windy outside, it’s the window Slightly irritated Try to tighten the window A man is approaching me I am going to get mugged Terrified Run in a dark, empty street A man is approaching me Is that my friend Steve? Curious, pleased Call out Steve’s name in a dark, empty street My husband is sitting, He doesn’t care about me Angry, resentful Call him self-centered reading the newspaper My husband is sitting, He is relaxing Glad Ask if he wants a drink reading the newspaper

38. Examples of Overlooked Facts Negative Thoughts Other Possible Facts It is raining outside and I’ll Maybe it stopped raining since I never get home on time came in an hour ago I’m not prepared for my exam I have read the material, gone to class and done some work I will always be alone I have friends and a lot of qualities that people like

39. Exercise 1: Lets start with some of your negative thoughts, is there any possibility that you can find another facts related to them? More specifically, facts that might challenge them? Negative Thought Other Possible Facts 1) 2) 3)

40. Exercise 2: Please write the circumstances. 1) The last time you were very upset Description of event : Thoughts: Behavior:

41. Exercise 2: Continued 2) The last time you were very angry Description of event: Thoughts: Behavior:

42. Exercise 2: Continued 3) The last time you were very anxious Description of event: Thoughts: Behavior:

43. Summary At the end of this module What I have achieved from this module? My thoughts might be more responsible for my bad feelings than the events. Event Thought Feeling Behavior

44. What have I found out? The result of my anxiety score?(explanation) The result of depression score?(explanation) The result of my PTSD scores?