Thoughts and Feelings: Taking Control of Your Moods and Your Life

314 Pages·2011·5.63 MB·English

by  Matthew McKay

“Chock-full of systematic strategies for the treatment of a wide variety
of psychological problems. Eminently readable and helpful for
professionals as well as patients.”
—Aaron T. Beck, MD, president of the Beck Institute for Cognitive
Therapy and Research Psychopathology
“An outstanding book. I recommend it without reservation for both
general readers and therapists. It stands apart from other similar books in
its reliance on scientific data, not fad, hype, or mysticism.”
—Jacqueline B. Persons, PhD, director of the San Francisco Bay Area
Center for Cognitive Therapy and clinical professor in the Department
of Psychology at the University of California, Berkeley “An excellent
resource, reference tool, treatment manual, therapy coach, and
compendium of techniques.”
—Arthur Freeman, EdD, ABPP, HSPP, president of the Freeman
Institute for Cognitive Therapy and director of clinical training and
supervision for the Center for Brief Therapy in Fort Wayne, IN
“One of the most comprehensive and empirically sound guidebooks in
all of self-help literature. All of the major problems in living are
covered.”
—Cory F. Newman, PhD, clinical director of the Center for Cognitive
Therapy and associate professor of psychology in psychiatry at the
University of Pennsylvania “For professionals and the public, this
wonderful workbook, like a wise teacher, can help make a positive
difference.”
—Thomas F. Cash, PhD, professor emeritus of clinical psychology at
Old Dominion University in Norfolk, VA “A jewel of a book:
supportive and empathetic, short on platitudes and long on practical
applications. A must-buy for all cognitive behavioral therapists.”
—Thomas E. Ellis, PsyD, ABPP, professor of psychology at Marshall
University in Huntington, WV

Publisher’s Note

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with
the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If
expert assistance or counseling is needed, the services of a competent professional should be sought.

Distributed in Canada by Raincoast Books
Copyright © 2011 by Matthew McKay, Martha Davis, and Patrick Fanning New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com

All Rights Reserved Epub ISBN: 9781608822102

Acquired by Melissa Kirk; Cover design by Amy Shoup; Text design by Tracy Marie Carlson; Edited by Jasmine Star
The Library of Congress has Cataloged the Print Edition as: McKay, Matthew.
Thoughts and feelings : taking control of your moods and your life / Matthew McKay, Martha Davis, and Patrick Fanning. -- 4th ed.
p. cm.
Includes bibliographical references and index.
ISBN 978-1-60882-208-9 (pbk.) -- ISBN 978-1-60882-209-6 (pdf e-book) -- ISBN 978-1-60882210-2 (epub) 1. Cognitive therapy--
Popular works. I. Davis, Martha, 1947-II. Fanning, Patrick. III. Title.
RC489.C63M34 2011
616.89’1425--dc23
2011035736
Dedicated to all the researchers and clinicians who have shown us what works.
Contents
Preface to the Fourth Edition
Acknowledgments
How to Use This Book
1: MAKING YOUR OWN TREATMENT PLAN
2: UNCOVERING AUTOMATIC THOUGHTS
3: CHANGING PATTERNS OF LIMITED THINKING
4: CHANGING HOT THOUGHTS
5: RELAXATION
6: WORRY CONTROL
7: COPING WITH PANIC
8: COPING IMAGERY
9: MINDFULNESS
10: DEFUSION
11: GETTING MOBILIZED
12: PUTTING VALUES INTO ACTION
13: BRIEF EXPOSURE
14: PROLONGED EXPOSURE
15: TESTING CORE BELIEFS
16: CHANGING CORE BELIEFS WITH VISUALIZATION
17: STRESS INOCULATION FOR ANGER CONTROL
18: COVERT MODELING
19: COVERT SENSITIZATION
20: PROBLEM SOLVING
21: WHEN IT DOESN’T COME EASY
References and Resources
Preface to the Fourth Edition
The first edition of Thoughts and Feelings appeared in 1981. It was an
introduction to cognitive behavioral therapy that was used by general readers
and therapists alike. It provided simple, step-by-step instructions for a dozen
specific techniques.
Over the years we came to realize the book’s limitations. To begin with,
some of the techniques had not stood the test of time. Later studies had shown
them to be less effective than newer, more powerful interventions. In addition,
although cognitive behavioral therapists were developing multistep protocols to
treat many disorders, the original edition of Thoughts and Feelings didn’t show
how to link a series of techniques together into an integrated treatment plan for
problems like depression, panic disorder, or anger.
With the second, third, and now fourth editions of Thoughts and Feelings,
the book has been revised to include more effective methodologies and reflect
changes in modern practices. Thoughts and Feelings now offers multistep
treatment plans for many mood-based problems. These plans are outlined in
chapter 1 to show you a sequence of relevant chapters and techniques for each
disorder. This is consistent with the way cognitive behavioral treatments are
conducted during therapy: You take a series of steps to acquire skills that serve
as building blocks in coping with problems.
For this edition, we have removed the chapter on thought stopping, a
technique that in recent years has been shown to be of little value. We replaced it
with a new chapter on defusion, a powerful technique now used in the third
wave of behavior therapies as a core treatment. Defusion has impressive research
support for helping manage anxiety, depression, and anger. We have also
removed the chapter on coping during exposure, because experience has shown
that relaxation techniques and coping thoughts work best when used before and
after exposure, not during exposure.
Two chapters have been significantly revised and renamed in light of current
research: “Flooding” has become “Prolonged Exposure,” and “Stress
Inoculation” has become “Brief Exposure.” Finally, the chapter “Getting
Mobilized” is now followed by a new chapter, “Putting Values into Action,”
which stresses the consistent application of values to life goals.
In the second and third editions of Thoughts and Feelings, we sacrificed a bit
of logic in order to keep the chapter numbering system consistent with the first
edition, and thus reduce confusion in classrooms where students were using
various editions. However, the cumulative changes since 1981 have finally
necessitated a complete rearrangement of the table of contents so that the most
basic skills are taught first, the more widely used interventions appear earlier,
and the less common techniques or treatments for rarer diagnoses appear later in
the book.
Our intention is still for both the general reader and the therapist to use this
book. The general reader will find that each treatment protocol has clear, easy-
to-follow steps that provide tools for genuine self-help. Therapists will find the
book to be a resource for the most effective treatment methods, as well as a
helpful take-home manual for clients.
Thoughts and Feelings was written because life is hard. To cope, all of us
have been given a random set of tools and instructions by parents, family,
friends, teachers, bosses, and others. Some of this has been helpful, some not.
Thoughts and Feelings is about tools that work. It is a guide for changing old
patterns of responding in order to take control of your moods and your life.
—Matthew McKay
—Patrick Fanning
—Martha Davis
Acknowledgments
Grateful acknowledgment is made to Norman Cavior, PhD, our teacher, and the
one who first introduced us to cognitive behavioral techniques. He continues to
be a source of wisdom and inspiration.
We also wish to acknowledge three fine writers who made significant
contributions to the second edition: Mary Hills Hoffman, Dana Landis, and
Susan Johnson.
How to Use This Book
We’ve chosen to present cognitive behavioral techniques in a workbook format
so you can practice them as self-help steps toward change. People in the helping
professions—therapists, doctors, nurses, social workers, even teachers and
supervisors—will find many of these techniques useful in their personal lives,
and also of value to clients, patients, students, or employees.
In chapter 1 you’ll find a list of twelve major problems and a specific, step-
by-step treatment plan for each of them. The treatment plan will give you the
sequence in which to work through relevant chapters and techniques. At the end
of chapter 1 is the Treatment Planner chart, which gives an overview of which
chapters you should read to treat these and a few other problems.
In most cases you’ll find it helpful to read chapters 2, 3, and 4 first, because
they represent the foundation of cognitive behavioral therapy. You’ll learn how
thoughts influence feelings and how habitual negative thoughts can impact your
mood. You’ll also find tools for changing your thoughts in order to relieve
anxiety, depression, and anger.
The full benefits of cognitive behavioral therapy can be realized only
through regular practice over time. Simply understanding a technique is of little
value without firsthand experience. In other words, this is not a book for passive
reading. You have to do the exercises, fill in the worksheets, and carry out real
changes in how you think and behave.
The length of time required to practice a particular technique will vary. See
the “Time to Mastery” sections for an idea of the time required to develop each
new skill. Because regular practice is the key to successful change, practice the
exercises daily. Some of the techniques will need to be “overlearned” so they
become automatic responses. The goal is to be able to use the techniques
wherever and whenever you need to, without having to refer to the book.
If you feel you have limited self-discipline or are not highly motivated, try
these two alternatives:
1. Make a contract with another person, as described in chapter 21, to
reinforce your commitment to learning and using the relevant techniques
in this book.
2. Seek a consultation with a cognitive behavioral therapist to help you