ADHD in Adults: A Psychological Guide to Practice by Susan Young & Jessica Bramham

Author:Susan Young & Jessica Bramham
Language: eng
Format: mobi
Tags: # Paperback: 318 pages, Clinical Psychology, Psychology, General
ISBN: 9780470012321
Publisher: Wiley
Published: 2006-11-01T22:00:00+00:00

Figure 9.1 Anxiety

spiral

START

I’ve got to

get out of

here

SITUATION

SITUATION

‘Here I am in a situation where

I usually get worried and upset,

(e.g. job interview, presentation

BEHAVIOUR

to colleagues, socialising at a

PANIC, RUN, ESCAPE,

party).’

HELP!

First symptoms of anxiety

begin, e.g. stomach churns, dry

mouth

PANIC

ATTACK!

THOUGHTS

THOUGHTS

‘It’s just as I thought. I’m starting

FEELINGS/PHYSICAL

FEELINGS/PHYSICAL

to get anxious. I won’t be able to

SYMPTOMS

SYMPTOMS

do this properly. People will

‘Oh, dear, I feel really terrible

think I’m stupid.’

now. I feel ill, I’m going to

faint, be sick, have a heart

attack. This will cause a scene.’

THOUGHTS

THOUGHTS

‘I can’t cope when I get

More symptoms of

anxious. I don’t know

anxiety, e.g. palms

what to say. I always do

clammy, heart racing

the wrong thing.’

Figure 9.2 Thought bubble anxiety spiral

ANXIETY

THOUGHTS

BEHAVIOUR

FEELINGS

Figure 9.3 The three-legged anxiety table

ANXIETY 159

something over which has created the crash, they may feel less frightened, go and

pick up the object and go back to sleep. Thus, different thoughts in the same situation

lead one to experience different feelings and to carry out different behaviours.

Negative, anxiety-provoking thoughts are diffi cult to identify for a number of rea-

sons. They are habitual and fl ash through everyone’s minds without us even realising.

They are automatic and occur without effort, and some thoughts further perpetuate

anxiety, for example:

• ‘I’m going to make a fool of myself’ (anticipation)

• ‘I can’t cope with this anymore’ (‘I-can’t-stand-it-itis’)

• ‘I can’t breathe, I’m choking’ (misinterpretation of body reactions)

• ‘I’ve got to get out of here’ (thoughts of escape).

A common technique that has been shown to be useful to help clients identify nega-

tive thoughts is keeping a ‘thought diary’. This is a record of the situation they were

in, what was going through their mind at the time and how they were feeling. These

feelings can then be rated for how much they believe in them. An example is pro-

vided in Table 9.3 for an individual who was having diffi culties at work, who is feel-

ing under pressure from their employer to meet a deadline and also having social

anxiety regarding socialising with colleagues. A blank version is provided on the

Companion Website.

Once the individual has learned to apply cognitive techniques to challenge negative

thoughts, the diary can also be used to record the challenges and then re-rate how

much they believe in them. Using this method, the client will be able to evaluate the

success of their cognitive challenges demonstrated by a weakening in their belief

system. Table 9.4 provides an example of negative challenges and a blank version is

provided on the Companion Website.

Table 9.3 Example of a thought diary

Time

How much do

and date

Situation

Feelings

Thoughts

I believe this?

Mon 4th

Getting ready Feeling jittery I wil never survive

40%

8.15 am

for work

and a bit sick

this week

Boss asks to

Mon 4th

I’m going to be

see me in his Terrified

50%

10.15 am

fired

office

Going to

Tues 5th

Feeling out of I’ve got nothing

pub with

70%

6.15 pm

place

to say

col eagues

Wed 6th

Deadline is

I can’t do this.

Complete panic

50%

12.00 pm

end of day

It’s all over

Table 9.4 Example of negative challenges in a thought diary

How much

How much do

do I believe

I believe the

Time and date

Situation

Feelings

Thoughts

this?

Cognitive Challenge

thought now?

Mon 4th

Getting ready for Feeling jittery I wil never

40%

I felt like this last

20%

8.15 am

work

and a bit sick survive this

Monday and got through

week.

the week

Mon 4th

Boss asks to see

Terrified

I’m going to

50%

I don’t know for sure I’l

20%

10.15 am

me in his office

be fired

be fired.

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