PANIC STATIONSPANICSTATIONS

Panic Stations
Module 4
The ABC's of Thinking and Feeling
Introduction

2

Learning some new ABC’s

2Analysing Your ABC's

3

How to Uncover Unhelpful Thoughts

4

Clarifying the A’s, B’s, and C’s

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The Thought Diary

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Module Summary

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About this Module

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Module 4: The ABC's of Thinking and Feeling

Page 1PANIC STATIONSIntroduction
So we have seen that thinking affects how we feel about things. If we are feeling happy and excited, chancesare, we have been thinking positive thoughts and about positive things. On the other hand, if we are feelinganxious, depressed, and upset, it is likely that we have been thinking negative thoughts. We call theseunhelpful thoughts (simply because they lead to unpleasant feelings or unhelpful actions!).
The aim of this InfoPax module is to further explore how thoughts can influence feelings by looking moreclosely at the thought process in relation to particular events. By looking more closely at this process inyour own life, you can begin to learn about the steps you can take to improve how you feel.

Learning some new ABC’s
All of us, at times, think things that make us feel sad or anxious, and that is a normal part of life. However,
if you often feel distressed or anxious, you might need to examine your thinking to improve how you feel.
To do that, let’s start by learning about a new set of ABC’s.
The “A” part of the ABC is the “Activating event”. It is the event or situationthat “activates” how we think and feel about something.
The “B” part of the ABC refers to “Beliefs”. In the previous module, we talked
about how our thoughts and beliefs influence our emotions about a situation. If
we think about a situation in different ways it leaves us feeling in different ways.
The “C” part of the ABC refers to “Consequences”. As we talked about, one type of consequence ishow our beliefs lead to us feeling a particular way about a situation. Another consequence of thosethoughts might be physical symptoms such as heart pounding, or sweating.
If unhelpful thoughts lead to distressing emotions, then it might be quite reasonable to say that the mosteffective thing to do is to change those unhelpful thoughts to helpful ones! So, how can you do that? To
start influencing the way you feel, you need to learn to be aware of, and “capture,” those unhelpful
thoughts and beliefs, with the ultimate aim of changing them. To do that, let’s start with doing an ABC
analysis.

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Analysing your ABC’s
When you’re analysing the ABC process, it helps to write it all down. Have you ever noticed that whenyour thoughts and feelings “swim” around in your head, it can get quite confusing? Writing down what
happened helps to clarify your thoughts and feelings, and how they are connected.
The ABC analysis begins with identifying the activating event. Simply write down anevent or a situation in which you experienced a strong negative emotion, such as,anxiety. Record the situation the same way a video camera might record — just thefacts. This may be either an actual event or situation leading to unpleasant feelings, suchas “Walking through the shopping centre”. It may also be a mental picture orrecollection, leading to unpleasant feelings, such as, “Remembering the last time that I
had a panic attack”. Do not include your thoughts about why the situation occurred,
who was responsible and how you felt about it. Just describe the event simply, withoutany ‘frills.’
Now, because how you respond to a situation can stand out clearly, the next step is toidentify the consequences. This includes
1. Your feelings. Write down the words that best describe your feelings. When you
have written down these words, rate the intensity of the emotion from 0 to 100.
The higher the number, the more intensely you felt the emotion. Now, have alook at all those feelings and then choose the feeling that best represents
the emotion you actually felt at the time and underline it.
2. Your physical symptoms. Physical symptoms are a primary concern for people with panic, so record thephysical reactions that you notice, such as heart racing, breathlessness, sweating, and so on.
3. Your actions/behaviour. You may also want to note any actions that you carried out, for example, if you
were using safety behaviours, or if you left the situation.
Now, keeping in mind the situation and the feelings you experienced, identify your‘Beliefs’ or thoughts, expectations, perceptions, and attitudes. Beliefs and thoughts arebest described as “self-talk”, or what you say to yourself in response to a situation orevent. Write these thoughts down. Ask yourself:•“What was I thinking of when the event occurred?”•“What was going through my mind at the time?”

When you have completed this task, read through each statement and then underline thethought that is most associated with the primary emotion you felt during the ‘A‘. We’ll now
call it your hot thought. Now rate how much you believe this thought on a scale from 0 to 100.
Let’s look at an example. Imagine you are walking through a shopping centre and you start to feel anxious.
To do an ABC analysis, you might ask yourself, "How am I making myself anxious? What am I thinking?"
You might identify a thought such as, "I don’t want to be here." If you only had this thought, you’d probably
not experience a strong emotion but only feel mildly anxious. If you do experience a strong emotional
response to this thought, it probably indicates that there are other thoughts underlying this thought.
Therefore, the thought, "I don’t want to be here" is only an initial thought, and you would need to discoverwhat other unhelpful thoughts were present to invoke such a strong emotional response.
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PANIC STATIONS

How to Uncover Unhelpful Thoughts
By asking yourself a number of questions, you can uncover any other unhelpful thoughts underlying an initialthought. Let’s use the example of walking through the shopping centre to identify the unhelpful thoughts
underlying the initial thought "I don't want to be here." The following is a description of the thoughts thatmight be going through your head as you uncover other unhelpful thoughts. The questions in bold are yourunhelpful thought discovery questions.

"I don't want to be here".
"I don't want to be here because…""I can feel my heart beating harder and harder”"…and that is bad because…""It will beat so hard I’ll have a heart attack!”"…and what will that mean?…
"… Nobody will know how to help me"…and what will happen then?
"…..I’ll be left there to die!”Your task is to become an expert at identifying your unhelpful thoughts. Sometimes, one or two thoughts
might not represent the other unhelpful ones you might have had. As such, to get to those other thoughts,
you might need to ask some of the following questions, called Thought Discovery Questions:“What is bad about that?”“What is it that I see happening in this situation?”“What am I concluding about myself or others in this situation?”“… and that is bad because …”“… and what does this say about me …?”

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It is best to be as specific as you can, even if you think that some of your unhelpful thoughts sound silly orembarrassing when you think about them. Discovering your unhelpful thoughts, no matter how silly theysound, is important in learning how to better manage your mood.
After you have done this, we will tackle the issue of where we go from here. At this point, it is importantthat you understand how to identify your feelings and thoughts surrounding a particular situation, especially
one in which you experienced unhelpful emotions. Unhelpful, or disturbed emotions are those that elicit astronger physiological reaction in your body, such as a tightness in the chest associated with anxiety, or an
increase in blood pressure associated with anger. Emotions such as depression, guilt, fear, rage, andanxiety, may also lead to avoidance and destructive behaviours towards yourself and others, They may
obstruct appropriate problem solving behaviours, and may cause long term physiological (e.g., hypertension
and heart disease) and psychological harm (e.g., psychiatric problems).
Doing the ABC analysis is taking the first step toward learning how to manage your mood (includinganxiety) and helping yourself feel better. Here’s an example of an ABC analysis recorded on a Thought
Diary:Thought Diary (example)
A

Activating Event

B

This may be either: An actual event or asituation, a thought, a mental picture orrecollection.

Walking to the meetingroom at work

CConsequences
1. Write down words describing how you feel.
2. Underline the one that is most associatedwith the activating event.
3. Rate the intensity of those feelings (0 to 100).

Panic (90)Stressed (60)1.

Jot down any physical sensations you
experienced or actions carried out.

- Heart pounding,lightheaded, dry mouth,
fast breathing- walked close to the wall
- Stopped for waterBeliefs
1.

List all statements that link A to C. Ask
yourself: “What was I thinking?” “What was I
saying to myself?” “What was going throughmy head at the time?”
2. Find the most distressing (hot) thought andunderline it
3. Rate how much you believe this thought
between 0 to 100.

“I can’t breathe – I’m going tosuffocate “
I’m going to have an attack infront of everyone”“I’ll have to run from the roomand they’ll think I’m crazy”
Thought discovery question: “… and what
does this say about me?”

“I’m going crazy” (85)At the end of this module is a Thought Diary for you to start doing an ABC analysis and recording yourunhelpful thoughts. When you’re completing the thought diary it may be handy to take another look at
those Thought Discovery Questions to try to really pinpoint which unhelpful thoughts are most connectedto those strong emotions. Before you do that though, let’s clarify the ABC’s.

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Page 5PANIC STATIONSCLARIFYING THE A’S, B’S AND C’S.

When you are first starting to try to break down an anxious experience into the components of A, B, andC, it can be easy to confuse them. We frequently talk about thoughts and feelings as though they are thesame sort of experience: “I feel like you don’t pay me enough attention”, instead of separating them: “Ithink that you don’t pay me enough attention, and I feel hurt about that”. Also, it is quite common for athought or a memory to be an activating event or situation. For example, thinking about catching public
transport (A) might lead to thoughts about having a panic attack (B), which then leads to anxious feelings(C). The following exercise can help you to clarify what are activating events, thoughts and emotions.

Is it a Situation, Thought or Emotion?
Situation, Thought or Emotion?
1.

Nervous2.

Catching the bus to work

3.

Something terrible is going to happen

4.

Planning an upcoming event

5.

They’ll think I’m weird

6.

Panic

7.

There’s no way this is going to work out

8.

Anxious9.

Shopping for my groceries

10. Fearful
11. Remembering the conversation with my workmate
12. Irritated
13. This shouldn’t be happening
14. Thinking about meeting friends at a cafe
15. I’m going crazyforCentrelinical
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Thought Diary
A Activating Event

B Beliefs

This may be either: An actual event orsituation, a thought, mental picture orrecollection.

1.
2.

3.

List all statements that link A to C. Ask yourself:“What was I thinking?” “What was I saying to myself?”“What was going through my head at the time?”
Find the most distressing (hot) thought and underline it
Rate how much you believe this thought between 0 to100.

C Consequences
1. Write down words describing how youfeel.
2. Underline the one that is most associatedwith the activating event.
3. Rate the intensity of those feelings (0to 100).

1.

Jot down any physical sensations you
experienced or actions carried out.

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Page 7PANIC STATIONSModule Summary•

Assessing the thinking-feeling connection involves analysing the ABC's of thinking andfeeling. In this process, A stands for "Activating Event", B stands for "Beliefs" and C stands
for "Consequences". The ABC analysis assesses how you feel and what you think inparticular situations by using a thought diary, and following these steps:•Activating Event: The ABC analysis begins with writing down an event or a situationin which you experienced a strong negative emotion, such as, anxiety. Record thesituation the same way a video camera might record — just the facts.

•Consequences: This often stands out most clearly, so write down the consequences
or what happened next. This includes writing down what physical symptoms you
experienced, your actions and behaviours in the situation and what emotions/feelings
you experienced. This includes underlining and rating the intensity of the emotion thatbest represents what you felt at the time - the primary emotion.

•Beliefs: Finally, the ABC analysis explores the thoughts that led to these feelings. This
includes writing down beliefs and thoughts, such as what was going through your mind
at the time. It is important to identify the hot thought, which is the thought most
associated with the primary emotion, by underlining it and rating how much you
believe that thought.

•Sometimes hot thoughts underly initial thoughts. By asking yourself some thought
discovery questions, you can uncover any other unhelpful thoughts. These questions
include asking yourself “What is bad about that?” and “What is it that I see happening inthis situation?” and “… and that is bad because …”.

•It is also important to clarify what is an activating event, what is a belief, and what is aconsequence, such as feelings.

•Using your thought diary to analyse the ABC's surrounding situations in which you havefelt anxious is the beginning of learning to change how you feel in those situations.

In the next module we will
look more closely at ourthought patterns – or what
we might call “unhelpfulthinking styles”.

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About This Module
CONTRIBUTORSPaula Nathan (MPsych1)
Director, Centre for Clinical Interventions
Adjunct Senior Lecturer, School of Psychiatry and Clinical
Neuroscience, The University of Western Australia
1Masters of Psychology (Clinical Psychology)

Dr Louella Lim (DPsych2)
Centre for Clinical Interventions
Dr Helen Correia (MApp Psych1; PhD)
Centre for Clinical Interventions

2Doctor of Psychology (Clinical)

Some of the material in this module was taken fromNathan, P.R., Rees, C.S., Lim, L., & Smith, L.M. (2001). Mood Management – Anxiety: A Cognitive Behavioural
Treatment Programme for Individual Therapy. Perth: Rioby Publishing.

BACKGROUND
The concepts and strategies in this module have been developed from evidence based psychologicalpractice, primarily Cognitive-Behaviour Therapy (CBT). CBT for panic disorder is a type of psychotherapy
that is based on the theory that panic disorder is a result of problematic cognitions (thoughts) andbehaviours. There is strong scientific evidence to support that cognitions and behaviours can play animportant role in panic disorder, and that targeting cognitions and behaviours in therapy can help many
people to overcome panic disorder. Examples of this evidence have been reported in the following:
Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for PanicDisorder and Agoraphobia. (2003). Australian and New Zealand clinical practice guidelines for thetreatment of panic disorder and agoraphobia. Aust N Z J Psychiatry, 37(6), 641-56.

REFERENCES
These are some of the professional references used to create this module.
Craske, M.G., & Barlow, D.H. (2001). Panic disorder and agoraphobia. In D.H. Barlow (Ed.), ClinicalHandbook Of Psychological Disorders, Third Edition. New York: Guilford Press.

FURTHER READING
There have been many other information resources written for people with panic attacks
Barlow, D. H., & Craske, M. G. (2000). Mastery of your anxiety and panic (3rd edition). San Antonio, TX:
The Psychological Corporation. (ISBN: 0127850783)
Royal Australian and New Zealand College of Psychiatrists. (2003). Panic Disorder and Agoraphobia:
Treatment Guide for Consumers and Carers. Available: http://www.ranzcp.org/publicarea/cpg.asp (clickon “Panic Disorder and Agoraphobia”). Accessed Feb. 2004.
Zuercher-White, E. (1998). An End To Panic: Breakthrough Techniques For Overcoming Panic Disorder (2ndEdition). Oakland, CA: New Harbinger Publications. (ISBN: 1567313760)“PANIC STATIONS”
We would like to thank Uta Juniper for the title of the InfoPax that this module forms part of:Nathan, P., Correia, H., & Lim, L. (2004). Panic Stations! Coping with Panic Attacks. Perth: Centre for ClinicalInterventions.
ISBN: 0-9751985-8-0 Created: June, 2004.
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