PANIC STATIONSPANICSTATIONS

Panic Stations
Module 7
Evaluation and Balanced Thinking
Evaluation and Balanced Thinking

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Thought Diary Example

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Thought Diary

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Following Through7

Reviewing the ABC's and the DEF's

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Module Summary

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About this Module

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Module 7: Evaluation and Balanced Thinking

Page 1PANIC STATIONS: Evaluation and Balanced Thinking
When you challenge your thinking by using the Thought Diary, you describe an Activating Event and you
identify your automatic and unhelpful Beliefs and thoughts (including the Hot Thought) that havecontributed to your experiencing distressing emotions (Consequences). You then use the Disputation
section to challenge your hot thought. This process helps you to start changing how you think to improve
how you feel.
The aim of this Info Pax is to give you information about how you can evaluate your thinking to include
your thought disputation. This will enable you to develop balanced thinking.
Changing your thinking to improve how you feel is not just thinking the opposite of negative thoughts.
Swinging the pendulum to the opposite extreme and being overly positive can sometimes be just as
unhelpful. Instead, it is important to create a balanced thought. Look at this example.
Hot Thought: “I’m going to get so panicky in my new job that I’ll get fired”
Overly Positive Thought
Everything’s going to be fine. As if I’m going to havea panic attack. I won’t even get the slightest bit
anxious, I’ve done this for years. It will be fantastic.
Balanced thought
I might be anxious in my new job, but it doesn’tmean I’ll have a panic attack. Even if I do, I havevaluable skills and experience. Besides, most people
get anxious in new situations.

Outcome: In this case, thinking overly positive
thoughts might lead to unrealistic expectations.
After all, we all get anxious sometimes, so if forsome reason you do get anxious, it is easy to thenfeel disappointed.
Outcome: In this case, thinking in a balanced way
means that even if you do get anxious, you can still
acknowledge your achievements and skills.

As you can see, balanced thinking means Evaluating your thoughts and including the positive and thenegatives – both of which are a part of our everyday lives. Think of yourself as a judge, trying to balance up
the facts of the case, taking into consideration all of the available evidence.
To create a balanced thought, ask yourself, “How can I revise my hot thought to take
into account all the evidence I have listed?” and write down your answer to this question.
This becomes your new, balanced thought. A balanced and helpful thought or belief is
one that takes into consideration all the evidence, objective information, and alternative
viewpoints. This is the fifth step of the ABC analysis – the Evaluation, where you replace
your original, unhelpful thought with this new, balanced, and helpful belief.
After you have written down your new, balanced thought or belief, ask yourself, “How do I feel now?”
Look at the most intense emotion you identified in section C, and re-rate how intense that emotion feels
for you now. Often, you will find that it is not as extreme and distressing. Finally, read through the
Detective Work and Disputation section again, and re-rate how much you believe the hot thought now.
This final step of replacing your unhelpful (hot) thoughts with balanced thoughts is very important.
Challenging your beliefs and evidence testing is the process of change, but the final step is where you MAKE
the change. You’ll probably find that this process becomes easier after some practice. So keep it up. Overthe next two pages, an example of the full Thought Diary (steps A to E) is provided, followed by one that isblank, for your use. Keep practising and remember that you can be your own expert at managing yourmoods!
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Thought Diary (example)
A

Activating Event

B Beliefs

This may be either: An actual event or a situation, athought, a mental picture or recollection.

Walking into the meeting roomat work

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”

CConsequences
1.
2.
3.

Write down words describing how you feel.
Underline the one that is most associated withthe activating event.

Rate the intensity of that feeling (0 to 100).

Panic (90)“I’ll have to run from the roomand they’ll think I’m crazy”
Thought discovery question: “… and what
does this mean?”Stressed (60)“I’m going crazy” (85)

Unhelpful Thinking Styles
1.

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

-

-

-

D

Do you recognise any unhelpful thinking styles you
might have been using? (Mental filter, jumping toconclusions, personalisation, catastrophising, black &white thinking, shoulding & musting, overgeneralisation,labelling, emotional reasoning, disqualifying/ignoring
positives)

Heart pounding,lightheaded, dry mouth,
fast breathing- Catastrophising
walked close to the wall
- Jumping to conclusions –Mind
Left to get a drink of water
reading- Jumping to conclusions Predictive thinking

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PANIC STATIONSMy HOT Thought“I’m going crazy”
FACTUAL EVIDENCE FOR

FACTUAL EVIDENCE AGAINSTMY HOT THOUGHTMY HOT THOUGHT- I feel strange, like I’m not-

The symptoms I have are
due to the fight-flight
response-

I am still able to recognise
how I am thinking-

I have had thesesensations before and it
only takes a little while
before they go down

connected to my body

- I can’t think clearly, mythoughts keep racing

Disputation questions:--E

The symptoms I have are part of a normal fear response. Everybody has
similar sensation s when they are in fight-flight, so it’s unlikely that I am
going crazy.
I’m stressed about the meeting because there’s so much to do before theend of the monthThinking this way adds to my anxiety and then I end up notconcentrating on what people are saying.

End Result
Balanced Thoughts: After looking at all the evidence for and against your hot thought, and having
considered the disputation questions, replace the hot thought with helpful, balanced thought/s.
I might feel a bit strange, but it doesn’t mean I’m going crazy. Many of these
symptoms are common to everyone when they experience fear and anxiety. I’m
stressed about work and that might be why I’m feeling some of these sensations
to begin with. They’re not harmful and they tend to go down after a while
anyway.

Re-rate Emotion: Now, re-rate the emotion you underlined in C, from 0 to 100.

40

Re-rate Hot Thought: Read through Detective Work & Disputation. Now re-rate how much30

you believe the hot thought, between 0 to 100.

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Thought Diary
A

Activating Event

B Beliefs

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

1.
2.

3.

C

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 to 100

Consequences
1.
2.
3.

Write down words describing how
you feel.
Underline the one that is most
associated with the activating event.
Rate the intensity of that feeling (0 to100).

Unhelpful Thinking Styles
1.

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

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Do you recognise any unhelpful thinking styles you might have beenusing? (Mental filter, jumping to conclusions, personalisation,catastrophising, black & white thinking, shoulding & musting,overgeneralisation, labelling, emotional reasoning, disqualifying/ignoring
positives)

Module 7: Evaluation and Balanced Thinking

Page 5PANIC STATIONS
D

Detective Work & Disputation
My HOT Thought

FACTUAL EVIDENCE FOR

FACTUAL EVIDENCE AGAINSTMY HOT THOUGHTMY HOT THOUGHT

Disputation questions:




E

What other ways are there of viewing the situation?
If I were not anxious, how would I view the situation?
Realistically, what is the likelihood of that happening?

How might someone else view the situation?
Does it really help me to think this way?
Think of some helpful self-statements

End Result
Balanced Thoughts: After looking at all the evidence for and against your hot thought, and having
considered the disputation questions, replace the hot thought with helpful, balanced thought/s.

Re-rate Emotion: Now, re-rate the emotion you underlined in C, from 0 to 100.
Re-rate Hot Thought: Read through Detective Work & Disputation. Now re-rate how muchyou believe the hot thought, between 0 to 100.
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Page 6PANIC STATIONS: Following ThroughOften, many people say they can understand the new helpful thought or belief in their minds, but find it
difficult to “feel” it or believe it. They understand that the new belief is balanced and helpful, but at thesame time, are not all that convinced. This is probably because the balanced thought or belief may havebeen newly ’activated’ into the knowledge system, but has yet to be integrated into the person’s belief
system.
This will take time and a bit of practice because you have probably established a habit of thinking in an
unhelpful way, especially when you are anxious. Now is the time to uproot the old habits and establish a
new pattern of balanced and helpful thinking. This process requires that you re-train yourself to think in a
helpful way and continue to practice it until it becomes an unconscious skill. It’s all about repetition,
repetition, repetition. One day, it will feel right and you might not even realise it. Remember how welearned to tie our shoelaces? We kept practising until we were no longer conscious of the way we bring
the laces together and how we tie the bow. Learning to think in helpful ways goes through the sameprocess.
Thought cards
You might want to write out your balanced beliefs on small cards and carry them in your pockets or
handbags so that you can refer to them regularly and in situations where you may become upset or
distressed. Remember that it takes a little time for a new habit to be established. Be persistent inpracticing your new helpful beliefs so that they will be integrated into your belief system. Use the Thought
Diary whenever you feel upset or distressed, and work through the process of identifying, challenging, andchanging your unhelpful beliefs. When you become familiar with this process, you can become better atmanaging your moods.
Turning your thoughts into actions
Another important way of integrating the helpful and balanced thoughts into your belief system is to ACT
ON THEM! This means applying the balanced thoughts to your life and translating them into action. Ask
yourself, “How can I change what I do to reinforce my balanced thoughts?” In the example thatwe’ve been using over the last few modules, the balanced thoughts are: “I might feel a bit strange, but it
doesn’t mean I’m going crazy. Many of these symptoms are common to everyone when they experience fear andanxiety. I’m stressed about work and that might be why I’m feeling some of these sensations to begin with. They’re
not harmful and they tend to go down after a while anyway..” What do you think this person could do to
reinforce their balanced thoughts? Sometimes, taking a look at the consequences (the “C”) might give yousome ideas. For example, they could try to stay in the situation rather than leaving, or perhaps they could
try to walk through to the room without walking close to the wall. If you have completed a thought diary,
you can probably already think of some ideas for yourself.
Following through is especially important if you often avoid doing certain things or avoid certain situations.
Avoidance of actions or situations can maintain and perpetuate anxiety because you never give yourself thechance to show that you can stay in the situation. We will be discussing this further in the modules tocome, but for now try to make small changes that can more strongly reinforce your balanced thoughts.
We’ve worked through a substantial portion of how you can change your thinking to combat social anxiety.
Now, just keep going. Follow through. Keep reviewing and practising those helpful and balanced
thoughts AND act on them!
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Reviewing the ABC’s – and the DEF’s
We’ve spent quite a while on looking at all the different components of how thoughts influence feelings,
and how you can start changing your thoughts to change your feelings. It might be useful to review thisprocess now, and summarise all the new steps that you’ve learnt. Below is an outline of the general steps
you need to take in order to replace unhelpful thoughts with more balanced thoughts.
STEP 1. Recognise the activating event and the consequences (“A” & “C”)
The very first step in being able to manage your feelings is to initially recognise when you are experiencing
a strong feeling and to be able to name the feeling. It also means recognising what kinds of situations
activate the whole thinking-feeling process and what kinds of consequences result.
 Activating events are an objective “snapshot” of the situation, with facts only – not beliefs or feelings.
 Activating events include situations and events, but also memories and thinking about something.
 Consequences include emotions especially (there could be more than one), as well as physicalsensations and behaviours.
 In the thought diary, underline the strongest emotion, then rate the intensity between 0-100.
STEP 2. Identify the thoughts and beliefs (“B”)
Now that you know what you are feeling it is necessary to identify what you are saying to yourself or
thinking. These are your beliefs, and you usually need to slow down your thinking and look at what’s goingon beneath the surface thought to get a good idea of how your thinking is influencing your feeling.
 Use the unhelpful thought discovery questions to get at the underlying thoughts (eg “what is so bad
about that?”) In the thought diary, underline the “hot thought” – the thought that relates most to the strongest
emotion – and rate how much you believe the thought between 0-100.
 Identify any unhelpful thinking styles that relate to the unhelpful thoughts.
STEP 3. Do some detective work and disputation to weigh up the evidence (“D”)
Okay, so now you have identified the beliefs, and the “hot thought” that is producing the intense feeling.
Now the next very important step is to do some detective work and disputation, examining the evidence
for and against what you are thinking.
 Identify what evidence there might be for the hot thought Ask yourself the disputation questions, such as looking at things from a different perspective, assessing
the realistic probability of things, and making sure your not missing the positives.
 Challenge the unhelpful thinking styles
STEP 4. Replace the unhelpful thought with a balanced thought (“E” and “F”)
Now that you have thoroughly evaluated all of the evidence, you are in a position to generate a morebalanced thought. Rather than being unrealistically positive, a balanced thought is a thought that takes into
consideration the evidence that does and does not support your hot thought.
 Incorporate aspects of the evidence for and against the hot thought that can contribute to a helpful,balanced thought.
 In the thought diary, re-rate what was your most intense emotion between 0-100.
 In the thought diary, re-rate how much you believe in your hot thought between 0-100.
 Try to strengthen your new balanced thought by using thought cards or finding ways to turn yourthoughts into actions.

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Page 8PANIC STATIONSModule Summary•

After completing A to D, ask yourself, “How can I revise my hot thought to take into
account all the evidence I have listed?” Then, write out an alternative explanation, whichbecomes your new, balanced thought•

A balanced thought or belief is one that takes into consideration all the evidence, objective
information, and alternative viewpoints•

Replace your original, unhelpful hot thought with this new, balanced, and helpful belief•

Integrating balanced beliefs into your system takes practice and repetition•

You could write out your balanced beliefs on cards and refer to them regularly and insituations where you may become upset or distressed•

Integrating helpful and balanced thoughts into your belief system also requires you to act
on them – applying them to your life and translating them into action•

In reviewing the ABCDEF process, there are a number of steps to follow
1. Recognise the activating event and the consequences (“A” & “C”)
2. Identify the thoughts and beliefs (“B”)
3. Do some detective work and disputation to weigh up the evidence (“D”)
4. Replace the unhelpful thought with a balanced thought and act according to thatthought (“E” and “F”)

In the next module, we will
discuss how to challenge
strongly-held thoughts andbeliefs that seem particularly
hard to let go of.

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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 Panic
Disorder 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.
Barlow, D.H. (2002). Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic (2nd Edition).
London: Guilford Press
Craske, M.G., & Barlow, D.H. (2001). Panic disorder and agoraphobia. In D.H. Barlow (Ed.), Clinical Handbook
Of Psychological Disorders, Third Edition. New York: Guilford Press.

FURTHER READING
There have been many other information resources written for people with panic attacks and panic
disorder.
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 (2nd
Edition). 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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