Lecture 6 & 7
Mental Relaxation
Part I & II
Dr. Paul Wong D.Psyc.(Clinical)
E-mail: paulw@hku.hk
Centre for Suicide Research and Prevention (CSRP)
Outline

A small summarization of the last few lectures

Introduction of a research on relation between automatic
thoughts and level of stress

The Cognitive approach to external stressor in daily life - ABC
model

Mental relaxation

“Questioning your thoughts” exercise – with a little extra more
work
In English
Stress is the reaction people have excessive
pressures or other types of demand placed
upon them. It arises when they worry that they
can’t cope.
Essential Components of Stress
External
Stressors
Behavioural Reactions
e.g., aggression, escape
e.g., demand at work,
relationship breakup
Cognitive
Processes
e.g., appraisal of
threat,
expectations of
coping or not, and
consequences
Emotional
Reactions
e.g., anxiety
Physiological Reactions
e.g., insomnia, increase heart rate,
increase blood pressure
A little recap:
Sources of Stress
External
Internal
External Stressors

Physical Environment (Noise, Bright Lights, Heat, Confined
Spaces)

Social Interaction (Rudeness, Bossiness, Aggressiveness by
others, Bullying)

Organizational (Rules, Regulations, Deadlines)

Major Life Events (Birth, Death, Lost job, Promotion, Marital status
change)

Daily Hassles (in-class exercise – Sarafino & Ewing (1999) –
Hassles Assessment Scale for Students in College)
Internal Stressors

Negative self - talk (Pessimistic thinking, Self criticism, Over
analyzing)

Mind traps/Thinking errors (Unrealistic expectations, Taking
things personally, All or nothing thinking, Exaggeration,
Rigid thinking)

Personality traits (Perfectionists, Workaholics)
Types of Stress

Negative stress (dy-stress)

Positive stress (eu-stress)
Note:
Most of the stress we experience is selfgenerated. How we perceive life - whether an
event makes us feel threatened or stimulated,
encouraged or discouraged, happy or sad depends to a large extent on how we perceive
ourselves.
Introduction
 Stress is subjective
 Cognitive interpretations of stressor directly affect
level of stress
Negative Automatic Thoughts (NATs) – are likely to be
the causes of stress
What research told us?

Methodology

Subjects: 197 male and 283 female

Automatic Thoughts Questionnaire – Positive (ATQ-P)
•

e.g. “I am a lucky person”, “Life is exciting”
Automatic Thoughts Questionnaire – Negative (ATQ-N)
•
e.g. “I am a loser”, “I am no good”
Source:
Ingram, R.E., & Wisnicki, K.S. (1988). Assessment o positive automatic
cognition. Journal of Consulting and Clinical Psychology, 56, 898-902.
Result
Depressed
Mildly Depressed
Non-Depressed
Measure
Mean
SD
Mean
SD
Mean
SD
ATQ-P
83.08
15.78
95.56
18.63
107.15
18.55
ATQ-N
71.08
16.24
71.13
18.71
53.01
15.00
Note:
For ATQ-P, the higher the score the higher level of positive thinking
For ATQ-N, the higher the score the higher level of negative thinking
Source:
Ingram, R.E., & Wisnicki, K.S. (1988). Assessment of positive automatic
cognition. Journal of Consulting and Clinical Psychology, 56, 898-902.
ATQ-P versus depression
90
60
30
0
non-depressed
mildly depressed
depressed
level of depression
ATQ-N versus depression
80
level of NATs
level of PATs
120
60
40
20
0
non-depressed
mildly depressed
level of depression
depressed
Discussion

The ABC model of Ellis’s theory
A : the activating event
B : the individual’s belief
C : the response or consequence
A
B
C
Cognitive appraisal varies from person to person
 different stress level facing the same event
Source:
Gillis, J.S. (1992) Stress, Anxiety, and Cognitive Buffering. Behavioral Medicine, 18(2), 79-83
Discussion
A
B
C
Stressor
Automatic thoughts
Stress level
Conclusion of this research

Positive Automatic Thoughts (PATs) act as a stress buffer

Negative Automatic Thoughts (NATs) exaggerate effects of stress

Possible solution:
•
Thinking from a different perspectives
Reference




Gillis, J.S. (1992) Stress, Anxiety, and Cognitive Buffering. Behavioral
Medicine, 18(2), 79-83.
Ingram, R.E., & Wisnicki, K.S. (1988). Assessment of positive automatic
cognition. Journal of Consulting and Clinical Psychology, 56, 898-902.
Lightsey, O.R. (1994) “Thinking Positive” as a Stress Buffer: The role of
positive automatic cognitions in depression and happiness. Journal of
Counseling Psychology, 41(3), 325-334.
Taylor, S. E. (1995). What is stress? In S. E. Taylor (Eds.), Health
Psychology (pp.219-254). Singapore: McGraw-Hall.
Mental Relaxation
Rationale

Relaxation is one of the popular approaches to stressmanagement, but people do tend to focus on physical relaxation

Physical relaxation is helpful because “it makes people feel good
at the time”

However, “I feel wonderful at my yoga class, but once I go back
to my home, I feel tense and worry again!!”
External Stressors
Behavioural Reactions
Cognitive
Processes
Emotional Reactions
Physiological Reactions
Caution:
 We don’t need to practice this mental
relaxation every time when we are sad or
upset,
 But, we use it when we have very strong and
prolonged bad feelings
 Thus, our target in mental relaxation is
exaggerated bad feelings.
Six Steps in Mental Relaxation
1. Get in touch with your feelings
2. Accept that you can cope with bad feelings
3. Reward your successes
4. Try to identify your self-talk
5. Test your self-talk
6. Teach yourself to think rationally
First three steps vs. last three steps
 The first three steps we do them on the spot to
help us cope with our bad feelings there and
then;
 Whereas, the last three steps we do them
later, when we have the time to review the
situation, as to prepare ourselves to cope
better in the future.
1. Get in touch with your feelings
 This can be trickier than it looks
•
i.e., men tend to deny bad feelings because men
should be tough and can take on any sufferings,
right?!
•
It is easy to mix up “feeling” and “thought”
•
- “I feel nervous” vs. “I feel that I am going to fail
the exam”
•
Then give yourself a rating from 0-100% of how
intense is the feeling
List of common bad “feelings”

Angry

Fearful

Frustrated

Down

Upset

Depressed

Hurt

Bitter

Disappointed

Disgust

Hopeless

Restless

Regret

Embarrassed

Mad

Jealous

Unhappy

Envious

Worried

Anxious

Confused

Guilty

Tense
2. Accept that you can cope with bad
feelings
“I just can’t cope”, “I have no choice”, “I can’t hold it anymore”
etc.
We are talking about “feelings” here, not the cause/stressor yet.
A general coping statement which we can tell ourselves:
“I expect to feel (feeling) (in a situation) but I can cope with
feeling (that feeling). So I won’t deny my feelings, but I won’t
exaggerate them either. Is there something constructive I can do
to improve the situation/ If there is, I’ll plan it now and do it. If
there isn’t, I am not going to make myself feel worse than is
reasonable. Now, what will I do instead?”
3. Reward your successes

If you can break the automatic ABC cycle, and making yourself
feel less negative, you have done a wonderful job to yourself.

E.g., you started to feel 95% anxious when you was asked to do
a presentation in front of 250 people. Then, you stopped your
negative thought by telling yourself a coping statement in your
head that you will find out ways to handle this request, and now
you are feeling 75% anxious, then, you have done something for
yourself already.

Then you can reward yourself by giving yourself “a pat on the
pack” or “self-congratulations”.
4. Try to identify your self-talk/automatic thought







Self talk = the first sentence/picture that comes into your mind
Once again, not as easy as we think
“ I don’t have any thoughts!”
“ I have been thinking like that since I was very young, and I just
can’t change.”
REMEMBER – the self-talk or automatic thought is the FIRST
statement or picture that come into your mind.
E.g., when being asked to do a presentation for 250 people, my
first picture that comes into my mind is “I am speechless when
someone asks me a question, and I stand there for 2 mins
scratching my head and have nothing to say”
or “I have been a lousy speaker”.
5. Test your self-talk

Now we go to the most challenging part – matching our
automatic thought with the thinking error;

This step is to test out how realistic or reasonable our self-talk is
and try to look at it critically to see if we are making any of these
common thinking errors.
Thinking errors

Common mistakes in Thinking: I short-listed 6 of them
1.
Overgeneralizing – e.g., if you fail once, you will fail forever
2.
Black-and-White Thinking – e.g., being in love must be very good,
otherwise it is very bad
3.
“Who needs evidence?” – e.g., people don’t like me
4.
Looking at the world through deep blue glass – e.g., I fail an
exam, and I must be stupid
5.
Imaging the worst – e.g., I fail an exam, I must be stupid, and I will
never graduate
6.
Taking things personally – e.g., the company did not make as
much revenue as the previous years, I must be the one to be
blamed.
E.g., I am a lousy speaker

Thinking errors that I am making

Overgeneralising “just because it happened in 2-3 classes out of
100 classes I did, does it mean that it apply to every class I
teach?! No!”

Imaging the worst “well, maybe I can answer all questions
easily!”
6. Teach yourself to think rationally

Exercise – “Questioning your thoughts” with a bit more details
this time
Paul’s demonstration
1.
Get in touch with your feelings
2.
Accept that you can cope with bad feelings
3.
Reward your successes
4.
Try to identify your self-talk
5.
Test your self-talk
6.
Teach yourself to think rationally

The incident -

Briefly describe the problem:
…

And how it makes you feel: (give a 0-100%)
…

And what you think about it: (the automatic thought)
…

Can I cope with this feeling?
…

What is the evidence that supports your thoughts?
…

What is the evidence against your thoughts?
…

…
Is there an alternative explanation of what happened?

What is the worst that could happen?
…

Could you live through it?
…

What is the best that could happen?
…
 What is the most realistic outcome?
…
 What is the effect of believing my original thought about this?
…
 The thinking errors:
…
 What could be the effect of questioning those thoughts?

What should I do about this problem?
…

…
What would I say to a friend if s/he were in the same situation?
Introduction of Irrational Beliefs

The concept of Irrational beliefs was proposed by Dr. Albert Ellis;

He suggests that all psychological problems arise from irrational
thinking;

Thus, solving all psychological problems involves changing our
irrational thinking to be more rational;

He suggests that there are 10 common irrational beliefs.
Straight Thinking Exercise

Describe the situation triggering your bad feelings:

Describe your bad feelings:

What do you think or imagine about the situation? Not sure?
Guess.

Which thinking errors can you find in your thouights about the
situation?

Which irrational beliefs are influencing your reaction to this
situation?