Emotions are extremely important. It is interesting to note though, that just as our emotions can lead to certain behaviours and outcomes, our behavioural outcomes can in turn alter our emotions.

 

You may recall an occasion when you were going to play sport or exercise at the gym, and did not feel like going. Recall the emotions – lethargy, disinterest, annoyance, fatigue. However, you went and took part anyway. Recall how your enthusiasm and enjoyment grew as you participated. The same experiences may relate to going to work or school. It is interesting to realise that we can, and commonly do, make our behavioural decisions independently of how we feel, and that our behaviour can generate our emotion.

 

Let’s see how alternative thinking and behaviour can lead to different outcomes in the below example.

WEEK 4  EMOTIONAL WELL-BEING

 

APPRAISAL & MOOD

Imagine you are selling a house you had owned and loved for many years, perhaps it is a house you grew up in, and contains many happy memories. You have put effort into preparing the house for sale and you are pleased with the work. You hope the house will find a buyer who will enjoy and appreciate it as you have. Think of the experience of following the real estate agent or prospective buyer through the house. Even as you begin to think of this scenario, you realise that they will view your house in quite a different light. They are distanced from the history and the memories the house evokes and are able to evaluate the advantages and disadvantages of the property objectively.

 

 

Some of the comments may be hard to listen to, critical as they may be of aspects of the house we may have built or designed ourselves, have grown used to and even perhaps love.  Some of the comments might provide a dampener on our expectations from the sale. And given the close association we have had with the house and how it reflects so much of our energy, effort and personality, some of the comments may seem to strike at some of our core beliefs about ourselves. This objective appraisal, nonetheless, is much more likely to be helpful in determining any further work that needs to be done and in evaluating the merits of offers relative to the broader market.

 

 

 

Our stream of consciousness is made up of thoughts, some clearly expressed in language, some less clearly articulated, and emotional/physical experiences. These form so fundamental a part of our lived experience that we have come to accept them as unquestioned truths. In this section we would like to encourage you to take a step back from these thoughts and subject them to objective evaluation or appraisal.

The internal landscape of our thoughts is so familiar, so habitual, that it seems like just the way things are, the absolute truth. Our thoughts seem definitive and important, we feel we must give them full attention. Sometimes we fall into long-term habits of unhelpful global negative thoughts such as “I’m useless”, and we come to trust and react to thoughts like that as though they are the actual truth. We may find ourselves thinking “I’m going to fail” as if it is a foregone conclusion. Imagine what the consequences of thoughts like that might be to our performance, our self-esteem, and our mood.

 

It can be a revelation to realise that our thoughts may, or may not, be true (at any specific time, in any particular context).  We can take a step back and examine them. We don’t have to automatically believe them.

Not surprisingly, we find that people living with chronic illness report a lot of similar thoughts and appraisals regarding their condition. These often reflect puzzlement or frustration. Some ask the “why” questions: “why me?” or “why do I always have the pain?” Some ask the “what if” questions: “what if my condition stops me getting a decent job”, “what if I can’t cope with this condition”, “what if never find a partner because of my condition”, and some are statements: “this condition will drive me crazy”, “this condition will stop me managing my life”.

 

Our global negative thoughts bring us to focus on what we cannot do rather than what we can do. They then encourage us to make overly negative global evaluations as a consequence of what we cannot do. That’s where the self derogatory terms such as “hopeless” or “useless” come in.

 

People might start deciding that “I will never be symptom-free” or that “I’ll never be able to do anything with my life”, “my life is a total disaster”. At the onset of severe symptoms, people may think “well today is a write-off so there’s no point in doing anything.

Why?
What if....?
Why me?
How To Appraise Our Automatic Thoughts

 

The first thing we usually notice is our emotion (or sometimes our actions or behaviour).  For example, we are feeling: bad, depressed, angry, frustrated, hopeless. Or we notice our behaviour – driving too fast, tailgating, short tempered responses to loved ones, avoidance, inactivity, staying in bed for long periods of time, failure to complete undertakings, and so on.  

 

You’ll notice that the behavioural response can be external, in other words something that we do physically, but it can also be a bodily action such as increased rate of breathing, increased heart rate, increased blood pressure, blushing, sweating, etc, or perhaps the opposite of these at times when our body seems to shut down a lot of the internal and external activity, such as during times of depressed mood.

We can then recognize that these are responses to events or situations, and it is helpful to try and describe the event or situation which led to our emotions or behaviour.

 

Finally, and most often unnoticed, are our thoughts which form the link between the events and our emotions and behaviours. These can be thoughts or even wordless images at any level of abstraction. At the more abstract end of the continuum they can be core, or broad ranging values and beliefs. At the less abstract end they can be just passing thoughts, and of course they can be anywhere in between. They are key to understanding the link between events that happen to us and our emotional and behavioural response.

 

So, let’s take the situation where someone’s attendance at university is affected by their IBD condition.

 

1.   The emotion may be sadness, frustration and anxiety, perhaps anger and also despair.  The associated behaviour may be avoidance – missing and then ceasing attendance at class, leading to eventual withdrawal from the course and dropping out of tertiary study.

 

2.   The initiating event is several episodes of diarrhoea upon arrival at university.

 

3.   Thinking through the process they may realise that the train of thoughts includes: “I hate having these symptoms”, “What if I have an episode of incontinence”, “This is never going to get any better”, “I won’t be able to cope”, “What’s the point of trying”, “I might as well give up now”.

By changing their thoughts about the initiating event, the student can obtain a completely different outcome. 

1.   The initiating event is still several episodes of diarrhoea upon arrival at university.

 

2.   However, this time the student has different thoughts. For example, "This has happened before, sometimes it settles down after a little while. I will take a short break and I should be able to get back to the lecture soon".

 

3.   The emotion may still be frustration and hopelessness, however, the students' behavioural outcome has changed and they continue successfully at university.

Changing Our Thoughts - Exercises

Please take the time to read the PDF documents about identifying, challenging and replacing negative automatic thoughts.  We encourage you to spend this week filling in the thought journal and continuing to practice the relaxation exercises.

Contact Us

IBD Clinic

Dept of Gastroenterology & Hepatology

Royal Adelaide Hospital,

North Tce, Adelaide, SA, 5000

Australia

08 8222 5207

 

 

 

 

 

 

 

IBD Clinic

Dept of Luminal Gastroenterology

Flinders Medical Centre

Flinders Dr, Bedford Park SA 5042
08 8204 5511