What’s in My Therapy Journal

I’m not in therapy, but I do have a therapy journal filled with my favourite therapy concepts and tools (the notebook it lives in is from the lovely Candace at Revenge of Eve). In this post, I’ll share some of what it contains.

Acceptance and commitment therapy (ACT) is probably the best fit for how I relate to my mind and the world, but there are also bits and pieces from other therapeutic approaches that I find helpful or interesting.

Cognitive behaviour therapy (CBT)

Cognitive distortions

Cognitive distortions are a CBT concept. My journal contains a list of my greatest hits (mind-reading, personalization, and acatstrophizing) and the situations in which I tend to lean into them.

I’ve also made note of the questions from the cognitive processing therapy (CPT) challenging questions worksheet that can help with challenging distorted thoughts.

Levels of thought

CBT identifies three levels of thought that can cause problems for us.

1. On the surface layer is automatic negative thoughts that jump up and bite us in the nose in response to situations.
2. Beneath those are underlying assumptions, which tend to take the form if… then…
3. Below those are core beliefs, which are absolute beliefs about the self, others, and the world.

Cognitive distortions show up on the automatic thoughts level, but there’s stuff underneath those thoughts that’s feeding into them.

Dialectical behaviour therapy (DBT)

Wise mind

Wise mind is another DBT concept. We’re in wise mind when both reasonable mind and emotion mind are engaged. Wise mind is a good place to make decisions from.

Acceptance and commitment therapy (ACT)

ACT hexaflex model

I’m a big fan of ACT (including the metaphors), and the ACT hexaflex does a nice job of representing the elements of psychological flexibility: attention to the present moment, values, committed action, self-as-context, cognitive defusion, and acceptance.

ACT relationship acronyms

Unhealthy relationships are DRAINs:

• Disconnection
• Reactivity
• Avoidance
• Inside your mind
• Neglecting values

Healthy relationships involve LOVE:

• Letting go
• Opening up
• Valuing
• Engaging

Taking VITAL action

• Values and goals
• Into the present moment
• Take notice: use observer perspective, notice physical sensations, emotions, thoughts, and urges to use safety behaviours
• ALlow: allow the experience to be just as it is, bring gentle curiosity, lean into anxiety, and increase willingness

Self-awareness

Recognizing avoidance: I’ve written down prompt questions from a costs of avoidance and control worksheet I found. I’ve also made notes of some of my own avoidance behaviours. Avoidance is definitely a favourite maladaptive coping technique for me.

Recognizing triggers: I’ve worked on recognizing when my reactions to events aren’t actually in response to the events themselves, but rather to past events or other issues that have gotten stirred up.

Recognizing emotions: I’ve got a 2-page list of different emotion names. I find it’s easier to pick from a list than to pull an emotion name out of my ass to describe how I’m feeling.

Recognizing trauma cognitions: There were a lot of thoughts that popped up in response to experiencing workplace bullying a number of years ago. Those have mostly receded by now, but they still get triggered occasionally, and having them written down helps me to remember where they’re coming from.

Self-exploration

• identifying my most important values (curiosity, freedom, independence, autonomy, open-mindedness, respect, self-awareness)
• list of reasons for living, partly drawn from Marsha Linehan’s Reasons for Living Scale
• Positive Qualities Record – a series of prompts from the Centre for Clinical Interventions
• Applied Mindfulness Process Scale – a tool to evaluate how well I’m practicing mindfulness

Skill-building

I’ve listed various skills I’m working on, such as:

• minimizing the use of avoidance and other unhealthy ways of coping
• unpacking where my reactions are coming from
• owning my reactions
• trying to recognize when I’m being irrational, and when I am, trying to decrease the amount of time I spent caught on the crazy train
• trying to engage wise mind more often and more quickly
• shifting from resistance to acceptance

I’ve also made note of various DBT skills acronyms.

Other things in my toolbox

• list of pleasant activities
• list of cognitive, mindful, and behavioural activities that are soothing
• reminders to practice self-compassion

So, that’s a quick overview of what lives in my therapy journal. What are some of the therapy-based concepts or tools that you use to support your own mental health?

The post Therapy Tools for Mental Health has more tools to support your mental health, and the Resources page has the Therapy Basics Toolbox, a downloadable mini-ebook.