Review: Mind Over Mood

Mind Over Mood: Change How You Feel by Changing the Way You Think, by Dennis Greenberger and Christine A. Padesky. New York: The Guilford Press, 1995. 215 pp. $23.95 (paperback).

mind-over-mood

It may seem unimaginable now, but someday you will look back and be thankful for whatever is angering you or making you anxious today—if, that is, such problems, in conjunction with this book review, inspire you to a study of Mind Over Mood: Change How You Feel by Changing the Way You Think. In their book, Dennis Greenberger and Christine Padesky teach skills that enable you to understand your emotions and make fundamental changes in your moods, behaviors, and relationships.

Greenberger and Padesky are cognitive therapists; as such, they emphasize the importance of thoughts and thought processes in one’s emotional well-being, holding that consciously recognizing one’s emotional states is the precondition to improving them. “Awareness,” they say, “is the first step toward change and better problem solving” (p. 49). Consider Vic, one of four persons whose progression is followed in the book:

When Vic learned that his primary emotional difficulties were with anger and anxiety, he began to focus his attention on the situations in which he felt angry or anxious. He learned to distinguish his irritable anger from the fearful worry of his anxiety. He began to identify these moods, instead of lumping them together as “numbness.” As Vic began to isolate what he was feeling, it became apparent to him that when his mood was anxious he was thinking “I’m losing control.” When his mood was angry, he was thinking, “This is not fair—I deserve more respect.” (p. 28)

In Vic’s case, it was not enough simply to become aware of his moods and the “automatic thoughts” that led to them. (The authors define “automatic thoughts” as thoughts that “simply pop into our heads throughout the day.”) But doing this was a crucial first step—one that, as Greenberger and Padesky show, anyone seeking to make profound emotional change simply cannot skip.

Having identified the main automatic thought underlying a mood—what they call the “hot thought”—Greenberger and Padesky advise readers to gather evidence. “[It] is helpful,” they say, “to consider your hot thoughts as hypotheses, or guesses. If you temporarily suspend your conviction that your hot thoughts are true, you will find it easier to look for evidence that both supports and weakens your conclusions” (p. 65). This process of evidence gathering, they continue, clarifies one’s thinking and reduces the intensity of one’s moods.

Throughout this process, Greenberger and Padesky teach readers to focus on data, information, and facts. Although this skill is really no different from good, objective thinking, they call it “alternative or balanced thinking” to usefully differentiate it from certain widespread and problematic methods. As they explain:

Alternative or balanced thinking is often more positive than the initial automatic thought, but it is not merely the substitution of a positive thought for a negative thought. It is important to differentiate and contrast alternative or balanced thinking with merely thinking in a more positive way. Positive thinking tends to ignore negative information and can be as damaging as negative thinking. Alternative or balanced thinking takes into account both negative and positive information. It is an attempt to understand the meaning of all the available information. (pp. 94–95)

Greenberger and Padesky show how this works for Ben, a depressed older man. Following a Thanksgiving Day spent with his family, Ben felt sadness—on an intensity scale from 1 to 10 he rated it an 8—and identified the “hot thought” as: “The kids and grandkids don’t need me anymore.” He then wrote down evidence that supported this thought along with evidence that did not. After looking at both, Ben chose to describe his situation more accurately: “Even though my children and grandchildren don’t need me in the same ways they used to, they still enjoy my company and they still ask for my advice. They paid attention to me throughout the day, although the attention was not as consistent or the same as it has been in the past” (p. 97). Having completed this process, Ben re-rated his sadness—giving it an intensity of 3. Using Ben’s example, the authors sum up the benefits of their approach relative to other options:

If Ben had simply substituted a positive thought, he might have concluded, “They need me more than they ever have.” If he had attempted to merely rationalize away his sadness, he might have decided, “They don’t need me anymore, but what do I care?” Positive thinking and rationalization can lead to problems. For Ben, positive thinking would have ignored real changes that were taking place in his family; rationalization could have led Ben to feel even more isolated and alone. In contrast, Ben’s balanced thought emerged from the evidence and allowed Ben to understand his experience in a way that lessened his sadness and increased his connection to his family.

Further, notice that Ben’s balanced thought is plausible and believable. The more an alternative or balanced thought is believable to you, the more it will relieve the intensity of your negative feelings. If you simply provide a rationalization or a positive thought that you do not believe, it is not likely to have a lasting impact. (p. 98)

Greenberger and Padesky recommend completing this entire process—what they call a “thought record”—a few times per week in writing. They include worksheets to do so (which often contain helpful questions), give advice on making action plans to solve problems, and encourage readers to actively seek out new information to test the accuracy of new thoughts.

As an example of the last, consider Linda, a woman who was so fearful of flying that thoughts of doing so would often lead her to a physical state that she attributed to having a heart attack. After weighing all the information, Linda came to a new thought—namely: “I’m not in danger when my heart races and I sweat. These physical changes can be caused by exercise, anxiety, or other factors. I’m not necessarily having a heart attack when I have these experiences” (p. 116).

To test this, Linda decided to experiment. In her therapist’s office, she would jog in place, thereby increasing her heart rate, and then see if it would return to normal. She thought of possible problems: “I may believe that I am having a heart attack and stop the experiment because of that.” She thought of strategies to overcome them: “I will tell my therapist that I think I am having a heart attack and my therapist will help me evaluate how to proceed.” And then she did the experiment—recording the outcome and what she learned: “a rapid heartbeat and sweating can be caused by anxiety and exercise” (p. 116). From there, she continued to experiment, visualizing herself in an airport, then in an airplane, and so on until she conquered her anxiety and even became a “frequent flyer.”

Greenberger and Padesky’s basic presentation comprises the first eight chapters of Mind Over Mood and shows that you can change how you feel by changing the way you think. The ninth chapter offers skills for making those same changes, but on a deeper level—by identifying the assumptions and core beliefs that underlie most of one’s daily thoughts.

“Assumptions operate as rules that guide our daily actions and expectations.” According to Greenberger and Padesky, they can usually be stated in “If . . . then . . .” form. For example, Marissa—a depressed woman who has often contemplated suicide—operated under the assumption that “If people get to know me, then they will see how despicable I am and reject and hurt me” (p. 129). Greenberger and Padesky call the underlying assumptions at the deepest level of cognition “core beliefs”:

Core beliefs are absolutistic statements about ourselves, others, or the world. Marissa’s core beliefs included “I’m worthless,” “I’m unlovable,” and “I’m inadequate.” Her core beliefs about others included “Others are dangerous,” “People will hurt you,” “People are malicious.” She believed that the “world was full of insurmountable problems.” (p. 129)

Greenberger and Padesky present two ways to identify assumptions and core beliefs: one is to look for recurring themes in weekly thought records; the other is to ask the same question in response to ever more fundamental answers, what the authors call the “downward arrow technique.”

For example, Marissa was called in by her supervisor for an evaluation meeting. Her automatic thought was, “I’ve made a mistake again. He’s going to fire me.” In order to find the core belief about the world underlying this thought, Marissa asked, “What does this say or mean about the world and how it operates?” Her answer: “Bad things are always happening to me.” Again: “What does this say or mean about the world and how it operates?” Her answer: “The world is hard and punishing.” One more time: “What does this say or mean about the world?” Marissa’s answer: “The world works against me” (p. 133).

Greenberger and Padesky show that these deeper beliefs, having been identified, can be changed in the same way as automatic thoughts. They recommend recording evidence that a core belief is not true—starting with “one piece of evidence every day the first week” and then “looking for two or three bits of evidence every day” (p. 140). They also recommend identifying and strengthening alternative core beliefs in response to new evidence:

Labeling experiences with a new core belief is like setting up a new file in your mind. In the same way that a well-organized filing system at home or work helps you store and retrieve information, a newly labeled core belief helps you store and remember experiences by giving you a place in which to organize them. Without the new file, experiences that don’t fit the negative core belief would be either misfiled or simply discarded. The new alternative core belief provides a name under which you can remember all the experiences you have, not just the negative ones. (p. 143)

Greenberger and Padesky caution against expecting instant results: “Core beliefs,” they say, “can take longer to change than automatic thoughts because we require a lot more evidence over time to convince us that these absolute and usually long-held beliefs are not 100% true” (p. 139). Indeed, in three chapters giving specialized information on how to cope with depression, anxiety, anger, guilt, and shame, Greenberger and Padesky show that it is not easy—not even for the people they chose to profile. Although all showed substantial progress, each had to work very hard and some of them for longer than others. But the gains each patient makes are believable, and their progress is quite moving.

The authors demonstrate that virtually anyone’s emotional health can be improved. As such, virtually anyone will find profoundly life-serving skills—and much inspiration—in Mind Over Mood.