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CBT at Work For Dummies®

Visit www.dummies.com/cheatsheets/cbtatwork to view this book's cheat sheet.

Introduction

Cognitive Behavioural Therapy, or CBT, is a type of practical helping strategy based upon years of research in the world of psychology. In the search for greater understanding of how you think and behave, CBT has developed into a popular helping tool. Since the early days of Freud and his ideas on the human mind and the many other theories and therapies that have followed, trying to get a clearer picture of the emotional roller coaster of life continues to be a popular topic. CBT seems to appeal to many people both in medical and personal settings. Personal development books rank very highly and continue to be popular. Is this because you are interested in trying to work out what is going on in your head? You may want to find out why you make the decisions you do about life, relationships, and in particular what is going on at work. You spend so much time during your working life dealing with people, issues, events, and interactions and at times you can find yourself struggling to get to grips with all of this. Is it any wonder that you may feel at times that you want to try to stand back and make some sense of it all?

CBT can help you identify what emotions are bubbling up inside you and teach you some practical strategies to help you reduce the negative ones that you could do without. You can apply CBT any time, in any situation that sends you into a spin, but in particular, this book uses examples in the work situation to help you pinpoint common examples of work life imbalances.

Whenever you are feeling worried or anxious about work, you could say it’s the warning light that you may want to do something about it to try to reduce the uneasy feelings. You are the only one who really knows how you are feeling. This book gives you an introduction to the ideas of CBT, and explains the practical strategies you can apply to reduce anxieties. There is some of the theory behind CBT included too, to help you put into perspective what makes it stand out from other therapies. You may also want to work with your medical professionals, perhaps a psychotherapist as well at times, but this book will guide you to making choices which are in your best interest.

In all the working situations I have come across in the different jobs I have done, including manufacturing work, education, sales, global financial organisations, central government, prisons, leisure industry and cruise ship lecturing, I found similar problems and difficulties. I encountered problems and emotional upsets both in my own working life and as a psychotherapist working for an international employee assistance H.R. company. All the examples are based on real-life scenarios, across a wide range of employment situations.

I worked for a year in California on a job exchange and first encountered being helped by an Employee Assistance Programme whilst working there. I returned to the UK and decided I would like to train to be able to work as a Stress Manager and apply the U.S.A. experience to my work as a psychologist in the UK. That was in 1989. Our group was the first to train in a new type of cognitive therapy. Since then, I have used CBT in my work both personally and professionally. This book is the result of wanting to share what I have learnt with as many people as possible, who also find work a struggle sometimes. I know that CBT can be helpful. I have learned this from all the hundreds of clients I have worked with, seeing them work through the difficult times and from the feedback they give saying how useful the CBT has been. I wish CBT had been around when I was in the early years of my career; I would have spent far less time agonising over work problems and decisions, insecurities and sleepless nights. If only I could have applied some CBT to my irrational thinking and understood that worrying and making myself anxious and upset was not going to help. CBT does not suggest that you don’t care about life and work, and become some emotionless automaton. CBT helps you to work out your unhealthy negative thinking and change it to a healthy concern that makes a good night’s sleep more of a possibility and your work life and career a calmer and rewarding path.

Once you have learned some CBT, you will have that knowledge and a toolkit to apply whenever you start to feel uneasy.

CBT is for life, not just for crises.

About This Book

This book is for people who want to find ways to help themselves reduce emotional upsets at work, learn a practical therapy and be able to apply these coping strategies at work and at home. Although the examples are work-based, the suggestions and learning can be equally applied in your personal life. Whatever level of work you are involved in, self employed, team member, management, employer or managing director of an international global organisation, this book is for you. I have worked using CBT techniques with all levels of people in their place of work, written training courses for organisations and provided individual therapy for many who have come for work related issues. This book will also help you to plan for the future, manage your career, provide yourself with coaching to enhance your experiences at work and recognise what sort of work preferences you have and how that fits with your personality. This book covers the following:

All the way through the book, the new ideas presented are backed up by putting them in the context of a situation in the workplace. I have found that clients find the real-life examples give meaning to the CBT and help them to remember how to do it. Like any new skill you learn, you need to understand, learn, apply and go over it again when new situations arise. I didn’t learn to ski by just watching the instructor and trying it out once; I needed to go over and over the techniques, try them out, fall over, pick myself up and have a think about what didn’t quite work out. The more I was prepared to put myself through the discomfort zone of possibly falling over, and work through it, the more the possibility of a smooth ski run was likely. Skiing eventually became automatic, but there are still times when a wobble reminds me to stay focused and re-apply the techniques.

How to Use This Book

You can use this book to dip in and out of the chapters and subsections. Each chapter is stand alone, and as you scan the contents, you may find that you want to immediately just read the bit that applies to you at this moment. This is fine. The book is designed this way. It is helpful for the beginner and the more experienced who may already have an understanding of what CBT is about. If you decide you really want to have a look at the CBT method and try it out on yourself, then reading Chapter 2 will give you a good introduction to the basic ideas and methods. You do not need to remember all the bits you read in order to move on; you will find you remember the bits that are significant to you anyway. You are the seeker in your own journey of self understanding. You can find your own way and take responsibility for your learning and decide what is useful for you. CBT is exactly that, taking responsibility for your own emotional wellbeing.

There are many stories, anecdotes, case studies, references and descriptions of different types of psychological conditions which can occur. Some of these have their own section or are in grey tinted boxes, called sidebars. These help explain how people feel at times and you can choose which interests you or skip to the ones that are personally relevant. The first section of a self-help book I turned to when I first discovered a book on stress in the 1970s was ‘The Symptoms of Depression’. I mentally ticked off 90 per cent of these symptoms. This was the start of understanding that what I was feeling was an actual condition, not a failure on my part to cope.

This book could be a start for you to want to find out more on particular areas. Chapter 23 provides you with information for finding more help, books, downloads, websites, mental health resources, apps and technical help, training resources and opportunities to further your knowledge. There are other For Dummies books that expand on some of the topics mentioned in this book. For example, there is a whole book devoted to CBT, another on Mindfulness and a specialist Mindfulness at work.

Within this book, you may note that some web addresses break across two lines of text. If you’re reading a hardcopy of this book and want to visit one of these web pages, simply key in the web address exactly as it’s noted in the text, pretending as if the line break doesn’t exist. If you’re reading this as an e-book, you’ve got it easy – just click the web address to be taken directly to the web page.

Foolish Assumptions

In writing this book, I have made a few assumptions about who you are:

This book addresses these issues and more besides. It is for anyone who wants to find out about CBT, mental health and work environments. While most employee referrals for CBT therapy are for people over the age of 18, the earlier you can have a greater understanding of yourself and others, the earlier you can start reducing the unsettling emotions in life.

Icons Used in This Book

There are some icons used in For Dummies books that appear down the side of the page. Here are explanations of the ones used in this book.

remember This icon encourages you to pay special attention to what’s being said.

tip This icon directs your attention to something to help make things clearer.

warning This suggests you pay particular attention to help avoid any pitfalls.

thinkaboutit This icon suggests you mull something over in your mind to give consideration to the idea.

truestory This icon tells you that the info beside it is a real-world example.

Beyond the Book

As well as the resources section at the back of the book, listing suggestions for further reading and access to other resources, I have included bonus online material.

There is a brief description of this treasure trove of free digital content and crucially where it’s hidden, just for you to discover.

Where to Go from Here

You may have gathered that I am a great advocate of CBT. I do think that even just a little knowledge about how it works and how you can apply it to yourself and become your own therapist for everyday emotional turbulence will help you steer a smoother course in your life. I have worked with thousands of clients and worked in many situations over the years, and CBT has been the most significant addition to all that work. You can choose how much or how little you want to learn. My aim is to share with you the knowledge and experiences I have built up in the hope that some of it will be practically useful to you. I hope you will take away the bits that are relevant to you and encourage others to find out about CBT, too. May you find your great journey of discovery interesting, helpful and even fun!

Part I

Getting Started with CBT at Work

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webextra Visit www.dummies.com/extras/cbtatwork for great Dummies content online.

In this part …

  • Learn to minimize stress and take control of your emotions at work.
  • Discover the components of CBT and see how you can connect your feelings to your thinking.
  • Change the way you think with the help of a CTB toolkit that you can make.
  • Identify with the struggles you encounter at work to help you make your workplace a healthier environment for you.

Chapter 1

Reducing Your Anxieties at Work with CBT

In This Chapter

arrow Understanding the pressures of the modern workplace

arrow Diagnosing your work-based emotional difficulties

arrow Tooling up with CBT to survive at work

The modern workplace is often a diverse, fast-paced environment fraught with challenges and potential problems. Your role is to get through each day as best you can and achieve your targets and goals. Considering how much time you spend at work during your lifetime, you’d be unusual if sometimes you didn’t wrestle with anxieties, self-doubt, anger, guilt, confusion and a general feeling of unhappiness.

Fortunately, Cognitive Behavioural Therapy (CBT) was developed to help you reduce these sorts of tensions and insecurities. In a sense, CBT guides you to become your own therapist, as you use its techniques to reflect on and tackle your troubling feelings. With CBT, you train yourself to recognise when things are getting tough and affecting your emotional wellbeing. You can then apply the CBT formula to work actively to reduce the intensity of the troubling emotions.

Think of CBT as helping you to be the world’s foremost expert on you! Your new internal voice disputes your irrational thinking, allowing you to decide whether you want to make changes in the way you view your job, other people and your employer in order to reduce your worries.

Here I introduce you to the basics of CBT and how it can help you at work. Throughout this chapter, I also provide an overview of the book as a whole, providing cross references to other chapters as appropriate.

Coping with Changing Roles at Work

The workspace is a constantly changing arena. People have always been concerned about finding ways to survive and coping with the diversification of jobs, whether they’re working on the land, in communities and villages or in specialised purpose-built offices.

You may yourself have held many different jobs, needing to adapt and retrain as necessary in order to make yourself eligible for different work roles. In fact, being flexible and having wide-ranging experiences and skills is often seen as an asset these days and not an indication that you can’t stick at a job.

The inspiration to write this book comes from my practical experience in working in many different jobs in various settings and recognising the common nature of the problems that people encounter at work.

For example, I’ve done manual work in a textile factory, taught young children in nurseries and primary schools and worked with emotionally challenged teenagers in the inner city. I’ve also studied to be a psychotherapist; worked in a ski-chalet in France, cooking and cleaning; managed lectures on a cruise ship; and written courses on change management for international financial organisations and national government.

remember The great thing about CBT strategies and skills is that you can apply them in all employment situations that people work in today, whether within local communities, in rural locations, towns or cities or in an international setting.

Stressing out at work

Workplace stress is a pretty familiar phrase in today’s marketplace and its negative effects on mental and physical health are well-documented. As a result, developing the skills and attitudes of mind to help you cope is a priority.

remember External forces, such as changing market economies affecting companies and resulting in redundancies, layoffs and closures, aren’t a reflection of your individual performance in a job but of factors outside your control.

Taking charge of your emotions

You can’t control many of the situations you encounter at work, including the bosses and managers you find yourself working under or the people in your team. But you can take control over how you’re affected by these factors. Chapter 11 talks more about CBT and work relationships.

Feeling helpless and lapsing into depression can be a response to feeling that you’re stuck in a difficult situation. You may start by experiencing feelings of anxiety, butterflies in the stomach and a dread of going into work, and fear progressing to panic. Such anxiety can result in you being more likely to make mistakes and may compound your worries. You can feel like you’re on a downward spiral of incompetence, and your self-esteem may plummet too.

The good news is that CBT can help you to train yourself to take charge of your negative emotions and do something about them before you fall into the pit of doom (your GPS won’t find it, but it’s there, just below the pothole of ruin and nestling behind the shaft of lost hope!). When you implement CBT, you become fully aware of your emotions. You’re encouraged to allow yourself to look at what’s happening and to use the CBT toolkit from Chapter 3 to work actively on dealing with your negative automatic thoughts (or NATs; see Chapter 8 for details), thus reducing the ‘disturbing’ emotions to less disruptive and manageable ones.

Thinking Rationally to Troubleshoot Your Emotions

Of all the counselling methods and therapies I trained in, CBT resonated most strongly with me. I was always a hurry hurry, rush rush type of personality, often working myself up into a state of anxiety and demonstrating low levels of tolerance for frustration. I usually achieved what I set out to do, but the road was fraught with anxiety, self-doubt and, at times, guilt.

Although I agreed with the ideas behind other forms of counselling, I felt that I didn’t have the time for weekly sessions and months of therapy. Fortunately, CBT is intended to be short-term therapy that you can apply to your whole life (see Chapters 16 and 19).

Here I lay out the basics of CBT, its practical nature and how the responsibility is on you to tackle your emotional problems and nobody else’s.

Meeting the CBT basics

CBT helps you to discover and prioritise your emotional problems, encouraging you to take responsibility for your emotional development (flip to Chapter 7 for more on these aspects). It uses examples of real-life problems to help you reinforce your learning and become accountable to yourself to work on the issues you identify as needing attention.

remember You can see CBT as comprising six areas:

  • Explaining the problems: Here are just a few examples of the long list of emotions and behaviours that may be causing you distress at work:

    - Anger

    - Anxiety

    - Confidence/self-esteem issues

    - Depression – withdrawal, feeling sad, loss of enjoyment

    - Low frustration tolerance – impatient, angry

    - Medicating yourself inappropriately

    - Panic – feeling fearful

    - Feelings and behaviours as a result of – illness, pain, and incapacity

    - Struggles with relationship difficulties

    - Unhelpful behaviours – eating, drinking, self harming

  • Identifying the emotions: You will then be encouraged to work out what emotions you are experiencing which are unsettling or distressing. (Check out Chapter 2 for how to start spotting and naming your negative feelings).
  • Working out the origin of the reasons for these feelings: There will always be a reason for a 'trigger' which sets you off worrying or feeling anxious, or angry or any other negative emotion. It may not be obvious at first but spending time working out what it is that sets off these feelings is an important step (you may find Chapter 3 helpful here).
  • Looking at your possible choices and options: You may think you are trapped and have no alternative paths to choose from. This in itself can set off negative thinking and feelings. There are always some choices, even if all of them are unattractive and hard to take. (Chapter 4 talks more about having options and making choices, for good or ill).
  • Deciding whether you want to work on changing the way you think about what’s happening for you: Sometimes you may decide that you are just going to put up with the difficult situations and decide you don't want to change. This is fine, you don't have to do anything. Having a look at the consequences of doing nothing, though, can be useful, as in the long term you may be setting yourself up for an even tougher journey in the future. Taking some time to consider all of this helps you make more informed choices. (Try Chapter 5 to think specifically about your problems in your workplace).
  • Learning and applying the CBT method of linking the feeling–thinking connection: If you decide you would like to work on reducing some of the negative feelings precipitated by your thinking, then you will need to learn the CBT methods to be able to apply them for yourself. Some people may choose to find a CBT therapist to teach them and others, like you, who is reading this book and is up for teaching yourself and ultimately helping you to be informed about CBT practice. (Chapter 7 is the place to start for using CBT at work).

Choosing to use CBT therapy doesn’t involve secrets or magic (no incantations featuring knee of newt or toe of toad!). You just make a conscious decision to learn and apply CBT to your troubles and to take responsibility for your own emotional wellbeing.

In certain situations, you can find that your choices are tough ones to make and you certainly won’t like some of the options available at work. But CBT works with you to look at the possible emotional and behavioural consequences of choosing to do nothing and carrying on upsetting yourself.

Often you can choose to ignore what’s happening, because it seems too painful or scary to admit the reality of the situation, but CBT helps you to pay attention to it and do something about it.

tip Seeing your options laid out in front of you, along with the ‘logic’ behind your irrational thinking and the consequences of continuing to think in a certain way, can be very enlightening.

As the old saying has it: ‘procrastination is the thief of time’. How often have you put something off until it becomes so urgent and pressing that the consequences start pushing over into a crisis? But then, after you attend to the task, you find that it wasn’t so bad after all and you wish that you hadn’t spent so long in a state of anxiety.

Tackling tough times with CBT

A core belief in CBT is that you can’t make changes without pain, which is why some people call it a tough therapy. It involves goals, guidelines, exercises, homework and the constant need to be ‘on your own case’. There is no change without pain.

You have to go through the discomfort zones to progress. (I discuss the specific issue of workplace changes in Chapters 13 and 17).

warning If you want to keep avoiding your problems – living in denial between episodes of distress, surrounded by the crutches of chocolate and hot drinks, and yet aware subconsciously that troubling moments at work lie around the corner – CBT won’t work for you. The fact is that you have to make CBT work for you.

CBT guides you through the process, however, because you work out what your unpleasant zones may be in advance of pushing yourself through them. You make the conscious decision to take on the necessary work yourself, in terms of changing your attitudes, and use appropriate coping strategies to see you through.

For example, imagine that your goal is to work alone on your company’s reception desk, but that the thought of dealing with members of the public (and their notorious unpredictability) terrifies you. CBT can help you to anticipate what the obstacles may be and how you may feel in advance, as well as to plan experiencing discomfort. No-one can experience the reality of stepping into the scary situation for you, though: you must do that yourself.

Recognising Problems in the Workplace

You have a core personality, partly determined by your genes, your environment and your upbringing (check out Chapter 9 for more details). Plus, how you present yourself varies in different situations. You may be aware of certain expectations of yourself in different roles, but essentially you remain the same person.

Finding out where you fit in and recognising your own work situation is helpful in identifying recurrent issues and potential struggles.

Experiencing conflict between your beliefs and actions

tip In order to be successful in the workplace, you need to be aware of what’s expected of you – because you can experience tension when this requirement doesn’t fit with who you are. The disquiet arises from a mismatch between what you’re thinking and how you’re being asked to behave. For example, you may feel angry at having to do some tasks or conform to certain working conditions and think that things just aren’t fair. You’d be correct.

But how hard you insist on gripping to your rigid views of how life ‘should’ be, bemoaning the fact that your work doesn’t measure up, is a large influence on how unsettled you feel at work.

remember CBT helps you to sort out this confusion. You don’t lose any sense of your true self and become an emotionless automaton with CBT, but you do find yourself making enlightened choices. I like to call this conscious compliance. You may not agree with something you need to do at work, but you do choose to comply, because ultimately doing so is in your best long-term interests.

Admitting your struggles

When you allow yourself to admit that things aren’t going along too well and that you’re struggling, you’ve made the first step towards doing something about it.

truestory I used to work for a company’s Employees Assistance Programme, taking calls on the confidential helpline. I know from experience that the hardest part of the process was for employees to pick up the phone and make the call to say they’d like some help.

Even calling your GP to make an appointment for a physical ailment can be tough, because you may feel that you have some weakness in yourself that you don’t want to have to admit. Sometimes, when you’ve spoken the words, you can feel that it’s all too real. But not attending to the warning signs leaves you open to the problem getting worse.

remember Saying ‘I’m struggling a bit here’ is perfectly okay. You’re likely to judge yourself much more harshly than your friends and co-workers do. When it comes to the crunch, if someone you work with gets a serious illness you often notice people’s genuine concern.

warning Emotional problems can progress into crises and become critical if you leave them unattended for a long time.

Looking after yourself at work

remember You have a responsibility to take care of yourself at work. Keeping yourself physically and emotionally healthy isn’t only in your best interests, but also in your employer’s and workmates’ too (as I describe in Chapter 5).

When you drag yourself into work when you aren’t feeling well, you’re often not met with sympathy and concern. Great relief is felt all round when someone else makes the decision and orders you to go home. Oh, the joy when your boss tells you not to come back until you’re better – though these moments are probably quite rare.

CBT can help you develop the confidence to recognise when you need time out to get yourself physically and mentally fit, and the skill to understand and rationalise why doing so is in your long-term best interests.

Discovering the Benefits of the CBT Problem-Solving Method

This book shows you enough CBT techniques to enable you to go off and apply them to your own situation. For example, Chapter 2 describes CBT’s basic principles and practical applications (which come in a handy ABC framework) and Chapter 3 talks you through building your own CBT portable toolkit for fixing your emotional problems. To help convince you of its benefits, I also include real-world stories of how people have used CBT successfully in the workplace. I draw them from my experience of working as a CBT therapist with hundreds of employees in the private and public sectors for more than 20 years.

remember CBT is an evidence-based theory, using scientific, logical and rational methods to construct, assess and test its effectiveness. It’s proved to help people reduce their debilitating emotional states. Many research papers show, for example, that CBT seems to have long-lasting effects in treating anxiety and depression, which may be due in part to the fact that people are encouraged to discover the therapy and help themselves to stay well over time.

Accountability in CBT through confidential assessment and monitoring is a key factor in many health organisations choosing to use CBT as their preferred method of providing emotional support to employees.

Increasing a company’s productivity and positivity

As CBT has gained in popularity, more companies and HR departments are recommending this therapy for their employees.

You can’t overestimate the financial advantages of keeping a workforce healthy and happy. Chapters 6 and 13–15 look at some of the benefits to an organisation of adopting strategies that keep stress levels to a minimum and offer support for stress-related issues.

tip During your work life you’re bound to experience struggles in your personal life that may then impact on your professional life. But the great thing about CBT is that knowledge of it is just as helpful for personal issues as work-related ones.

Being an ambassador for CBT

When you’ve got the hang of CBT and are actively using it in your life, you may find that work colleagues comment on the change in you: perhaps you seem more relaxed and they want to know how you manage to stay calm during a crisis. Of course, you know that using CBT is an active therapy. You appear calm because underneath you’re consciously going through the ABC technique, which I explain in Chapter 2, to be on the alert for feelings of rising panic in yourself. You can then rationalise your thoughts to keep that anxiety in check.

For those moments when co-workers ask you, Chapter 14 encourages you to become a CBT ambassador yourself! I’ve taught many a colleague some principles of CBT in coffee breaks who tell me that they still apply them years later.

Selecting the work life you want

remember One aim of using CBT is to have only a healthy concern for what’s happening around you, rather than a debilitating state of anxiety about events.

Work can make many demands on you, some of which may not be to your liking. You may need to fulfil those demands to keep your job, but CBT encourages you never to lose sight of who you are. Even in the harshest of conditions, people have kept their sense of values and personal beliefs. Viktor E Frankl was a survivor of the holocaust who endured terrible conditions. He’s quoted as saying:

Everything can be taken from a man but one thing: the last of human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.

CBT is about helping you to uncover your beliefs and attitudes and check whether they’re helping or hindering you. (Chapter 4 has loads of useful info on the importance of maintaining a healthy attitude at and about work, and Chapter 10 talks about creating your own philosophy on work.) You can always choose your own way (Chapter 12, in particular, shows you how).

Becoming balanced professionally and personally

The issue of striking a healthy work–life balance (which I cover in Chapter 16) is a concern across many countries and cultures. The blurred boundaries between work and personal life can impact heavily on people.

tip Make sure that your life isn’t dominated by work, if that’s not what you want. Check out how your life is working every now and again, and use CBT to help identify when you’re getting out of balance.

CBT suggests that you work towards an acceptance of some situations and events and not to upset yourself about things beyond your control. When you can truly accept some difficult things, and change the way you view them, you free yourself up to move forward.

Once we accept our limits, we go beyond them.

—Albert Einstein

Chapter 2

Discovering How CBT Works

In This Chapter

arrow Getting to grips with CBT

arrow Considering the basics

arrow Using CBT to help yourself

People have visited doctors or healers of some sort for physical illnesses and injuries for centuries. Today, humans know more about their bodies and what to do when things go wrong than ever, and more professionally trained medical personnel are available.

People are also becoming increasingly familiar with the idea of seeking help when life gets to be an emotional struggle. Sometimes people’s mental health can become so adversely affected that they have difficulty coping with everyday life, let alone work. But the balance between merely having a tough time and becoming seriously anxious and depressed, resulting in an inability to function properly, varies from individual to individual.

When you experience struggles that affect your emotional state, you can be confused as to where to go for help, and even feel embarrassed – which is where cognitive behavioural therapy (CBT) comes in. In this chapter, I describe CBT’s role, the basics of how it works and how it can help you improve your emotional wellbeing.