A Cognitive-Behavioural Approach to Coping with COVID

The presence of COVID-19 has undoubtedly increased many people’s anxiety and stress. Whether you are experiencing job loss, financial strain, home schooling, or health troubles, we are all facing some level of increased stress and strain in our lives.

With all of the uncertainty and change occurring around us, it can feel difficult at times to cope. It’s important to acknowledge during this time that there is no one right way to feel, and it’s normal to experience a variety of emotions as we process and come to terms with our current reality. It’s common to see rapid changes in our emotions daily, hourly, or in severe cases, within minutes. Allow yourself space to feel the emotions you are experiencing, recognizing the days that you might need to tend to your mental health with greater care.

As we continue to settle into this new normal, it’s essential that we find ways to adapt, process, and cope with all of the changes we continue to endure. Coping is the process in which we invest our own conscious effort to solve personal and interpersonal problems in order to minimize and tolerate stress and conflict. Coping strategies are the methods we employ to practise minimizing and tolerating stress in our lives. If you have attended therapy, you will know that learning coping skills and how to use them is often a key to overcoming various mental health concerns.

Cognitive Behavioural Therapy (CBT) is one of the most effective therapeutic interventions to address a wide range of psychological issues, including but not limited to anxiety, depression, phobias, relationship issues, and major psychological challenges such as losing a job or facing a major illness. CBT is based on the key principle that changing the way we think about a situation will ultimately change the way we feel. It focuses on challenging and changing unhelpful ways of thinking that lead to unhelpful behaviours, while improving emotional regulation and developing coping strategies to solve current problems in one’s life.

Take a minute to reflect on your personal experience with the pandemic. Can you think of a time you may have let your thoughts get the best of you? Did that increase your stress? How did you respond to that situation? Was it different from how you would typically respond? Now consider: was there anything you could have done differently? If you answered “yes” to many of those, this is where CBT coping strategies can be effective. Small shifts in our thinking can ultimately help us change the way we feel, and can help us manage stressful situations in a rational and effective manner.

The following sections discuss common coping strategies used in CBT to help manage the stress and anxiety you may be experiencing during COVID-19. When used in conjunction with other coping strategies — such as breathing exercises, progressive muscle relaxation, and meditation — CBT coping strategies can be very effective in creating lasting change and a shift in your mindset.

Cognitive restructuring

Our thoughts play a powerful role in determining how we feel and act. As humans, we tend to trust and believe what our brain is telling us. If we think negatively about something, chances are we will begin to feel negative. On the other hand, if we think positively about something, we may begin to feel positive. Cognitive restructuring is the process of identifying and challenging the negative and irrational thoughts and beliefs we have. These negative and irrational thoughts are known as cognitive distortions. Cognitive distortions, or “stinky thinking,” are essentially a collection of biased and faulty ways of thinking about ourselves that we have unknowingly created over time. There are several cognitive distortions, originally written about by Aaron Beck, one of the founders of CBT, and later modified and popularized by David Burns.

Familiarize yourself with the common cognitive distortions and see if any of your thoughts fit with them. Here are two examples you might experience during COVID: emotional reasoning and catastrophizing.

Emotional reasoning is the belief, “I feel it, therefore it must be true.” If we think about how we are managing our feelings during COVID, it’s easy to fall into the rabbit hole of believing all of our thoughts. An example might be “I feel we are all going to die, therefore it must be true.” Considering that we most often believe what our brain is telling us, you can see how this kind of statement can be problematic and negatively impact your mental well-being. Later on we will introduce ways you can begin challenging these distortions.

Catastrophizing is the “binocular” effect, where we tend to over-exaggerate the meaning, importance, or likelihood of something happening. An example might be “The world is going to end. We are going to run out of food and no one will survive.” This shows that we are most likely exaggerating the likelihood of something happening, even though it feels overwhelming.

Now that you have some familiarity with what cognitive distortions are, the next step is to gain increased awareness of our thoughts in order to detect these possible distortions in our thinking.

Monitor your thinking

In order to recognize whether or not our thoughts are cognitive distortions, we must begin to understand them and where they are coming from. Self-monitoring is based on the idea that we will not be able to address uncomfortable thoughts and feelings without awareness, and without understanding which situations specifically bring up these thoughts and feelings. Aaron Beck referred to our inner voice as our “automatic thoughts” — our perceptions of the world around us. Most of the thoughts we have on a daily basis are relatively harmless. Typical thoughts might be “I need to go out and get the mail,” “I need to thaw the chicken for dinner,” or “wow, I really did a good job on that!” Of course, there are times when our self-talk can be negative and self-defeating, leading to negative emotions. If you had to keep a tally of all the negative thoughts that crossed your mind in a day — about yourself, or anything in particular — would that number outweigh the positive things you think to yourself?

When we begin to tune into our thoughts, we can begin to understand what makes us feel bad and which thoughts might be worth challenging and working through. The best way to monitor our thinking is to write down our thoughts every time we find ourselves feeling down or bad about something. Often we will be able to discover triggers, and can usually identify themes and patterns in the beliefs we have that are manifesting in negative thoughts.

This is known as a thought journal or thought log. Make yourself a copy of the following headings, either typed or written:

• Date and time
• Situation
• Automatic thoughts
• Emotions
• Your response

The situation refers to what you were doing when the thought occurred. This could also include what was happening earlier that day that may have led to the negative thought. Automatic thoughts are any thoughts that cross your mind that you perceive as negative. In the emotions column, write down any emotions that you felt as a result of your automatic thought. Your response is what you did directly after the thought — how did you respond to your negative thinking?

Try tracking yourself for the next week. You might not catch every single time you think a negative thought, which is okay. The point of this exercise is to be able to break down your thoughts and think analytically about them. Once you have a few events tracked, look back on them and reflect. Are you able to identify which specific cognitive distortion was at play? Is there any evidence that your automatic thought is true? Thought journals basically compile our “worst case scenario” thoughts. Now that you’ve already thought of the worst possible outcome, what do you think is the best case scenario, or the most realistic? How likely are the best and worst case scenarios to happen? Once you have done this, ask yourself how much you buy into the automatic thought you originally had. What is your level of emotion now that you have reasoned with yourself?

Working through negative thoughts

You’ve now become familiar with ways in which you can identify if your thoughts are faulty and illogical. Tracking your thinking is incredibly valuable in understanding your thought processes and where they might be coming from. Now that we have this awareness, we can actively work to change our thoughts.

Sarah Edelman, author of Change Your Thinking: Overcome Stress, Combat Anxiety and Depression, and Improve Your Life with CBT, talks about how for many of us it may feel logical and somewhat simple to detect that our thinking is irrational or faulty, but the challenge lies in being able to change it on a “gut” level. Simply put, the awareness of irrational thoughts is not enough on its own to change our thinking. Edelman recommends keeping “logical statements” handy to refer to when negative thoughts resurface and are difficult to work through.

Here are some examples of logical statements:

This is inconvenient, but it’s not a disaster.

Hassles are a normal part of life.

Everyone has a right to feel upset about what is going on right now, including me.

You might want to write some of your logical statements on cue cards or sticky notes around your house so that you can easily refer to them. This might sound strange, but having them readily available will make it much easier to practise reciting logical statements when you find yourself thinking negatively.

De-catastrophizing

We learned above about the distortion of catastrophizing, which is essentially the tendency to exaggerate the negative consequences of undesirable situations. A person who is prone to catastrophizing may be someone who experiences anxiety, anger, frustration, and hurt often. This often happens because we tend to perceive situations as far worse than they actually are. Therefore, in order to change these thoughts, we must learn to de-catastrophize.

De-catastrophizing involves asking yourself simple questions such as these:

Does it really matter?

What can I be grateful for?

Is this within my control? What can I do about it?

What is most likely to happen?

Is there anything good about this situation?

What can I learn from this experience?

Both logical statements and de-catastrophizing have the same goal: to help us rationalize our thinking and view our cognitions from an externalized perspective. Disputing your own thoughts is incredibly useful and can support you in rationalizing your thinking, leading to overall increased mood and emotional wellness. During this unprecedented and unpredictable time, it’s important that we remain diligent in ensuring our mental well-being is taken care of. There is no shame in monitoring your thinking and creating awareness of your thoughts and the role they play in your emotions and behaviour. Remember, your thoughts are valid, and it’s entirely okay to feel varying emotions.

Over time, you might begin to understand patterns or themes in your negative thoughts. Maybe they all surround one specific event, time of day, or watching the news. With this awareness you can begin to effectively respond to the trigger. Maybe this means you limit yourself to one news story a day, or that you practise breathing techniques before you go into the grocery store to calm your anxiety. You will begin to understand what works for you and what is most effective in those moments, with greater awareness and understanding of your triggers.

Small goals

Now that you have become more aware of patterns of thinking, and of how to detect when you are having irrational thoughts, it’s important to make sure that you are filling your time with activities that improve your mood and quality of life. Goals can be somewhat overwhelming for people and can be a major source of stress, so it’s important to meet your own needs and attune to what you can handle at this particular moment in time. Humans are wired to be motivated and passionate. We set huge goals for ourselves — whether financial, buying a house, or obtaining a certain career — and the list goes on. As our focus is often on the bigger picture, we sometimes forget to focus on the smaller moments. It has become increasingly clear to me over the past few months during this pandemic that finding purpose, meaning, and pleasure in our daily lives is incredibly important for our mental health.

CBT supports this by suggesting that setting goals and managing them can be very effective in motivating healthy behaviours.

Setting small and achievable goals can help us feel energetic, proud, and more like ourselves. Instead of placing pressure on yourself to achieve large-scale goals, meet yourself where you are at. Maybe this looks like setting a goal to go for a daily 20-minute walk, or simply to get out of bed. Whatever it is, make sure it fits your current situation and is achievable for you. Remember, give yourself permission to exist in whichever state you are in right now.

“Personal happiness is possible, even in an unhappy world. Now, you won’t be as happy in an unhappy world as in a better one — I don’t think there’s much doubt about that — but you can still choose to be pretty happy, even in a poor environment. That’s possible. Fighting irrationality and trying to be happy in a nutty world has great advantages. It’s challenging. It’s interesting. It’s rewarding. It’s self-helping. Your very determination to work at it can keep you reasonably happy.” — Albert Ellis

Online CBT therapy with FP Counselling

There comes a time when you might feel as though you can no longer manage and cope with hardship in your life on your own. If you feel you would benefit from therapeutic support, our therapists are skilled in employing interventions from CBT, among other evidence-based approaches. Read about our anxiety therapy or book a free 20-minute consult.