Before going any further, we are going to introduce you to a key concept in CBT called the “ABC model”. The ABC model shows how your thoughts and beliefs impact the way you feel and behave. This model can be extremely powerful in helping us understand why certain problems occur and how we can intervene to stop them. First, we will look at this model generally, before applying it to chronic fatigue in the next section.
It is often wrongly assumed that our feelings and emotions are caused by external situations, people or events. For example, we often hear people say things like “staying home all the time is so depressing” or “she makes me so nervous”. These statements are based on the assumption that the external event or person has directly caused our feelings. What this does not acknowledge is that our thoughts and interpretations also play a role in how we feel.
The ‘cognitive’ part of CBT highlights the importance of our thoughts when trying to understand our emotions and behaviour. If we look closely, our feelings and behaviours are impacted more by our perception or interpretation of an event, rather than the event itself. Our perception and interpretations come in the form of our thoughts (words or images in our mind). This explains why two people can have very different reactions to the same situation.
For example, say two people had the same experience of walking down the street and seeing a friend. Both people wave at their friend, but the friend doesn’t wave back. Person A thinks, “Oh no, I must have done something to upset her!”. As a result, Person A feels anxious and spends the afternoon worrying. Person B, on the other hand, thinks “Oh well, she must not have seen me”. As a result, Person B doesn’t experience a strong reaction and continues to go about their day normally.
The idea that people’s thoughts influence the way they feel and behave is central to CBT. This idea is summarised in the picture below. As you can see, a situation (A: activating event) triggers your automatic thoughts (B: beliefs), which then leads to your reaction (C: consequences). Your reaction includes your emotions (e.g., anxiety, sadness), physical response (e.g., fatigue, muscle tension), and your behaviour (e.g, avoiding, worrying). You can remember this sequence as the ‘ABC’ acronym.
Our thoughts and beliefs are often habitual and happen so quickly that we usually aren’t consciously aware of them. That’s why it can feel like situations lead directly to the consequences. We are often more aware of our emotions, physical sensations and actions, than we are of our thoughts. However, our thoughts are there, and they impact all of these things. As such, it is important to become skilled at recognising our thoughts (we cover this more in Week 4).