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People sometimes have distorted or negative thoughts about themselves, which do not reflect the reality of a given situation. Such thinking may be ingrained by the unfair and negative utterances of significant others, even starting during childhood. Any of these ring a bell? As a child did anyone ever say, ‘ You will never amount to anything!’ or ‘You’re stupid!’. As a teenager ever hear, ‘You’re untidy – just like your father!’. As a young adult anyone ever say ‘ He is just using you – he doesn’t really love you!’. In the work place, ‘You have probably reached the limit of your potential and are not a suitable candidate for promotion’ and so the list goes on.

At all stages of life, distorted or negative thinking lies in wait for us like a trap ready to be sprung. For people with chronic diseases, and especially for people suffering from depression and other mental health conditions, the potential is magnified many fold and may range from taking an issue and blowing it out of all proportion, for example thinking that ‘every mosquito that bites me carries the Zika virus’, to unfair or unreasonable chronic labeling; ‘I’m a diabetic’, or ever hear someone say or read ‘Obese people eat too much and don’t exercise because they don’t have enough willpower’. Ever think, ‘I’m a failure because I have a chronic disease’, or ‘Cancer is a word in a death sentence’. And this one is a real ‘bear trap’: believing that I’m a mind reader and know what others are thinking about me… ‘ They think that I’m a fat slob’.

Transformation Is A Process

The role of family, friends and work colleagues is not to tell the person with chronic disease that everything is going to be fine. Sometimes it’s not going to be fine. No, their job is to encourage the self-transformation of thinking from the negative and distorted to the fair and reasonable by considering possible alternative explanations that are based on evidence or fact. If you happen to be a person with a chronic disease then start by thinking about how someone you know well and trust might react or respond in a similar situation. Then brainstorm your situation with this person in an open and honest way. For people who hold religious beliefs – prayer and seeking spiritual guidance forms an essential part of the transformative process.

Fear, guilt and shame are an unholy threesome. Put them in the mix and out pops the mother of negative thinking: self-condemnation. Transforming negative thinking is a cognitive exercise – a thinking exercise – and just like physical exercise it needs a commitment to consistent practice. Transformation is seldom an event – it is almost always a process. So be persistent and most importantly be gentle with yourself. Changing behaviour – in this case changing negative thinking – takes time.

Changing Negative Thinking Takes Time

The behavioural exercise of changing negative thinking is not a one-off result of a single interaction. As we saw because transformation is a process and not an event it needs to be consciously practiced as a self-care behaviour until it becomes a habit. Now to help you get some practice in changing negative thinking, I suggest that you try this simple exercise. It’s called the ‘Three Column Exercise’ by experts in the field of behavioural change and it’s designed to help you in transform negative thoughts into thoughts that are perhaps more fair and realistic.

You are going need a pen or pencil and paper or if you prefer you can do this by inserting a 3 column multiple row table on a Word document or similar.

The Three Column Exercise

Column 1 is headed Triggering Situation; Column 2 is headed Negative Distorted Thought and Column 3 is headed Fair and Realistic Thought.

You should now have a 3 column table headed ‘triggering situation’ in column 1 ; ‘negative distorted thought’ in column 2 and finally ‘fair and reasonable thought’ in column 3. As an example of how to do this exercise, I want you to think about someone who has, out to the blue, cancelled a coffee date without any explanation – she simply sent you a text message saying, ‘sorry, can’t make it’.

In the row below Triggering Situation write or enter the words ‘cancelled coffee date’. Below Negative Distorted Thought write ‘maybe she does not like my company’ and then below Fair and Realistic Thought write ‘something serious must have come up for her to suddenly cancel’. The example I’ve used, speaks to a hypothetical negative thought that could arise in me if a friend cancelled a coffee date at short notice:

To practice this exercise, write down in the first column whatever it was that triggered a recent negative thought. In the second column write down the actual negative thought that surfaced as a result of the triggering situation. Then finally, in the third column, try and come up with an alternative thought and may offer a fair and realistic explanation for the triggering situation. This is where you may need some help from a close and trusted friend or relative. Discovering and accepting that there may well be an alternative to the negative thought that has been ‘eating’ at you is not always easy.

If you are plagued by negative and distorted thoughts, then for the next week or so I suggest that you practice the ‘Three Colum Exercise’ at least once a day. Teach others the exercise and encourage them to practice it. Better still, do it with a small group of friends or colleagues you trust and who know that you can be trusted. In each instance focus your thoughts on the answer you come up with in the third column – Fair and Realistic Thought. Reflect on what you consider to be a fair and realistic response to a triggering situation, and slowly…perhaps even very slowly – you will begin more and more to say goodbye to negative thoughts.

At UpForIT we are concerned about ‘whole-person’ health and that includes helping people to deal with the emotional consequences of obesity, diabetes and other conditions that go to make up the metabolic syndrome. If you would like to know more about the work we do and how we may be able to help you, please email me at

I’m Dr Peter Hill for UpFor It. Till next time, stay healthy and safe.