Are your negative thoughts bringing you down? You may be experiencing an ‘Attack of the NATS’ (Negative Automatic Thoughts)

What are NATS and why do they ‘attack’?

Negative automatic thoughts (NATs) are thoughts that tend to occur involuntarily as part of our day-to-day ‘self-talk’ and inner dialogue about how we are doing. They help us to monitor whether things are going OK or whether something needs our attention and possibly to change in our lives. Self-talk can be a useful safeguarding tool, helping us to stay on the ‘straight and narrow’ in our lives, achieve our goals and navigate our relationships and social groups. As a consequence, most of us are constantly experiencing inner self-talk, both positive and negative. The issue is that some of this self-talk can include fast and involuntary negative interpretations about ourselves, others or the world around us, which can leave us feeling distressed.

This inner voice, or internal monologue, is a powerful tool that allows us to solve problems, organise our thoughts and make sense of our experiences. It also allows us to assess potential threats to our wellbeing, both physically and socially. However, as human beings we can be particularly sensitive to things that may be wrong, uncertain or threatening. This means that our attention can sometimes become focused on what is not OK rather than on the things that are going well. When this happens, our self-talk can become increasingly negative, contributing to negative self-talk and Negative Automatic Thoughts (NATs). It is also an important aspect of being social animals that we naturally have a kind of ‘radar’ which compares ourselves to others, helping us to understand where we fit within our social group and whether we feel safe, accepted and secure. The downside of this tendency, however, is that we can become overly critical of ourselves, others and the world around us in ways that can be detrimental to our mental and physical wellbeing.

It was Aaron T. Beck who developed the cognitive model that became the foundation of Cognitive Behavioural Therapy (CBT), through his pioneering work with people experiencing difficulties such as anxiety and depression. Within CBT, automatic thoughts can occur quickly and involuntarily in response to situations, and some can become negative and distressing. NATs can often follow predictable patterns and themes, sometimes referred to as cognitive distortions or thinking errors in Cognitive Behavioural Therapy (CBT). A large part of CBT involves becoming more aware of these patterns, examining the thoughts and considering whether they are accurate, helpful and supported by the evidence. This can help us to reduce ‘awfulising’ and ‘catastrophising’ about situations which may not be as bad as our NATs are telling us. They can also include general statements such as ‘I am a failure’, which may be linked to our ‘core beliefs’ about ourselves and the world around us. These core beliefs can develop and become reinforced through our experiences during childhood and adulthood.

How NATS affects people

Our tendency to experience Negative Automatic Thoughts (NATs) can contribute to psychological distress, which can then influence our behaviour. This is because NATs can turn an event in our lives into a cascade of emotional, behavioural and physical consequences. Thus, from one ‘activating event’, we can become caught up in catastrophising and awfulising, persuading ourselves that life is indeed awful when the reality may be much more manageable.

When a NAT is triggered, the way we interpret the situation can contribute to the brain’s threat response, creating a difficult feedback loop across four distinct areas of a person’s life (Clark and Beck, 2012):

1. Emotional Distress
NATs can contribute to emotional distress and significantly alter our mood. When we are distressed, our thoughts can feel incredibly convincing, and we may experience our interpretations as though they are facts, even though they are subjective interpretations rather than objective reality. This can contribute to ‘unhealthy negative emotions’ such as anxiety, depression, anger, resentment, hurt, guilt or shame, as opposed to healthy negative emotions, which can be appropriate and helpful responses to difficult situations. For example, feeling sad after a relationship ends can be a healthy negative emotion. However, thinking ‘I will never be happy again because nobody will ever love me’ can turn that sadness into a much more distressing and overwhelming experience of depression.

2. Physical Symptoms
In addition to emotional distress, when we interpret something as threatening, this can activate the body’s stress response, including the sympathetic nervous system (the ‘fight-or-flight’ response). This can contribute to physical symptoms such as panic, a rapid heart rate, shallow breathing, headaches, gastrointestinal problems and butterflies or knots in the stomach. If we remain under prolonged stress, our bodies can also become physically and emotionally exhausted, which can contribute to feelings of fatigue.

3. Behavioural Changes
Often, as a way of coping with the emotional pain associated with NATs, people can start to alter their behaviour in ways that unintentionally reinforce their negative thoughts and beliefs, often creating a vicious cycle of negativity. This can include behaviours such as avoiding social events or commitments, over-preparing, procrastinating or constantly seeking reassurance from others. This can be particularly debilitating if our core beliefs also include perfectionistic tendencies, which can make the prospect of failure feel even more threatening.

4. Self-Fulfilling Prophecies
With prolonged exposure to NATs, there can be a feeling of doom or gloom and a belief that history will repeat itself. This can lead to self-fulfilling prophecies, where our behaviour unintentionally reinforces the negative predictions we are making. It can be difficult to get out of this mindset, but Cognitive Behavioural Therapy can help to break this cycle through the use of psychological and behavioural tools.

The most damaging aspect of persistent NATs is therefore not simply the thoughts themselves, but the way they can influence how we feel and behave. It is important to get help to find a new way of thinking about the challenges in our lives, so that we can feel more empowered and less like a victim of circumstance.

How I can help

CBT sessions can be a good way of understanding, evaluating and reframing your NATs into what I call ‘PATS’ (Positive Automatic Thoughts), or, in other words, more supportive and compassionate self-talk. However, PATS are not about forcing ourselves to think positively or pretending that everything is wonderful when it is not. Instead, they are about developing more balanced, realistic and compassionate ways of responding to ourselves and the challenges we face. PAT 'boosts' can also improve your mood and well-being with self-talk such as 'I am strong, resilient and can cope with anything that comes my way'. With my ideal of PAT 'boots' you can create the 'you' you want to be in the future, and with enough practice, the unconscious gets the memo and starts to believe it as well. If people tell us enough times that we are useless, unworthy or stupid we start to believe it, on the other hand, if we tell ourselves enough that we are strong, resilient and worthwhile we can also shift our 'core beliefs' about ourselves to having a more optimistic and resilient mindset.

In addition, in the sessions we use CBT to explore the connection between your experiences in childhood and adulthood that may have contributed to the development of NATs and negative core beliefs, and identify patterns that may be keeping negative thoughts and feelings going. Rather than simply accepting NATs as the truth, our work in sessions would aim to understand where these thoughts have come from, evaluate whether they are accurate and helpful, and develop lasting methods for coping with life’s challenges in a more balanced and compassionate way. Life is not always ideal, but we can reach a level of acceptance about the things we cannot change, but also change the things we can with the help and support of ourselves and others around us.

A 4-Step CBT Approach to Changing NATs

Aaron Beck’s cognitive model provides the foundation for many CBT techniques used to identify and evaluate NATs. A useful four-step approach for challenging and changing NATs is:

1.) Identifying the NATs
The first step is to notice and identify negative thoughts when they occur. These thoughts are often immediate reactions to situations (e.g., ‘I’m going to fail this presentation’). To do this, it can be useful to have a ‘thought record’, which is a structured worksheet where thoughts are logged along with the situation, emotions and evidence for and against the thought, before considering an alternative and more balanced thought.

2.) Examining the Evidence
The evidence can then be examined by looking at what supports the thought and what contradicts it. This is where thinking errors can sometimes be identified, such as catastrophising, overgeneralising or absolute all-or-nothing thinking.

3.) Generating Alternative Thoughts
Based on the evidence, a more balanced and realistic perspective can be developed. The aim isn't to replace a negative thought with an unrealistically positive one, but to develop an alternative perspective that is more constructive, compassionate and grounded in reality.

4.) Behavioural Experiments
These new perspectives and predictions can then be tested in real-world situations to see whether the negative predictions actually come true. Behavioural experiments can provide new evidence and help us discover that situations may not turn out in the way our NATs predicted. Over time, this can help to develop more compassionate self-talk and a more balanced outlook on life.

Example: The fear of being rejected on dates

Zaf, who has just come out of a long marriage and subsequent divorce, is worried about starting dating again. He is anxious about going on dates and being rejected. He has not had to go on dates for many years and, following a difficult marriage and divorce, may have developed or reinforced negative core beliefs about himself. These beliefs can then contribute to associated NATs, resulting in low self-esteem.

Thought (NAT): ‘I am a failure, I had a failed marriage, nobody will want me.’
Core belief: ‘I am a failure’ / ‘I am unlovable.’
Feeling (Emotion): Anxiety, sadness and shame.
Behaviour (Action): Avoids going on dates or asking anyone out due to the fear of rejection and perceived failure.

Within our sessions, Zaf would be able to talk through his marriage break-up in order to understand what happened and how this experience has affected his thoughts, feelings and behaviours. We would identify his specific NATs and explore how these may be linked to deeper core beliefs, before examining the evidence and considering whether these thoughts are completely accurate, helpful or fair.

We could then look at his negative thought of ‘I am a failure, I had a failed marriage, nobody will want me’ and develop an alternative perspective that is more in line with his core values and goals in life, such as: ‘My marriage ending doesn't mean that I am a failure. I can use the experiences from my marriage to become a better partner in a new relationship, and find someone I am more compatible with.’

The aim of ‘PATS’ (Positive Automatic Thoughts) is not to pretend that everything is perfect, but to develop stronger, healthier and more realistic beliefs about ourselves. This can help to build self-worth, resilience and hope for the future. Zaf could also then try some behavioural activation techniques by going out on dates while reciting his more positive beliefs or ‘PATS’ about himself, and develop ‘high frustration tolerance’ to any rejections he may get along the way. In this way, he can build up resilience and improve his self-esteem and belief that he is indeed lovable and can be a good partner to someone.

So, from the above explanation and example, the next time you have an ‘Attack of the NATS’, put pen to paper (or fingers to keyboard) and take a closer look at what your NATs are telling you. Ask yourself: Are they facts, or are they interpretations? What evidence supports them – and what evidence does not support them.

Sometimes, changing the way we talk to ourselves can be the first step towards changing the way we feel about ourselves and changing our life for the better.