Use CBT wisely:3+1 Steps toward Stress Management


When giving a lecture to the local book club, I shared the famous self-help book written by a Stanford Psychiatrist Dr. David Burns: "Feeling Good" (Link to Amazon comments are at the end of this article). Some previous research has studied the impact of this book to our lives. They found that over 70% people with depressive mood experienced improved symptoms or even recover after reading this book.


Why this book is so helpful? It is based on CBT (cognitive behavioral therapy), and guide readers to practice coping tools step by step. CBT is an evidence-based treatment method and has been widely applied in hospitals and clinics in America. In my lecture, I combined my own clinical experiences and this book, introduced some basic ideas and tools of CBT, especially how to use CBT to cope with anxiety, stress, depression, and interpersonal challenges. Now I want to summarize some main points in my lecture here, and hopefully it is helpful to some of you.


Some surveys used to estimate that every one out of five people may suffer from depression. A lot of time, when we are under stress, the problem we are facing is not "how to deal with it," but keep on saying "I am fine!" Dr. Winch explained the concept of "emotional hygiene" in his TED talk. Isn't interesting that even a 5-year-old child knows to cry and ask for help when they are wounded physically, but we as adults don't know whether our emotions are wounded or how to ask for help?


Q:if my family members or my friends are depressed/stressed out, what should I do?

Step 1: Catch the Automatic Thoughts

Take a look at this simple list of automatic thoughts, how many of them are you connect with?

-Jump to conclusion

I know what you are thinking of, I know what the future look like, I don't need any evidence! 

"You guys were talking right before I came in, and now you are quiet, you must talk negatively about me just now!"


Everything has a its worst aspect, which is the one I always notice.

"I broke up.....uh, I will be single forever!"

-All-or-Nothing thinking

Everything has only black and white sides. No other possibilities! 

"If I cannot get A+ for all the classes, there will be no future for me!"

-“Should” Statement

"I should have done...."

"I must....."

-Mental filter

"You/Me are full of flaws....this this is wrong....that that is annoying..."

-Discounting the positives

My strength? I don't know what you are talking about...


I think I am = I am!

"I am total loser."

-Personalization & Blame

"It is all my fault."

-Emotional Reasoning

My emotion controls my life. 

"I don't feel like doing this right now, let me just postpone it."


Q:I know that I think too irrational sometimes, but I don't know how to get rid of these thoughts, what should I do? 

Step 2: Check Our Thoughts

A Chinese old saying says: when we are inside of the mountain, there is no way for us to see the shape of the whole mountain. If we are able to step back a little bit, shift an angle, we may see a different picture. 

Here are some tips you can practice:

Examine the evidence:

What are the evidence supporting my thoughts? 

What are the evidence against my thoughts? 


What did I say to myself? 

If similar things happened to my friends and family, what would I say to them? 

Cost-benefit analysis:

What are the advantages for thinking this way? 

What are the disadvantages for thinking this way? 

Middle Path:

If things don't follow my expectation, what does that mean? 

Is there any other possibilities except black and white thinking? 

What is the worst possible consequences? Can I handle that? 


Step 3: Change Self-Talk

Change the language: 

I am talking to myself with hurtful languages? Change it, especially the part with self-criticism.

Shift attention:

Cannot convince self or others? Think about something else, or something positive.

Mood / Thought  Log:

Track thoughts and process them.


Step +1:Self-Care

Dr. Kristin Neff developed the theory of self-compassion. She discussed some common misunderstandings to self-care. For example, we may think taking care of ourselves means that we are weak, selfish, stop ourself from moving forward. Actually, no one will be able to pour from empty glasses. If we only know how to live our lives for others or for external reasons, the energy from our inner self will dry up one day.

When coping with stress and depressive mood, please ask oursevles: 

Have I eaten my meal regularly recently?

Have I slept well recently?

Have I communicated with others recently?

Have I engaged in physical exercises recently?

Have I left time for myself and engage in activities I like recently?



If you are under a lot of stress or if you are bothered by negative emotions, please remember 3+1 steps:

Catch:catch the automatic thoughts

Check:check our thoughts

Change:change self-talk

  + the most important---self-care!


About the book "Feeling good":

I have two versions of this book, one is smaller and one is bigger, with forms that you can copy and practice. This book is designed for people who don't know psychology or CBT very well. It is well-written and easy to follow. Here are the links to the two versions I have (you can directly click the links to their Amazon pages and read the reviews).

Audio Book can be found in iTunes Store or through Amazon (click the pictures below to check more details):

Dr. Yishan Xu Author intro.png

Office Location:

885 N. San Antonio Rd., Suit O,

Los Altos, CA 94022

SF Bay Area