I'm sure you've all had the following experiences. One day, my boyfriend seemed to be a different person in a Whatsapp conversation, and his tone suddenly became cold and his reply was short. At that time, you may be thinking, "Am I doing something wrong?" "Doesn't he love me?" "He must have a new love." When I talk to my friends, I often get a reply of "Oh, it's fine!" But can we really stop thinking about it right there?


Written by Dr. Chow Ka Wai, School of Mental Health, Castle Peak Hospital


When someone around you is on the tip of the bull's horn, or you notice your own or others' negative emotions and body horns, you can also try to use the techniques in cognitive behavioral therapy theory to help you see the problem from different perspectives and angles through rhetorical questions, and get out of the trap of thinking.

My outpatient, Jia Ming, is a man in his 40s who suffers from depression. On the day of the outpatient clinic, he walked into the consultation room with a cane in hand, accompanied by his mother. He was originally a successful engineer, but unfortunately a traffic accident three years ago adapted his story, which unfortunately caused him to have his leg amputated, and he can no longer walk freely. After that, it was as if he was wearing a pair of sunglasses, and everything seemed to turn dark and hopeless in front of him. He felt so inferior that he couldn't hold his head up anymore, and even covered his face with a hat every time he went out. For 3 years, he has been receiving medication on an outpatient basis, but he still can't get out of the abyss completely.

On the same day, he shared with me some of the experiences that bothered him during his recent physiotherapy treatment. During the training, he always felt that the eyes of the patients' families around him were focused on him, which made him feel very uneasy and inferior, and finally chose to give up receiving treatment. At this point, the mother sitting next to him said, "I have advised him to ignore the others and pretend not to see." If you were Jia Ming's mother, what would you tell him? Later, Jiaming told me that he felt that other people looked at him because they discriminated against and looked down on him, which made him feel inferior, and then he gave up treatment.

Jiaming's subjective belief in his own views without sufficient evidence is exactly what we call a "thought trap" - "jumping to conclusions". Through patients sharing their worries with me, I found that many of them have fallen into the "thought trap" like Jia Ming. If mental illness is compared to an abyss, in the early stages of treatment, patients grasp the rope thrown down by the doctor, and pull them out with drugs, but they are often stuck in the stubborn "thought trap" halfway through. What exactly is that a "thought trap"?

Each person's perception of things is influenced by their personal experience and background, which forms their own thought patterns. Some of the common "thought traps" that can lead to mental illness include "All or Nothing Thinking", e.g. "Meaningless work means quitting immediately"; "Overgeneralization" (e.g. your boyfriend's brief reply that he doesn't love you) "Jumping to Conclusions" e.g. the example of Ka Ming. When a normal idea goes to the extreme, it can become a "thought trap" that goes to the top of the bull's horns.

In fact, in addition to prescribing drugs, psychiatrists often treat patients through psychotherapy, and one of the popular psychotherapy methods is cognitive behavioral therapy.

The theory of cognitive behavioral therapy asserts that "thoughts" are the main driving force of people's emotions and behaviors, so only by fully understanding the correlation and reciprocity between the three can we enable patients to get appropriate treatment out of the predicament. For example, Ka Ming has a "jumping to conclusions" mindset, which leads him to immediately conclude that they must be looking down on me, which makes him feel inferior and nervous, and his body will also sound different warning signals such as rapid heartbeat, dry mouth, dizziness, hand tremors, etc., and finally he even chooses to give up treatment. Thoughts, emotions, behaviour and bodily sensations are all closely related. To break the vicious cycle of negative reactions and behaviors, we need to actively change from these elements. The goal of CBT is to allow patients to see other possibilities of the same thing by changing their thought patterns, so that they can discover that it is not the objective facts themselves that affect our emotions, but our subjective thoughts about things.

If a friend asks you about seemingly unreasonable speculations and ideas, don't say "I'm sorry," but try to come up with other possibilities to help them get out of the trap of thinking.

Imagine if Ka Ming had been able to detach himself from his fixed thinking and analyze the reasons why other people looked at him from different angles, such as out of curiosity or even appreciating his courage to stand up for treatment, he would have become more positive and hopeful for recovery. On the contrary, choosing to avoid or even consolidate one's own stubborn thoughts will only lead the patient deeper and deeper.

Of course, the most scientifically based approach is to receive a full range of cognitive behavioural therapy, but Hong Kong people may not be able to spare time due to their busy lives, and given the limited resources of hospitals, this may not be the most practical approach. However, when someone around you is on the tip of the bull's horn or notices the negative emotions and body horns of yourself/others, you can also try to use the techniques in cognitive behavioral therapy theory to help you look at the problem from different perspectives and perspectives through rhetorical questions, get out of the trap of thinking, establish a positive and healthy way to face emotions, and reduce avoidance behaviors. The next time a friend asks you a seemingly unreasonable speculation or idea, don't say "It's too much" and try to come up with other possibilities to help them get out of the trap of thinking.

Castle Peak Hospital. (File photo/Photo by Zheng Zifeng)

"Hong Kong 01" "01 Medical Clinic", in collaboration with the School of Mental Health of Castle Peak Hospital, publishes a column written by medical staff on alternate Tuesdays.

"Cheng" means to let the water settle and then become clear. May you quietly savor each little story, see the subtleties, understand your own and others' hearts, and see things and feelings more clearly. See clearly, know how to cherish, may this column soothe your emotional waves, enjoy the quiet years. I hope you can share this experience with the people you care about, so that you can have one more partner on the road to a better life.

Details of the story have been revised to protect patient privacy.


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