The Complete Guide to Understanding and Managing Anxiety After 50

Woman journaling in home office.

Changing Your Thoughts: A Gentle Introduction to CBT

Our thoughts are not always facts. When we’re anxious, our minds have a tendency to create stories that are often distorted, negative, and focused on potential threats. Cognitive Behavioral Therapy (CBT) is a highly effective, evidence-based type of psychotherapy that helps people learn to identify, question, and change these unhelpful thought patterns. While working with a therapist is the best way to learn CBT, you can start practicing some of the basic principles at home.

Identifying Unhelpful Thinking Patterns

The first step is to become a curious observer of your own mind. Notice when your thoughts fall into common anxiety-fueling traps. Here are a couple of examples:

Catastrophizing: This is the “what if” game on overdrive. You take a small concern and your mind immediately blows it up into the worst possible outcome. A friend doesn’t text back, and you immediately think, “They must be angry with me, and our friendship is over.”

All-or-Nothing Thinking (also called Black-and-White Thinking): You see things in absolute terms. If a situation is anything less than perfect, you see it as a total failure. “I forgot one item at the grocery store. I’m so forgetful and can’t do anything right anymore.”

Just noticing these patterns without judgment is a huge step. You can say to yourself, “Ah, there’s that catastrophic thinking again.” This creates a little bit of space between you and the thought, reminding you that a thought is just a thought, not a reality.

The Three-Column Thought Record: A Mini-Example

A simple thought record is a powerful tool for challenging these automatic negative thoughts. It helps you slow down and look for a more balanced and realistic perspective. All you need is a piece of paper and a pen. Draw three columns.

Here is a worked mini-example to show you how it works:

Column 1: The Situation (Just the facts)

My doctor’s office called to schedule a follow-up appointment to review my lab results.

Column 2: My Automatic Thought & Feeling (The first thing that popped into my head)

Thought: “Oh no, they must have found something terrible. It’s bad news. I’m sure it’s cancer.”
Feeling: Panic, fear (rated 9 out of 10).

Column 3: A More Balanced & Realistic Thought (Looking for other possibilities)

“It is standard procedure to schedule a follow-up to discuss any lab results, good or bad. My doctor is thorough. It could be about my cholesterol, or a minor vitamin deficiency we discussed. There are many possibilities other than the worst-case scenario. I cannot know for sure until I go to the appointment. Worrying now will not change the result, it will only make me feel sick.”
New Feeling: Concerned, but less panicked (rated 5 out of 10).

The goal is not to pretend everything is fine or to engage in forced “positive thinking.” The goal is to see the situation more clearly and reduce the emotional intensity by considering other, more likely explanations. Practicing this gently over time can help retrain your brain to be less reactive and more balanced.

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