In this post, we are going to focus on an important part of the CBT Iceberg and look at the intermediate level of beliefs: Rules for Living. As we go beneath the iceberg it will become more difficult but also more rewarding and life changing to restructure these aspects of your cognitive maps. Remember that resistance will be natural and typical as this is a level of change that takes time and perseverance. This level of change is “life work.” Rules for living are more difficult to challenge and change than automatic thoughts but less difficult than core beliefs.
After we examine the characteristics of rules for living we will turn to the next behavioral intervention designed to tackle these rules: Behavioral Experiments. Behavioral experiments involve challenging rules by changing the “if” part of the rule to test whether new “then” conclusions can be made.
Rules for Living
Rules for living are sometimes referred to as “intermediate beliefs” or “compensatory strategies” in the CBT jargon. They are “intermediate” between automatic thoughts and core beliefs and they often lead to ways of compensating for core beliefs. For example, if someone has a core belief: “I am inadequate and will be rejected” then they may compensate for this belief by developing a rule: “If I stick to myself then I can’t be rejected.” The rule is designed to protect against the core belief becoming activated.
We all have rules and we would not be able to function without them. These rules exist implicitly even if a person cannot explicitly articulate what they are. Rules are ever present, even if they are not immediately obvious. For example, even the belief: “I do not believe in rules” is a rule! Stated differently, this belief in rule form would look like: “Always reject rules and never stick to a consistent principle.” There is, therefore, no way of getting around the fact that we all have rules that we follow whether we are aware of them or not. These rules often exist on a subconscious level (below the water line on the CBT iceberg) and need to be brought to consciousness for evaluation.
Rules are learned and are not genetically hardwired, though genetics may predispose us to adopt certain rules easier than others. Rules are thus heavily influenced by sociocultural factors and by our families of origin. Rules tend to be transmitted from parents to children and form the rationale for many of the behaviors we adopt. It is difficult to change behavior without understanding the rule that drives that behavior. Rules therefore tend to be stubborn and resistant to change as we wouldn’t adopt rules that we didn’t think made us safe or functional in some way.
When starting to examine rules, it is easiest to translate them to an “If….then” framework. For example, a couple may come to therapy to talk about their constant conflict with each other and an inability to repair their relationship. They may simply report: “We fight a lot and drift apart afterwards” but a skilled CBT therapist may identify a maladaptive rule in the background such as: “If I say sorry then I’ll appear weak.” As you can see, the rule is probably at the heart of the couples troubles but it is often not articulated immediately as: “If…then.” With skillful probing, a therapist needs to be able to take vague statements and put them into the “if…then” rule framework so that clients can more easily understand their psychological world.
If…then rules also contain lots of unexamined implicit assumptions that need to be analyzed. For example, “If I say sorry then I will appear weak” can also be understood as a set of assumptions. This rule implies a certain definition of weakness, assumes that others share this view and assumes that denying weakness is desirable and valuable. In many cases, the person will simply not have examined this rule in such depth and will probably not be aware of the assumptions that fall apart upon examination. In some cases the rule may be more entrenched so the assumptions can become targets for standard CBT challenging techniques such as identifying distortions or the evidence technique.
Rules can also be thought of as contingency plans. A contingency is something that occurs when a given condition is met. For example: “If I am put in a new situation…then I remain quiet” can be thought of a contingency. The condition of “new situation” triggers the contingent behavior of silence. Contingencies are similar to the “compensatory strategies” we listed earlier. They are planned ways of achieving goals when certain situations arise.
Rules for living are important because they organize and coordinate our daily existence. They can also be viewed as “coping strategies” that help individuals deal with stress. For example, if a person is terrified of rejection they may develop the rule: “If I’m nice to everyone then they’ll like me.” Being nice becomes a coping strategy for preventing the feared outcome of rejection. This rule is probably useful in many situations but there are others where this rule would lead to a person becoming unassertive and avoiding healthy conflict. This leads us to the next skill therapists need to develop: how to tell helpful from unhelpful rules.
Helpful vs. Unhelpful Rules
Since we all have rules it’s important to be able to distinguish between maladaptive and adaptive aspects of rules. There are certain typical characteristics of helpful rules that include:
- Being Realistic: Helpful rules will reflect a realistic view of reality and will not be distorted too much in any one direction. These rules will be realistic to achieve and will not reflect impossible standards. For example, the rule: “I must be perfect at everything” is clearly unrealistic because it is not achievable by anybody. A healthy approximation of this might be: “I do my best when focusing on things important to me.” This is a much more realistic rule that is capable of being achieved.
- Flexible over time, experience and learning: Helpful rules are not too rigid and are able to be adapted when new learning or experience calls for change. For example, the rule: “I shouldn’t trust new people” may be developed in high school and may be based upon experiences of being bullied. However, this rule may cease to be useful later in life and would become maladaptive if it could not be changed to suit new circumstances.
- Intelligent: Helpful rules make accurate distinctions between what we can and cannot control. They focus on process rather than outcomes since outcomes are often out of our control. For example, the rule: “If I study hard then I will always get 100%” is outside of the person’s control and is therefore unhelpful. Changing this rule to: “If I have a test then I study until I know the material” is a much more helpful rule since it focuses on what the person can control (studying) rather than the outcome that depends upon another person’s judgment which is outside of the student’s control.
- Meaningful: Helpful rules are necessary and meaningful to the individual and are not superfluous or not needed. For example, a person may be taught the rule: “Always knock on wood when speaking of your own good fortune” but not really believe in it. Since this rule isn’t meaningful, it is probably unhelpful in the grand scheme of things.
- Tend to lead to behaviour patterns that “work.” We can judge the efficacy of rules by judging the behaviors that they lead to. If a rule leads to dysfunctional or maladaptive behaviors then the rule itself is probably unhelpful. Helpful rules will lead to behaviors that facilitate beneficial goal achievement and will not hinder those goals.
In contrast to helpful rules, unhelpful rules have the following inverse characteristics:
- Unrealistic: These rules reflect a distorted view of reality and set impossible standards that cannot reasonably be maintained.
- Rigid: These rules are inflexible and completely resistant to change even when new data reveals their inadequacy. For Example: “If I enroll my kids in many activities, then I am a good parent” may be rigid when new evidence (child exhaustion) fails to modify the rule.
- Unreasonable: These rules focus on what is outside of a person’s control rather than what they can control. They focus on outcomes rather than processes.
- Unnecessary: These rules are often safety behaviors that don’t really keep the person safe. For example, knocking on wood doesn’t really keep a person safe but the person may believe it does.
- Lead to dysfunctional behaviors: A rule can be determined to be maladaptive simply because it leads to maladaptive behaviors.
Below are some examples of common rules for living that form the cognitive map for certain DSM diagnoses:
- “If I say something dumb at a party then people will think I am stupid.” (Social Anxiety)
- “If people hurt me, then they should never be trusted again.” (Attachment Disorder)
- “If I think about something terrible, then it will happen.” (OCD)
- “If this job doesn’t work out, then I am a failure.” (Depression)
Identifying Rules for Living
As has been previously mentioned, Rules for Living are not always explicitly articulated by people and need to be skillfully identified. There are many different sources that you can look to when determining your rules for living that include:
- Thought Records: Your rules are sometimes listed directly as automatic thoughts in a thought record. They can also emerge from multiple thought records after identifying general themes in them.
- Socratic Dialogue: Sometimes rules are identified in conversation with the client. For example, if a therapist gives a suggestion and the client resists there may be an underlying rule you’ve identified. A therapist may say: “I wonder if saying sorry would solve the problem” and a client may respond: “That’s out of the question.” A little more probing may identify a general rule that the client has about apologies in general.
- Client value judgments or anger: Another good source for identifying rules is when you notice yourself responding with judgment or anger to certain people or situations. Judgments and anger are both frequent responses to rule violations. For example, if you are angry with your husband, ask him what rule he broke that is causing this response.
- Shoulds, Oughts and Musts: People will also frequently frame rules with words like: “should” “ought” or “must.” Pay attention when these words are used as they are good hints that you are probably dealing with a rule for living that needs examination.
- Society and Culture: Having knowledge of certain subcultures may provide good hints for a therapist trying to identify rules. For example, a person who comes from a Christian background will probably have rules that reflect that worldview. Similarly, a person with a Muslim background will probably have rules influenced by that religion.
Challenging Rules for Living
Rules for Living can be challenged using standard cognitive restructuring techniques or they can be challenged using behavioral experiments. We will first briefly discuss cognitive restructuring techniques and then look at behavioral experiments in more depth afterwards.
Just like automatic thoughts, Rules for Living can be taken through the process of identifying distortions, generating evidence and creating balanced rules. For example, if you identify the rule: “If I am not the top in my class then I am nothing” then you can examine its validity and utility. This rule clearly reflects all-or-nothing thinking, over-generalizing and a host of other distortions. Examining the evidence a client has for this belief may reveal where this rule came from and whether it is realistic, reasonable and flexible. This rule can also be examined for its utility: “What effects does this rule have on your life?” and for double standards: “What would you tell a best friend who was not the top in their class?” After going through this process, you may be able to generate a balanced rule: “If I do my best in class then I can be satisfied with the results.”
Whenever a person reasons using rules, they are using certain patterns of inference to justify those rules. Rules are claims that: “If x situation occurs then y response is necessary or forbidden.” The rule mediates between what is claimed as fact and what the client claims needs to be done about that fact. Reasoning with rules also frequently involves reasoning with analogies as the person says: “X should be done in Y situation.” “My rule is activated because this new situation is similar enough to situation x to justify this y response.”
However, this line of reasoning is subject to certain tests to ensure sound reasoning is occurring.
- Do the facts of the situation justify activating the rule? This test ensures that the essential requirements of the rule are met before it’s activated. For example, if a client has a rule: “If someone is rude to me then I must be rude back” we need to ensure the essential facts of the situation justify the rule activation. We need to determine if the person really was being rude or whether there was some other explanation for the behavior. Clients may be activating rules in situations that don’t meet the essential requirements of the rule.
- Have all relevant aspects of the situation been considered? Ensure that a client considers all aspects of a situation before activating his rule. For example: “If my child misbehaves then he should be disciplined” should only be activated if all aspects of the situation have been considered. Is the child really misbehaving or is there some other explanation that would cause this rule to be deactivated?
- Is the rule itself based upon sound principles? Clients should reflect on why they believe a rule is useful and the evidence base needs to be examined. For example, the rule: “If my husband is upset then I must do everything to please him” may be based on examples from past relationships. This general rule may have been formed based on inadequate data
A general process for challenging rules is listed below:
- Identify the unhelpful rule First identify the rule using the sources we have already discussed.
- Work out where it came from: Try and understand what role this rule has served in the clients life and whether it was once useful or not.
- Ask: Is the rule realistic, reasonable or achievable? Examine the rule according to the criteria discussed about helpful and unhelpful rules.
- “Name” the negative consequences of having and keeping this rule: Examine the rules utility and usefulness in the client’s life.
- Identify a more helpful rule, if there were one: Generate a balanced rule that can be experimented with.
- Plan how to adjust life with new rule: Troubleshoot and debrief rule changes with the client at subsequent sessions to solidify gains.
Cognitive Restructuring is sometimes not enough to challenge resistant rules for living. When these tools are not enough, behavioral experiments are powerful interventions for challenging rules for living. As mentioned earlier, behavioral experiments challenge rules by manipulating the: “if…” part of a rule to challenge the “then” conclusions that clients have. The rule is based upon the foundation that “if” will reliably lead to “then” and the behavioral experiment is designed to cast doubt on this assumption.
For example, the rule: “If I speak up in class then I will be ridiculed” can be tested through a behavioral experiment. The client needs to speak up in class in order to test whether the rule is accurate or not. Now, usually, the rule is based upon a few isolated experiences that the client has had so you will need to make sure the experiment is done with new situations that are likely to yield a difference outcome. Ideally, testing this rule in a variety of circumstances will be more beneficial rather than just doing it once.
Behavioral experiments are a perfect bridge between cognitive and behavioral interventions. They help us gather data/evidence against our most influencing negative assumptions. They are designed like an experiment to test the predictions or validity of our conclusions by exposing us to new information. They can be done in session, but they are also often designed in session and then done as homework between sessions.
Behavioral experiments are often confused with exposure work but they are different interventions. While exposures are done to reduce fear/anxiety, behavioral experiments can be used for a variety of reasons, such as changing a rule or testing a new idea. Also, behavioral experiments do not involve prolonged toleration of anxiety but instead simply involve a changed behavioral response and then reflecting upon the data generated. While exposures usually need to be repeated over and over, behavioral experiments usually only need to be done a few times until the client shifts the initial conclusion. Instead, behavioral experiments are uniquely designed events aimed at testing a hypothesis (or rule). Behavioral experiments can include conducting surveys, introducing new behaviors/thoughts and monitoring the results of those changes.
A step-by-step guide for conducting behavioral experiments is included below for your convenience:
Steps to Doing Behavioral Experiments
Phase 1: Pre-Experiment Work
Step 1: Write down the assumption, rule or expectation that you want to test. For example, the belief: “If I speak up in class I will be ridiculed” might be recorded here.
Step 2: Design an Experiment that will accurately test whether this prediction will come true or not. Answer the following questions: how are you going to measure this? How many times? Determine specifics to your plan: what, when, where, who and how? The experiment usually flows naturally from the rule. For the above example, the series of experiments might include: “I will speak up in math class on Monday, science on Wednesday and Art on Friday.”
Step 3: Make your predictions about what the likely outcomes of the experiment are and rate how likely you think each outcome is to happen out of 100. Also, write down alternative predictions that you might not think are likely. For example, the client may predict: “When I speak up, I will be made fun of” or “When I speak up people will be surprised.”
Step 4: Problem solve barriers by anticipating what could go wrong and then creating a contingency plan to deal with it. For example, the student about to speak up in class might anticipate that looking at everyone’s faces before doing so might scare her. She may then resolve to purposely avoid doing so until she has spoken up. She might also develop coping statements she can use in the moment when her fear becomes heightened.
Phase 2: Conduct the Experiment
Step 5: Conduct the Experiment that was planned, ensuring all of the details that were planned were followed through on.
Phase 3: Post-Experiment Work
Step 6: Review outcomes to determine if your predictions were confirmed. Does the new data justify a new rule or hypothesis? Determine if you need to do a re-test or to gather more data. If your hypothesis was confirmed brainstorm why it may have been.
Step 7: Revision and New Experiments. If your hypothesis was not confirmed and you feel you have enough data to adapt a healthy rule, you don’t need to do any more experiments. You may want to anyways, to solidify gains but that’s up to the therapist and client. If your predictions were accurate, new behavioral experiments need to be designed that will be more likely to yield positive outcomes. Determine what characteristics of the situation led to the negative outcome and then try and eliminate them on subsequent experiments. The client will need to learn how to differentiate between contexts that suit the rule and contexts that do not.
You can also do behavioral experiments much more informally by reducing them to their core components. For example, you can design something relatively quickly for a client with social anxiety that might look like this:
- Prediction: Thought, “I will do something dumb and everyone will laugh” (90% confidence)
- Task: Go to mall, drop change on floor
- Record: How many people stop and laugh, how that makes me feel
- Bring back: What (actually) happened, how you felt, how “right” you were about prediction
Rules for Living and Behavioral Experiments