Body Dysmorphia - Thought Record Sheet

What’s the outcome?

Situation Emotion/s Initial thought, image, Alternative response What did I do?
& Trigger Rate 0 – 100% doub, feeling, worry What could I do or have
What would be a healthier How long for? done instead?
Physical Meaning of the initial more balanced perspective? Defusion technique?
Sensations? thought or image. How many times? What’s the best response?
Re-rate Emotion
What’s the worst thing?

What helped or would have been

STOPP! Take a breath…. helpful?
What’s the bigger picture? What could I do differently?

Is there another way of seeing it? What would be more effective?

What advice would I give Act wisely. Consider my
someone else? goals/values.
What went through my mind?
What emotion did What disturbed me? What importance am I giving this If I gave this issue less
What happened? I feel at that time? What’s the real issue here? issue? How important is it importance, what would I feel or
Where? When? What else? How What did it mean that I had REALLY? Is my reaction in do differently?
Who with? How? intense was it? that thought or image? proportion to the actual issue? What will be most helpful for me or
What am I responding to? If I didn’t give it such importance,
What did I notice? What did I feel in What’s the worst thing about how would that intrusive thought What did I feel like doing but didn’t? the situation?
What did I react to? my body? that? (about that issue) affect me? What did I do instead? What will the consequences be?
www.get.gg © Carol Vivyan 2010, permission to use for therapy purposes www.getselfhelp.co.uk