Thoughts That Break Your Heart: Learning Empowered Thinking for Cardiac Health by Arthur M. Nezu, MD

There are three types of thinking habits that are particularly "cardiotoxic," or potentially poisonous to your heart, they are: fearful thoughts, angry thoughts and depressive thoughts. These thoughts are so destructive to your psychological, emotional, and physical health that they have been associated, either individually or in combination, with heart disease (Sirois and Burg 2003) as well as many psychological or medical problems. Learning to make your thinking more empowered can be a very important tool for reducing your own negative thinking patterns and the likelihood of subsequent harmful health effects. Let's begin by learning more about these three different types of negative thinking patterns.

Fearful Thinking: When you are caught in a fearful or anxious thinking pattern, you become a prisoner to all that you fear. Much of your energy is focused on avoiding the unpleasant aspects of anxiety. Fear-based thoughts usually contain an anticipation of harm. Examples include when you hear yourself making internal statements that you may fail at something important or that other people may get angry with you. Another common fearful thought involves mind reading, or assuming that you know what others think when you have little or no proof.

Examples include: He thinks I'm crazy, They're probably laughing at me, I'm going to screw up, or She doesn't care about me. Have you ever experienced any of these thoughts? In this case, your mind has decided to accept the worst possible outcome. Often, people focus on the worst-possible scenario-for example, the likelihood that a plane is going to crash. Statistics prove that it is more likely that a person will get injured or die in a car accident than in a plane crash. Some people focus on the worst-case scenario, allowing the horrors of a plane crash to "justify" not boarding a plane but fearlessly getting into a car to travel. In this way, fear-based thinking is not only inaccurate, it is usually irrational.

Angry Thinking: Angry, hostile, and cynical thoughts are actually quite similar to fearful thoughts. The difference between hostile thoughts and fearful thoughts is the content. Specifically, the content of hostile thoughts involves other people, those whom you can blame for your disappointments. You might view others, particularly those who disagree with you, as foolish and lacking intelligence or insight. When you engage in angry thinking, your mind tells you that others don't respect you or recognize how important, smart, or great you are. You have learned that by seeing others as stupid, faulty, or unappreciative, you can avoid looking at any faults or problems of your own.

Focusing on yourself may be too threatening and likely to engender very unpleasant emotions, so you have learned that it is better to engage in hostile thinking, keep such emotions away, and perceive yourself as in control. The problem is that you are likely to feel irritable and impatient with others most of the time. Unfortunately, it is you and your heart that will actually suffer.

Although people who have hostile thinking habits are less likely to see a counselor and seek help in changing (since they believe everyone else is at fault), many eventually do because they have experienced a personal, legal, financial, or medical setback that revealed their angry thinking or behavior as problematic. Because of the association between hostile thinking and medical conditions such as hypertension and cardiac arrhythmias, many heart patients are referred by their physicians to psychologists and counselors for help in changing their hostile thinking.

Depressive Thinking: Depressive thoughts can seem like the opposite of hostile thoughts. When you are absorbed in depressive thinking, your mind is telling you that you are defective, inferior, or worthless. You usually do not engage in many fearful or hostile thinking patterns, because you are convinced that the reason things are unlikely to work out or make you happy is that you are basically inadequate. While people who engage in hostile thinking believe that they can control hurt or personal insult by blaming other people or avoiding the situation, with depressive thinking you tell yourself that change is hopeless and convince yourself that nothing much will turn out well. You view yourself as likely to fail, envision that your vulnerabilities will be revealed, and predict that you won't experience much pleasure or enjoyment in your life.

Unless you confront your disempowered ways of thinking, the habits you have learned will likely be repeated, and you will continue to trigger a cycle of distressful emotional reactions. Through techniques of cognitive therapy pioneered by psychiatrist Aaron Beck and others, countless people have successfully learned to change their negative thoughts. This therapy approach is based upon the observation that how you feel is determined by what you think (Beck 1976).

Excerpted and edited with permission from: The Emotional Wellness Way to Cardiac Health by Arthur M. Nezu, MD et al (New Harbinger Publications; 2005: $16.95;