Negative core beliefs bias attention and meaning-making, often linking early experience to current automatic thoughts, affect, and behaviour.
Look for
Global self-statements
Patient language
“I am not good enough”
Formulation use
Negative core beliefs provide a bridge between developmental learning and current interpretations.
Rumination may feel like problem-solving but often maintains low mood, shame, threat, and cognitive inflexibility.
Look for
Long repetitive analysis
Patient language
“I keep going over it”
Formulation use
Rumination may maintain distress by keeping attention fixed on negative meanings without corrective action.
Shame often links trauma, attachment threat, avoidance, concealment, anger, self-criticism, and disengagement from care.
Look for
Downcast gaze
Patient language
“There is something wrong with me”
Formulation use
Shame may explain avoidance, anger, withdrawal, or self-attack when the patient feels exposed or dependent.
Splitting can simplify unbearable ambivalence but may destabilise relationships, teams, and self-experience.
Look for
Sudden idealisation or devaluation
Patient language
“They are the only one who understands me”
Formulation use
Splitting can organise otherwise overwhelming mixed feelings, but it may make alliance ruptures more likely.
Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.
Look for
What-if chains
Patient language
“What if something goes wrong?”
Formulation use
Worry may function as an attempted safety strategy that keeps threat active and uncertainty intolerable.