The Power of “What Then, So What?”: A Therapist’s Reflection on Reframing Negative Thoughts

One of the most common struggles I hear from clients—whether they are dealing with anxiety, depression, or burnout—is the feeling of being trapped inside their own mind. They describe racing thoughts that spiral into worst-case scenarios, or a negative inner voice that constantly tells them what’s not working. Often, these thoughts take on a life of their own, leaving them exhausted, discouraged, or even paralyzed.

In my work as a private-practice psychologist in Denver, CO, I often introduce a deceptively simple but powerful Cognitive Behavioral Therapy (CBT) technique: the “What then? So what?” method. At first, clients usually smile at how straightforward it sounds. But when they practice it, many are surprised at how it can cut through cycles of rumination and open up space for a calmer, more balanced perspective.

Where This Approach Comes From

CBT, one of the most widely researched therapies, is based on the principle that our thoughts, emotions, and behaviors are interconnected. Decades of research show that when we shift the way we relate to our thoughts, we can change how we feel and how we act.

The “What then, so what?” strategy is one way of challenging cognitive distortions—those mental habits like catastrophizing (“everything will fall apart”), mind-reading (“they must think I’m incompetent”), or overgeneralizing (“I always mess things up”). It helps us slow down and test the story our mind is telling us, instead of automatically believing it.

How “What Then, So What?” Works

Here’s the basic idea:

1. Identify the worrisome or negative thought.

2. Ask yourself: “What then?” (What would actually happen if this came true?)

3. Follow it with: “So what?” (Would it really be catastrophic? Could I cope?)

This isn’t about dismissing concerns. Like visualizing a downward arrow, we practice tracing thoughts down to their logical end. Often, people find that the “scary thought” shrinks when examined more closely. Instead of being swept away by rumination, they begin to see possibilities, resilience, and options. And then... people can take action from their values, instead of their worries.

Case Reflections on Reframing Negative Thoughts

Here are a few ways I’ve seen this play out in sessions (details changed to protect confidentiality):

• Anxiety at Work A client once told me: “If I make a mistake in this presentation, my boss will think I’m incompetent.” We paused. “What then?” I asked. They considered: “Maybe she’ll be disappointed.” And “So what?”  and "What next?" line of questioning led them to reflect: “I’ve made small mistakes before, and she’s still trusted me with big projects. Even if she were frustrated, I could still recover.”This reframing helped reduce their racing heart and allowed them to focus on doing their best and learning from the experience (which were their chosen values), rather than chasing perfection.

  
  

• Burnout and Exhaustion Another client, in the middle of burnout, felt overwhelmed: “If I don’t answer emails tonight, everything will collapse tomorrow.” We slowed down: “What then?” They replied: “Some emails may be delayed.” And “So what?” series of questions brought this realization: “Delays happen. People usually understand. I need rest if I’m going to keep functioning.” This shift allowed them to put down the laptop and reclaim their evening, a boundary necessary for mitigating against burnout.

  
  

• Depression and Self-Criticism One client struggling with depression often said: “If I cancel plans again, my friends will stop liking me.” Through “What then?” they recognized: “Maybe they’ll be disappointed.” And with “So what?”: “If they are true friends, they’ll still care. If not, maybe it’s a sign I need relationships where I can show up as I am.” That shift didn’t erase their sadness, but it loosened the grip of self-blame and opened the door to more compassionate self-talk.

Why It Works for Rumination and Pessimism

Rumination—going over the same thought again and again—is exhausting. It often shows up in both anxiety and depression, and is a frequent companion to burnout. The “What then, so what?” technique interrupts the loop. Instead of spinning endlessly, you create an endpoint: you trace the thought out, reality-test it, and often discover it’s less catastrophic than your mind first suggested.

This approach also softens the pessimistic bias many of us fall into when burned out or depressed. By asking “So what?”, you invite in perspective, resilience, and even humor. Moreover, it makes room to consider how your personal values could lead the way instead of your negative thinking.

Bringing It Into Your Life

The next time you catch yourself spiraling, try it:

• Pause and notice the thought.

• Ask: “What then?”

• Follow with: “So what?”

• Notice if the thought begins to loosen its grip.

You may find this simple questioning doesn’t erase the thought, but it takes away its power. With practice, clients tell me it helps them feel less controlled by their anxiety, reframing negative thoughts so that can are more able to live in alignment with their values.

Final Reflection

In therapy for anxiety, I often remind clients: our thoughts are not always facts. The “What then, so what?” method gives us a way to check our mind’s stories and invite in a gentler, more balanced outlook.

Whether you are navigating burnout, struggling with depression, or caught in the anxious “what ifs,” this small shift can help you find steadier ground.

And sometimes, that’s enough to make the difference between being trapped in rumination and reclaiming your peace of mind.

👉 If you’re in Denver, CO and struggling with anxiety, depression, or burnout, virtual therapy can help. Together, we can work on practical strategies like these—while also getting to the root causes—to help you move from exhaustion and self-doubt toward clarity, purpose, and renewal.

Other Online Therapy Services I Offer in Colorado

When the weight of anxious thoughts begins to show up, online therapy for anxiety in Denver can offer the relief and reconnection you’ve been searching for. In our work together, we’ll focus not only on managing symptoms but on helping you feel grounded, empowered, and well again.

Beyond burnout and stress recovery, I offer a range of mental health services through my Colorado-based online therapy practice. These include specialized care for anxiety, support for trauma survivors, and guidance for individuals facing difficult life transitions. Whether you're feeling lost in your relationships or navigating a period of personal change, I provide thoughtful, individualized care that meets you where you are. I invite you to explore my website to learn more, dive into helpful blog content, and schedule a consultation whenever you’re ready to begin your healing journey.

About the Author

Dr. Jennifer Olson-Madden is a licensed psychologist and expert in Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT), dedicated to helping clients achieve purposeful and successful outcomes through inspired and committed action. With over 15 years of licensure in Denver, CO, and more than two decades of experience in treating anxiety and chronic stress. She not only practices the skills she teaches professionally but also integrates its principles into her own life daily.