What is Cognitive Behavioral Therapy (CBT) and why does that matter?

by | Oct 15, 2022 | Secrets of Psychotherapy

Cognitive Behavioral therapy (CBT) is a style of therapy. There are many styles and others include Freudian (also know as psychodynamic), Client-Centered, Gestalt, Behavioral, and more.

CBT at its core helps clients to understand that emotions (particularly distressing ones such as anxiety, depression, anger, guilt, and resentment) are, for the most part created by the way we think. With that understanding (note that understanding is not enough), clients are taught how to change their negative thoughts that create the emotions so that the emotions reduce or even disappear.

Let me demonstrate how this works. Right now, as you read this, I want you to identify the emotion you are most likely to feel when you are distressed. Perhaps that emotion is feeling anxious, depressed, angry etc. Now that you have identified the emotion, I want you to rate it on a scale of 1-10 with one being it is at a very low intensity and 10 it is at a very high intensity. The next step is for you to raise that emotion 1 level on the scale. For example, if it is at a 3, raise it to a 4. Once you have raised it one level, I challenge you to raise it one more level. Most people are able to raise their emotions 2 levels.

Assuming you were successful in raising your emotion, ask yourself “How did I do that?” The answer is that you thought about something that you would say, “Makes me anxious, depressed, angry, etc. Your thought process is the mechanism that activated your emotion. If you can raise your emotion then you can learn to lower it. That is the basis for CBT. You learn how to identify and change the thoughts that are creating your emotional distress.

For the process to work, you must practice over and over so that your negative thinking auto-pilot which creates your emotional distress is changed into accurate or true thinking which will reduce your emotional distress. While you can do this without a therapist (for example, by using CBT workbooks), it is much more likely that you will succeed if you have a skilled therapist working with you.

For more understanding of the auto-pilot process that must be corrected see my Blog on “The Auto-Pilot.”

Here are some quick lessons about CBT:

  1. It is not a quick fix. It takes ongoing practice and consciousness.
  2. People have ingrained set cognitive patterns that have been learned from early on. These patterns must be re-learned for CBT to be effective
  3. CBT requires ongoing practice to retrain the old patterns into new patterns. In tennis it is like learning to stop running around the backhand. As a child one might learn to run around the backhand (and hit with the forehand as that is a stronger shot). That process becomes ingrained. When a tennis player wants to be more competitive he/she must replace the now instinctive running around the backhand with hitting with the forehand. In CBT the individual replaces old dysfunctional thoughts with new functional ones. However, the negative thoughts are running on auto pilot and are corrected (consciously) by new thoughts.

Words of Wisdom:

  1. Practice, Practice, Practice. DO thought records. Be conscious of negative thinking (catch your should, musts, needs, have to’s, etc.) and change that thinking (at least in your mind even if you do not verbalize it or act on it).
  2. Work on not projecting your negative thinking onto others (Avoid “shoulding” on others).
  3. Embrace ultimate truths such as, “There is nothing I “have to” do. Everything I do is ultimately my choice.”

Embrace the philosophy of CBT:

  1. Accept that everything you do is because you “want” to do it given all the circumstances.
  2. Accept that others have the right to be who they are even if you do not like their behavior.
  3. Realize that you always make the best choice at that moment in time, given all the information (cognitive and emotional) you have available to you.
  4. Embrace that you will always be able to traverse whatever challenge is before you which may mean solving and issue or accepting that you cannot solve/fix the issue. This has always been true and will always be true.