What is Cognitive Behavioral Therapy (CBT)?
The Cognitive Behavioral Model rests on the premise that our feelings are very difficult to change without also changing our thoughts and behaviors. In fact, the way we think about ourselves and the world strongly influences the decisions we make, how we behave, and ultimately how we feel. Each of us views the world through a unique lens that can become clouded by our negative emotions and irrational thoughts.
Here’s an example:
Imagine you have a very important exam coming up and your thought/belief is “I’m going to fail.” Because of this thought, you start to worry so much and feel so uncomfortable that you decide not to study. In this example, the thought led to a negative feeling which then led to a behavior that wasn’t productive.
The point of CBT is to identify which thoughts are causing problematic feelings or behaviors and then challenging the validity of those thoughts. To do this, we must first identify those “automatic thoughts.”
Automatic thoughts are thoughts that “pop up” in response to a situation or event. Many times we don’t even recognize them. They happen automatically. Automatic thoughts stem from core beliefs about ourselves and the world.
For example, if our core belief is “I’m unlikeable” then we might automatically assume that others don’t like us even if there is little evidence to support that belief.
One can see how automatic thoughts might influence how we feel…
The core belief “I’m unlikeable” will drive the types of thoughts Sally has in various situations. Because Sally doesn’t believe she is likeable, she might automatically think Dave doesn’t like her when he is a few minutes late. This might make her feel discouraged, anxious, rejected, and insecure.
Harmful core beliefs lead to negative thoughts, feelings, and behaviors. CBT aims to identify and challenge harmful core beliefs.
Below are examples of cognitive distortions and how we might correct those distortions.
Making broad interpretations about something from a single event or occurrence.
Example: “I didn’t perform well on my math test. I suck at math.”
Cognitive Correction: “I didn’t perform well on my math test. I am upset with my performance on this test, but I can learn from my mistakes and improve my math skills for the next test.”
Believing that doing something or thinking something will influence unrelated situations. (Commonly seen in those with Obsessive Compulsive Disorder)
Example: “If I don’t say this word four times then my family might be harmed.”
Cognitive Correction: “I feel worried about harming my family, but is there any factual evidence that my family would be harmed if I don’t say the word four times?”
Assuming that emotions reflect the way things actually are.
Cognitive Correction: “Even though I feel like a bad husband because I forgot to pick up milk from the store, that does not mean I am a bad husband. Here are some reasons why I am not a bad husband…”
All or Nothing Thinking
Example: “I will never be good at basketball.”
Cognitive Correction: “Although I am not satisfied with how I played today, I can learn from my mistakes and improve in the future.”
Example: “My wife is always upset. She would be fine if I did more to help her.”
Cognitive Correction: “My wife seems upset. I don’t want to see her upset, but I can’t control how she feels. The best I can do is support her in the ways I know how.”
Example: “I should go to the gym today.”
Cognitive Correction: “I don’t really want to go to the gym today, but I know I will feel better if I do.”
Example: When you give a presentation and people compliment you and you immediately reply with “yea, but I think it went on too long and wasn’t interesting.”
Cognitive Correction: Give yourself permission to feel positive emotions.
Example: “My boyfriend didn’t call me last night. He is cheating on me.”
Cognitive Correction: “My boyfriend didn’t call me last night and I am worried. Even though I am worried he might be cheating on me, I know there are many other potential explanations.”
Example: “I don’t have to go to school and receive a degree in that because I already know the information.”
Cognitive Correction: “If I want to work in this industry, a degree is required. Therefore, I will have to go to school even though I know a lot about this topic.”
Example: “He thinks I am stupid and worthless. I just know it.”
Cognitive Correction: Ask yourself, “What factual evidence do I have to support this?”
Although this barely scratches the surface of cognitive behavioral therapy (CBT), it gives you an idea of what it is and how we apply it. In summary, CBT is a type of therapy based upon the idea that our thoughts, behaviors, and feelings/emotions influence each other in complex ways. CBT is a time-limited, structured, and goal-directed therapy designed to help identify negative thinking patterns that contribute to troubling mood states.
- The Mindfulness Workbook for OCD by Jon Hershfield
- Mind Over Mood by Dennis Greenberger