Getting Started With COGNITIVE THERAPY

Objectives

• To introduce you to the concepts and model of Cognitive-Behavioral Therapy (CBT)

• To determine if the application of CBT skills are appropriate for you

• To introduce you to my approach to CBT

• To set your expectations of future Thinker Coach content

Keywords: CBT | Stress | Anxiety | ADHD | Depression

Introduction

Cognitive-Behavioral Therapy (CBT) is a form of psychotherapy that seeks to improve one’s moods by challenging and correcting any distortions in one’s thinking. Often, we confuse assumptions with facts which then lead to problems in our beliefs, thoughts, feelings, and behaviors. CBT seeks to identify and correct these errors in thinking.

CBT focuses on the here-and now. It concerns itself primarily with the day-to-day problems you face in life—standing in a long line at the grocery store, or dealing with a gossiping co-worker. Though, as I will discuss below, CBT has also been shown to be effective in treating more serious, chronic problems such as drug or alcohol addiction, phobias, or PTSD.

What is Cognitive-Behavioral Therapy (CBT) and What is Its Model?

As its name suggests, Cognitive-Behavioral Therapy (CBT) uses an understanding of cognition and how it relates to our behaviors in order to improve a person’s quality of life. Thoughts, emotions (or moods), and events we experience all interact with each other, according to the CBT model. They influence each other and one or all of these aspects can act as a catalyst that causes changes in the others. A central tenet of CBT is that your thoughts are the most powerful aspect of these and ultimately have the power to gradually shape your moods and experiences. Control your thoughts, and you can control your moods and experiences in life.

Now let’s look at each of these components and how they fit together.

At the center of this model is beliefs. Before you can come to understand how your model is operating inside of you, you need to first put your own beliefs under a microscope. Beliefs in this sense does not just refer to ineffable things like religious or political beliefs. Belief also involves your assumptions about yourself, your values, your past, present, and future. It also involves your assumptions about other people—their motivations, values, and their past, present, and future.

Cognition (Thoughts in the model above) involves not just what we think, but how we think. This is a key distinction. Our minds operate with various processes. Those processes are uniquely formed in each individual, starting at birth and developing throughout adolescence. Fortunately, these processes can also be changed. Sometimes, these processes are influenced gradually over time, such as a manipulative parent. Or, they can be influenced suddenly and drastically, such as a traumatic event like being attacked by a mugger—potentially even resulting in Post Traumatic Stress Disorder (PTSD). 

Behavior refers not only to your actions, but also to your reactions. How do you react to certain events? How do you react to certain people and their actions? And, actions here do not just refer to physical actions. It refers to what other people say and how their thoughts manifest through their actions. In effect, this entire model is also happening in other people as well and the output of their model becomes an input to yours in the form of events to which you then think and react according to your model.

Feelings are the bellwether of the model simply because you are going to experience feelings (or the lack of feelings) and that part is fairly obvious. After all, when you feel frustrated or enraged, you probably know it. But what is not so easy is to identify what emotion you are experiencing and why. For example, anger and frustration can feel very similar but those are two different reactions, involving a different set of beliefs that caused them. But feelings can often be the easiest starting point to understanding how the puzzle of your CBT model is playing out inside you.

These three components (thoughts, feelings, and behaviors) are all feeding each other all the time, spiraling both into and out from your core beliefs. With your behaviors ultimately becoming how you outwardly manifest all of them. Your outward behaviors are how other people experience you—how they think about you or feel about you and how they react to you. 

Are other people attracted to your behavior or are they pushed away? Is your outward behavior resulting in your life being productive, improving, and flourishing, or is it destructive to yourself and others around you?

What Conditions Can CBT Help Improve?

CBT is not just for people with mental health disorders. It can literally help everyone. Problems such as stress and anxiety are things everyone experiences in everyday life. But it has also proven effective with more severe problems such as depression, panic, jealousy, guilt, shame, alcohol abuse, and drug abuse.¹ Additionally, there is evidence it helps with conditions such as sleep disorders and chronic pain.² CBT can also be effective in treating chronic disorders such as phobias, obsessive-compulsive disorders (OCD), and Post-Traumatic Stress Disorder (PTSD).³

The skills CBT teaches improves self-esteem, reduces fear, and increases self-confidence. It helps to solve relationship problems and improve overall quality of life. You can apply CBT skills to diet and nutrition, exercise, smoking cessation, and all-around elimination or minimization of bad habits. These are benefits that everyone can apply to their life.

So, how does CBT operate in practice? What evidence exists for its effectiveness? How can you get the most out of utilizing CBT skills in your life? What is my approach as the Thinker Coach to CBT? And finally, what are your next steps to take if you want to get started? I address each of these questions below. 

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¹ Greenberger, Dennis, and Christine A. Padesky. Mind over Mood: Change How You Feel by Changing the Way You Think, Guilford Press, New York, NY, 2016.

² Cully, Jeffrey A, et al. “A Provider's Guide to Brief Cognitive Behavioral Therapy.” A Provider's Guide to Brief CBT | South Central MIRECC, Department of Veterans Affairs, South Central Mental Illness Research, Education, and Clinical Center (MIRECC), 12 Dec. 2013, https://www.mirecc.va.gov/visn16/guide-to-brief-cbt-manual.asp.

³ Rector, Neil A. “Cognitive-Behavioural Therapy: An Information Guide - CAMH.” The Centre for Addiction and Mental Health , Centre for Addiction and Mental Health, 2010, https://camh.ca/-/media/files/guides-and-publications/cbt-guide-en.pdf.