Cognitive Behavioral Therapy
Cognitive Behavioral Therapy, or CBT, is a treatment for many different mental health disorders that creates positive, controlled connections between thoughts and emotions.
Our thoughts influence our emotions and our emotions influence our actions. Hearing a positive message and believing it will change your emotions about stressors, and your actions will reflect that.
What if our thoughts are distorted? What if we don’t have time to think about a situation, causing us to react impulsively, in a negative and harmful way? What if there are harmful beliefs deep within our subconscious that we aren’t aware of?
Many people with mental health disorders struggle to stay in control of their thoughts.
Cognitive Behavioral Therapy helps to alleviate that struggle by giving us helpful tools that challenge our negative thoughts.
What is Cognitive Behavioral Therapy?
Cognitive behavioral therapy, usually referred to as “CBT,” is a form of talk therapy that aims to create a positive connection between thoughts, emotions, and actions.
CBT helps patients find negative distortions they believe and restructure them. It’s a retraining of their thought patterns so they can react to stressful situations in a healthier way.
It is an incredibly useful form of therapy that can help treat:
- Anxiety
- Depression
- Addiction
- OCD
- Sleep disorders
- PTSD
Even those without a formal diagnosis could build healthier behavioral habits using mindful CBT techniques.
Through CBT, individuals can learn to control the thoughts and emotions that dictate their behavior. Once you can grasp the “why” of your reactions, you can work towards changing them.
Goal-Oriented Therapy
CBT is highly goal-oriented. You and your therapist will work together to find real achievable goals to work towards. This could be to change a specific reaction, or to react differently to specific situations and triggers.
Building momentum as you work toward a goal is a motivating aspect of CBT.
With its goal oriented approach, CBT is a short-term method of therapy. CBT is not an evergreen treatment, and patients should expect to end CBT at some point. That doesn’t mean all the work is done, however. Patients use tools they’ve learned in CBT long after they’ve “graduated” from it.
The History of CBT
Most people attribute Dr. Aaron Beck as the father of Cognitive Behavioral Therapy in the 1960s. Although, the foundations of his theories may have begun as early as 1913.
Due to its age, CBT is a well-researched form of psychotherapy. Over time It’s been proven to be an effective treatment for not only mental health issues, but also for some physical ailments such as chronic pain.
The CBT Triangle
It’s a retraining of their thought patterns so they can react to stressful situations in a healthier way.
The connection between thoughts, emotions, and behaviors makes up the cognitive triangle. This triangle is the essence of CBT. Connecting thoughts, emotions, and behaviors creates a healthy strategy of gaining control of reactions you may have once thought were uncontrollable.
Thoughts
The first point of the triangle is thoughts. To begin retraining, it’s important to understand your thoughts. This step involves verbalizing what goes through your mind in targeted situations. Usually these targeted situations are the anxiety-inducing scenarios that trigger symptoms of certain mental health disorders.
Emotions
The second point is emotions. The connection between your thoughts and your emotions will become more apparent. Negative thoughts lend themselves to negative emotions. Likewise, positive or even neutral thoughts can lead to positive emotions.
Behavior
The third point is behavior. After targeting what goes through your mind and what emotions you feel in these targeted situations, you can begin to identify exactly how they are influencing your negative behaviors.
After these three points have been identified, you can begin to navigate their connections, and begin building new connections in order to adapt healthier behaviors.
Changing thoughts will lead to changing emotions, which will lead to a change in behavior.
Three Areas of Thinking
CBT approaches thoughts from three different areas. They are:
- Automatic thoughts
- CBT core beliefs
- Cognitive distortions
These are considered areas of cognition, and they influence us in different ways.
Automatic Thoughts
This area of cognition includes unpremeditated thought. It’s what your brain tells you in the moment.
Small moments can have big effects on our daily moods.
How we perceive an event like getting ignored by a friend or getting cut off while driving is important. During each of those events, it’s easy to assume negativity. And those negative thoughts can bring down our moods and affect our behavior.
If we’re able to reprogram our negative automatic thoughts into positive thoughts, we’ll be able to process events more healthily. Even if we can acknowledge that some thoughts are automatic and intrusive, we can learn that they were momentary lapses that don't define us, and we can create new positive thoughts.
These automatic thoughts can be influenced by core beliefs and cognitive distortions.
CBT Core Beliefs
During CBT sessions, you and your therapist might also work on identifying any core beliefs that are self-sabotaging.
Where automatic thoughts influence us during certain events, core beliefs influence us in a host of ways. They affect how we view ourselves and our reality.
Similar to our automatic thoughts, negative core beliefs can be challenged and changed.
Cognitive Distortions
Another area your therapist may want to work on is any cognitive distortions. These are fallacies that may have existed in your thinking long before any symptoms of a mental health disorder surfaced.
They can be caused by mental health disorders, however. But they are also closely associated with all different types of trauma, as well as abuse and manipulation.
Cognitive distortions are areas of thinking that are harming a person’s ability to perceive events accurately. By correcting these distortions patients will be able to process their experiences more correctly.
Some of these distortions include:
- Shoulds: developed when a person has a hard set of rules about how everyone should behave
- Heaven’s Reward Fallacy: sacrificing self will eventually pay off
- Always Being Right: feeling a need to put others on trial to prove your opinions are absolutely right
- Emotional Reasoning: believing that your emotions are considered fact
These fallacies and distorted thoughts are at the root of our negative thoughts that lead to negative emotions. Incorrect perceptions of ourselves, others, and situations cause the emotions that lead to the behavior that a CBT patient wants to change.
Cognitive Behavioral Therapy Exercises
While participating in CBT, your therapist may give you some exercises to practice in between sessions as “homework.”
These exercises will help you through your therapy sessions but are also helpful for daily life. These exercises can be used by anyone in a daily context to boost mindfulness and reduce anxiety.
If we’re able to reprogram our negative automatic thoughts into positive thoughts, we’ll be able to process events more healthily.
Journaling
Journaling is a helpful technique to gather thoughts and feelings. Keeping a ledger of general events and any thoughts connected to those events is a great way to find any distorted cognitions or negative thinking that can be challenged and adapted.
A CBT-specific journal may include particular information including:
- Time
- Mood
- Situation
- Intensity of emotion
It’s a bit more structured than freewriting, but that added structure can help identify areas of improvement.
Play the Script Until the End
Using CBT for anxiety is a helpful way to understand underlying fears. Playing the Script Until the End is a helpful exercise or people struggling with anxiety.
This exercise involves thinking through a stressful scenario and thinking through the worst-case scenario. By doing this, you may find that the outcome is not as made as your anxiety is making it.
Breathing Techniques
Oxygen is an important ingredient our bodies need to function properly. Frequently taking deep breaths is a helpful way to dump more oxygen into our bloodstream.
Practicing good breathing has many benefits, and can be practiced in a number of ways. The most common form of breathing exercise is box breathing.
Group CBT
CBT can be applied to a group setting as well as a 1-on-1 setting.
Benefits of Group CBT
Group CBT (GCBT) can have many advantages. Group therapy is a helpful type of therapy for some as it lets people meet others who are struggling with the same issues as them.
Though It’s Not For Everyone
There are a few obvious negatives to GCBT. Due to the nature of the setting, patients will need to be comfortable with sharing personal information in a group setting. This is hard or even impossible for some people.
Creating a good group setting isn’t the easiest task. Both therapists and patients need to work at creating a positive atmosphere that is helpful for everyone involved.
CBT vs DBT
Dialectical behavior therapy, also called DBT, is a type of talk therapy that uses CBT to help people whose emotions are very intense. It combines mindfulness and coping strategies as well as CBT’s goal-oriented approach.
DBT approaches treatment from emotions and CBT approaches it from thoughts.
DBT might be more helpful for some people because it promotes acceptance. It encourages patients to work with their negative emotions rather than fight them.
DBT is a very effective therapy for borderline personality disorder, those who struggle with self-harm, and people with chronic suicidal thoughts.
Unlike DBT, CBT relies on a cognitive approach. Meaning patients are encouraged to apply logic and rationale to their situation. That could be difficult for individuals who are dealing with more extreme feelings.
In short, DBT approaches treatment from emotions and CBT approaches it from thoughts.
CBT at Sequoia
At Sequoia Behavioral Health we take a holistic approach to mental health treatment. Located in Mesa, Arizona, we offer inpatient treatment based on individualized needs. We aim to inspire healthy change by equipping people with the tools to enhance resilience and engage in a life of meaning.
Schedule a call to see if Sequoia Behavioral Health is right for you.