Imagine waking up each morning overwhelmed by a cloud of dread about the day ahead. You’re trapped in a vicious cycle of negative thoughts, each feeding into the next, building a formidable barrier between you and peace of mind. Whether it’s stress from work, anxiety about future uncertainties, or a lingering sadness that taints your enjoyment of life, finding a pathway to psychological well-being might seem akin to navigating a maze without a map.
So, what can you do? How can you break this cycle when you’re aware that your actions might be detrimental, yet you’re unsure of the alternatives? This is where Cognitive Behavioural Therapy (CBT) can make a significant difference.
What is Cognitive Behavioral Therapy?
CBT is a robust form of psychological treatment proven effective for a range of issues including depression, anxiety disorders, alcohol and drug misuse, marital problems, eating disorders, and severe psychological conditions. Extensive research demonstrates that CBT significantly enhances functioning and quality of life. It operates on the fundamental principle that our thoughts, feelings, and behaviours are interconnected, and that altering negative thought patterns can affect changes in both feelings and behaviours, and that changing behaviours can alter our feelings and negative thought patterns.
How Cognitive Behavioral Therapy Works
Many people associate therapy with lying on a couch, discussing one’s mother and traumatic past, receiving only nods or «mhms» from the therapist. However, encountering a CBT session can be quite a revelation, as it differs significantly from these traditional notions of psychotherapy. CBT sessions are interactive, practical, and structured. They focus on specific problems and offer direct tools and techniques to manage and overcome these problems. In CBT, the therapeutic process is normally divided into three key phases:
- Assessment: This initial phase involves a detailed examination of the client's problems. The therapist and client work together to identify specific problem areas. This could include understanding the situations, thoughts, and behaviours that lead to difficulties in the client’s life.
- Analysis: In this phase, there is a deep dive into understanding why these problems exist. The therapist helps the client to uncover patterns of thinking or behaving that contribute to their distress. This involves looking at how certain thoughts or behaviours are unhelpful, and exploring their origins and impacts.
- Intervention: This is the action phase, where strategies and techniques are applied to modify the problematic thoughts and behaviors. The interventions are practical exercises and tasks that the client undertakes, both within and outside of therapy sessions. These might include exposure therapy, thought records, or behavioural experiments.
For example, Ginny has sought therapy because she struggles to participate in social situations. Her job involves many important social events, and she has noticed that her inability to partake is affecting her relationships with her colleagues. She absolutely hates this and does not know how to stop being so afraid. She tried to go once. She prepaid and got ready to leave, but taking the step to leave her apartment proved too difficult, so she decided that Netflix and a glass of wine would be a better way to spend her evening, even though it felt terrible not to have been able to go.
- Assessment: The therapist and Ginny discuss everything she has been feeling, thinking, and doing when confronted with social situations to explore possible explanations for why it is too difficult to make the leap. They explore both the past and the present to understand.
- Analysis: When the CBT therapist understands what is going on, why Ginny started to struggle and why she is still struggling today, this information is shared and discussed between them. This is crucial because understanding the situation makes it easier to determine what needs to change. They do not want to guess how to intervene; they want to know.
- Intervention: Now it is time to make some changes. Ginny realizes that she anticipates a lot of negative scenarios that might occur if she goes to the party: “What if I say something weird?”, “What if my clothes are too formal or informal?”, “What if nobody talks to me, or they are bored when they do?” Her therapist helps her challenge these thoughts and prevent them from dictating her behaviour. Then, together, they create a plan to expose Ginny to what she fears the most, equipping her with all the necessary tools to manage the situation effectively.
The process of CBT is highly collaborative. Both the therapist and the client have active roles in the therapy sessions and in the work done between sessions. This collaborative effort helps to empower the client, making them an active agent in their process of change, also giving them the tools on how to manage problems in the future without the need of a therapist.
Moving Beyond the Past
While our past is crucial as it shapes who we are today, dwelling on it can impede our progress. CBT helps clients focus on the present and future, learning from the past but not being anchored by it. We discuss the past to understand our learning and experiences but shift focus to current actions and forward-looking strategies.
Benefits of Cognitive Behavioral Therapy
One of the key benefits of CBT is that it is short-term and goal-oriented, typically lasting anywhere from a few weeks to several months. We do not want to suffer longer than necessary! This does not mean the benefits are fleeting; rather, the changes are designed to be long-lasting. CBT provides clients with tools and techniques that are not just about coping in the moment but are skills that clients carry with them for life. This approach ensures that individuals do not have to rely on continuous therapy but can manage independently, reducing the likelihood of future relapses. The benefits of CBT include:
- Evidence-Based: CBT's effectiveness is backed by substantial research, making it a reliable form of therapy for various psychological problems.
- Skill Development: Clients acquire valuable life skills that enable them to effectively tackle a variety of life's challenges. These skills, learned within the therapy setting, can be generalised to address similar issues that may arise in the future.
- Sustainability: While the therapy itself is often short-term, the tools and strategies learned are enduring, helping ensure that the improvements are maintained long term.
Embracing Negative Emotions
Even though CBT talks a lot about change, it is essential to acknowledge that feeling bad is sometimes necessary. Negative emotions are a normal part of life; they teach us resilience and give context to our happiness. How would we recognise joy if we never experienced hardship? How would we handle danger without fear? Thus, not every problem requires therapy – many challenges can be managed on our own, even though we feel bad in the moment. However, when these issues persist and begin to impact our daily lives significantly, seeking therapy may be the appropriate step to take, and this is when CBT would be able to help us.
Sinews MTI
Psychology, Psychiatry and Speech Therapy