Cognitive Behavioral Therapy (CBT)

what is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a structured way of learning that your thoughts, emotions, and behaviors are interrelated. This is something you can use to your advantage in therapy, by learning what your specific patterns of thinking, feeling, and behaving are, and replacing unhelpful patterns with more helpful ones. 

Most people are easily able to identify their experiences in at least one of these domains (thoughts, emotions, behaviors), while struggling or having more difficulty identifying, understanding, or expressing the others. For example, some people can tell you exactly what they’re thinking at any given moment, while others would be stumped and respond with “I don’t know” or “I’m not thinking anything.” 

Similarly, some people could tell you that they’re feeling vulnerable, sad, anxious, or afraid, while others wouldn’t be able to put a word on their emotions, and maybe even feel confused by the question (e.g., “I feel fine”). There’s a distinct line between your thoughts and your emotions and CBT helps you better define it and use it to your advantage. For example, being able to tell a loved one that you’re feeling hurt and misunderstood because you perceived something they did or said as insensitive. This would allow them to see your point of view more clearly, empathize, or give them an opportunity to correct their own language so that you can better understand their experience.

Lastly, CBT helps you become more aware of your behavior, and both how it influences your thoughts and feelings, as well as how it is hugely impacted by what you think and how you feel. For example, imagine you have a huge project due tomorrow and your boss says to you, “we need to talk.” Many people would immediately jump to the worst possible conclusions. “She’s taking me off the project,” “He’s going to ask me to re-do everything,” “How much more work can they throw at me?!” This train of thought would likely make you feel more anxious, frustrated, or depressed. You might also notice your heart rate increasing, your muscles tensing up, and your face going red or pale. Finally, you might find yourself lashing out at your coworkers, coming home huffing and puffing, and possibly trying to cope with it any way you know how (e.g., drinking, smoking, over-eating, zoning out in front of the TV). 

Now imagine there’s an alternative way for this situation to play out. Imagine that after hearing your boss say “we need to talk” your first thought is, “last week he told me I was doing a great job on this project and to keep it up. Maybe he has suggestions for how I can make it even better or wants to congratulate me on how well it turned out.” You might still be uncertain until you actually meet with your boss, but given this thought, you might feel curious and ask what your coworkers think of the project. This wouldn’t necessarily be such a “bad” thing, but in fact, you might even feel creative and motivated to make improvements, or allow yourself some time to relax or do something fun. 

In these two examples the situation and the facts were exactly the same. However, what you thought, how you felt, and the actions you took would be completely different. 

CBT isn’t about forcing you to have positive thoughts all the time. It is about looking at what thoughts are serving you well, and what thoughts might actually be misleading. If you struggle managing your emotions, CBT can help you better regulate them. For example, if you find yourself having panic attacks, “temper tantrums” or outbursts, or crying out of the blue, CBT can help you understand these patterns and give you the skills you need to feel more in control. Finally, if you’re unhappy with your situation or behavior (e.g., isolated/alone, single/discontent in relationship, family difficulties, stuck in a difficult situation, etc.), CBT can help you identify actions you can take to improve your situation based on your goals. It can also show you how some situations might improve with slight shifts in your thinking and more skillful management of your emotions. 

CBT is often used as an umbrella term for many different specific types of therapy. For example, Acceptance and Commitment therapy (ACT), Dialectical Behavior Therapy (DBT), and Exposure and Response Prevention (ERP) are all under the CBT umbrella. They teach individuals how to navigate challenging thoughts, emotions, behaviors, and physical sensations in a way that’s more conducive to their goals and values.

CBT is also sometimes referred to as a style of therapy. Although in my opinion this is incomplete information and somewhat false advertising, sometimes therapists use “CBT” as a selling point and to convey that their therapy can be short-term, structured, or skills-based (regardless of whether the therapist has formal training in the aforementioned treatments). If you are interested in specific CBT interventions, ask your therapist questions about how they can help you with your specific concerns. Most CBT therapists work collaboratively and directly and can be transparent in explaining what to expect from treatment and how it can work for you.

For more information on CBT or to see if this is the right approach for you, contact me for a free 15-minute consultation.