Understanding CBT
Cognitive behavioural therapy is a school of Psychotherapy that aims to help people overcome their emotional problems.
Cognitive means mental processes like thinking. The word "cognitive" refers to everything that goes on in your mind including dreams, memories, images, thoughts, and attention.
Behaviour refers to everything that you do. This includes what you say, how you try to solve problems, how you act, and avoidance. Behaviour refers to both action and inaction, for example biting your tongue instead of speaking your mind is still behaviour even though you are trying not to do something.
Therapy is a word used to describe a systematic approach to combating a problem, illness, or irregular condition.
A central concept in CBT is that you feel the way you think. Therefore, CBT works on the principal that you live more happily and productively if you're thinking in healthy ways. This principal is a very simple way of summing up CBT.
CBT is a powerful treatment because it combines scientific, philosophical, and behavioural aspects into one comprehensive approach to understanding and overcoming common psychological problems.
Progressing from problems to goals
A defining characteristic of CBT is that it gives you the tools to develop a focused approach. CBT aims to help you move from defined emotional and behavioural problems towards your goals of how you'd like to feel and behave. Thus, CBT is a goal-directed, systematic, problem-solving approach to emotional problems.
Making the Thought - Feeling Link
Like many people, you may assume that if something happens to you, the event makes you feel a certain way. For example, if your partner treats you inconsiderately, you may conclude that she makes you angry. You may further deduce that her inconsiderate behaviour makes you behave in a particular manner, such as sulking or refusing to speak to her for hours (possibly even days; people can sulk for a very long time!).
CBT encourages you to understand that your thinking or beliefs lie between the event and your ultimate feelings and actions. Your thoughts, beliefs, and the meanings that you give to an event, produce your emotional and behavioural responses.
So in CBT terms, your partner does not make you angry and sulky. Rather, your partner behaves inconsiderately, and you assign a meaning to her behaviour such as "she's doing this deliberately to upset me!" thus making yourself angry and sulky.
Emphasising the meanings you attach to events
The meaning you attach to any sort of event influences the emotional responses you have to that event. Positive events normally lead to positive feelings of happiness or excitement, whereas negative events typically lead to negative feelings like sadness or anxiety.
However, the meanings you attach to certain types of negative events may not be wholly accurate, realistic or helpful. Sometimes, your thinking may lead you to assign extreme meanings to events, leaving you feeling disturbed.
Psychologists use the word "disturbed" to describe emotional responses that are unhelpful and cause significant discomfort to you. In CBT terminology, "disturbed" means that an emotional or behavioural response is hindering rather than helping you to adapt and cope with the negative event.
For example, if a potential girlfriend or boyfriend rejects you after the first date (event), you may think, "This proves I'm unlikeable and undesirable" (meaning), and feel depressed (emotion).
CBT involves identifying thoughts, beliefs, and meanings that are activated when you're feeling emotionally disturbed. If you assign less extreme, more helpful, more accurate meanings to negative events, you are more likely to experience less extreme, less disturbing emotional and behavioural responses.
Thus, on being rejected after the first date (event), you could think, "I guess that person didn't like me that much; oh well - they're not the one for me" (meaning), and feel disappointment (emotion).
Acting out
The ways you think and feel also largely determine the way you act. If you feel depressed, you're likely to withdraw and isolate yourself. If you're anxious you may avoid situations that you find threatening or dangerous. Your behaviours can be problematic for you in many ways, such as the following:
- Self-destructive behaviours, such as excessive drinking or using drugs to quell anxiety, can cause direct physical harm.
- Isolating and mood-depressing behaviours, such as staying in bed all day or not seeing friends, increase your sense of isolation and maintain your low mood.
- Avoidance behaviours, such as avoiding situations you perceive as threatening (attending a social outing, using a lift, speaking in public), deprive you of the opportunity to confront and overcome fears.
Learning Your ABCs
When you start to get an understanding of your emotional difficulties, CBT encourages you to break down a specific problem you have using the ABC format, in which:
- A is the activating event. An activating event means a real external event that has occurred, a future event that you anticipate occurring, or an internal event in your mind, such as an image, memory, or dream. The A is often referred to as your "trigger".
- B is your beliefs. Your beliefs include your thoughts, your personal rules, the demands you make (on yourself, the world, and other people), and the meanings that you attach to external and internal events.
- C is the consequences. Consequences include emotions, behaviours, and physical sensations that accompany different emotions.
Writing down your problem in ABC format - a central CBT technique - helps you differentiate between your thoughts, feelings, and behaviours, and the trigger event.
Consider the ABC formulations of two common emotional problems, anxiety and depression. The ABC form may look like this:
- A: You imagine failing a job interview.
- B: You believe: "I've got to make sure that I don't mess up this interview, otherwise I'll prove that I'm a failure."
- C: You experience anxiety (emotion), butterflies in your stomach (physical sensation), and drink alcohol to calm your nerves (behaviour).
The ABC of depression may look like this:
- A: You fail a job interview.
- B: You believe: |I should've done better. This means that I'm a failure!"
- C: You experience depression (emotion), loss of appetite (physical sensation), and stay in bed avoiding the outside world (behaviour).
This article has been compiled from extracts taken from Cognitive Behavioural Therapy for Dummies, authors Rob Willson & Rhena Branch.
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