What is Cognitive Behavioural Therapy?

Have you ever considered the idea that it is not your outside circumstances that determine how you feel? It’s not the traffic in the morning that makes you feel angry, or the person who stands you up on a date that makes you feel unlovable, or the presentation at work that makes you feel anxious.

There’s something else at play, and this is a good thing!

Once we stop focusing on the things that we can’t control, like the traffic or other people’s behaviour, we can begin to look inward at ourselves. This allows us to change what we can control – how we think, how we perceive things, our behaviour and how we respond to difficult situations. Ultimately, this can change how we feel.

So, where do we begin?!

Cognitive Behavioural Therapy (CBT) is a well-known form of therapy that combines cognitive psychology and behavioural psychology. In other words, the science of our thinking and our actions. The best thing is that it’s evidence based, which means that it has been rigorously tested and proven to be effective through scientific evaluation.  CBT has proven to be effective in the treatment of depression, anxiety, relationship problems, sleep difficulties, chronic pain, work related stress and many more conditions. But Cognitive Behavioural Therapy is equally as helpful for alleviating day-to-day stress as it is for combatting enduring psychological distress.

Changing your thoughts can help lead to behavioural changes, and vice-a-versa.

To change your thoughts, you need to look at both the cognitive (how we think) and behavioural (how we react) components of our thoughts. Both components are important in order to effect meaningful, lasting change in a person and help them manage and maintain good mental health.

 

Cognitive component:

1.Be aware of your negative or unhelpful thinking

We have to be aware of our mind, as often our thoughts are automatic and we respond to them without challenging them. Did you know that the average person has between 12,000 and 70,000 thoughts per day? And of those thoughts, most of them are negative and repetitive? Keeping a thought diary is a useful way of becoming more self-aware of your thinking.

2. Examine your thoughts and ask yourself if you’re engaging in a thinking error. Examples of thinking errors include:

    • Black and white thinking: Categorising things into one of two extremes, such as seeing situations as good or bad.
    • Catastrophising: Blowing things out of proportion and thinking the worst-case scenario will occur.
    • Personalising: Attributing negative external events such as a rescheduled meeting or heavy traffic to something about you or something you’ve done, when there is actually no link.
    • Jumping to conclusions: Making a judgement with no supporting information.

3. Look for the evidence and deal with the facts

Once you have acknowledged that your belief is just a thought and not a fact, try and look for evidence of what is actually going on and deal with the facts.

4. Come up with a more rational or helpful thought about the situation 

Use the evidence to come up with a more helpful and less distressing way of perceiving the situation. e.g. If a meeting has been rescheduled it is much more likely to be because of an issue with an unrelated project than it is to be about you personally.

 

Behavioural component:

Now that we have examined the ‘C’ in CBT, let’s look at the ‘B’ or the behavioural component. After all, CBT is action-orientated so we must find ways to practice it effectively.

1.Graded exposure

Identify those behaviours or things that you are doing that are maintaining the problem. If a behaviour is maintaining a problem it means that it is keeping the problem alive, like kindling to a fire. Did you know that avoidance is the greatest maintaining factor for anxiety? For example, the more you avoid social situations because they make you feel uncomfortable, the greater your anxiety around social situations will be. Encourage yourself to slowly engage in situations that you find difficult and make sure you start with easier situations, and build up to the more difficult ones.

2. Behavioural experiments

Create behavioural experiments or exposure tasks to challenge your unhelpful thinking. For example, if you believe that the lift will break down and you’ll be stuck for hours and unable to breathe (so you always take the stairs at work)… take the lift with a colleague and see what actually happens!

3. Activity scheduling

Schedule positive activities to gain a sense of achievement and enjoyment in your week…. from tidying your linen cupboard to texting a friend, it doesn’t need to be complicated.

4. Physiological component

The fight/flight/freeze response is our body’s automatic survival response to a perceived threat. It can include a racing heart, sweating, shaking and dilated pupils. Learning techniques to get your body to relax when there is a perceived threat is important for being able to face difficult situations that you may be avoiding.

 

Related techniques:

In addition to shifting unhelpful thinking and undesirable behaviours, CBT also includes the acquisition of many other skills and techniques to improve how we feel.

  • Relaxation training
  • Mindfulness techniques
  • Goal setting
  • Problem-solving techniques
  • Communication training

Homework

CBT has homework! It’s like going to the gym; you have to learn to condition your mind in a different way. You also need to start behaving differently and setting yourself behavioural tasks each day or week for effectively changing how you feel.

In practice

The most effective way to benefit from CBT is to be guided by a qualified professional, such as a psychologist. There are also many APPs available that apply the techniques of CBT, which can help you with changing your thinking and behaviour. Either way, it is empowering to know that it’s up to you to change how you feel!