What is Cognitive Behavioural Therapy (CBT)?

CBT entails challenging unhelpful cognitions (thoughts) and behaviours. It is a therapy which focuses on the ‘here and now’ entailing practical cognitive and behavioural strategies.

Thoughts: For instance, you may typically manage your unhelpful thoughts by pushing them away, trying to think of something more positive, or responding to the thought with a behaviour, in an attempt to counteract the distressing thought. Perhaps this helps in the short-term, reducing those feelings of anxiety and depression, but what about in the long-term? How is this panning out? Pushing these thoughts away can also take up valuable time and energy in your day and/or can alter the things you do. For example, deciding to not leave the house, cancelling on seeing a friend, or maybe putting off important tasks. 

CBT helps by exploring these thoughts and finding alternative ways in managing them. Have you considered letting the thought just sit in your mind? Perhaps a scary proposition for now! How about challenging the thought itself? What could be an alternative thought?

Behaviours: CBT also explores your behaviours. How might we be maintaining our problems through our behaviours? Are our behaviours maintaining our depression or anxiety? We look at this in detail and challenge these behaviours and look to alter them. Again, this can sound scary as the things we do (our behaviours) may serve a purpose in the short-term in managing these difficulties, but in the long-term they could be holding you back from feeling better within yourself. It is also common to get stuck in habits; some are helpful, some are not.   

Now let’s consider a couple of examples here…

The thought, ‘I can’t do things how I used to so what’s the point in trying?’ These types of thoughts are common in depression and when battling a chronic physical health condition. The thought may trigger an emotional response such as feeling low, depressed and tearful. If we consider the behaviour which may follow this thought and emotion, it could possibly be to avoid doing things altogether. Avoidance is common in depression. Furthermore, lack of motivation can also lead us to avoid. This can lead to a lack of purpose, pleasure, accomplishment, isolation and it essentially continues to maintain the depression. A vicious cycle! Now what if we were to consider alternatives or adjustments to assist us in the daily activities we struggle with? Perhaps then we can still find enjoyment in the things which are difficult and live a life in-line with our values. CBT can help with this.

A second example…

The thought of, ‘what if I undercooked the chicken and caused harm to my family and friends?’ Understandably, this type of thought will elicit a level of distress and worry. The corresponding behaviour may be to go and check on the people we believe we’ve hurt (seeking reassurance). Or we may develop behaviours such as routines or rituals, which help reduce the level of distress i.e., tapping a certain number of times, not stepping in the cracks on the floor, or repeating a string of words in a particular order. The list of routines and checks we feel we need to carry out can become endless, increasing over time. Once again, this may help in the short-term, aiding in a reduction of feeling distressed and the thought of causing harm dissipates, but usually this is short lived. In the long-term, it does not reduce the anxiety. It can entwine into other areas in our life. Have you noticed feeling more anxious about things? Are you worrying more? Consequently, we end up undermining our ability to cope with distress, we question our judgement, our memory and this impacts on our confidence. Consider also the time it takes to carry out these behaviours and the impact on living life. The checking intensifies and the distress is pushed to one side, but only momentarily. CBT can help here, challenging thoughts and changing those behaviours!

Hopefully by now (fingers crossed) you’ve gained a brief understanding of CBT as a form of therapy, exploring and challenging thoughts and behaviours. Essentially, doing things differently to break those cycles of depression and anxiety. Perhaps the two examples provided above are not relevant to you, but I hope they provide some understanding of CBT. Essentially, CBT can assist in a range of mental health difficulties including (but not limited to) depression, generalised anxiety disorder, obsessive compulsive disorder, phobias, health anxiety and PTSD. It uses a range of evidence based psychological techniques.  

Daunting as it may sound, CBT is insightful and can allow you the opportunity to discovery what makes you think a certain way and what leads you to act in certain ways. It provides safe space for reflection, new learning and discovery about yourself.

Let’s also be clear, CBT is not something that is done to you. Rather, it is a collaborative journey with your therapist entailing trialling strategies (cognitive and behavioural) within your sessions and for you to continue using these strategies outside of your sessions. The more you put in, the more you get out of therapy! Of course, helping you to get to where you want to be and improving your emotional wellbeing.

Please don’t hesitate to get in touch if this sounds like something you’d like to explore.