Cognitive Behavioral Therapy (CBT): What is it and how can it help you? - Humantold

Cognitive Behavioral Therapy (CBT): What is it and how can it help you?

Macaul Hodge, MHC-LP July 10, 2024

Cognitive behavioral therapy (CBT) is a comprehensive therapeutic model that has helped many individuals with anxiety, depression, and other mental disorders.

Consider this scenario: You type out a text to a friend you haven’t seen in a while. It’s not a simple text to send because you worry about saying the wrong thing. You’d like to see this friend again, but with how much time has passed you’re not quite sure where you two stand. You click send. *swish* Off it goes. 

Waiting for a response feels like agony. All the fears you had about this relationship seem to be ringing true. All the fears you have about your role in all relationships begin to bubble up. The day goes on and this friend has yet to respond. 

Thoughts that are all too familiar set up camp in your brain. Thoughts like: the reason they are not responding is because they’re mad at you. They’re not responding because they hate you. They’re not responding because you’re worthless. Maybe it’s because you’re ugly, or boring, or awkward. 

These thoughts are your inner critic who likes to tear you down. This inner critic has a way of jabbing at your most sensitive and tender insecurities. This critic is often reserved only for you, since no one else deserves this kind of cruel treatment. 

Naturally, holding such negative thoughts about yourself has an impact on your mood. Feelings of anxiety are increasing along with sadness, loneliness and rejection. 

Your mind has been infiltrated with all these self-downing thoughts and you’re feeling really low. So, how does that affect your behavior? Maybe you spend a lot more time at home, laying in bed. You notice chores piling up and your hygiene taking a dip. It’s possible you ignore other people’s texts, because if you’re all the terrible things your thoughts have convinced you of, then what’s the point? 

The Core of CBT: Thoughts-Feelings-Behavior

CBT tells us that emotional distress is not caused by the situation itself, but our perception of the situation. Based on our past experiences, we create, and constantly re-create, an intricate belief system about ourselves, others, and the world around us. Some of these beliefs date back to early childhood, and therefore are so entrenched in our being we aren’t able to distinguish them from cold-hard fact. This is the lens through which all other experiences are filtered. These are our core beliefs. 

From our core beliefs, we create automatic thoughts about any and all things happening around us. 

For example, let’s say, Person A learned at an early age that the world is unsafe and people cannot be trusted. They hold this core belief.  

Meanwhile, Person B’s experiences led them to believe that people are generally kind and the world is mostly safe. 

Imagine, a frazzled fast-walking man passes by Person A and Person B, shoving them a bit as he maneuvers past. 

The automatic thought this generates is going to sound different for Person A than for Person B. Person A may think the man is rude, disrespectful or dangerous. Alternatively, Person B thinks he’s rushed and frantic; he has somewhere important to be and is running late. 

Note, these automatic thoughts will elicit divergent feelings. Person A feels angry or fearful while Person B feels indifferent or briefly peeved. 

How these two respond to the encounter correlates to their thoughts and coinciding feelings. Person A might lash out at the stranger or show up at their destination short-tempered. Person B’s behavioral reaction is more muted and short-lived. 

Person A and B’s perception of the situation differed, which led to disparate outcomes. What’s important to recognize is that our perception is not fact. In actuality, the beliefs we hold have a tendency to distort our interpretation of reality. 

CBT works to help us recognize the mistakes we make when interpreting the world, also known as our cognitive distortions, then provides a framework for combating irrational or inaccurate thoughts.

Common Cognitive Distortions: An abbreviated list of irrational thoughts that influence our emotions

  • Catastrophizing: jumping to the worst case scenario

  • Overgeneralization: Assuming that if something happened once or a few times, it is bound to always happen
  • Personalization: the belief that one is responsible for things outside their control; that they are the cause or did something wrong
  • Mind Reading: the belief that one knows what others are thinking or what their intentions are 
  • Emotional Reasoning: confusing feeling with fact

    • ie. “I feel like a bad friend, therefore I am a bad friend”

  • Disqualifying the Positive: noticing only the negative aspects of a situation and ignoring the positive

    • ie. focusing only on the one piece of negative feedback while tuning out the compliments that came before it

  • “Should” Statements: Believing things are supposed to be one way
  • All-or-Nothing Thinking: a tendency to jump to extremes or absolutes

    • ie. believing something is a failure if it wasn’t 100% successful 
    • ie. thoughts that include “always”, “never”, or “every”

Steps to Overcoming Cognitive Distortions:

  1. Notice your thought patterns

    1. Before you can begin combatting unhelpful thoughts, you have to become aware of what they are
    2. A therapist may provide you with a thought record to keep track of scenarios that elicit strong feelings and the thoughts attached to them

  2. Utilize relaxation techniques

    1. Automatic thoughts can bring up intense feelings quickly; sometimes we need to calm our nervous system before we can find rational thought
    2. Engage in deep breathing, grounding techniques, or tense then relax your muscles

  3. Socratic Questioning: Use the following questions to evaluate your thoughts for validity and helpfulness

    1. What is the evidence to support this thought? What evidence runs counter to it?
    2. Am I looking at all the evidence or just what supports my thought?
    3. Is my thought based on facts or my opinion?
    4. Am I making assumptions? Are there alternative explanations?
    5. Might other people have different interpretations of the same situation? 
    6. Am I having this thought out of habit? Is this a thought I often come back to?
    7. Is my thought a likely scenario or is it the worst case scenario?

  4. Be intentional about your behavioral response

    1. What behaviors might this situation have evoked in you in the past? Was it aggression, shutting down, avoidance, isolating?
    2. Based on your new interpretation of events, what behavior is most appropriate? What behaviors will get you closer to what you want?

What Next?

CBT is a comprehensive therapeutic model that has helped many individuals with anxiety, depression, obsessive-compulsive disorder, eating disorders, and post-traumatic stress disorder- to name a few. Moving through the steps above is a start! That said, utilizing CBT with a mental health professional can help you gain greater insight into yourself, and how your thoughts, emotions, and behaviors are impacting one another. Having this awareness will allow you to have more control over your interpretations of the world and how you respond to it.

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