Cognitive-Behavioral Therapy
Cognitive-Behavioral Therapy
You may have heard the term “Cognitive-Behavioral Therapy” or CBT. Some clients even reach out to us specifically wanting to begin treatment with this type of therapeutic approach. But what is it?
CBT was pioneered in the 1960s by psychiatrist Aaron T. Beck, who identified cognitive distortions in patients experiencing depression. Cognitive distortions are patterns of thinking that negatively affect emotions and behavior. Identifying and challenging these distortions can create changes that lead to improvements in mental health.
There are many types of cognitive distortions, and not all may apply to every person. Some common distortions are:
-All-or-nothing thinking, or using absolute terms like “always” or “never”
-Jumping to conclusions, or making negative assumptions without evidence
-Catastrophizing, or expecting the worst-case outcomes
-Personalization, or blaming oneself for events outside one’s control
-Emotional reasoning, or believing one’s feelings automatically reflect reality
In addition to identifying cognitive distortions and finding other ways of looking at situations, CBT utilizes a “Thoughts, Feelings, Behaviors” model that demonstrates how our perceptions impact our choices. When I am in sessions with clients, I like to use a visual depiction of this model that uses simple graphics to illustrate the chain of events that happen after we experience a situation. When we look at each component of the model separately, we can often break down where our reactions begin and how to interrupt unproductive patterns.
You can create a “Thoughts, Feelings, Behaviors” graphic of your own. Simply label four parts of a paper: Situation, Thought, Feeling/Emotion, and Behavior/Action.
-You can write or draw something that represents what happened in a situation under “Situation.”
-You can write a statement or draw an image representing your thought after the situation, under “Thought.”
-Next you can draw or write something that represents how you felt under “Feeling/Emotion.” Often this category carries the strongest emphasis for clients, especially if fear or anger occurred. In other cases, clients have an easy time expressing their thoughts but cannot name an emotion that follows. We may spend time identifying a variety of emotions here.
-Finally, you can draw or write what you did under “Behavior/Action.” Did you argue? Did you withdraw from the situation? Was this a behavior you have done before or something new?
In many instances, clients can recognize a pattern in this cycle of “Thoughts, Feelings, Behaviors.” We may spend time talking about when and how this pattern began, or how you would like to make changes in it.
Cognitive restructuring is one CBT tool in which we learn to catch a thought as it happens, challenge it with logical questions, and change it by practicing a new and more realistic perspective. I like to write down clients’ own phrasing of new perspectives to help them create affirmations based on their own experience.
Behavioral activation is another CBT tool in which clients involve themselves in rewarding activities that counteract depression and anxiety. Clients will often hear me ask about personal values as well as identifying one or more activities that feel good, and committing to doing those in the week before the next session. When we change our interactions with our environment, we change our behaviors in ways that add up to positive impacts on our mental health.
I love CBT techniques that can help us break down why certain situations have felt bad, and how we can change them in a way that has lasting positive effects. Connect with me or any of our Kildaire Counseling clinicians to start your own close look into your “Thoughts, Feelings, Behaviors” and the changes you want to make.
