What is cognitive behavioral therapy?
Cognitive behavioral therapy is a type of psychotherapy in which negative patterns of thought about the self and the world are challenged in order to alter unwanted behavior patterns or treat mood disorders such as depression.
Research has shown cognitive behavioral therapy (CBT) to be an effective type of psychotherapy for ameliorating depression and anxiety. It is based on the premise that it is our thoughts that lead to our feelings. In this model, we see that negative thinking leads to negative feelings and consequently, dysfunctional behaviors.
The thoughts that lead us to conclusions about our lives, ourselves, and other people may not even be true. The lens through which we experience the world may in fact be distorted. CBT asks us to question the assumptions we have made (often based on previous childhood experiences) and test them to determine if they are accurate. Additionally, CBT asks us to look for evidence before we automatically believe our thoughts.
In the following example, Emma, our fictional character, plays out this scenario.
The beginning of Emma’s work-day is harried and leaves her feeling not quite put together; no clean laundry, no time to wash her hair, putting on whatever is to hand and skipping the make-up. Emma arrives at work feeling frumpy and unattractive. As she enters her building, a group of her co-workers, women Emma has not quite managed to connect with, are conversing and laughing. As Emma passes by, a burst of laughter erupts from the group. “They are probably laughing at me. I look so awful today.” Emma thinks. This thought leads to more thoughts about her “hopeless appearance”, her inability to connect with other women and make friendships, and finally spirals completely out of control into a state of self-loathing. Consequently, when a co-worker asks Emma to join the group after work for drinks, she hastily declines and goes home alone. Again.
Let’s examine this scenario. What thought set in motion this spiraling down into a state of self-loathing? Emma automatically made the assumption that she was the object of derision and laughter. But was this even true? A whole chain of emotions and ultimately an event is the consequence of this one thought. If continued unchecked, that inaccurate assumption leads to depression and isolation.
With Emma, we see that depression is linked to thoughts that are overly negative about herself. This is a common pitfall for survivors of sexual abuse. If you are dealing with depression, look for signs that your thoughts about yourself are harsher than they should be; looking at facts rather than assumptions. CBT asks us to evaluate thoughts and events based on truth, and not through the lens of negativity that our past has taught us.
Sometimes we are not even aware of the thought that precedes an emotion. CBT also seeks to develop mindfulness, a stepping back and becoming aware of our thoughts so that we can question them, and ultimately change them wherein they are self-limiting. Becoming aware of our thought patterns frees us to choose our thoughts mindfully and develop positive behaviors.
Books to learn more:
Retrain Your Brain: Cognitive Behavioral Therapy in 7 Weeks: A Workbook for Managing Depression and Anxiety by Seth J. Gillihan, PhD; this book provides an easy to understand explanation of the guiding principles of CBT as well as self-help exercises to use the method.
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