What is CBT and how will it help me?
Cognitive Behavioral Therapy, or CBT helps you to change the way you think, feel and behave.
You might be asking yourself, why do I want to change the way I think, feel and behave? It’s a fair question, I agree.
You might be interested though, in making some changes if you have any form of stress, anxiety or panic, as for most of you reading this, it will be how you think feel and behave that not only makes you anxious, but also keeps you anxious.
Cognitive: Your thought processes and memory
Behavior: What you do and what you do not not do. What you say and what you do not say.
Therapy: An organized model to help you solve a problem.
CBT is psycho-educational
This simply means that it teaches you how your thoughts, feelings and behaviors interact with each other.
Although we do not mean to, we often create our own distress through habitual ways of thinking.
Cognitive Behavioral Therapy helps you to understand this, and break it down.
For example, if you spend your day worrying about things, the chances are, you will start to feel this in your body.
You might feel nervous or on edge. It may even prevent you from doing things. If you stop and think about it for a moment, most of the things you worry about never happen.
In a way, we are unintentionally creating our own distress.
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Take a moment and think if you do any of the following things.
If you have an argument with someone, do you think about it afterwards. Do you imagine it in your head, having conversations with the person about what you would like to say?
Do you sometimes feel yourself getting angry because of the conversations you are having with yourself (and the other person) in your head?
You do not need to be in a real conversation with the person to feel something in your body, we are perfectly capable of upsetting ourselves with our thought processes!
When having a conversation with someone you do not know very well.
Do you find yourself thinking, “what will I say?” “I’m boring” “I’ve nothing to say” “What made me say that?”
It is very hard to pay attention to the conversation when inside our head we are second guessing what the other person is thinking about us.
This may make you feel uneasy, embarrassed, or uncomfortable with other people, thinking that they are judging you.
Hopefully you are beginning to see that it is your “self talk” how you talk to yourself in your head that can make you feel something in your body.
CBT helps you to make sense of this by teaching you how your thoughts, feelings and behaviors and linked.
In other words, what you think, affects what you feel … and do.
For example, say you were out shopping and for the first time ever, you felt symptoms of anxiety or maybe even had a panic attack. It is understandable that this experience will make you feel very frightened.
If you were able to carry on and not think about it again, chances are, you will be fine. However, for most of us, this frightening experience will get played over and over again in our mind – by our thought processes.
We may try hard to figure out exactly what caused us to feel the things we felt. We may spend a lot of our time, worrying if it will happen again – in doing this, we are creating what is called anticipatory anxiety.
Worrying about the sensations in our body, can be seen in our behavior – we might visit the doctor more often than normal for reassurance – only to find that hearing it is just anxiety does not reassure all the thoughts we are having in our head
The thought processes themselves create more anxiety in our body and a vicious cycle begins.
Feeling symptoms of anxiety in our body and worrying in our head can lead to behaviors that may be helpful in the short term, but cause us problems in the long term.
For example, if you feel your heart racing and experience a tightness in your chest and notice that you are hot and sweaty, you might sit down, or clutch something for support. These are called safety behaviors.
You might even start to attach the feelings of anxiety to the place where it first happening – a particular shop for example and decide it is safer to avoid that shop altogether as it (the shop) may make you feel anxious.
How will CBT help with Anxiety?
It will teach you that it is not the shop ( or any other person, place or thing) that is making you feel anxious. Our brain attaches emotions to memories which needs to be broken down.
You may have anxious memories attached to the shop that are not helpful to you and which may be responsible for restricting which shops you feel safe in.
It will help you to see that you may misinterpret symptoms of anxiety, for example
Say, out of the blue, you felt dizzy, confused and had muscular tension
You might think “There is something seriously wrong with me”
You might feel more anxiety
This, in turn, affects your behavior. You might sit down or leave what you are doing when you feel the symptoms
Later when the experience has passed, you go over it again in your head, creating more anxious thoughts and feelings.
It would be easier if you thought
This is anxiety and will pass, it always does
You felt uncomfortable but were able to manage
You carried on with whatever you were doing.
CBT helps you by
Looking at your thought processes: You will learn to replace unhelpful thought processes with more helpful ones. You will also be taught about the deeply held beliefs you have that may be underlying your anxiety.
Looking at what you do: You will learn how to calm your body and brain. You will also be taught about your own safety behaviors and avoidance and understand how these may actually be maintaining your anxiety.
What is expected of me?
CBT is psycho -educational which simply means you will be taught all about anxiety how your thoughts and feelings and behaviors are all linked together.
You will be assigned activities to complete. CBT is not like traditional counseling where you just talk. You will come to understand how anxiety develops and will be shown exactly how to reduce your anxiety.
It is therefore, very important that you complete the activities as you are teaching yourself and your brain to respond differently.
Will we focus on my childhood? CBT focuses on what is happening in your life right now. That does not mean that it ignores the past. We are all made up of our past experiences, our beliefs that we have acquired throughout our life and CBT understands this.
However, in CBT for anxiety, you will not be looking at your early childhood years to reduce anxiety. The anxiety that you experience is happening now. We work with how it is happening in your life right now.
CBT comes from earlier forms of therapy:
- Cognitive Therapy, and
- Behavioral Therapy
Cognitive Therapy is one part of Cognitive Behavioral Therapy, that looks our thoughts (our cognition’s.)
Cognitive Therapy focuses on our thought processes. Most of us will have noticed that our thought processes can change depending on how we feel at any given time, but when our mood changes significantly, our thought processes can be problematic.
You can get into a habitual way of thinking that is no longer based on reality. Cognitive Therapy helps you identify and change these unhelpful thought processes into more helpful, reality based thinking.
Cognitive Therapy and Thinking Errors
According to Cognitive Therapy, depression and anxiety are maintained by what is known as negative automatic thoughts. The thought processes may be negative in that they have a negative impact on you and also they may not be correct.
- ” I always fail”
- “Nothing I do is ever good enough”
- “I will never be able to do it”
- “I can’t cope”
- “Other people seem to manage everything just fine. I’m hopeless”
- “Nothing ever works out for me”
These are typical negative automatic thoughts that can be addressed with Cognitive Therapy.
Cognitive Therapy helps you to identify the mistakes you might be making in your thinking.
Common Thinking Errors
- Mind Reading: You work on the assumption that you know what other people are thinking “He thinks I’m a loser” “She does not like me”
- What if?” You always ask (either out loud or in your head) What if something bad happens? What if it does not work out? What if…? and the answers given never seem satisfactory as you will always find another What if?
If you experience anxiety or have had panic attacks, you will be very aware of the impact this has had on your thought processes. You may spend quite a lot of time thinking about your symptoms.
- What if there really is something wrong with me?
- What if I do have a heart attack the next time?
- What if the doctor doesn’t believe that this really is happening to me?
- What if I go mad?
- What if people see that I am anxious?
- Negative Filtering: You seem to focus almost exclusively on the negative and find it difficult to see (not necessarily a positive) but a more reality based side
- Fortune Telling: You see the future negatively. Something bad will happen. It will not work out
Cognitive Therapy helps you go from feeling overwhelmed, to being able to break it all down and think and feel differently about things.
It is not positive thinking, rather it is reality based thinking. Often the way we think about things are down to habitual thoughts that we have about ourselves and our ability to cope, and often they are not correct.
Behavioral Therapy looks at how changing our behavior can lead to positive changes in how feel. For example, each time a person fears that they may become anxious in a situation, they may start to avoid it.
This avoidance behavior helps in the short term, but does not help long term.
Consider someone who experienced anxiety in a large shopping mall.
They may fear that the anxiety may return if they go back to the mall. This behavior becomes problematic as they may start to change their behavior without really realizing it. For example, shopping somewhere smaller or somewhere that is further away from them.
In Behavior Modification, the person would be encouraged to start shopping in the large mall again, together with relaxation techniques. With practice, the person will be able to shop normally again without experiencing or fearing anxiety.
It is the combination of looking not only at how you think, but also at the things that you do (and do not do) that sets CBT apart. It helps you to change how you feel, by not only changing how you think, but also what you do.
See also Guide to panic attacks
CBT gives you the knowledge and skills to stop your panic and anxiety attacks. Armed with what CBT therapists often call “your toolkit” you will eventually overcome your panic attacks and anxiety.