CBT is a working collaboration between therapist and client – the client brings the expertise of their thoughts, feelings and behaviours and a CBT therapist will bring the maps (formulations) so we can work together to challenge unhelpful thinking and build in helpful habits of thought and behaviour to ease distress.
CBT is a phrase used for a specific kind of therapy which helps us notice our thoughts and the stories or predictions that our minds tell us. This noticing can help us distance from our thoughts and see them as thoughts not facts.
Thoughts affect how we feel - emotions as well as how our body feels - symptoms.
Thoughts also influence what we do - whether we get out of the house or answer the door, go to work, reply to a text or open a letter. Our thoughts can make us avoid and withdraw. Thoughts feelings and behaviours form a vicious circle which conspire to keep us feeling flat (depression) or activated (anxiety).
Anxiety thoughts tend to have a future focus, a negative prediction and negative self-perception. Like - “something bad is going to happen and you can’t cope”.
Depression thoughts tend to have a looking back (rumination) focus – over things already past, and tend to have a negative or critical self-talk. Like “I’m a failure / not good enough”. Examples of some tricky beliefs that can cause difficulty are:
- "I must do well and win people's approval otherwise I am worthless..."
- "I'm worthless because..."
- "Other people must treat me considerately and kindly in exactly the way I want them to (or they should be blamed or punished)"
- "It is awful that..."
- "Life must give me all I want quickly and easily and give me nothing I don't want..."
- "I can't stand it that..."
These thoughts are the result of faulty interpretations or core beliefs that have usually helped us to make sense of a situation at some earlier point in our lives. They affect how we perceive ourselves or others or the world. These interpretations are made often when our brains and hearts were younger and developmentally more vulnerable. A small child usually doesn’t wonder why or what’s wrong with an adult when a parent is abusive - they normally simply wonder “what’s wrong with me?”. They can take too much responsibility upon themselves. These faulty beliefs or core beliefs mean we can repeat, over and over, faulty patterns of thinking and behaving which further embed the negative belief.
CBT helps you notice and reflect on patterns of thoughts and behaviours in order to identity the core beliefs and to begin to find ways of being irreverent to these beliefs by challenging the thoughts or behaviours to test the predictions that keep you stuck.
As a therapist trained in CBT it’s important to let you know Cognitive behaviour therapy involves a lot of psychoeducation – so early sessions share a lot of information - and it aims to teach you to identify, evaluate and change dysfunctional thinking patterns so therapeutic changes in mood and behaviour can occur which help you change your internal and external environment in the longer term.
This approach is very useful with behaviour change and in current and future or goal focussed work. CBT can help without needing to explore a lot of past history, though it will look to identify persistent unhelpful patterns of thought or behaviours.
It can be very helpful for one to one or individual counselling.
CBT is an evidence based practice recommended by NICE guidelines: