3 LESSONS LEARNED FROM COGNITIVE BEHAVIORAL THERAPY
Last week I told you all about how to get the most out of your therapy sessions. Cognitive behavioral therapy is the most widely researched therapy intervention, and for most of the most common mental health conditions it is the absolute best therapy approach.
You might not know much about CBT, though, so today I’ll tell you 3 of the main lessons that underlie how CBT works.
If you’re not in therapy, these lessons might help you know where to focus your energy in overcoming your own mental health struggles; and if you are in therapy (even CBT), these lessons should help you consolidate what you’re learning. Let’s get into it.
WHAT IS CBT?
Cognitive behavioral therapy has been developed for a huge range of mental health conditions. Now we have CBT for just about everything: CBT for insomnia, CBT for depression, CBT for anxiety, CBT for panic, CBT for OCD, trauma-focused CBT, etc.
So what is CBT? Cognitive-behavioral therapy is a specific type of individual therapy intervention that focuses on the interaction between how you feel, what you think, and what you do.
The theory behind CBT maintains that your thoughts, feelings, and actions interact.
Here’s an example.
Something happens: You wave to someone you know at the grocery store but they don’t wave back.
You think: She must be mad at me. I must have said something wrong the last time we spoke.
You feel: Concerned
You choose to: Grab your groceries quickly and avoid her in the store. Don’t make eye contact next time you see her.
Once that cycle has started, it perpetuates: Next time you see her, you feel anxious, you think she hates you, and you avoid her. This just keeps going in a downward spiral of anxiety.
But when we change any single element of our response, the entire pattern can change. Let’s look at the same example again.
Something happens: You wave to someone you know at the grocery store but they don’t wave back.
You think: She must not have seen me. This place is really crowded.
You feel: Unbothered
You choose to: Approach her and say hello.
Scenario #2 obviously feels a lot different.
Maybe she is mad at you, but in scenario #1 you just made that assumption, acted like it was true, and then carried it forward into the rest of your life — and that’s heavy.
In scenario #2, you have a chance to test out your assumption. Maybe it’s true she was ignoring you because she’s mad at you…maybe it’s true she didn’t see you. If you approach her and say hello, you can find out and the feelings you carry forward into the rest of your life are more accurate.
CBT is all about helping you get from scenario #1 to scenario #2 in your life. It’s simple…but not easy. And here are 3 of the main lessons from CBT.
COGNITIVE-BEHAVIORAL THERAPY LESSON #1: IDENTIFY THE BELIEFS HOLDING YOU BACK
Cognitive-behavioral therapy is based on the premise that changing our thoughts has a powerful impact on changing the way we feel.
And ultimately, most of us have the goal of feeling differently: we want to feel less anxious, less depressed, more confident.
Through CBT, we can identify the beliefs that hold us back and keep the anxiety, depression, insecurity, shame, etc. alive.
Here are some examples of beliefs that might be holding you back:
- There’s something wrong with me.
- I’m not good enough.
- I don’t deserve good things.
- I am incapable and incompetent.
- If I love someone, they will leave me.
- It’s not okay to ask for help.
- I can’t do anything right.
- I’m bad.
- I will die alone.
- Everything is my fault.
- I’m unlovable.
- People are untrustworthy.
- The world is dangerous.
- I can’t change.
- I’m broken.
- I’m only worthwhile if I’m perfect.
- I’m not enough.
- I can’t be helped.
Identifying the beliefs that are holding us back is a key step in being able to move forward in our lives. It’s like realizing you’re carrying around a very heavy backpack and then finally setting it down.
COGNITIVE-BEHAVIORAL THERAPY LESSON #2: CBT IS NOT THE SAME AS “THINKING POSITIVELY”
At its heart, CBT is all about changing the thoughts and the actions that keep our anxiety, depression, and other mental health struggles alive.
In part, this means that in CBT, we work to identify unhelpful thoughts. Often, those thoughts are unhelpful in a negative direction: we’re more critical of ourselves than we deserve, we make consistently negative predictions about the future, and we think people are thinking badly of us.
But CBT is not about just replacing our thoughts with happier thoughts.
Being unreasonably positive is just as unhelpful as being unreasonably negative.
Here’s an example:
Too pessimistic: No one can be trusted.
Too optimistic: Everyone can be trusted.
Just right: Some people can be trusted, and I can learn in what way and to what extent the people in my life are trustworthy.
CBT is all about collecting real evidence…in real life. If something is dangerous or has a strong probability of not working out in our favor, it’s important to account for that. If you’re going into an unsafe situation, it isn’t helpful to “think positively.” Instead, CBT is all about “thinking accurately.”
Mental health conditions affect how accurately we think, so CBT helps us undo that and think more accurately.
COGNITIVE-BEHAVIORAL THERAPY LESSON #3: YOUR ACTIONS MATTER MORE THAN ANYTHING ELSE
CBT has always included two main components: changing your thoughts and changing your actions….which ultimately changes your feelings.
But recent research has told us that it actually might be the actions part that makes the biggest difference in how helpful CBT is.
Our brains learn best by doing. That’s why most people like science better than history — it’s so much more rewarding to learn by conducting an experiment than by just reading a book. And most of us realize we learn a new skill best when we can try it ourselves rather than just being told how to do it. We learn more by doing than by thinking.
Unfortunately, most of us try to think our way out of being anxious and depressed. We recognize our thoughts are irrational…we know that the thought “I’m a total failure” is extreme. We can easily generate all sorts of contradictory evidence. We know that checking the locks for a third time isn’t actually necessary. We know there’s nothing about driving that should make us panic. And we go around and around in circles wondering why we stay upset over something that we know isn’t true.
Recognizing the beliefs that are holding us back is important — that’s lesson #1 after all. But ultimately, the actions we take are the most important.
We have to recognize that the thought “I’m a total failure” is holding us back and then we have to do something about it. We have to challenge ourselves to do something we’re afraid of and see what happens. We have to challenge ourselves to not check the locks for a third time. We have to get on the interstate and drive.
We have to take actions that are scary. No amount of thinking will make them less scary. It’s doing them that will make them less scary.
CBT IN A NUTSHELL
Those are your three main lessons from CBT.
CBT is a wildly effective intervention. It’s simple and it’s effective.
If you’re wanting to get your feet wet with CBT, consider trying my free 5-day email course.
It uses CBT principles to help you reverse the downward spiral of negativity. It’s perfect for those times when your thoughts are just snowballing…or you’re overthinking a situation. Sign up here.
CBT has been the gold-standard psychological treatment for just about every major mental health condition for a long time. But over the past couple of decades, a newer treatment has been gaining traction and the research base is super impressive. It’s now rivaling CBT in how well it treats anxiety and depression, and if you don’t know about it, you definitely should. It’s called Acceptance and Commitment Therapy and I’ll tell you the 3 major lessons learned from ACT next week. Don’t miss it.
Talk to you soon,
Dr. Finch
P.S. Remember, this is education, not treatment. Always consult with a psychologist or therapist about your mental health to determine what information and interventions are best for you. See the disclaimer for more details.
Hayden C. Finch, PhD, is a practicing psychologist in Des Moines, Iowa, dedicated to helping you master your mental health.
