What is cognitive behavioral Therapy?

cognitive behavioral Therapy

What is CBT

What is CBT or Cognitive Behavioural Therapy and how do therapists use it?

CBT therapy is a very different type of therapy because it is short term and it is one of the only therapies that we can monitor and kind of statistically show that people are improving. Most therapies don't work quite so I don't even know what word I want to use, but they're not quite as direct and not so A plus B equals C, you know.

Most therapies are very circular, and maybe we feel this way, and I don't know What's your relationship with your mother and your father? Right. We might go back into our history of CBT beliefs, and the main belief behind CBT, So, in a CBT world, it wouldn't just be that, let's say My dad wasn't around when I was young and he left and he never came back. It wouldn't be that that happened. That's not what's affecting me. It would be my thoughts about it like, "I'm not worthy"," he didn't care about me", "He didn't value our family" or whatever it might be, right? CBT focuses on those beliefs. And because of that, some of the main things that we use are things that I use a lot with my clients and what they call it, and I'm checking. These are my CBT flashcards, so that's what my notes are. So, one of the things that I use a lot is called in the CBT world they call it thought tracking, and that is almost what I want to call that "eating disorder voice" or "self-harm Voice" versus "healthy Voice". And what they do in the thought tracking is they have you keep a record of all those automatic thoughts.

"Automatic thoughts" being: "My dad had left" but it's not just because my dad left. My automatic thought is, "I'm not worthy", "I'm not important", and "he doesn't value our family", and all of that follows. So, for many of us it might be, you know, "I deserve to be punished" "I don't deserve to eat that" or whatever it might be that feeds into our eating disorder, our self-harm, or anxiety or depression. So in CBT, they have you keep track of it. Have you kept this thought tracking record so that we can notice what usually goes "unnoticed" thoughts? There are a ton of tools when it comes to CBT.

Tools

We have three flashcards here on tools. But I'm just going to give you a couple that I end up using most and that's why I thought tracking would be the most helpful. Another thing that we can do is there's a lot in here. As I'm looking through this just to make sure I don't miss anything they have automatic thoughts, so those are the ones that happen you know without us being aware, and then you keep track of it in the thought tracking. Then they have "underlying assumptions" which are the kind of things I will have people when we realize that automatic thought You know, like, "I'm angry", "I'm not worth it", or whatever it might be. We want to find what's the underlying assumptions. So, we might ask what we call downward arrow questioning and I know this is getting intense but I'm trying to break it down into very easy-to-understand portions. So, if my automatic thought is "I'm not worth it" or "They forgot about me" or whatever right? Then I'd say "So what does that mean to you?" and then you would say "That they didn't consider it and you know, that my dad left right? So that would mean that he just left and he didn't care." "So what does it mean if he didn't care?" "Well, then you know that I'm a bad person.". Right we keep asking so with then, "What does that mean to you if that's true" Because a lot of our automatic thoughts we actually believe are true. And that's why CBT can be so powerful. Because a lot of times we're just not aware of all these thoughts that we have all day every day. And these thoughts can stir us up. We can get really angry. We can get really sad. We can get anxious and we get depressed. But bringing this to the forefront and recognizing what those automatic thoughts are and then, doing that downward arrow questioning where we're like, "Well what does that mean?", "Okay, well if that is true, then what does that mean to you?" and you can work this down until you can figure out what that core belief is which could be anything from "I'm worthless" to "I'll never be good enough" to "My mom will always favor my brother" Whatever that thought may be, you can see how once we can recognize what those automatic thoughts are we can get to that point and that's what makes it so powerful. And so there are a ton of tools around CBT to help with that. So I'm going to skip ahead and I'm not going to go through every one of the tools that helps with that, but you may notice them if you're working with your therapist who is a CBT therapist. Now another portion along with the automatic thought records and you know all of that kind of stuff is thought-stopping.

Thought stopping

So, let's say we're having all these automatic thoughts okay? I get up in the morning and I  automatically think "Ugh. I overslept by twenty minutes. I'm so lazy. I'm so stupid. I'm so fat. I'm so dumb. I'm so...", right? We might have that running right away. So, in CBT they have us do what they call "thought stopping". Now, we're supposed to actually, and it's funny but there are a couple of things we can do. Some people will prefer to verbally say "Stop!" "Stop it!". You tell yourself to stop, right? Some of my clients like to visualize they're driving fast towards a stop sign and they can't go any farther. It's like a cement wall with a stop sign. Whatever helps you to stop. For me, if it was me If I had all the automatic thoughts coming up, it would help me to verbalize it. Because sometimes what's going on in our brain is so noisy that we can't even, visualize may not help. The actual verbalization loud, out loud can help. We don't want to do that if we're in the middle of a, you know, fancy dinner or we're out at a party but you can get the idea. So, that's another thing that we'll have you do.

CBT and DBT also are very closely linked. We want to bring awareness to the thoughts that we have every day. Whether they are automatic, or whether they are the same message over and over, we want to figure out what the underlying core belief is. We do that downward arrow questioning and then we also want to be able to think stop. So, when they come in quickly we want to be able to stop them. Because, if I go back to their original portion of CBT, the whole reason that we have it is because they believe that our life and our experience isn't what happens to us. It's what we think about what happens to us. That's kind of that thought record and thought-stopping all in one. You can see how can be powerful. Most of you if you're in the UK or if you're in many portions of Europe, I know that they utilize CBT first and they'll have you do it. You'll notice that it's usually short-term. It'll be anywhere from I believe six to ten sessions, usually eight to ten I want to say about when you end up stopping. But they can have you do also some role-playing and things. You can get into it so that you can start verbalizing those thoughts and you can start changing them and turning them into a kind of more positive or "healthy Voice". They also discuss a lot about catastrophizing or jumping to conclusions like because we have these big negative thoughts we will make, we'll catastrophize, that black and white thinking that I talk about a lot it's something that they also address in CBT because it's our thoughts, right? We're catastrophizing, we're thinking black and white. And those are some the things, the "cognitive distortions" they call them, that we'll try to turn around and to make healthy thoughts. So hope that makes it kind of clear. You can google CBT and you can look up a lot of information on it, but that is how I utilize it in my practice and how you will most likely find it utilized in people that you see. And that is the reason that it's most hopeful because it's all about our thoughts, right? And we have to change our thoughts, our behavior, and our belief about ourselves. So hope you found that useful. Keep checking back.

What is cognitive behavioral Therapy?