CHAPTER 1
The Basics of Cognitive Behavioral Therapy
Cognitive Behavioral Therapy is the integration of two types of therapy that were developed independently of each otherācognitive therapy and behavioral therapy. Cognitive work has to do with understanding and claiming the nature of oneās own beliefs and assumptions, and behavioral therapy is more concerned with how one acts under certain conditions and in various contexts. When you bring these two models together, you get Cognitive Behavioral Therapy (CBT), a modern, widely encompassing manner of improving oneās life.
Definition of Cognitive Behavioral Therapy
Thefreedictionary.com (www.thefreedictionary.com) defines Cognitive Behavioral Therapy as a type of psychosocial therapy that assumes the individual seeking treatment has maladaptive, or counterproductive, thinking patterns, which in turn cause maladaptive behavior and ānegativeā emotions.
Time magazine said that cognitive therapy is āā¦ quick, practical, goal-oriented.ā This type of therapy involves education, skill-building, and problem-solving. It may or may not be accompanied by medication.
These maladaptive behaviors are seen as the result of negative beliefs or thoughts, which become the focus of therapeutic work. Cognitive-behavioral treatment helps the individual to consciously form new thoughts that are more likely to bring the positive results he or she wants out of life. CBT is not a distinct, separate type of therapy, but rather a group of types of therapy that focus on short-term cognitive and behavioral changes.
Which Conditions Can Cognitive Behavioral Therapy Help?
This approach can be used in any everyday situation where there is a persistent, unwanted belief and a corresponding maladaptive response. For example, a young man does not date because he is certain that anyone he finds attractive would turn him down. Changing the thought and belief, along with practicing new behaviors, does wonders to create a more satisfying relationship life.
Other conditions that have shown improvement with the use of cognitive-behavioral work include:
- Mood disorders
- Personality disorders
- Social phobias
- Eating disorders
- Obsessive-compulsive disorders
- Addictions
- Anxiety
- Agoraphobia
- Post-traumatic stress disorder (PTSD)
- Sleep difficulties
This integrated approach has also proven helpful in cases of pain management involving arthritis and back pain.
When Is Cognitive Behavior Therapy Not Suitable?
If you do not have a specific belief or attitude that needs to be changed or improved, it is possible that psychotherapy, with a general approach, would be more helpful. In addition, people with severe psychosis or organic brain impairment would probably not be good candidates for this therapeutic approach.
How Can CBT Help Me?
Cognitive Behavioral Therapy can help you look a little deeper into the beliefs and thoughts that have led to your current circumstances, and will teach you how to take emphatic action toward creating a new, more positive existence.
You Are Not Alone
Beginning any form of therapy can be daunting, but just remember, you arenāt alone. You have the help of this book and all the knowledgeable research, writing, and experience that is behind it. All the changes that you seek will happen in increments. Keep in mind that it takes courage to deeply accept oneās part in the creation of unhappiness or troubled circumstances. That awareness is an important first step in making desired changes.
The willingness to look at things in a different way is an important part of the picture. So is having the humility to ask for help. American culture has a vein of rugged individualism that was helpful when settling this country, but it is not helpful when you are exploring and taming the inner terrain of your mind. For that, youāll need experienced guides.
Clarity on the Desired Changes
In order for you to get the most out of Cognitive Behavioral Therapy, you will need specific goals instead of vague hopes. For example, if youāre unhappy and want to be happy, it will be difficult to know what you need to work on specifically. If you have spent considerable time with yourself and various spiritual and therapeutic helpers in fine-tuning your desires, it is more likely that this approach can bring about some good results.
Responsible Self-Monitoring
Cognitive Behavioral Therapy can help you fine-tune your awareness of the thoughts, beliefs, emotions, and behaviors that create your life as it is today. You can more or less become your own watchdog or gatekeeper, catching yourself as you begin to go down a habitual primrose lane that has previously brought nothing but poor results. You can benefit from this approach if you want to stand a little taller, literally and figuratively, joining the ranks of full adulthood, leaving behind all the baggage that has, up until now, paralyzed your development.
Goals of Cognitive Behavioral Therapy
In CBT, you will learn to distinguish between thoughts and emotions. You might think you already know how to do this, but in fact, many people are rather blurry in their understanding of the differences between the two. Sometimes in arguments or discussions a person says, āI feel that ā¦ā when what is meant is, āI think that ā¦ā
In Cognitive Behavioral Therapy, you will learn about your automatic thoughts, those deeply held premises that regulate your daily existence. You may not think you have any such automatic thoughts, but you do. Otherwise, every day would start from ground zero, and be composed of an impossible amount of thoughts and choices. An example of an automatic thought is āPeople should obey the law.ā Another is āIt is important that everyone like me at all times.ā One can surmise already that the first thought is beneficial and the second one is not.
You will learn which of your automatic thoughts are not useful to you, possibly even biased and harmful. Carefully you will analyze and discard thoughts that are not helpful and create new ones that positively affect your present life. You will learn how to interrupt the automatic thoughts that have, until now, orchestrated your existence, and replace them with thoughts that are more beneficial in creating a happy life.
In Cognitive Behavioral Therapy, you will learn how you have conditioned yourself to cope with certain fears and anxieties by avoiding the situations and thereby restricting your life. CBT sessions help you face those difficulties and, with support, recondition yourself so that you no longer need to avoid what was previously perceived as being quite scary. You will learn that temporary negative emotions in connection with what was feared are not dangerous, and that eventually they fade.
You will learn which of your thoughts, beliefs, and emotions are maladaptive, causing difficulties in your life. You may discover some of the origins of those roots, but large amounts of time will not be spent on the past. Instead, you will become aware and change what has not been working to your benefit.
It is a daunting task to remodel your mind, but the benefits are worth the efforts of facing surprises and resistance along the way. At times, you might feel scared and believe that it is simply too difficult, but the freedom from habitual anxieties, fears, and outdated behaviors will bring a newfound exhilaration.
Related Techniques
Many approaches are available to the cognitive-behavioral therapist. Different interventions include the use of imagery, guided relaxation, exposure to the feared stimuli, restructuring negative self-talk, and creative adaptation to constraining circumstances. Cognitive Behavioral Therapy may be focused and short-term, helping a client to overcome a certain situation, such as fear of flying in airplanes. Over a period of weeks, the therapist and client work on certain structured steps to bring about the result of feeling relaxed and safe while flying.
What Can I Expect?
The cognitive-behavioral therapist may have a variety of tools in his toolbox. You might expect any of the following methods:
- Homework assignments
- Mentally rehearsing a situation
- Journaling
- Role-playing, in which the therapist models the desired behavior
- Conditioning, especially with children, when the therapist provides a reward
- Desensitizationāgradual exposure to a feared situation until it is no longer feared
- Testing beliefsāencouragement in looking at irrational beliefs and testing them in real-life situations
Depending on the therapistās style, the client could expect any combination of these methods to come into play, according to the behaviors and beliefs that are problematic.
Who Can Help Me?
Although anyone can use cognitive-behavioral techniques, it is generally a part of the professional training of the following types of mental health workersāpsychologists, clinical social workers, psychiatrists, and counselors. At times, a primary care physician may suggest certain cognitive-behavioral changes on a short-term basis. Generally, this therapeutic approach is no longer than sixteen weeks. And donāt forget, you can help yourself with this approach. You may seek out the help of professionals, and then again, you may not need it. Many of the techniques discussed in this book are quite accessible on a self-help basis.
Addressing Negativity
Negativity can prevent you from having a happy life. It is like trudging around, praying for unwanted results! It may seem like quite a challenge to think about positive things when disappointing things are happening in your life or nearby, but being able to do this is a key to a satisfying existence. Itās...