What is Cognitive Behavioural Therapy?
All of my patients who struggle with anxiety and/or depression have heard me go on about the power of cognitive behavioural therapy (also known as CBT). CBT is first-line therapy for mild to moderate anxiety and depression. This means that if you have been diagnosed with mild to moderate anxiety and/or depression, cognitive behavioural therapy should be the first part of your treatment plan before drug therapy. Too often, this important first step is missed.
CBT is a form of psychotherapy that seeks to identify and correct errors in cognition that contribute to the negative feelings and self-limiting beliefs we often develop about ourselves. These errors in cognition act like self-sabotaging "tapes" (referred to as automatic thoughts) that we play over and over in our minds on repeat. Left unchecked, these "tapes" can really limit us and can lead to the development of depression and anxiety.
CBT is a form of psychotherapy that seeks to identify and correct errors in cognition that contribute to the negative feelings and self-limiting beliefs we often develop about ourselves. These errors in cognition act like self-sabotaging "tapes" (referred to as automatic thoughts) that we play over and over in our minds on repeat. Left unchecked, these "tapes" can really limit us and can lead to the development of depression and anxiety.
Here's how it works:
Imagine a little girl who behaves badly in class one day, eliciting the anger of a teacher and causing the teacher to declare that the little girl will never amount to anything. That little girl doesn't necessarily have the life experience or wisdom to recognize that this is just one person's opinion, or that this message was relayed out of anger, and so this message is received as a true statement and incorporated as an internal "tape," which repeats the message that she will never amount to anything. This automatic tape will keep playing the same old song any chance it gets! Any subsequent events in the girl's life that reinforce this message only serve to turn up the volume on the tape even louder. We all have experiences like this that lead to the development of negative beliefs, and throughout life, the messages become louder and louder until we are firm believers that we are unloveable, helpless, and/or defective. |
As you can imagine, listening to these negative tapes throughout our lives can contribute to the development of anxiety, depression, and low self-esteem.
In CBT, the first step is to identify what negative tapes or automatic thoughts are repeating in your own mind. These could be anything but might look like any of the following:
Once you have been able to identify what negative thoughts are repeatedly being played in your mind, you can start to challenge those thoughts. In essence, in CBT you become "captain of the debate team," and you learn how to objectively evaluate all the evidence that proves these thoughts are true, and all the evidence that proves they are not true. More often than not, when we do this kind of exercise, we learn that most (if not all) of the self-defeating messages we fill our heads with are inaccurate and untrue! There is a bumper sticker that states "Don't believe everything you think." That's the idea with CBT. We need to remember that just because we think a thought doesn't mean the thought is true! Many of our thoughts are lies and fabrications!
CBT will also teach you more constructive ways to talk to yourself. This is a life skill that we all need and should be taught as young children, in my opinion. For example,
I don't know about you but just reading the first part in each example makes me feel stressed out, but when I say the second part, I feel like I can relax again. Our thoughts are this powerful! By learning how to talk to ourselves with kindness and self-compassion, we naturally improve our self-esteem and mood.
In CBT, the first step is to identify what negative tapes or automatic thoughts are repeating in your own mind. These could be anything but might look like any of the following:
- I'm alone.
- I'm a failure.
- No one likes me.
- I'm not good enough.
- I can't handle anything.
- Bad things always happen to me.
Once you have been able to identify what negative thoughts are repeatedly being played in your mind, you can start to challenge those thoughts. In essence, in CBT you become "captain of the debate team," and you learn how to objectively evaluate all the evidence that proves these thoughts are true, and all the evidence that proves they are not true. More often than not, when we do this kind of exercise, we learn that most (if not all) of the self-defeating messages we fill our heads with are inaccurate and untrue! There is a bumper sticker that states "Don't believe everything you think." That's the idea with CBT. We need to remember that just because we think a thought doesn't mean the thought is true! Many of our thoughts are lies and fabrications!
CBT will also teach you more constructive ways to talk to yourself. This is a life skill that we all need and should be taught as young children, in my opinion. For example,
- "I’m not good at this" becomes "If I practice, I will get better."
- "I give up" becomes "I can do this! I have done lots of difficult things before. I will ask for help when it gets hard."
- "I made a mistake so that makes me a failure" becomes "Mistakes help me learn what to do differently next time. I’m allowed to be human and to learn!"
- "No one likes me" becomes "Even though I may not have hundreds of friends, I have several friends who I know I can count on, and I value these friends. I know that I attract the right people into my life, and I will continue to attract more friends in my future."
- "This is too hard" becomes "This may take some time and effort but I can do it! I will break it into small manageable pieces and get started."
- "Bad things always happen to me" becomes "I have been through some traumatic events, but I've come out stronger and more equipped to handle these challenges if they happen again. I have also had many good things happen to me, and there's a good chance I'll continue to attract good things in the future."
I don't know about you but just reading the first part in each example makes me feel stressed out, but when I say the second part, I feel like I can relax again. Our thoughts are this powerful! By learning how to talk to ourselves with kindness and self-compassion, we naturally improve our self-esteem and mood.
Do you need to work with a therapist to do CBT?
You do not need to work with a therapist to do CBT, though it can be helpful, especially if you struggle to identify which automatic thoughts are getting in your way, or if you feel you currently lack the discipline to do the exercises in a work book. For those without access to a counsellor or therapist, there are two great DIY books on CBT that guide you through the process, first identifying your self-sabotaging automatic thoughts, then learning which cognitive distortions you tend to fall victim to, and finally re-structuring your thoughts so that they build you up you instead of tear you down. These books are:
As I mentioned, CBT is first-line therapy for anxiety and depression. I am blessed that I am able to support my patients through their CBT journey and also fill in the gaps, utilizing prescription medications, homeopathic remedies, herbal remedies, and clinical nutrition to support mood. Using these tools, I am able to provide a truly holistic approach to mental health.
To learn more about working with me, please check out my Home page.
- Feeling good by David Burns
- Mind over Mood by Greenberger and Padesky
As I mentioned, CBT is first-line therapy for anxiety and depression. I am blessed that I am able to support my patients through their CBT journey and also fill in the gaps, utilizing prescription medications, homeopathic remedies, herbal remedies, and clinical nutrition to support mood. Using these tools, I am able to provide a truly holistic approach to mental health.
To learn more about working with me, please check out my Home page.