Cognitive Behavioral Therapy

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,: 2023

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Do you have a tendency to lash out emotionally or say and do things that you later regret? Have you ever asked yourself how you feel or what you want, only to hear the answer? I don't know. If so, then this book is for you. In the chapters that follow, we'll explore the root causes of all those behaviors in life that sabotage our happiness and undermine our well being. Whether it's poor communication in relationships, addictions, unmanaged anxiety and depression, or simply a constant feeling that you're not living to your fullest potential, there's usually one predictable root cause behind it all lack of awareness. Traditionally, a psychologist or psychotherapist could help you more deeply understand who you are, what you want, and how you tick. But if that's not a possibility for you, rest assured that you can master the very same techniques for yourself and become your own therapist.

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Throughout this book, we'll look at the lives of fictional people who are all experiencing very different life challenges. Yet in their own way, each of them has just one problem a lack of awareness of their emotions, core beliefs, blind spots, and expectations. As you read, you'll be invited to look more closely at your own emotions, thoughts, and beliefs and how they are motivating certain behaviors and habits. Being your own therapist doesn't take any magical skill or superhuman ability. All it takes is the willingness to be honest, to ask questions, and to courageously take action according to the insights that you glean. Let's jump in. Meet Clara. Going about her life one day, she encounters two particular situations.

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Situation 1 is that she receives an email from a work colleague asking her a question about a presentation she gave two weeks earlier. She reads the email, understands the question, and answers it factually. Situation 2 is that Clara gets home from work and sees that her husband hasn’t arrived home yet. She immediately thinks, “He’s been in a car crash and he’s dead." Terrified, she immediately takes action by blowing up his phone with panicky messages, then furiously Googles “how to plan a funeral." Later, she feels a little ashamed of how over-the-top her actions were. What is the difference between these situations? In both, Clara is having a cognitive response to some stimulus in the environment.

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Yet in Situation 2, it’s clear that her thoughts about the situation are not helpful or accurate. In fact, it’s not the situation itself that compels Clara to feel and act as she does, but rather her thoughts about the situation. This is the key insight behind cognitive behavioral therapy, or CBT: that not all of our thoughts are for our benefit. Thoughts, feelings, and actions are all connected. The way we think about things affects how we feel, and how we feel affects how we act. How we act, in turn, changes our world in ways that confirm or reinforce how we think or feel. The American Psychological Association (APA) explains that there are three core concepts behind CBT: 1. Psychological problems are caused at least in part by unhelpful or inaccurate ways of thinking. 2. Psychological problems are also caused in part by maladaptive (i.e., not useful or healthy) behavior patterns and habits—and many of these are themselves caused by our thinking.

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3. Because we learned how to think in these maladaptive ways, we can unlearn them. In other words, if we hope to address our psychological problems, we can do so by starting with the maladaptive thoughts that underpin those problems. The idea is that if you can become aware of your thought patterns and how they’re affecting your life, then you can take steps to change them for the better. Without awareness, old habits keep playing out and patterns keep repeating themselves. We’ll learn more about Clara throughout the chapters of this book, as well as three other people who are experiencing mental health difficulties that you may recognize in yourself. For Clara, CBT is a way to get a handle on her anxious thought patterns so that she can control them rather than them controlling her. But CBT has also been proven to help when it comes to •Depression •PTSD •Stress management •Self-esteem issues •Eating disorders •Anger management •Chronic Pain Basically, if your thoughts are involved at any point, then CBT can help. But before we go on, it’s worth understanding that CBT (and indeed all the techniques we’ll explore in the chapters that follow) is not a silver bullet.

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It’s not for everyone or all problems, at all times. What it can do, however, is help you gain awareness of the cognitive component of your own mental health issues so that you can make changes. This is a theme we’ll keep returning to: No single theory is “right” or the solution; rather, it’s the awareness and self-mastery that we gain by using this or that technique that really matters. In CBT, the goal is to take automatic, negative, unhelpful, and unconscious thoughts and deliberately transform them into conscious, helpful ones that allow you to live the kind of life you want to live. If you’re reading this book, chances are that there is something in your life right now that is causing you distress, yet you don’t have a firm handle on it. Using CBT and the other techniques we’ll explore, you will learn 1. How to slow down and become aware of the difference between situations, thoughts, feelings, and actions/behaviors 2. What your core beliefs are and how they play out in your life 3. To challenge and replace your irrational beliefs and sabotaging assumptions 4. How to spot bad mental habits and cognitive distortions and take control Just like Clara, some of your thoughts day to day will be neutral, accurate, helpful, and realistic. But some of them won’t be. If we wish to become our own therapists, where do we start?

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After all, if our thinking itself is distorted, how can we trust it to help us solve that very same distortion? Bear in mind that cognitive distortions are normal. Everyone has them. They only become a problem when we fail to recognize them as distortions. This is the power of CBT—we learn that we don’t have to believe everything we think. What we can do is stop, become aware, and notice what we are thinking. Then, we can hold that thought up to the light and really look at it. Is it true?

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Is it helpful? Does it inspire the kind of action that will create the life we want? Does it feel good, and does it align with our values? Maybe we find out that the thought is a pretty good one, after all, and we keep it. But if we discover that a thought is truly not serving us, we empower ourselves to make different choices. How to Spot a Cognitive Distortion A cognitive distortion only feels like the truth. It feels like we are neutrally observing reality—but we’re not. Take a look at some common distortions and see if you have ever entertained thoughts of this kind in your own life before.

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All-or-nothing thinking, where we see only in black-or-white extreme terms instead of the more likely grey areas in between. “She said she wasn’t interested in dating me, so obviously she hates me." Should statements, where we labor under some assumptions about what we ought to be doing and the rules we ought to be following. “I don’t know why I’m so uncertain at the moment; I should be happy!" Catastrophizing, where we assume the worst possible outcome is the one that will happen. “If I lose my job, I’ll never find another one and I’ll be destitute and forced to beg on the streets ... ” Overgeneralization, where we assume that one observation applies to other unrelated situations. “She didn’t want to date me, so that means nobody ever will." Filtering, where we interpret neutral or positive events through a negative lens and come to some preconceived conclusions.

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“She said she’d go out with me ... so I guess that means she feels sorry for me." Closely related is discounting the positive, where we ignore the good and focus heavily on the bad. “I don’t care that most judges gave me a perfect score—why did that one judge only give me a nine out of ten? What did I do wrong?" Mindreading, where we assume we know what others think and feel, without any evidence. “I have to host Christmas every year; people expect it and would be so disappointed in me if I stopped." Personalization, where we put ourselves at the center of things and assume that we are responsible for things that really have nothing to do with us. “My son is failing chemistry, and I feel like it’s my fault for not supporting him better."

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And so on. In fact, there are probably as many types of cognitive distortions as there are thoughts! Clara has a thought that is catastrophizing (“he’s had a car crash”), which she wholly believes in the moment. But she can recognize this as a distortion by stopping and becoming aware of her thoughts as thoughts and not automatically assuming that every thought is true. Then she can deliberately challenge her thoughts and consciously choose what to think, behave, and feel. This process of deliberately engaging with our thoughts is called cognitive restructuring, and it’s a popular CBT technique. It’s not dissimilar to becoming aware that you are looking at life through a filter or a lens. CBT lets you ask what kind of image you’re seeing, whether it’s distorted or not, and whether you can put a different lens on the camera entirely.

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Here’s how. Step 1: Become aware Cognitive distortions have power because we’re unaware of them. The first step, then, is to notice them happening when they happen. A good clue that your thinking is distorted is a feeling of disproportionate response, i.e., if you feel that you’re suddenly emotional without really understanding why, become curious about what assumptions you’re habitually falling into. Don’t assume that it will be easy to spot your thoughts at first—it takes practice and honesty! One way is to deliberately pause every time you feel upset, angry, confused, etc. Slow down and sit quietly somewhere with a journal and write down your thoughts. Don’t censor yourself or get carried away with blame or shame.

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Clara might write a stream of thoughts that looks like this: “He never comes home late from work. It doesn’t make any sense that he would, so I’m sure that something must have happened. That’s the only thing that can explain in this situation. And I’m all alone here, and I have no idea what I’d do if something happened to him ... I can’t even think of how I would go on if I knew he was gone ... ” And so on. Step 2: Appraise Take a step back and look at the thoughts. Ask yourself: Can I recognize any distortion here? Do I have any real evidence for this conclusion? Is there potentially another way of looking at this?

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Naturally, this takes some willingness to be honest. Clara might zoom in on the thought “there’s no other explanation for his lateness” and ask herself if she knows this to be factually and logically true. She considers alternatives. He might have been in a car crash, sure, but he also might be stuck in traffic or was asked last minute to stay at work. He may have taken a detour to pick up Clara’s favorite takeout for dinner that evening! Do the same and ask yourself about the quality of these thoughts. How do they make you feel? What actions do they inspire?

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Now look at these feelings and actions and ask if they are what you want for yourself. If not, then deliberately tell yourself (try actually saying it out loud to yourself) that it’s just a thought, and a thought can be changed. Step 3: Reframe No, it is impossible to change the world just by changing our thoughts. But we can always change our perspective on that world, how we frame things, our interpretations, our focus, and the filter we place over what we see. Is there an upside or benefit you’re ignoring? Are you treating certain assumptions as true when they aren’t? Try to imagine what your perspective looks like without those assumptions. Clara, once she noticed how awful she feels when she believes her distorted thought (“he’s dead!”) and how much she dislikes the behavior it causes, tells herself that there is an explanation for her husband’s lateness, but she doesn’t know what it is right now, and that’s okay.

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She tries on a few perspectives, asking herself questions and challenging her assumptions. After a little internal dialogue with herself, Clara feels calmer as she thinks, “It’s certainly unusual that he’s late, but I have no idea what’s happening, so there’s no point in getting anxious." A nagging, persistent voice tells her, “But what if he is dead, though?” and Clara looks at this, realizing that it, too, is just a thought, and she can pause, become aware of it, appraise it, and deliberately choose to listen to it or not. She dismisses this thought. She can see an anxious detour that this thought is inviting her to take, but it doesn’t mean she has to go down that path. Five minutes later, her husband turns up at home—he had a puncture but it’s all fixed now. You might be thinking that CBT must only be useful for simple situations like Clara’s, but the beauty of the technique is that it can be applied to all sorts of mental distortions, big or small, temporary or long lasting. For example, Clara might try therapizing herself with this CBT technique in small ways, but in the longer term, she starts to notice far-reaching effects.

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She begins to be aware of her tendency to catastrophize in all sorts of situations. Though “rewriting” a simple thought doesn’t seem like much, these small changes start to make big shifts in Clara’s life. One day, her husband casually suggests she apply for a big fancy job that’s opened up with twice the pay and plenty of interesting perks. Clara immediately dismisses the idea, but then stops and thinks, why? She practices the same process of pausing to become aware, appraising her thoughts and then moving ahead in conscious awareness, and notices for the first time how quickly she turns down a challenge. When she examines her thoughts, she realizes it all comes down to catastrophizing. In the past, she wouldn’t have even noticed herself thinking the thought, “Don’t bother trying that; it’ll never work out for you. It’ll be a disaster ... ” yet all the same, it would influence her actions and how she felt about herself.

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But with the increased awareness that this CBT technique is teaching her, she can pull these unconscious assumptions out into the light and ask whether they’re really working for her. In this way, the simple technique of cognitive reframing can have deep and lasting effects on your life. Thanks for joining us again today. You can get more info on Nick Trenton at bit. Ly nick Trenton. And be sure to join us again next Thursday for another episode of The Science of Self, where you improve your life from the inside out. Bye.