About Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) provides a framework to help you make sense of thought and behaviour patterns (an ‘unhelpful cycle’) that make you stuck in your difficult emotions.
CBT starts with recognition of emotions. How do you feel? What labels would you give to the emotions you feel? (e.g., sad, angry, anxious, worried, disappointed, frustrated)
You can also ask yourself what kind of situations or triggers give rise to these emotions in your everyday life. For example, does your anxiety happen the first thing in the morning? Or does it happen when someone says or does something?
When we have negative emotional reactions, our brain may be reacting to the situation in a somewhat biased way. Our thought patterns might be all-or-nothing (“It’s not perfect so it’s not good enough”), self-critical (“I’m useless” “I’m a bad person”), or ‘catastrophic’ (jumping to the worst case scenario).
Physical sensations often become noticeable when we feel strong emotions. For example, anxiety makes us feel physically agitated because it activates our fight or flight survival response in our body. Both depression and anxiety can make us feel exhausted and drained, too. Our sleep, appetite and energy level may be change.
We may then end up engaging in certain behaviours in an attempt to remove those unwanted emotions and feelings: for example, avoiding certain situations or people, or doing some ‘safety’ things to keep the feared thoughts at bay and to feel more in control. They would work in the short-term, but in the longer-term, they tend have some ‘costs’ – including reduced self-confidence, problems piling up, social disconnection, and worsened mood.
If we know what our unhelpful cycle of emotions, thoughts, physical sensations, and behaviours looks like, we can find a way of changing the patterns. This is the central idea of CBT.
CBT predominantly focuses on bringing changes to unhelpful patterns that are affecting you currently. We may also explore some of the past life experience so we could better understand the origin of beliefs and behavioural strategies.
What is involved in CBT sessions?
The exact details of CBT exercises vary depending on the main difficulty that we focus on. Here are some examples:
- Self-monitoring to increase awareness – to be able to notice triggers, emotions, thoughts, physical sensations, and behaviours without judgement
- Improving lifestyle ‘fundamentals’: sleep, diet, and exercise
- Re-balancing your activities – social and alone, ‘have to’ and ‘want to’, restful and active, and so on.
- Moving towards your goals – reflecting on what matters to you and taking small actions to get closer to your goals
- Dropping survival/safety-seeking behaviours with negative long-term impact
- Setting a helpful interpersonal boundary and improving communication
- Developing mindful awareness of thoughts and emotions as well as the external world around you – ‘present moment focus’
- Practicing taking a step back from unhelpful thoughts and considering alternative perspectives with greater flexibility
- Identifying and changing unhelpful ‘should/must’ rules and expectations
- Developing self-acceptance and kindness to yourself, step by step
CBT is a collaborative process, so our work together will be shaped by your goals and our joint evaluation of how things are working for you. CBT has a ‘home practice’ element: after each session, you are encouraged to work on one or two home practice tasks chosen based on our discussion. The more you put into the home practice, the more you will benefit from CBT.
CBT is a relatively short-term therapy. The idea is that at the end of the process you feel you are equipped with useful ideas and skills that would help you deal with challenges of life by yourself.
British Association for Behavioural and Cognitive Psychotherapies (BABCP) is the lead organisation for quality assurance of CBT delivered to clients in the UK and Ireland. I have a full accreditation with BABCP.
In addition to CBT, I incorporate various ideas and methods from Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy (CFT). ACT has an emphasis on developing openness to difficult experiences, creating helpful distance from our tricky over-thinking mind, and making commitment to taking actions that we choose in line with our ‘values’ (i.e., what matters to us) with mindful awareness. CFT tells us that we all have a natural, built-in ability in our brain and body to soothe our survival mechanism that drives depression and anxiety, and that we can consciously choose to nurture our own compassionate mind to improve our relationship to ourselves and others.
May Breeze 