Cogntive Behavioural Therapy (CBT)
What is CBT?
It is a way of talking about:
- How you think about yourself, the world and other people
- How what you do affects your thoughts and feelings.
CBT can help you to change how you think ("Cognitive") and what you do ("Behaviour)". These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the "here and now" problems and difficulties. Instead of focussing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.
When does CBT help?
CBT has been shown to help with many different types of problems. These include: anxiety depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue.
How does it work?
Thoughts- Emotions- Physical feelings -Actions
Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it. There are helpful and unhelpful ways of reacting to most situations, depending on how you think about them.
For example:
Situation: |
You've had a bad day, feel fed up, so go out shopping. As you walk down the road, someone you know walks by and, apparently, ignores you. | |
Unhelpful |
Helpful |
|
Thoughts: |
He/she ignored me - they don't like me |
He/she looks a bit wrapped up in themselves - I wonder if there's something wrong? |
Emotional:
|
Low, sad and rejected | Concerned for the other person |
Physical: |
Stomach cramps, low energy, feel sick |
None - feel comfortable |
Action: |
Go home and avoid them | Get in touch to make sure they're OK |
- a number of uncomfortable feelings
- an unhelpful behaviour.
If you go home feeling depressed, you'll probably brood on what has happened and feel worse. If you get in touch with the other person, there's a good chance you'll feel better about yourself. If you don't, you won't have the chance to correct any misunderstandings about what they think of you - and you will probably feel worse. This is a simplified way of looking at what happens. The whole sequence, and parts of it, can also feedback like this:
CBT can help you to break this vicious circle of altered thinking, feelings and behaviour. When you see the parts of the sequence clearly, you can change them - and so change the way you feel. CBT aims to get you to a point where you can "do it yourself", and work out your own ways of tackling these problems.
How do you use CBT in a therapy session
During your sessions we can break each problem down into its separate parts, as in the example above. To help this process, I may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions
Together we will look at your thoughts, feelings and behaviours to work out:
- if they are unrealistic or unhelpful
- how they affect each other, and you.
We will then discuss and doscover ways to change unhelpful thoughts and behaviours. It's easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, you need to do "homework" - practising these changes in your everyday life. Depending on the situation, you might start to:
- Question a self-critical or upsetting thought and replace it with more helpful (and more realistic) one that you have developed in CBT .
- Recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.
