When people are struggling with different challenges in their lives they may do a quick google search to look for psychological support – often this search will be for ‘counselling’ rather than the wordy ‘Cognitive Behavioural Therapy’. Given the scientific and alien-sounding name, it is understandable that it’s a less popular or common term amongst the general public. However, the fact CBT is recommended by NICE (National Institute of Clinical Excellence - the people that recommended different forms of treatment to the NHS based on research) as the psychological treatment for a range of anxiety disorders and depression should make it surprising that it is a lesser known therapeutic entity.
In a nutshell, CBT is all about how our thoughts, feelings and behaviours are interlinked and have a reinforcing impact on one another. The ‘cognitive’ part is a psychological term for thought processes and this part of therapy looks at how the way we think and the
beliefs we have, influence how we feel and how we respond. The ‘behavioural’ part relates to our actions - this part of therapy explores what we do or don’t do and how some behaviours can be unhelpful to us and keep us feeling and thinking in a negative way.
Take the example - you have messaged someone and they appear to be ignoring your message; the thoughts you have about this will influence how you feel and how you respond but likewise how you respond will influence subsequent thoughts and feelings. One person in this situation might think ‘how dare they ignore me, who do they think they are!’ causing them to feel angry and to ignore the person next time they get in touch, or even block them and more than likely, they end up staying angry with them.
Another may think ‘they mustn’t like me/have I upset them?’ 'what if they've taken my message the wrong way?' causing them to feel down, ruminate and keep checking their phone waiting for a reply thus reinforcing the feeling of sadness and worry.
Someone else might have the thought ‘they must have read my message and been so busy they have forgotten to reply..they might have a lot going on’ leading to them feeling indifferent about the situation and ringing the person the next day to check how they are.
This illustrates how one event can be interpreted in a number of ways and the way it is interpreted will have ongoing influence over our emotions and behaviour.
An important thing to remember is; the thoughts guiding our interpretations are opinions and not facts. We can only assume the reason for that person’s lack of acknowledgement. Yet when we are low or anxious our thoughts become more negative – it’s as if we have a negative mental filter that only allows information in which supports our negative thoughts such as; ‘It says they have read my message so they must be ignoring me on purpose’.
I for one know that I often read messages 'on the go' and it wouldn’t surprise me if I had inadvertently ignored the odd text message/what's app. The thing with depression and anxiety is; the negative thoughts we experience generate such a negative feeling that the opinions we have start to feel real and we take them as fact. However the reality is we never know what someone else is thinking and there are usually a number of possible alternative perspectives on any given situation where we don’t have all the facts.
This is where CBT comes in. CBT helps with this by teaching people to take a step back from the situation, identify their unhelpful thought processes/opinions and start looking for actual evidence to support or disconfirm their thoughts. Considering the evidence allows the negative thoughts to be challenged and the generation of alternative interpretations and rational perspectives. Once you stop taking negative thoughts as facts you are no longer reinforcing negative feelings and unhelpful behaviours. Therefore challenging your thinking can help you break free from the vicious negative cycle maintaining your depression or anxiety.
I hope this post goes some way to explain what CBT is all about and helps it seem a little less mysterious and obscure. Whilst it's name can make it sound complicated it's really all about how the way we think and behave, influences our emotions.
In a later post I will talk more about the unhelpful role of certain behaviours and how behaviour can make it difficult to challenge and change negative beliefs.