CBT | About Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (commonly called CBT) is often viewed as a gold-standard of care for many mental health diagnosis including Depression and Anxiety.
What exactly is CBT?
The CBT approach will look at how your thoughts (cognitions) influence your feelings and behaviors. Many times, our thoughts will have “errors” in them (these are called Cognitive Distortions). These errors can lead to us feeling and behaving in particular ways that aren’t always the best. “Catastrophizing” is a common one, this is where you take a small negative and make it into a very big deal. You think of the worst possible thing that can happen. An example of this is if you make a minor mistake at work and now you’ve got yourself convinced that you are going to be fired. This can lead to you feeling highly anxious which can also lead to difficulties focusing at work, constantly questioning yourself and maybe even making more mistakes. Interesting enough, this may lead to a poor work performance which can then end up where you do get disciplined or even let go which then further reinforces your catastrophic thinking (“see, I knew this was going to happen…”).
In CBT, your therapist will help you identify your thinking process during situations and explore how these thoughts affected your feeling and behavior. They will then assist you in identifying a more helpful way to think about the situation. You will likely have some sort of homework, such as keep a thought record, to help you identify when you are engaging in cognitive distortions. You may also explore some internalized beliefs you have about yourself, others, and the world (called Core Beliefs) that may be influencing your thoughts. For example, if you have a Core Belief of “I’m not worthy” you may then have thoughts around always failing, not being enough, feeling like you have to constantly “perform” or “earn” others approval and love.
What does CBT treat?
CBT can be very helpful in treating Depression and Anxiety, as it looks at how your thinking may be keeping you stuck in an anxious or depressed state. Also, many times our thoughts when we are depressed or anxious are very skewed and do not have any truth to them. Keeping a thought record and engaging in exercises that help you challenge your cognitions and identify more helpful ones can help alleviate depressive and anxiety thinking.
Are there limitations of CBT? What does CBT not treat?
CBT is a more analytical approach to our thoughts and while this can be great, sometimes we are in a state where we aren’t able to access that more rational, analytical part of our brain. In those situations, we must first work on calming our body down before we can engage in that more analytical, rational area of our brain.
Also, CBT doesn’t do much of a “deep dive” into our histories, including our childhood and past experiences. Looking at and identifying our Core Beliefs will address some of this, but it doesn’t do a lot of processing through those experiences. This is why many therapists will take a more eclectic approach, meaning that they will utilize a lot of CBT techniques while using other theoretical lenses (theories on how we think mental health struggles are formed and maintained within a family system) to understand their client and what may be contributing to their current struggles.
Another area where CBT may not be that helpful is in treating OCD (Obsessive Compulsive Disorder). Many times in OCD, one will engage in a more compulsive analyzing of their obsessive thoughts, which ultimately reinforces and keeps the obsessions going. Sometimes OCD can look like a more generalized Anxiety disorder and if a therapist is not familiar with OCD, they may treat it using CBT techniques. This may unfortunately reinforce the analyzing compulsions and therefore keep the obsession going. There are aspects of CBT that can be used in treating OCD, but the therapist needs to be careful to inadvertently engage the client in their compulsions.
Do you use CBT in your therapy?
I do.
I find many aspects of CBT to be very helpful in my treatment, however, I also pull in a lot of other components from other types of therapy.
I consider my approach to be a more holistic model, as I will be looking at the “bigger picture” of a person. I consider their histories, including their childhood/family dynamics and past experiences to be very important in understanding how they may be feeling and thinking about themselves now. I also think it’s important for us to understand how our brain and body’s physiology play a very important role in our mental well-being. This has lead to me utilize other therapy models including Mindfulness-Based Therapy and Somatic Experiencing Therapy while using a Family Systems approach.
Interested in my CBT therapy? Reach out and schedule a consultation or session here.
Disclaimer: This is not a replacement for a therapeutic relationship or mental health services. This is for educational purposes only and should be in used only in conjunction in working with a licensed mental health professional. If you are in California and looking for a professional therapist feel free to use the contact me to request an appointment or search Psychology Today for local therapists in your area.
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