What is Cognitive Behavioral Therapy?

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Overview of CBT

Psychoanalyst Carl Jung opined that “Thinking is difficult; that’s why most people judge [Ed: instead of thinking].” There’s an unspoken corollary to Jung’s statement: the consequences of being judgmental rather pensive.

Judgemental

Anyone who opts for being prejudiced one way or another rather than willing to ponder the ramifications of issues and beliefs, is a person who refuses to compare and to contrast different ideas. They do not weigh the merits and demerits of a line of thought. That puts anyone with a legitimate argument in favor of something, or against something, at a serious disadvantage. Their thinking process doesn’t matter to the person whose mind is made up and refuses to consider the facts of a given issue. Enlightening discussions cannot ensue. That leads to hostility and worse. One way to correct the impasse is to engage in psychotherapy, so that thought processes can be analyzed and reconsidered. Ever heard the phrase “You need an attitude adjustment”? It’s pretty much a casual way of announcing the problem that Cognitive behavioral therapy (CBT) addresses.


Table of Contents:

What is Cognitive Behavioral Therapy?
What Does CBT Do?
How Does that Work?
What’s Missing from the Picture?
You Said WHAT?!?
A Changed Mind
Subjective and Objective Thinking
Therapy Makes Me Feel Like I’m Going Crazy!
What a CBT Counselor Wants
A Changed Response
Does Cognitive Behavioral Therapy Work?
CBT can be Quick


What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy, often referred to a “CBT,” is a form of talk therapy. The therapist and patient focus on developing, then increasing the patient’s coping skills. CBT also focuses on repairing a person’s attitudes, beliefs and thoughts so that they become based on factual information instead of assumptions and prejudices. Problem-focused and action-oriented, CBT corrects distorted thinking. Patients can feel surprised to learn that they chose mistaken thinking patterns so long ago or so subtly that they aren’t consciously aware of having made that choice. A reality check in the therapist’s office, CBT can help addicts to overcome addictions, and it can people in many kinds of distress.

The Cognitive part of the phrase is about knowing. The patient and therapist will explore what the patient knows as facts versus the fictions that the patient assumes to be true. The Behavioral part of the phrase is about addressing maladaptive behaviors. The therapist explains how and why the patient’s responses to life are sabotaging his or her success and happiness, and how to respond in productive ways instead. CBT empowers a person to interact more successfully in society, including business, family and romantic situations.

Psych Central offers an overview that explains CBT here. This Cognitive behavioral therapy – Overview – Mayo Clinic is another look at the self-help CBT world. Point 6 of the National Association of Cognitive-Behavioral Therapists site offers insight into the Socratic method upon which CBT is based, and Point 10 explains the Inductive aspect of the CBT method.

What Does CBT Do?

CBT helps a person to recognize and to make realistic choices for coping with their problems instead of worsening them with unrealistic thinking and behavior. CBT therapists and counselors help their patients to assess the pluses or minuses in their thinking and behavior patterns. They discuss why some thinking patterns mess up a person’s progress. They also talk about why some behaviors alienate people instead of getting them to do what the patient wants.

Once the patient understands how and why they are responsible for causing some of the problems in their lives with specific counterproductive behaviors and thinking, therapists can explain better actions and thinking processes that result in cooperation.

Thinking Patterns

How Does that Work?

A conversational interaction between a patient and their CBT therapist, Cognitive Behavioral Therapy helps someone to identify, to challenge and to change their point of view about troubling issues. A person in need of solutions to one problem, or to several problems, can address them with their CBT therapist aka counselor.

In the course of the weeks-long conversation that develops, the CBT therapist first listens to a patient’s description of what is bothering them so much that they need help to deal with it. Then the therapist responds to what they heard. That feedback becomes the energy of the CBT relationship.

CBT therapists help patients to understand that their assessment of a situation might be distorted. The patient’s thoughts about the original problem and everything associated with it might be

• mistaken,
• misunderstood
• misinterpreted to serve a purpose that undermines personal progress

or

• simply uninformed

Things might not be a patient’s fault or the fault of the person(s) they blame. Someone might have expected a different result from their efforts than the one which was experienced by the patient. And if relevant facts were not known at the time of a distressing event, then they and everything else about the upsetting situation needs to be understood in context. Only then can those facts and the people involved with them be accepted as part of the situation and dealt with accordingly.

Context

A CBT therapist’s goal is to help the patient to think clearly without assumptions and with purpose. The focus is on behaving appropriately, not inappropriately in response to a sense of distress.

A response is a reasonable behavior based on realistic expectations for the results of that behavior. A reaction, however, is behavior that was not well-considered. Punching someone out or using vulgar language is not persuasive. Those are coercive, reactionary actions that force a person to obey, not to cooperate by choice. Forcing someone to do what you want instead of convincing them to cooperate with you are two very different realities. The consequences of a person’s reasonable or reactionary behavior need to be thought through and evaluated before taking actions that can be beneficial or destructive.

CBT follows the same format around the world. Check out the United Kingdom’s easy to understand How CBT Works chart from the National Health Institute.

What’s Missing from the Picture?

Sometimes there are “holes” in the explanations that patients tell to their CBT therapists. The counselors will ask about the missing information so that overlooked or intentionally skipped over facts will be filled in.

Clarify

Patients don’t always want to tell someone how they messed up in life. Sometimes there are “holes” in the explanations that they tell to their CBT therapists. The counselors will ask about the missing information so that overlooked or intentionally skipped over facts will be filled in.

The patient will learn about themselves as the CBT counselor shares insights about why the patient tends to leave out specific details from time to time. Patterns of thinking and behavior about that recurring word/phrase absence, plus the words/phrases that are used instead, will be identified. The therapist will make sure that the patient understands their past mistakes in thinking about problems and choosing what to do about them.

The two-way discussion to follow those revelations will focus on correcting the patient’s problematic thinking/non-thinking process so that the patient can become receptive to other ways of thinking. Problems identified and worked on can lead to thinking behaviors that improve over time and get desired results. There is more than one way to process an idea, even a sense of anger, frustration and sadness. CBT can help people to think things through in more satisfying ways.

You Said WHAT?!?

A patient’s exaggerations or understatements will be challenged by the therapist. They hold a person back from identifying the exact problem to be solved. CBT therapists help their patients to be realistic about what’s going on, to speak of facts, not opinions or clichés. Let’s look at people who need CBT therapy mess themselves up.

Opinions tend to shut down honest assessments and on-going thought processes. Making up your mind and failing to think facts through prevents a person from adjusting to a simple reality and to an evolving reality. Being opinionated is easier than goal-oriented thinking, but being opinionated is dangerous to people who are stuck with their negative, sometimes destructive decisions. The refusal to adjust to reality is a choice that they and everyone else will probably regret. CBT helps a person to stop being opinionated and to be open-minded instead.

Just the Facts

Clichés can’t effectively portray a reality because they they’re only good at creating a vivid image of one specific problem and only of that problem. Clichés lose power when they’re used to describe other issues. If clichés are used again and again, the people saying and hearing them don’t even bother to think clearly, they’ve become so tired of the repetitions. People sometimes use clichés to avoid the hard work of thinking or to avoid strong, upsetting emotions; they become judgmental instead (Jung said it best, above).

Clichés fail to communicate immediacy and accuracy. A CBT therapist will explain why it is important for patients to use everyday language, or invite them to create a new image, to describe the situation that bothers them.

A Changed Mind

A patient’s beliefs and attitudes affect their feelings and behavior. As someone’s cognitive behavioral therapy continues, they’ll learn to keep things real. The goal is to break out of a cycle that kept them stuck in a repetitive loop of problems worsened by poor responses to them. Beliefs will lose the harshness which undermines progress. Apathy will yield to genuine interest. Insights will point to potential solutions, and all of that leads to progress.

Changed Mind

People who succeed with CBT stop looking at life in an emotionally charged, self-defeating manner. This frees them to choose thoughts and actions that promote desirable results in social interactions, that promote appreciation for oneself and that promote and appreciation for all the rest of life.

Successful CBT patients grow to understand that revenge or passive-aggressive behavior, among other counterproductive responses to problems, are not productive. The patients realize that counterproductive responses will only cause anger, long-term complications and the absence of solutions to the original problem.

CBT is focused on improving the quality of the patient’s life by letting the patient learn how not to undermine it and how to improve the quality of their life. That improvement comes with a significant change in the patient’s personal or subjective and emotionally charged perception of events, ideas, and intentions into an intentionally objective, emotionally neutral assessment of facts. Changing our perceptions of events and ideas change a person’s reality. Being conscious of the choices we make matters to the quality of our futures.

Subjective and Objective Thinking

Let’s consider the differences between subjective and objective thinking. A person is free to change their personal, subjective thoughts that are based upon emotion and personal preferences rather than on rational logic and to choose to understand objective realities free of human prejudice i.e., prior decisions, in positive ways. Objective thought is rational, goal-oriented and logical. Subjective thought isn’t.

Subjective vs Objective

Think of turning on a radio and being able to hear soothing music or upsetting news reports, then choosing to continue listening to the broadcast or seeking a different one. It’s all a matter of the choice a person makes. What we say and what we do contribute to our thinking processes. Moving the dial to something more desirable, and changing a formerly negative mindset to an upbeat attitude is a choice that can be nurtured. It can become a habit.

Therapy Makes Me Feel like I’m Going Crazy!

There’s a bit of irony involved in any therapeutic process, but it heralds a positive development. A patient might start to feel even worse as they work past their unproductive or counterproductive thinking patterns. They might feel embarrassed, ashamed, or inadequate for instance. They might even wonder if they’re going crazy, considering the jumble of old and new thinking processes occupying their minds.

Therapists know how to get past that problem, which is part of the inner growth process; it signifies the changes happening to the person’s assessment of simple facts.

Change can be uncomfortable at first. Creative insights will follow all the complications that come up during and between CBT therapy sessions. As the CBT patient changes the way they respond to life, how they think and how they respond to perceived problems he or she will gradually begin to experience the successful solutions they’d wanted to achieve. We’ll look at changed response a bit more in a few paragraphs.

Those creative insights and satisfying solutions will be coaxed along by CBT counselors asking “Can you…” What if…” “And then what…” plus other clarifying, open-ended questions that lead to enlightening discussions and realizations.

It’s not uncommon for successful CBT patient to eventually express surprise that they used to find it difficult to think clearly about various issues and that they feel relief with their new ability for clear-headed thinking processes. Clear-headed thinking will feel “easy” and desirable with enough practice.

What a CBT Counselor Wants

The goal of CBT therapists is to promote clear thinking and to share ideas about effective coping strategies so that patients can take specific steps to achieve the results they need for making progress in life.

A Therapists Desire

A Changed Response

CBT patients learn new thinking patterns and develop new coping skills that they can use for dealing with problems lifelong. A patient’s adjusted perspective and improved behavior become their enduring characteristics, their auto-pilot in a sense.

A non-medicated method for treating depression and anxiety, CBT is also used in addiction therapy. Though medical supervision is sometimes necessary in addiction therapy, addictions begin with unfocused, unrealistic thinking in need of repair.

CBT can also be used for better managing a variety of physical and mental health problems.

CBT Treatment

Here is a partial list of cognitive behavioral therapy techniques for problems that CBT can address and improve on:

Addiction

Back Pain (the Treatments portion of the article mentions the use of CBT)

Cognitive Behavioral Therapy for Depression

Exposure therapy

Proven Strategies for Controlling Anger

Why it’s done · ‎Self-esteem check

Does Cognitive Behavioral Therapy Work?

The “Patient” and “Therapist” satisfaction ratings in this Effectiveness of cognitive behavioral therapy report can give you an idea of CBT’s effectiveness. The process is so simple that less experienced CBT therapists do as good a job with it as their more experienced colleagues. Surveys show that patients with all sorts of mental health problems are usually happy with the results, too. Other forms of therapy might be better for people with different diagnoses and preferences, but the evidence that CBT works for many people and many situations is clear.

CBT Can Be Quick

Cognitive Behavioral Therapy usually lasts a few weeks, with five or more sessions each week. Those sessions might last only half an hour or up to one hour.  Specific types of CBT take longer, though, in order to completely address a person’s needs. If your therapist is using CBT via online therapy, it can be even quicker. However, it’s not something you or your therapist would like to rush.

CBT Speed

A lesson that patients learn with CBT is that complaining about a problem or blaming other people for it will leave a person stuck in the problem. They can’t make progress if they don’t to think outside those limiting ideas. Changing the thought from “why me?” to “what’s next?” is a game changer. Speak with an online or in-office CBT therapist/counselor who just might convince you to give CBT a try.

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Yocheved Golani

Yocheved Golani

Yocheved Golani is a popular writer whose byline has appeared worldwide in print and online. A certified Health Information Management professional, she is a member of Get Help Israel. Certified in Spiritual Chaplaincy (End of Life issues) and in counseling skills, her life coaching for ill people puts healthy perspective into a clients’ success plan for achieving desired goals.
Yocheved Golani

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