Cognitive Behaviour Therapy (CBT – which has many variants) is a widely used evidence-based model of therapy that is helpful in addressing a range of psychological disorders.
The underlying model of CBT is relatively simple to understand, and although understanding the model is not the same as getting CBT from a trained psychologist, it can still be a useful tool to use in your own life.
In this post I am going to explain how.
CBT – the basics
Imagine breaking up your everyday experiences into 5 categories:
Events/situations – These are the things that happen to you, or that you are involved in. It includes events, the behaviour of other people, the material world.
Feelings/emotions – These are your subjective experiences of your mood or how you are feeling in any given moment (e.g. happy, sad, surprised, disgusted, angry, fearful).
Physical sensations – These are the sensations you experience as arising from in your body. It might be muscle tension, or pain, or light-headedness or stomach churning or something similar.
Beliefs, evaluations and thoughts – These are the contents of your thinking mind. Thoughts are the most readily accessible. They are the constant chatter in your head, that might take the form of words (e.g. like a commentary) but can also include images and memories.
Underneath these thoughts lie the constant stream of evaluations that you mind is making about the situation you are in, the people you are with, how you are feeling, etc. These are not as easily accessible to the conscious mind, because your brain is constantly assessing an enormous amount of information, and as such it wouldn’t be feasible for you to be consciously aware of all of it.
Underneath these evaluations, lie your beliefs. Your beliefs are your roadmap or blueprint to understanding yourself, the world, other people, the past and the future. They are how you construct the world symbolically, and are the result of your past experiences, biology, culture, society, and learning. Like evaluations, your beliefs are not always consciously available to you, but can often be elicited through questions or observing your behaviour.
Behaviours – These are the actions we engage in to interact with the world, both the physical world outside our skin, but also the internal world inside our skin. It includes physical behaviours (e.g. picking up a drink, walking over to talk to a person), which are observable to others, as well as our mental behaviours (e.g. writing a mental list, ruminating on a recent event) which are typically not observable to others. Our behaviours are typically the component of experience that feels most within our control, although not always the case (for example, addictive behaviours can feel very much outside of our control).
CBT holds that these are all related in a logical way. CBT specifically posits that if we understand a person’s thoughts evaluations and beliefs, then the links between the situation that a person finds themselves in, and their feelings, physical sensations and behaviours will all make sense.
Let’s consider a basic example:
Michael and Jess both arrive at a party. The door swings open and they both see a big crowd in the back, and hear some loud music playing.
Jess hears the music, likes the song that is playing, and thinks to herself “this is going to be a good night”. She feels energised and walks confidently through to the crowd to find her friends and a great night begins.
Michael sees the crowd and thinks to himself “ahh shit, I hate big crowds”. He gets a sinking feeling in his stomach and feels despondent. He edges in through the door but makes an immediate beeline to a less crowded part of the room where it is quieter and he can collect his thoughts.
From an outsider’s perspective, both Michael and Jess found themselves in the same situation, but reacted quite differently. Their reactions however make sense when we understand how each of them evaluated the situation and the thoughts that popped up in their head as a result.
If we questioned both of them further, we’d probably be able to unearth some beliefs they hold that make sense of their evaluations. For example Michael might believe that “I am not particularly good in big crowds. I get overwhelmed and don’t really know what to say”. This would help explain his reaction. Jess on the other hand might believe “I love big crowds, the energy they create is addictive”. This makes sense of her reaction.
So CBT, in essence, helps people make sense of their feelings, physical sensations, and behaviour through an understanding of their beliefs, evaluations and thoughts.
CBT assumes that not all these beliefs, evaluations and thoughts are easily accessible to our conscious mind. Hence why CBT is delivered typically as a therapy, with ongoing practice, homework exercises and interactions with a therapist. These allow people time and practice to learn to identify some of the thoughts, evaluations and beliefs that are not immediately available to our conscious minds.
That doesn’t mean however that you can’t benefit from learning the CBT model and doing some simple exercises in your own life. Let us take a look at one of those exercises.
Using CBT idea in your own life
OK, for this exercise you will need to first make peace with the idea that your evaluations and beliefs are not always rational.
This can be a little hard at times because we all like to think that we are seeing the world, ourselves, other people and the future in an accurate way, but I’m afraid that is not the case.
In fact, humans demonstrate a large range of different cognitive biases (errors in thinking). It’s amazing we even manage to get our shoes on in the morning.
To sink this idea into your head, memorise this face.
This is Albert Ellis, the father of Rational Emotive Behaviour Therapy (REBT – closely connected to CBT). He loved letting people know that some of their underlying beliefs about themselves, the world and others were irrational.
All you need to do for this exercise is print out the word document at the bottom of this post and keep it close to you (you could also keep the file on your laptop or mobile device and complete it electronically).
This document lists a range of common thinking errors or ‘cognitive distortions’ that people make.
Your task is to simply notice which, if any, of these thinking errors you make during periods of high emotion. If you catch yourself doing one of them, mark it on the sheet with a tick or a cross.
Over time, you’ll learn which of these you use most often, and then during times of high distress, you can ask yourself “Am I engaging in _______ at the moment”?
There is no need to share these observations with anyone, so be as honest as you can with yourself.
You may find this process difficult at first, because we aren’t used to analysing our thinking in this way. We are so caught up in the thoughts themselves, that we don’t think about the thoughts. As with anything, practice makes perfect. Albert has confidence in you 🙂
Where to from here
Let me know how you go with this exercise.
In future posts we’ll explore other CBT-based strategies for getting to know your beliefs, evaluations and thoughts better.
In the meantime, feel free to research CBT online. There is a lot of stuff written about it, so plenty to learn.
If you would like to start using CBT specifically to cope with difficult emotions (e.g. anxiety, depression), consider signing up to https://moodgym.com.au/ It is free to use for all Australians. It is an online program that will guide you through a series of CBT exercises focused on helping alleviate difficult emotions.