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CBT (Cognitive Behavioral Therapy): How exactly does it work?


In a previous article called 15 common cognitive distortions- how our thoughts influence our mental health, I outlined a list of common cognitive distortions. In review, cognitive distortions are irrational thoughts that usually reinforce negative thinking and emotions and often serve to keep us from positive change. With effort and practice, you can reduce or change your irrational thinking style by practicing the exercises below. This article aims to introduce what a cognitive behavioral therapist might cover with you in therapy as way to help you reach your therapy goals.

Identify your style of cognitive distortion(s)
. Begin by creating a list of your automatic thoughts and examine them for similarities with a list of cognitive distortions, then outline them in a Thought Record. An examination of our cognitive distortions allows us to see which distortions we tend to use most often.

Examine the evidence.
A thorough examination of an experience or situation allows us to identify the basis for our distorted thoughts. Are our automatic thoughts 100% true, all of the time? Or can we identify concrete evidence that proves our automatic thoughts are NOT true all of the time? These ‘exceptions to the rule’ are what allow us to begin to refute our irrational thoughts. For example, if you typically struggle with social anxiety, try to identify a number of experiences and situations where you have had less or no social anxiety.

Judge yourself fairly.
‘Self-talk’ can be thought of as the running dialogue we have with ourselves that often comes across as hypercritical and demeaning. Aim to view yourself in the same compassionate and non-judgmental way that you would talk with a good friend in a similar situation. We tend to respond best to encouragement and constructive examination of progress rather than punitive and defeating self-talk.

Think on a continuum.
Instead of thinking about your situation or problem on an either-or scale, evaluate things on a continuum, or scale of progress. This will allow you to see yourself in terms other than ‘failure’ or ‘success’. Think about and evaluate any given situation as a partial success in progress, with a series of smaller and larger goals to be achieved over time.

Enlist the support of wise others.
Greater perspective and insight can be achieved when we seek the opinions of others regarding whether our thoughts (often in the form of worries and fears) are realistic. When we remain isolated in our view of a given situation or problem, we can lose sight of concrete evidence that refutes our negative thinking.

Labeling. Do we define ourselves with labels such as ‘shy’, ‘incapable’, ‘bad tempered’, or ‘ commitment phobic’? A close examination of the labels we uses for ourselves will likely will reveal that they represent specific behaviors (perhaps that have occurred in patterns), but nonetheless do not accurately capture you as a whole person who is capable of change, growth and maturity.

Refrain from blaming.
We often get stuck blaming ourselves or others entirely for the problems and predicaments we experience. While identifying circumstances and individuals that have contributed to your problems or predicament can be helpful in understanding their origins, it can be rob us of our energy to create change. Regardless of the degree of responsibility we assume ourselves or can pin on others, our energy is best utilized in identifying healthy ways of coping and identifying resolutions to problems, rather than remaining fixated on playing the blame game.

Cost-Benefit Analysis.
It is helpful to list the advantages and disadvantages of our patterns of feelings, thoughts, and behaviors. A cost-benefit analysis will help us to ascertain what we are gaining from holding on to cognitive distortions, negative feelings, and behaviors that perpetuate our current circumstances. For example, we may feel resentful and angry towards a housemate, but refuse to behave in a way that could resolve the matter, because we think they ought to be the one to change. By making a list that outlines what we are gaining by our approach, we may find that it is easier to expect change from another rather than ourselves because it feels less convenient and/or fair.

Respectfully submitted by Dr. Christina Villarreal, Clinical Psychologist in private practice, Oakland, CA

Reference:

Burns, D.D. (1989). The feeling good handbook: Using the new mood therapy in everyday life. New York: William Morrow.
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