Cognitive Behaviour Therapy (CBT)

CBT AND THOUGHTS
We should not be afraid to admit we have made a mistake, for it is in this realisation that wisdom begins. Mistakes are commonly held to be easily recognised, such as forgetting an appointment, failing to turn the washing machine on and such like. But there are mistakes than can have much more far-reaching effects on our well-being than such ordinary errors. Our mistaken subconscious thoughts, called Negative Automatic Thoughts (NATs), can seriously undermine us, or lead us to misunderstand the intentions of others. The bad news is that NATs are often extremely difficult to identify. The good news is that Cognitive Behaviour Therapy can be of significant assistance in identifying them. And, once they are identified, it’s the beginning of the end of them, and the stress and unhappiness that they can cause.

CBT’s BEGINNINGS
In the 1960s Aaron T. Beck, an American psychiatrist, noticed that many of his patients seemed to be carrying on an internal conversation during their treatment sessions. When he questioned his patients on this, they frequently admitted that he was right. Furthermore, these internal dialogues were usually negative automatic thoughts (NATs); the patients were guessing that Beck was angry with them, that he thought they were hopeless, and the like. Beck realised that often such NATs powerfully affected his patients’ moods and that, once the client had identified the thoughts, they were in a better position to understand why they didn’t feel so great. They could take steps to overcome their problems and feel better. From this beginning the therapy that has become known as Cognitive Behaviour Therapy (CBT) developed.

CBT CLARIFIES WHERE OUR PROBLEMS COME FROM
CBT is simple and easy to understand and, once learnt, can be used for the rest of our lives as an aid to balancing our attitudes and ourselves. CBT provides a powerful means for helping us to identify underlying thoughts and dealing with our daily problems. CBT focuses on our thoughts, our beliefs and our perceptions as a means to understanding where our difficulties lie. For example, if we expect life to be ‘fair’, CBT challenges this misplaced expectation and therefore allows us not to feel resentful when something ‘unfair’ happens.

CBT IS USUALLY BRIEF
CBT is a brief therapy when the presenting difficulties have a simple cause. But it can also be used to help us to develop a deeper sense of the meaning of life, the universe, and everything. The answer can be as simple as forty-two or as long as a piece of string.

NATs IN ACTION
As previously explained, in CBT one of the main focuses is on the thoughts that constantly underlie our waking lives, and which affect our behaviour and mood. If you try to stop your thoughts, to have a completely empty mind, you will probably find it very difficult. To realise this allows you to know that you are thinking practically every waking moment. These thoughts have power; they affect the way you feel and behave. Imagine you’re a shy person who predicts that everyone will look at you when you enter a room. You imagine that they KNOW that you have nothing to say and are not interesting. Yet you have to enter the room. Nightmare. You can think of nothing to say. You go red; you hunch over and shuffle to the side of the room. You have no idea whether everyone looked at you when you entered. Because you hope no one will talk to you, no one does. Some of your predictions have been brought about by your behaviour while other predictions remain unknown because you were unable to check out whether everyone stared at you or not, but you BELIEVE that they did.

This is just one example of how NATs work. Most of us have countless such experiences that undermine us. Here are just a few further examples of common beliefs together with some possible alternatives: I’ll always be alone (I haven’t got a date tonight). I’m so stupid (I didn’t understand that, please say it again). Nobody could ever love me for myself (my parents only praised me when I did well at school, but I have friends who seem to like me). I’ll fail; I always do (I didn’t get the last job I applied for). It’s too difficult (I must ask someone to explain that). I’ll be late (which is hardly the end of the world). I can’t cope (let’s just have a cup of tea for a moment). It’s all my fault (I am not responsible for everything). It’s all your fault (you are not responsible for everything). There’s a bunker, I’ll go in it, as usual (I’ll think past the bunker, then I’ll miss it). C.G. Jung said that when an inner situation is not made conscious, it appears outside as fate … It’s not my fault! (Well then, who is responsible?)

HOW DOES CBT WORK?
Unlike most therapies, CBT is rather structured. The therapist will ask you what particular problems you have and how you would like to feel when your therapy is over. These problems and goals are the basis of each of your sessions and their specific details are likely to change over time. You will be given homework at the end of each session, homework that has been agreed upon in discussion with your therapist. The homework is important because it speeds your treatment and it allows you to experiment with ideas that have been discussed in therapy to see if they work for you. You and the therapist will probably have a collaborative relationship and dependence on the therapist is discouraged in favour of self-reliance.

Thus, by capturing and examining negative automatic thoughts, a person is in a position to examine them and judge how realistic the thoughts are. No-one likes me may become My boss was angry with me. I’ll always be depressed may become I wasn’t depressed last month. I can’t go out becomes I could try to have coffee with Tom. These changing thoughts, based on a more realistic appraisal, can lead to better coping skills. Improved coping skills, based on a new hypothesis, can lead to healthy changes in attitudes and behaviour. Our mood will improve and we’ll feel better. And when we learn to confront our NATs, which drain our energy as they affect our mood, we will find a concomitant energy increase; we can reclaim the energy from our NATs and return it to ourselves.

But what about those people who feel that everything is fine, they are not anxious, stressed or depressed and their life is great. They are certainly right, for if you feel good, you feel good. Still, could you feel better if you reassessed your goals every now and then; if you checked that you were still on track? Perhaps you might usefully look around to see if there is anything that you might change for the better.