How Does CBT Work?
You may have decided that you need to talk to someone, but you may not know what kind of therapy you need, or how CBT works.
(CBT) is a present-focused, goal-oriented, talking therapy. CBT is based on the idea that it is not situations or events that make us feel bad, but the way we think about them that has the largest impact on how we feel.
There is a close relationship between our thoughts, feelings and behaviours, with each one impacting the other two. It’s hard to think “I’m a failure,” for example, without then feeling worried, anxious or depressed. Our thoughts influence how we feel and, in turn, affect what we do. If you think, “my boss doesn’t appreciate me” you might start procrastinating at work, or arriving late/leaving early, doing the bare minimum. Unfortunately, the thoughts and behaviours we choose to engage in are not always helpful! CBT will help you identify unhelpful thoughts and behaviours, and decide whether the strategies you are trying are actually helping you move towards your goals, or whether they are hindering you.
Managing the Unmanageable
One of the attractions of CBT is that it can help you to make sense of your thoughts and feelings when things feel confusing or out of control. Like sorting through pieces of a puzzle, CBT allows you to take seemingly unrelated problems, piece them together and see how they are connected.
For example, take the following list of problems you may experience:
• Low mood
• Self-critical thoughts
• Tired all the time
• Constant worry
• Drinking a bit too much alcohol
• Falling behind at work
• Procrastinating on important tasks
Can you see how the above problems might be related to each other? Whether the worries are about your work, or your loved ones, worry itself is tiring! It can lead to a low mood, which can impact productivity. You might fall behind in your work put off tasks because you are afraid of failing or not doing a good job. You might cope with your low mood and anxiety by having an extra drink or two in the evening, which can leave you feeling worse for wear and lead to self-critical thoughts, such as “I’m not good enough” or “I’m not up to the job.”
During CBT sessions, we will take the time to explore and understand the main problems you are struggling with and how they relate to one another, allowing us to break them down and find practical, effective solutions.
Breaking Problems Down with CBT
Once we have a good idea of your main problems, we can break them down even further; every problem will have thoughts, feelings and behaviours associated with it.
Here are the five main components that we will look at:
- Trigger: what caused the negative thought, belief or behaviour? This can be an external event—relationship conflict—or an internal event, like a thought or feeling.
- Thoughts: what are you thinking? Are you blaming yourself or worrying about the future?
- Emotions: how do you feel? Are you sad, lonely, anxious, angry?
- Physical sensations: what do you experience in your body? When you feel sad or anxious, for example, you may experience heart palpitations, muscle tension, nausea, churning stomach, headaches, etc.
- Behaviours: what do you do to cope? Are there more effective or healthier strategies?
To bring this to life, let’s take a look at two examples.
Mark is a 33-year old associate who was recently told by his boss that he is underperforming. The below diagram depicts the relationship between this “trigger” event and Mark’s thoughts, feelings, behaviours and physical symptoms in relation to this event.
In the above example, the trigger to Mark’s negative thoughts was the feedback he received from his boss. The trigger was external-something that somebody else said to him. The negative thoughts that Mark had in response to his boss’s feedback highlight to us the meaning that Mark attached to the feedback he received from his boss. These thoughts then lead to feelings of sadness, frustration, etc. which lead Mark to procrastinate and be less productive, not to mention the physical symptoms he experienced in response to the negative thoughts he had.
Beth is a 29 year old Associate who felt overwhelmed from thinking about everything she has to do.
As this example highlights, your own thoughts can be the trigger to further negative thoughts. So, in the example above, thinking about “everything I have to do today” leads to further negative thoughts and predictions, i.e., “I will never get it all done”; where do I even begin”. These thoughts are what drive anxiety. Thinking about everything you have to do today can lead you to feel anxious and overwhelmed, which might also be accompanied by unpleasant physical symptoms like tension and difficulty concentrating, which can have the opposite desired effect-instead of getting started on your tasks, you put them off and find other less important activities to distract you from your negative feelings.
In both of the examples above, each component – thoughts, emotions, physical symptoms – has a knock-on effect on the others. And, when you understand the relationship between these components using your own examples, you can start to make changes and see the knock-on effect on the other areas.
In our CBT sessions we will develop an understanding of your problems using the CBT model, and we will apply CBT techniques to help you make the changes you desire.
“I liked the combination of talking, getting empathy, being challenged when I needed it and then getting some practical actions to work on. I found this so helpful, I’ve suggested CBT to others I see who get themselves stuck in a similar hamster wheel”. (JM from the City)
CBT Skills and Techniques
CBT is a skills-based approach. In our CBT sessions, I will teach you skills and techniques that you will be able to apply to everyday situations long after our work together is over. You will learn to:
- Differentiate between helpful and unhelpful thoughts
- Distinguish thought from fact
- Broaden your perspective (instead of “all-or nothing” thinking)
- Experiment with the future rather than trying to predict it
- Try new behaviours and assess how they work for you
- Live according to your values (what is important to you)
Can CBT Help Me?
Cognitive Behavioural Therapy can help address a wide variety of problems, but it isn’t the right approach for everyone. CBT is a good therapy for individuals who like working towards solutions, who have clear goals in mind and are willing to take responsibility of change. In our preliminary phone call, we’ll discuss whether the clinical evidence shows CBT to be helpful for the type of problems you are experiencing. Next, we’ll discuss whether a focused, structured, present-focused therapeutic approach is right for your unique personality and needs.
CBT works well if you:
• are willing to have your current thinking style challenged
• take personal responsibility for change
• recognize that you need to change and are prepared to change
• are open to new ways of thinking and viewing situations
• are willing to experiment with new behaviours
• are prepared to invest in yourself (financially and time-wise)
CBT works best when you are prepared to take personal responsibility for change, and are willing to change. Allowing your therapist to give you feedback on what she understands you to be saying is also vital for the therapy process.
Personal Responsibilty: What Do You Want to Change?
CBT works best when the target for change is you as opposed to something or someone outside of you. We can’t change other people, and many situations are out of our control, but we can change the way we relate to others and our experiences. Sometimes you may need to change a situation—i.e., leave your job or an unhealthy relationship. But before you do that, it’s a good idea to look at whether something within you, is making it difficult to stay, and whether you might need to change, rather than the job or relationship.
It’s About the Now
In CBT we are less concerned with what caused a problem than what is keeping it going. It’s a much more efficient use of our time to help you work out what is keeping your anxiety or depression or stress or anger alive, rather than looking at how you got here in the first place.
Ready to get started?
If you are ready to begin cognitive behavioural therapy, or if you have additional questions about attending for CBT at CBT Canary Wharf, please get in touch with me via email, phone 020 7531-1220, or click on the button below.