Cognitive behavioral therapy, or CBT, is one of the most widely used methods of psychotherapy. Decades of research have shown that CBT is effective for a range of problems, including addiction, depression, anxiety, eating disorders, post-traumatic stress disorder, and more.
There are several features that make CBT such a popular treatment option. First, CBT has been shown to be at least as effective as medication for non-psychotic disorders such as depression and anxiety. It is also helpful for psychotic conditions such as schizophrenia, but only in addition to medication. It’s best to avoid medication whenever possible. Even if expense is not an issue, medications only work for as long as you take them, and there are almost always side effects, to to which people are sensitive in varying degrees. Some people are just going to need medication no matter what, but if you can get similar results from talk therapy without medication, that’s definitely an advantage.
Second, CBT tends to have a limited run. Instead of weekly session–or daily sessions, as with psychoanalysis–that go on indefinitely, CBT typically lasts about eight to 10 weeks. This is because the goal of CBT is to help you act as your own therapist by teaching you new skills. Third, CBT is flexible and its basic framework can be used to treat many conditions. It is the basis for other effective forms of therapy, including acceptance and commitment therapy, or ACT, and dialectical behavioral therapy, or DBT, which has proven to be effective for treating personality disorders and other issues. Finally, CBT is specific and oriented towards results. There’s none of the deep family history or dream interpretation of psychoanalysis. It focuses more on immediate problems and their solutions.
So how exactly does CBT work? CBT is based on the simple insight that thoughts create emotions. Many of our negative emotions and behaviors are created by distorted or maladaptive thinking patterns. We often learn these patterns at a young age, from our parents or as a result of some trauma. As we grow up, our situation changes, but the old thought patterns persist and make us miserable. CBT aims to replace these maladaptive thought patterns with more useful ones.
Exactly what these patterns are depend on the individual. It’s the job of a skilled therapist to help you identify what kinds of thoughts are causing you so much trouble. There are around 14 common cognitive distortions, but most people specialize in a few. For example, perfectionists tend to catastrophize, believing that it would be awful to make any kind of mistake, and they tend to split, believing that any effort they make will turn out completely good or completely terrible. As a result, they tend to suffer from intense anxiety, feel hopeless when things never turn out perfectly, and end up avoiding new challenges altogether.
A CBT therapist will help you identify your own cognitive distortions and show you ways to combat them. For example, she might ask a perfectionist client about a situation when she felt especially anxious or depressed. Then they might discuss what she was thinking about when she had those feelings. Once those thoughts have been identified, the therapist will help her identify productive ways to reframe those thoughts. The process of transforming distorted, negative thinking into rational, positive thinking is called cognitive restructuring.
The next step is to start replacing those maladaptive thoughts with more realistic thoughts. So if her thought is, “I can’t do this new thing perfectly, so I shouldn’t do it at all,” her new, more realistic thought might be, “I can’t do this perfectly, but this particular task only has to be good enough, and I can do that,” or “I can’t do this perfectly, but with practice, I will be able to do it well.” Both thoughts are more realistic and promote action over rumination.
Of course, it’s easy to admit a belief is not totally rational and commit to changing it when you’re sitting comfortably in a therapist’s office. It’s much different when you’re living your life and something stressful happens. Then, your best intentions to replace maladaptive thinking patterns with healthier, rational thinking patterns may instantly evaporate. Making the change takes practice, which is why CBT therapists typically assign homework. This is sometimes in the form of worksheets, but is often in the form of journaling.
A typical CBT homework assignment might be to write down a situation from your day when you felt especially anxious. Then, write down your belief about what happened, and the specific emotions you experienced as a result of that belief. Then, you would write down a belief to replace the one that caused you to feel anxious. So, if your belief was “It will be a disaster if I mess this up,” your more rational replacement might be, “I really would like to get this right, but if something goes wrong, I can probably find a way to fix it.” This might seem pointless to do after the fact, but it’s a way of practicing a new way of thinking. Eventually, you’ll learn to spot the faulty beliefs when they arise and you will be able to counter them automatically.
CBT is not a panacea, but it is effective for a broad range of problems. It’s a standard method of treatment for therapists and treatment centers everywhere for good reason. Its methods are backed by research, and it’s flexible enough that its methods can constantly be refined to be more effective. Whether you’re struggling with addiction, mental illness, or both, working with a skilled CBT therapist to learn more effective ways of thinking is a rock solid foundation on which to build your recovery.
If you’re struggling with addiction or mental illness, The Dawn Medical Rehab and Wellness center can help. We are one of Thailand’s most respected addiction treatment and wellness centers. We use cutting-edge treatment modalities to provide personalized care to treat addiction, depression, anxiety, bipolar disorder, personality disorders, PTSD, and executive burnout. See our contact page to reach us by phone or email.