Cognitive Behavioural Therapy (CBT) is a popular form of psychotherapy or ‘talk’ therapy.
CBT is a common treatment method for a wide range of mental health issues and is often the first form of treatment used, thanks to its unobtrusiveness and simplicity. CBT works by identifying negative thought patterns and retraining the mind to process thoughts differently.
In this article, we’ll explain the basics of Cognitive Behavioural Therapy, list the disorders against which it is most effective, and outline some proven methods that you can implement yourself to help deal with a wide range of stressors.
What is CBT?
CBT helps identify negative and irrational thought processes and then uses other techniques to train the mind to process information differently, thus resulting in a less harmful and more rational outcome. In England, 1 in 6 people report a common mental health problem like anxiety or depression in any given week.1 For common mental health issues like these, psychotherapy methods such as CBT are the most effective treatment.
Thanks to its structure, simplicity, versatility and effectiveness, psychologists often use psychotherapy as a default treatment method, where it then can go on to be used independently or as a complementary therapy.
CBT works as it helps you become aware of instantly assuming the worst. It then helps change those negative thought patterns that have a detrimental impact on behaviour, thoughts, emotions and ultimately, actions. Cognitive Behavioural Therapy mostly focuses on identifying these negative thought processes. Once identified, techniques such as journaling, mindfulness and role-playing can be used to overcome the thoughts.
How can CBT be used?
Cognitive Behavioural Therapy works best in the short term. It’s most effective when used to treat a specific problem and the negative thoughts that a client has around that problem.
CBT has been proven to be effective when dealing with:
- Drug addiction & abuse
- Eating disorders
- Sex & love addiction
Cognitive Behavioural Therapy is a preferred type of treatment in a lot of these cases, as it can quickly identify issues. CBT is a tool that the client can use to manage day to day symptoms, while other forms of therapy and medication treat the root of the problem. Another significant benefit of CBT is that it has little to no adverse effects on both developing and full-grown minds and bodies, making it an effective treatment for teenage depression2.
What are the benefits of talk therapy?
CBT can be used to manage symptoms of mental illness and prevent a relapse of mental illness symptoms as it’s based on the concept that thoughts and feelings ultimately affect behaviour. A simple example of this could be that a person scared of sharks will avoid going swimming in the ocean.
By looking at such thought processes rationally and exploring them in-depth, the client sees things clearly, and ultimately for what they are. While they cannot control everything around them, they can take control of their feelings and emotional responses to specific stressors.
Cognitive Behavioural Therapy is also a way to foster the growth of coping and problem-solving skills. It can also be used to deal with grief or loss, manage emotions and help give a new perspective of problems3. Due to its versatility and effectiveness, many experienced psychologists consider CBT as a useful life skill for dealing with situations in day to day situations.
CBT steps & strategies
You may be asking yourself ‘what does a psychotherapy meeting look like’? While there’s no ‘one size fits all’ answer, there are some common elements of most CBT and psychotherapy sessions.
Here are some basic steps you may see during a session:
Identifying & exploring negative thoughts
The first, and often hardest step is finding the source of the negative thought. This doesn’t always mean triggering the thought, but it may involve discussing the problem that you’d like to conquer.
Becoming aware of your feelings toward these thoughts
Once the source of the negative thought process is identified, you’ll be encouraged to share your thoughts about it. This may involve thinking out loud, talking about other times you’ve felt these feelings, as well as exploring other things that make you feel negative, anxious, stressed or depressed.
Identifying irrational, negative or irrational thoughts
Your therapist may talk to you in more detail about your thoughts on a particular matter, and ask you to try and identify patterns in your thoughts. In doing this, you may also be asked to pay attention to your physical and emotional response.
Reshaping the thought process
Once you’ve identified negative thought patterns, the next step is to ask yourself if it was based on fact or your previous experiences. This step is most often the hardest as you may have thought this way for as long as you can remember. But like forming a regular daily habit, your thought patterns can also be changed for the better.
Building a new process
Once the thought process has been identified and analysed, your therapist will help you plan a process that you can use any time you find yourself thinking in that same way.
Now that you’re aware of a destructive thought process and the tools you need in order to change it, you can implement this therapy yourself when the need arises.
Like quitting a substance, CBT is a gradual process that’s built on incremental steps tailored to your individual situation. By having an end goal in sight and taking smaller, more frequent steps towards it, you see progress sooner, thus making the end goal more achievable.
Rational Emotive Behaviour Therapy (REBT)
Albert Ellis (1913-2007) proposed that we each hold a unique set of assumptions about ourselves and the world. These guide us in life and also determine how we react to various situations. Some of our assumptions may be irrational, meaning that some individuals respond in ways that indicate the situation may not result in joy or happiness.
Ellis called these basic irrational assumptions4.
Ellis broke these assumptions down into three parts:
- The activating event
Sometimes called the ABC method, 5Ellis argued that it’s not the activating event that causes negative emotions, but rather the person’s unrealistic interpretations of this event. These unrealistic interpretations foster an irrational belief system rather than a rational one. The result is that over time, these irrational beliefs lead to an unhealthy negative emotion.
While psychotherapy and CBT is essentially nothing more than talk therapy, it does present a small but specific number of risks.
Exposure to grief and trauma
Psychotherapy often involves identifying and exploring negative thoughts, which can be quite traumatic for some people. Being upset or angry is common, but may lead to a feeling of exhaustion by the end of a session.
Exposure therapy, such as confronting a fear, can be an effective way of overcoming it. However, the anticipation of facing the fear may be worse than actually facing it. While this stress and anxiety are only temporary, it’s important to be aware that exposure therapy may be an effective method for you.
Emotional preparedness and willingness
CBT works best if the individual is open for change and willing to try things that may be somewhat unpleasant in order to overcome the problem.
Able to work with rigid structure
Cognitive Behavioural Therapy is based on an established framework of steps. It’s suited for clients who are open to constructively talking about themselves and answering questions that may be hard to answer.
Open to long term change
While CBT is an effective form of therapy with an experienced professional, it’s also a great life skill to implement when needed. Should you find yourself having negative thought patterns around other parts of your life, proactiveness in implementing these coping mechanisms yourself may also be beneficial in increasing your quality of life.
It’s important to note that while talking about some topics may be stressful and difficult, an experienced professional will create a comfortable environment to talk about these hard things and support you through the entire process.
Coronavirus and its impact on mental health
Coronavirus has a deadly effect on the human body. But we’re starting to learn6 that it’s also wreaking havoc on the mental health of millions of people globally. Increased social separation and isolation are causing anxiety, stress and depression in many otherwise healthy individuals. Studies have shown7 that the economic downturn has also resulted in more addictive behaviours.
The UK Gambling Commission states that 42% of gamblers purchased more gambling products in April 20208. The same article states that gamblers who are using three or more products have been spending more time and money on their gambling habits.
The British Office of National Statistics (ONS) reported a 5.1% increase in alcohol sales in April 2020, even though retail spending on average dropped by 10.4%9. In Australia, social distancing has drastically limited the effect of safe injecting rooms and increased wait times for common drug and alcohol addiction treatments10.
Coronavirus and CBT
Many restrictions to stop the physical spread of coronavirus have led to the breakdown of routine and structure. This has affected the way many people care for their own mental health, changed the possibilities of getting help and seized the coping mechanisms of many.
In dealing with mental health related to coronavirus, Cognitive Behavioural Therapy is used regularly.
With all the fear and uncertainty around the current epidemic, it’s easy to see how one can build an irrational fear of coronavirus.
“I can’t go outside because I’ll get sick”.
For those suffering from anxiety, depression and other mental health disorders, such thought processes are not uncommon. But Cognitive Behavioural Therapy can help address these thought processes and rewire them.
Asking yourself questions about what sounds reasonable and based on fact is a great way to resolve irrational thoughts.
“Does it make sense, and is there evidence that wearing a mask, washing my hands and keeping my hands away from my face decreases my chances of contracting the virus?”
“Does it make sense, and is there evidence that me disinfecting my house every day decreases my chances of contracting the virus?”
It’s clear that the first answer is a rational and reasonable “yes” while the second is an irrational and fear-related “yes”. Shifting your attitude from “I’m going to get sick” to “I’ve followed the recommendations of scientists who know more about this than I do” can help you look at the situation in a more rational and reasonable light.
Talking to a loved one about seeing a therapist
In the last 30 years, attitudes and treatments toward mental health and getting help have changed dramatically. For many people, merely talking about their worries and concerns with a friend or family member is an adequate form of therapy. For others, seeing an experienced therapist is the best option. If you have a friend or family member that you feel might benefit from seeing a therapist, here are a few ways that you can get them the help they need:
Timing is never perfect
There’s no ideal time to tell someone you’re worried about them. A calm, one-on-one situation may be the best time to bring up the idea of seeking help. During or immediately after a fight or argument is not.
Be honest, yet sincere
“I’ve noticed that you haven’t been feeling yourself lately”.
“I’m wondering if you’re feeling a little overwhelmed with everything that’s happening”.
Simple compassionate questions based on genuine concern, rather than finger-pointing and putting blame can be an effective way to start a conversation about mental health.
You may not be the right person
If there’s someone else in your loved one’s life that you suspect they may feel better talking to, offer to connect them.
“Am I the best person to talk to, or is there someone else you’re more comfortable with talking to about this?”
Put yourself into the equation
Use “Me”, “I” and “My”. By putting yourself into the equation but not making the conversation about you, you’re showing that their behaviour is affecting others. Also, consider some kind of ‘trade-off’ – “Do this for me for my birthday. Seeing you helping your depression would be the best birthday gift for me”.
Be prepared for a variety of responses
Understand that you may face a lot of resistance and negativity toward the idea of your loved one seeing a therapist. You may need to educate them on what a therapy session is like or reassure them a therapist isn’t trying to ‘break’ or ‘fix’ them.
Leverage but don’t threaten your relationship
Try leveraging your relationship and explaining how important your friend or family member is to you, and how seeking therapy would make your relationship better. However, avoid giving ultimatums.
Explain problematic areas
Many people claim they don’t have a problem and therefore, don’t need therapy. Try pointing out specific situations where your loved one’s mental health has affected you, and explain how it made you feel. Doing this without being judgmental can help your loved one see the need for a therapist.
Show genuine support
It’s easy to say ‘you need help and I’m here for you if you ever want it’. But taking that first step can be incredibly hard for your loved one without having genuine support. Consider making an appointment for your loved one and paying for it. This decreases the amount of work that your loved one has to do to start the process. If they refuse to go, see the therapist yourself to get more support about helping your loved one.
Show continuing support
Once your loved one has seen the therapist a few times, been supportive, but not invasive.
“This therapy is for you, but you’re never alone, and I’ll be here to support you no matter which direction you’re headed”.
Words like these show that you’re willing to help more if you can, but also respect their individual privacy and trust between them and the therapist.
Wind it down positively
If this is your first time talking about mental health with your loved one or suggesting therapy, it can be quite exhausting for both parties. Reassure your loved one that you’re happy to have the conversation, and remind them that you’ll continue to be there for them.
Cognitive Therapy at The Kusnacht Practice
“Many of our clients find Cognitive Behavioural Therapy very effective for mental well-being.”
– Professor Wulf Rössler, world-renowned practitioner of psychiatry at The Kusnacht Practice.
At The Kusnacht Practice, our qualified psychiatrists regularly use psychotherapy, CBT and other discussion therapies to treat a wide range of problems. A CBT session at The Kusnacht Practice spans multiple one-on-one sessions with a single psychotherapist. Together, you’ll explore negative feelings, emotions and thought patterns that have a detrimental outcome on your behaviour and overall mood. Many of our clients are asked to keep thought journals to track their mood and discuss what they’ve written during regular sessions.
If someone you know is struggling with their mental health and you’d like to get them help, reach out to The Kusnacht Practice. Showing support and helping a loved one talk about their feelings can change their life for the better. Contact us about treatment on +41 43 499 60 50 or [email protected]