What is CBT?
Updated: Oct 11, 2018
You may have heard of CBT before, it is often talked about in relation to mental illness and with the growing awareness over recent months with the rise in mental health awareness campaigns, it is becoming more widespread and popular. But what exactly is it? Well, CBT originated from Dr. Aaron Beck's cognitive theory which stated that thoughts, feelings and behaviour are all connected and that individuals can be helped towards overcoming their difficulties by identifying and changing unhelpful or inaccurate thinking and problem behaviour. He found through his work with depressed patients that many patients were stuck in a negative vicious cycle of thinking, feelings and behaviour and that they could come to feel much less depressed by finding alternative ways of seeing themselves, others and the world around them.
We can probably all think about times where we might have been in a similar situation but have had a completely different experience than perhaps a loved one or friend might have had. For example, we might have been invited to a party, we might be thinking, 'great, how exciting, sounds like fun!' We will feel excited and happy and take actions such as putting it in our diary or buying something new to wear. However our friend might be thinking differently about this prospective social event. They might be thinking for example, 'Oh no! How am I going to get out of this, I won't know what to say, I won't fit in'. They will feel anxious and experience a sense of dread. They might avoid responding to the invitation or spend time trying to think of an excuse not to go! In both examples, the situation is the same however our thinking about it is very different.
Why do some people not like parties?
The example above highlights how two people can think differently about the same situation but why is this so? Have you ever wondered where thoughts come from? We form patterns of thinking from our experiences with the world. Our experiences help shape our view of ourselves and how we relate to others in different situations. We develop core beliefs about ourselves, other people and the world around us. If through our life experience, we have any negative experiences we might develop rules or strategies to avoid further potentially negative experiences in the future. It is from these rules that negative automatic thinking occurs.
In therapy we create a formulation, or map, of your own personal experiences, core beliefs, rules and coping strategies in order to make sense of the problem. In this sense you will be an integral part of the process as you are the expert on your own life. Your CBT therapist will have some knowledge of how particular problems are maintained or might be able to help you identify your core beliefs if you are unsure of what they might be. From the formulation it is usually apparent as to what appears to be keeping you stuck with the problem. You can agree goals with your therapist and will plan each stage of therapy. Your therapist will then serve as your coach as well as teaching you CBT strategies to help you overcome your problem. There is an equal relationship between you and your therapist, collaboration is an integral part of CBT and if something isn't working for you, you and your therapist work together on finding a solution. At the end of therapy you will eventually be your own therapist and you will have all the tools you need to solve future problems as they arise. CBT therapy is about helping you to help yourself, which is hugely empowering.
Will CBT be right for me?
Because of the person-centered nature of CBT and the individualised formulation, CBT can help most people with most problems. However we can't say CBT suits everyone as there is never only one solution to a problem. CBT is less suited to people with personality disorder however some may and do benefit. CBT is not advisable if you are acutely suicidal*, you need to have more intensive support in order to keep you safe and once the feelings subside a little CBT can be very helpful in addressing the underlying problem. (*If this applies to you, you need to seek help immediately by either going to your GP or to A&E where you can be seen by a mental health professional.) It is usually apparent quite early on in therapy if CBT will suit you or not, if you are not seeing change within a few weeks then this might be a sign that the treatment is not right for you and a discussion about this with your therapist will be helpful. Ultimately there really is only one way to find out if CBT can help and that is to give it a try!