Permanent Zen Blog: What is Cognitive Behavioral Therapy and How does it Work?
Cognitive behavioral therapy (CBT) focuses on challenging and changing unhelpful mental distortions (e.g. thoughts, beliefs, and attitudes) and behaviors, improving emotion regulation. Originally, it was designed to treat depression, but its use has been expanded to include treatment of a number of mental health conditions, including anxiety.
It is different from historical approaches to psychotherapy such as the psychoanalytic approach where the therapist looks for the unconscious meaning behind the behaviors and then formulates a diagnosis. Instead, CBT is a "problem-focused" and "action-oriented" form of therapy, meaning it is used to treat specific problems related to a diagnosed mental disorder. The therapist's role is to assist the client in finding and practicing effective strategies to address the identified goals and decrease symptoms of the disorder. CBT is based on the belief that thought distortions play a role in the development and maintenance of psychological disorders, and that symptoms and associated distress can be reduced by teaching new coping mechanisms.
Cognitive Distortions
Many of the most popular and effective Cognitive Behavioral Therapy techniques are applied to what psychologists call “cognitive distortions” .
Cognitive distortions: inaccurate thoughts that reinforce negative thought patterns or emotions.
Cognitive Distortions are faulty ways of thinking that convince us of a reality that is simply not true.
There are 15 main cognitive distortions that can plague even the most balanced thinkers at times:
Filtering
Filtering refers to the way many of us can somehow ignore all of the positive and good things in our day to focus solely on the negative. It can be far too easy to dwell on a single negative aspect, even when surrounded by an abundance of good things.
Polarized Thinking / “Black and White” Thinking
This cognitive distortion is all about seeing black and white only, with no shades of grey. This is all-or-nothing thinking, with no room for complexity or nuance. If you don’t perform perfectly in some area, then you may see yourself as a total failure instead of simply unskilled in one area.
Overgeneralization
Overgeneralization is taking a single incident or point in time and using it as the sole piece of evidence for a broad general conclusion. For example, a person may be on the lookout for a job but have a bad interview experience, but instead of brushing it off as one bad interview and trying again, they conclude that they are terrible at interviewing and will never get a job offer.
Jumping to Conclusions
Similar to overgeneralization, this distortion involves faulty reasoning in how we make conclusions. Instead of overgeneralizing one incident, however, jumping to conclusions refers to the tendency to be sure of something without any evidence at all. We may be convinced that someone dislikes us with only the flimsiest of proof, or we may be convinced that our fears will come true before we have a chance to find out.
Catastrophizing / Magnifying or Minimizing
This distortion involves expectations that the worst will happen or has happened, based on a slight incident that is nowhere near the tragedy that it is made out to be. For example, you may make a small mistake at work and be convinced that it will ruin the project you are working on, your boss will be furious, and you will lose your job. Alternatively, we may minimize the importance of positive things, such as an accomplishment at work or a desirable personal characteristic.
Personalization
This is a distortion where an individual believes that everything they do has an impact on external events or other people, no matter how irrational the link between. The person suffering from this distortion will feel that they have an unreasonably important role in the bad things that happen around them. For instance, a person may believe that the meeting they were a few minutes late in getting to was derailed because of them and that everything would have been fine if they were on time.
Control Fallacies
Another distortion involves feeling that everything that happens to you is a result of external forces or due to your own actions. Sometimes what happens to us is due to forces we can’t control, and sometimes what happens is due to our actions, but the false thinking is in assuming that it is always one or the other. We may assume that the quality of our work is due to working with difficult people, or alternatively that every mistake someone else makes is due to something we did.
Fallacy of Fairness
We are often concerned about fairness, but this concern can be taken to extremes. As we know, life is not always fair. The person who goes through life looking for fairness in all their experiences will end up resentful and unhappy. Sometimes things will go our way, and sometimes they will not, regardless of how fair it may seem.
Blaming
When things don’t go our way, there are many ways we can explain or assign responsibility for the outcome. One method of assigning responsibility is blaming others for what goes wrong. Sometimes we may blame others for making us feel or act a certain way, but this is a cognitive distortion because we are the only ones responsible for the way we feel or act.
Shoulds
“Shoulds” refer to the implicit or explicit rules we have about how we and others should behave. When others break our rules, we are upset. When we break our own rules, we feel guilty. For example, we may have an unofficial rule that customer service representatives should always be accommodating to the customer. When we interact with a customer service representative that is not immediately accommodating, we might get angry. If we have an implicit rule that we are irresponsible if we spend money on unnecessary things, we may feel exceedingly guilty when we spend even a small amount of money on something we don’t need.
Emotional Reasoning
This distortion involves thinking that if we feel a certain way, it must be true. For example, if we feel unattractive or uninteresting in the current moment, we must be unattractive or uninteresting. This cognitive distortion boils down to:
“I feel it, therefore it must be true.”
Clearly, our emotions are not always indicative of the objective truth, but it can be difficult to look past how we feel.
Fallacy of Change
The fallacy of change lies in expecting other people to change as it suits us. This ties into the feeling that our happiness depends on other people, and their unwillingness or inability to change, even if we push and press and demand it, keeps us from being happy. This is clearly a damaging way to think since no one is responsible for our happiness except for us.
Global Labeling / Mislabeling
This cognitive distortion is an extreme form of generalizing, in which we generalize one or two instances or qualities into a global judgment. For example, if we fail at a specific task, we may conclude that we are a total failure in not only this area but all areas. Alternatively, when a stranger says something a bit rude, we may conclude that he or she is an unfriendly person in general. Mislabeling is specific to using exaggerated and emotionally loaded language, such as saying a woman has abandoned her children when she leaves her children with a babysitter to enjoy a night out.
Always Being Right
While we all enjoy being right, this distortion makes us think we must be right, that being wrong is unacceptable. We may believe that being right is more important than the feelings of others, being able to admit when we’ve made a mistake or being fair and objective.
9 Essential CBT Techniques and Tools
There are many tools and techniques used in Cognitive Behavioral Therapy, many of which have spread from the therapy context to everyday life. The nine techniques and tools listed below are some of the most common and effective CBT practices.
Journaling
This technique is a way of “gathering data” about our moods and our thoughts. This journal can include the time of the mood or thought, the source of it, the extent or intensity, and how we responded to it, among other factors. This technique can help us to identify our thought patterns and emotional tendencies, describe them and find out how to change, adapt, or cope with them.
Unraveling Cognitive Distortions
This is a main goal of CBT and can be practiced with or without the help of a therapist. In order to unravel the cognitive distortions you hold, you must first become aware of which distortions you are most vulnerable to. Part of this involves identifying and challenging our harmful automatic thoughts, which frequently fall into one of the categories listed earlier.
Cognitive Restructuring
Once you identify the distortions or inaccurate views on the world you hold, you can begin to learn about how this distortion took root and why you came to believe it. When you discover a belief that is destructive or harmful, you can begin to challenge it. For example, if you believe that you must have a high paying job to be a respectable person, but you lose your high paying job, you will begin to feel bad about yourself.
Instead of accepting this faulty belief that leads you to think unreasonably negative thoughts about yourself, you could take this opportunity to think about what makes a person “respectable,” a belief you may not have explicitly considered before.
Exposure and Response Prevention
This technique is specifically effective for those who suffer from OCD. You can practice this technique by exposing yourself to whatever it is that normally elicits a compulsive behavior, but doing your best to refrain from the behavior and writing about it. You can combine journaling with this technique, or use journaling to understand how this technique makes you feel.
Interoceptive Exposure
This technique is intended to treat panic and anxiety. It involves exposure to feared bodily sensations in order to elicit the response, activates any unhelpful beliefs associated with the sensations, maintains the sensations without distraction or avoidance, and allow new learning about the sensations to take place. It is intended to help the sufferer see that symptoms of panic are not dangerous, although they may be uncomfortable.
Nightmare Exposure and Rescripting
Nightmare exposure and rescripting are intended specifically for those suffering from nightmares. This technique is similar to interoceptive exposure, in that the nightmare is elicited, which brings up the relevant emotion. Once the emotion has arisen, the client and therapist work together to identify the desired emotion and develop a new image to accompany the desired emotion.
Play the Script Until the End
This technique is especially useful for those suffering from fear and anxiety. In this technique, the individual who is vulnerable to crippling fear or anxiety conducts a sort of thought experiment, where they imagine the outcome of the worst case scenario. Letting this scenario play out can help the individual to recognize that even if everything they fear comes to pass, it will likely turn out okay.
Progressive Muscle Relaxation (PMR)
This is a familiar technique to those who practice mindfulness. Similar to the body scan, this technique instructs you to relax one muscle group at a time until your whole body is in a state of relaxation. You can use audio guidance, a YouTube video, or simply your own mind to practice this technique, and it can be especially helpful for calming nerves and soothing a busy and unfocused mind.
Relaxed Breathing
This is another technique that is not specific to CBT but will be familiar to practitioners of mindfulness. There are many ways to relax and bring regularity to your breath, including guided and unguided imagery, audio recordings, YouTube videos, and scripts. Bringing regularity and calm to your breath will allow you to approach your problems from a place of balance, facilitating more effective and rational decision making (Megan, 2016).
These techniques can help those suffering from a range of mental illnesses and afflictions, including anxiety, depression, OCD, and panic disorder, and they can be practiced with or without the guidance of a therapist. To try some of these techniques without the help of a therapist, see the next section for worksheets and handouts to assist with your practice.
WHY REIKI HEALING IS EFFECTIVE FOR DEPRESSION & ANXIETY
Many individuals who are either suffering through depression or anxiety tend to rely on some form of medication. However, there is a growing number of people who are becoming aware of the fact that depression and anxiety can be cured without the use of anti-psychotics. Depression and anxiety need to be understood as energy imbalances rather than a mental disorder. Thus, in order to cure depression or anxiety, it’s critically important to treat the imbalanced energy and the behavior and mindset that proliferates the imbalance.
To overcome the root cause of depression or anxiety, Reiki in New York, as well as Spiritual Counseling can prove to be powerful solutions.
Reiki is a technique of transferring the universal energy to the patient by the practitioner to area of the body where it is needed. Turning to Individual Reiki Sessions NYC can help you regain the natural flow of energy that our bodies need to be relaxed, happy and healthy.
Namaste!