So what is Cognitive behavioural therapy, exactly? And what can you expect from working with a CBT therapist?
What is CBT?
In some ways, it’s in the name. Cognitive refers to how we think. Behaviour refers to how we act.
CBT is a short-term, highly structured form of psychotherapy that helps you recognise and troubleshoot the link between the way you think and the way you end up acting. You learn how your thoughts might be creating a life in which you are unhappy.
Key Ideas of Cognitive Behavioural Therapy
A key concept of cognitive behavioural therapy is that it’s often not event themselves that are upsetting you. Rather it is the meaning you attribute to what you experience.
We often get very upset over assumptions we have made that are not even true, but we become so caught up in our emotions and thoughts we don’t realise how far away from facts we have veered.
The main idea behind how CBT is that your thoughts, feelings and behaviours form a loop.
When your thoughts are negative, you feel negative, and you take negative action, which causes more negative thoughts, and the cycle continues.
This loop becomes a repetitive and increasingly negative cycle until you might feel hopeless and like there is no way out.
An example of this would be if you have a negative thought that “nobody really likes me”. It creates feelings of low self-worth and sadness. So you take the action of not showing up at a party you meant to go to. Which leads to negative thoughts about how you always miss out on good things, and so another loop begins.
Note that you probably didn’t know if all the people at the party liked or disliked you, but you assumed it to be true.
The good news that CBT helps you find a way out of this negative thinking loop. It provides practical ways to stop the loop, either by altering your thoughts or your behaviours.
So what does a CBT session look like?
In your first CBT session or two, your therapist might take you through a questionnaire about your life to learn about who you are and what bothers you. This is when you might find yourself discussing your past, even though CBT is for the most part a present-focused therapy. You’ll discuss what issues you are experiencing, and what goals you have for your therapy.
After that, you’ll generally spend time learning how to identify and challenge your thoughts, feelings, and behaviours, using some of the tools listed in the next session. You will likely sometimes use worksheets.
You will also share the results of the homework you’ve done (unlike other forms of therapy, CBT involves weekly assignments).
How does CBT work differently than other forms of psychotherapy?
CBT is a present-based therapy. Many other therapies look to your past to understand your present, but CBT tends to just stick to what’s going on for you here and now.
Cognitive Behavioural Therapy Techniques
CBT is a very developed therapy, so there are now many tools your therapist might use with you. But here are a few examples:
Thought records – these are worksheet that help you practise recognising and challenging your negative thoughts before they turn into a negative action (we talk more about thought records in our article on Balanced Thinking).
Behavioural interventions – this is about recognising the activities that improve your mood, then working to have you do that activity more. A simple example would be if going to the gym elevates your mood, but depression means you never get to the gym. Your CBT therapist might help you be accountable to achieving more of this behaviour.
Activity monitoring and scheduling – this helps you get a clear picture of how you actually spend your time. It does things like challenge ideas you have about what you do and don’t actually achieve.