Sam came in highly nervous to attend his first therapy session. He was distressed and stated his doctor wanted him to have Cognitive Behavioral Therapy (CBT) for his depression, anger, and anxiety. Sam feverently added, “I don’t have a million dollars to spend on therapy and don’t want to be in here for the rest of my life.”
Sam was informed that CBT is a form of psychotherapy that emphasizes the important role of thinking about how we feel and what we do. CBT is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this fact is that we can change the way we think, to feel / act better even if the situation does not change.
CBT is based on the scientifically supported assumption that most emotional and behavioral reactions are learned. Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting. Many therapists who utilize CBT also ensure that they are understanding the dynamics of the clients family of origin, personal history, relationships, communication style when upset, and medical history. These factors are important for the therapist and client, in order to gain a detailed and more accurate basis for the foundation of negative thinking and painful emotions.
CBT is considered among the most effective and rapid therapies in terms of results obtained. What enables CBT to be briefer is its highly instructive nature and the fact that it makes use of homework assignments. CBT is time-limited in that we help clients understand at the very beginning of the therapy process that there will be a point when the formal therapy will end. The ending of the formal therapy is a decision made by the therapist and client. Therefore, CBT is not an open-ended, never-ending process. That is not to say that people may not come back periodically.
Cognitive-behavioral therapists believe it is important to have a good, trusting relationship with their therapist but that is not enough. CBT therapists believe that clients change because they learn how to think differently and they act on that learning. Therefore, CBT therapists focus on teaching rational self-counseling skills.
CBT does not tell people how they should feel. The fact is we feel what we feel. However, most people seeking therapy do not want to feel the way they have been feeling. Our feelings however are closely tied in with the thoughts that we begin to generate ( most of us are never aware that we have these thoughts prior to the feelings of fear, anger, anxiety, shame, depression, inferiority, etc).
In therapy Sam was able to acknowledge that his depression, anger, and anxiety comes from certain thoughts.” I know what they are thinking about me.” (MIND READING). “This always happens to me” (OVER GENERALIZING). I should be more outgoing, smarter, everything other than I am. (SHOULDS). “If I try to make a change something terrible will happen”. (CATASTROPHIZING). What if I try to change and x, y, and z happens? Thus, Sam has 2 problems. The situation he is confronting and how he has assigned a personal significant meaning to it.
Cognitive-behavioral therapists want to gain a very good understanding of their clients’ concerns. That’s why they often ask questions. They also encourage their clients to ask questions of themselves, like, “How do I really know that those people are laughing at me?” “Could they be laughing about something else?”, “What is the evidence for this thought?”
Cognitive-behavioral therapists have a specific agenda for each session. Specific techniques / concepts are taught during each session. CBT focuses on the client’s goals. We do not tell our clients what their goals “should” be, or what they “should” tolerate. We are directive in the sense that we show our clients how to think and behave in ways to obtain what they want. CBT therapists do not tell their clients what to do but how to do it.
CBT teaches you how to question your situation and thoughts and move in a direction that is healthy for you and those around you.
When we learn how to more calmly accept a personal problem, not only do we feel better, but we usually put ourselves in a better position to make use of our intelligence, empathy, knowledge, energy, and resources to resolve the problem.
If you or a loved one suffers from depression or anxiety please ask your family physician for a referral for CBT or you can make an appointment directly through our office.