Cognitive behavioural therapy (CBT) is a popular psychological treatment which has been shown to be effective in treating common disorders such as anxiety and depression.
CBT is not a new therapy by any means and it has a practical structure which makes it easily measurable. These factors have resulted in a large body of successful clinical trials which, more recently, have secured its position as one of a range of recommended treatments on the NHS.
What is CBT?
Cognitive behavioural therapy is a type of talking therapy which involves identifying and challenging unhelpful thoughts. It works to help people learn alternative thinking patterns and behaviours which can then improve the way they feel. CBT explores the relationship between feelings, thoughts, and behaviours, and evolved from two distinct schools of psychology: behaviourism and cognitive therapy. Its roots can be traced to these two approaches.
Behavioural Therapy Roots
Behavioural treatment for mental disorders has been around since the early 1900’s. Key proponents like Skinner, Pavlov, and Watson developed theories of change and behavioural treatments. Behaviourism is based on the idea that behaviours can be measured, modelled, and changed.
The first wave of behavioural therapy came about in the 1930/40s in response to the emotional impacts faced by the many WWII veterans returning from war. This need for effective short-term therapy for depression and anxiety coincided with a build up of behavioural research regarding how people learn to behave and react to life situations. Behaviourism offered an alternative to the dominant model of that time, psychoanalysis.
Cognitive Therapy Roots
American psychologist Albert Ellis was one of the key figures who developed cognitive therapy. He stressed the importance of thoughts/feelings and behaviours and devised a theory called rational emotive behaviour therapy (REBT) in the 1950s. This is now considered one of the earliest forms of cognitive psychotherapy. It is based on the idea that a person’s emotional distress arises from their thoughts about an event rather than the actual event itself.
In the 1950s and 1960s, American psychiatrist Aaron T. Beck noticed patterns with his depressed clients. They seemed to hold negative views of self, others and their future, and no matter how much exploration of their past occurred, these negative views did not shift. This led him to start researching whether holding negative views about self, others and the world, might be part of the reason somebody was depressed. Cognitive therapy was up and running.
Automatic Thoughts in Cognitive Therapy
Beck understood the importance of the link between thoughts and feelings, and he coined the term “automatic thoughts” to describe the thoughts that pop up in people’s minds. He discovered that although people aren’t always aware of these thoughts, they can learn to identify and report them. He found that people who were upset had negative thoughts that tended to be unrealistic, and by uncovering and challenging these thoughts, long-lasting and positive change can result. In essence, CBT helps people to recognise their thoughts and test them out. This then allows the possibility of finding alternatives and opens up choice.
By the 1960s, a number of empirical studies into how cognitions affect behaviours and emotions were carried out. This period became known as the cognitive revolution. It emphasised the role that conscious thinking plays in psychotherapy.
Combining the Approaches
Behavioural therapies were successful in treating a number of conditions, including phobias and anxiety. As the popularity of cognitive therapies began to soar, therapists started to use behavioural techniques and incorporate these to successfully treat disorders. Although each of these schools of thought has a different emphasis, both are concerned with what is happening to the individual in the here and now.
CBT can be Helpful in Treating a Range of Issues
CBT continues to evaluate it’s techniques and treatments. This has built up a large body of research about its effectiveness for use with a broad range of psychological issues. It has been shown as an effective form of therapy for treating a range of conditions, including:
Having trouble controlling your negative thoughts? Feeling anxious or depressed and wish you could switch off those thoughts? Sometimes, it’s those thoughts, rather than a particular situation or incident that may be causing anxiety or depression.
What are Cognitive Distortions/Errors?
Thinking errors happen when your thoughts and reality don’t match up, often without you even realising. These are also called ‘cognitive distortions’. They’re faulty patterns of thinking that are self-defeating, meaning it’s possible to get caught in a loop of negative thinking that can end up becoming a self-fulfilling prophecy. And they happen to all of us, for example:
I’ve just failed that test. I’m a useless student and should never study again
Holding this thought might prevent you studying again or doing anything where testing is involved.
If the initial thinking error is dealt with appropriately, the negative cycle (see diagram below) and any resulting depression or anxiety could be avoided.
The diagram below shows how the thinking error cycle could get triggered after someone is invited to a party, when the day of the party arrives:
Cognitive Behavioural Therapy (CBT) can help you recognise your distorted thoughts and learn to question them. With practice, you can learn to break the cycle of negativity that could be triggered by negative thinking, and replace it with a healthier, more balanced way of thinking.
Here are 7 common thinking errors that can be helped by CBT.
1 “All or Nothing” Thinking
If you are routinely thinking of things in terms of ‘never’ or ‘always’, you may be tempted to view anything less than perfect as a failure. Try to find the ‘in between’ and learn to accept that there is a wide range of possible outcomes between complete disaster and total perfection.
If you get 85 per cent correct on a test, you think you are a complete failure because you missed 15 per cent.
If you don’t look like a model, you decide you are really ugly.
You’re passed up for a promotion at work, so you think that means the company is planning to make you redundant.
Try to find the “in between”. Remind yourself that there is usually a broad spectrum of outcomes between absolute perfection and complete disaster. Very few situations are truly all-or-nothing.
If you are thinking of something in terms of “never” or “always”, can you think of an exception? If so, that means it’s not truly “never” or “always.”
Is it really that bad or am I being extreme?
What other ways are there of looking at this situation?
2 Mental Filter
Are you dwelling on the negative aspects of any given situation, disregarding the positive side? If so, you may need to shift your mindset to acknowledge the good things that exist and learn not to let your negative thinking dominate.
Your presentation was well received by your superiors at work, but you noticed a typo in one of the slides. Instead of enjoying the compliments your boss gave you, you’re only thinking about the typo and expecting to get terminated soon for paying poor attention to detail.
Focus on the concrete facts. In the example above, your boss said you did a great job. That’s a concrete fact. Don’t waste time thinking about the unknowns; the possibility of you getting sacked is an unknown.
Try to rewrite the problem or situation as though you were telling it to a sensitive child. Only include the positive parts of the story. Then read it when you’re feeling overly anxious.
What are the positives in this situation? Try to focus on them more.
3 Fortune telling
Do you tend to jump to conclusions based on your negative thinking, convinced that a certain situation or opportunity is bound to turn out badly? Rather than letting foregone conclusions limit your thinking, learn that you do have control over the outcome.
“If I apply for this job, they will laugh at me and toss my CV.”
“If I ask this girl out, she will definitely turn me down.”
How do you know it will turn out this way?
What facts do you have that prove this negative outcome will inevitably occur?
How do you benefit from reaching this conclusion?
What will happen to you if you continue thinking this way?
4 Mind Reading
Similarly, you may be making negative assumptions about a person’s intentions or thoughts. While you engage in a thinking error known as ‘mind reading’, you are assuming people focus on your flaws through their responses, even though that may not be the case at all.
“My friend didn’t answer the phone. She must be trying to avoid me because I annoy her.”
“My son’s teacher must think I’m stupid because I forgot to sign his permission slip.”
How do you know that?
Does assuming something make it true?
Even though the conclusions reached from mind reading are often incorrect, it is still helpful to try to let go of your need for approval and accept that you can’t please everyone all the time.
Another type of negative of thinking error is the habit of creating a broad generalisation out of a single isolated incident. But an unpleasant situation that occurred once doesn’t mean that the same thing will happen every time.
Your spouse got mad because you spilled wine on the carpet. You start to think, “He’s mad at me. He always gets mad at me. That probably means he hates me and wants to divorce me. I must be the worst wife in the world.”
You failed your driving test on the first try. You tell yourself you’ll never get your license and you’ll be stuck riding the bus for the rest of your life.
Try to think of times in your life when a particular negative situation did not end up being a sign of things to come or have a long-term outcome.
Just because this happened once, does that really mean that it’s going to happen every time, or are other outcomes also possible?
6 Disqualifying the positive
Are you constantly dismissing good things, compliments you receive or positive things people say? With this thinking error, you are discounting the good, while looking for a negative message or ulterior motive.
A friend compliments your hair. You decide she is not saying it because it’s true but rather because she wants something from you or is just being polite.
Make a list of your positive attributes and accomplishments.
Try to accept compliments when people give them to you with a simple “thank you”.
If that doesn’t count, what does count?
Who decides what counts and what doesn’t?
Why do you think good things can’t happen to you?
Are you in danger of seeing yourself as the cause of everything negative that happens, even though you are not responsible? You may be feeling guilt or shame as a result of something that is not your fault.
“My daughter didn’t make the soccer team. I’m sure it’s because I didn’t practice enough with her. ”
“My husband hit me because I’m a bad wife.”
How do you know that? (In the examples above, how do you know your daughter didn’t make the soccer team because of you? Did the coach say so? How do you know you are a bad wife?)
Challenge yourself to find out just how much responsibility you could truly have for what occurred.
Try to think of external factors that could have also contributed to the situation.
If you are suffering from thinking errors, you’ll be pleased to hear that recognising cognitive distortions is the first step towards correcting them. Your negative thought patterns can be changed.
At KlearMinds, we have experienced cognitive behavioural therapists that can help you address your individual issues and give you the tools to change your thoughts for the better. Please feel free to contact us.
Beck, J. S. 2010. Cognitive Therapy. Corsini Encyclopedia of Psychology. 1–3.
Burns, David D., MD. (1989). The Feeling Good Handbook. New York: William Morrow and Company, Inc.
When you suffer from anxiety, it is natural for you to want to feel better as soon as possible. Many people seek cognitive behavioural therapy (CBT) as their treatment of choice for anxiety issues. This is because evidence-based research demonstrates that CBT for anxiety can be a highly effective treatment; in fact GPs often recommend it. But how long will the treatment take? It’s a question that many people ask when considering treatment.
The coronavirus pandemic has resulted in many changes to our lives in the last few weeks, leaving many of us facing a varied array of emotions.
Whether it be growing fears over contracting coronavirus itself, cabin fever from being stuck at home day in day out, or a feeling of paranoia from self-isolating, it’s imperative to focus on our mental health and concentrate on our wellbeing over the coming weeks.
The lockdown has forced many of us to change our routines and plans, ultimately knocking our minds into an unfamiliar frequency. In light of this, it’s important to move with the changing times and reprogram our minds to ensure we can deal with anything that comes our way – a similar concept to that used within cognitive behavioural therapy (CBT) treatment programs.
The principles of CBT work on the premise of altering people’s attitudes and behaviour, changing how someone responds to and deals with an emotional problem. This is particularly relevant when it comes to dealing with the mental repercussions of self-isolating; by recognising and understanding our own cognitive processes, we can alleviate the feeling of stress currently being felt throughout the nation.
Recognising The Changes in Your Routine
With our daily routines and timetables being disturbed, it can be easy to pay too much attention to our body’s defence mechanisms by worrying and panicking. However, by taking the time to recognise how our routines are being changed, this can help us to process these changes in a very different way.
Redefine your own routine and find methods that suit the adaption in a way which benefits you personally. Don’t let the lockdown take away control of your routine – set new goals and milestones to take back control of your day.
Understanding The Effects on Brain Processing
We all have an inherent ‘fight or flight’ mechanism that floods the brain with adrenaline as a primitive biological response. However, the coronavirus outbreak doesn’t warrant this type of response, since neither taking on or running away from the virus are viable options.
In other words, there is no correct response to combat this pandemic and it is therefore entirely up to you how you decide to respond to it.
Creating Healthy Coping Mechanisms
Through reflecting, recognising and reacting to our new environments we can start to slow down our bodies’ innate need to respond, giving us time to decide on new ways to combat stress that suit you as an individual.
Try and concentrate on things you already know alleviate stress; set a routine, get a good night’s rest and, where possible, bathe in natural light. Keep your brain active with various tasks, puzzles or games, and undertake mindfulness techniques. Create achievable goals, keep active and develop a new fitness routine.
By changing the way your brain processes events such as COVID-19, you can reduce some of the anxiety this could be causing. Re-align your thoughts and re-examine your attitude towards the situation before adapting your behaviour in a way that feels healthy and productive.
Our qualified therapists here at KlearMinds can offer expert support to provide a more in-depth understanding of how CBT can help with the challenge of maintaining mental wellbeing during self-isolation. For more information, please do not hesitate to contact us today or visit our online counselling page.
Cognitive Behavioural Therapy (CBT) is based on the idea that thoughts, feelings and behaviours are interconnected and that by changing one you can change the others. It’s an effective ‘talking therapy’ technique that’s been known to help people deal with a variety of mental health issues, from anxiety and depression to self-esteem and substance misuse.
Put simply, the goal is to learn skills that you can take home and use to address real-life problems as they arise. The more you become comfortable using these techniques, the more of a habit CBT will become. We wrote a detailed blog about CBT here.
Here are 3 self-help techniques you can practise at home:
1 – Practice mindfulness and meditation
It is well known that practising mindfulness can have a wide range of positive impacts on mental health. Put briefly, mindfulness means intentionally and consciously paying attention to being in the present moment without letting judgement get in the way. It can help people suffering from harmful automatic thoughts to disengage from obsessive rumination and stay firmly grounded in the present.
For instance, if you’re constantly worrying about work problems when you’re trying to fall asleep, or you can’t concentrate on an important assignment because your mind keeps darting to an argument with a friend, you’re not focused on what is happening in the present moment.
Use your breath and your senses to bring yourself back to the here and now. Here are some short meditation practices that will help to train your mind.
2 – Take little baby steps
Ask yourself the old question: How do you eat an elephant? And the answer is always: One bite at a time. Whether you’re working to overcome depression or breaking an unhealthy habit, change won’t be happening overnight. The trick is to break the big goal down into lots of little easy-to-score goals. Psychologists call this ‘successive approximation’.
Map out the path to victory by setting yourself up for lots of little progressive ‘wins’ and celebrate each of your key achievement. Be proud of any positive change, however small, and recognise the fact that progress isn’t linear. Not only will this make the long journey to better mental health seem much less daunting, progress will happen slowly but surely.
3 – Reframe your negative thoughts
When you feel negative or depressed, it can be difficult to recognise that there are good things in life too. This can be particularly pronounced during autumn or winter, especially if you are suffering from Seasonal Affective Disorder (SAD).
Try to rebalance your mind by a simple exercise of writing down three positive things in your day. Continue your gratitude journal every day; it’s a powerful tool to help forge new associations in your mind that make it easier to see the positives.
You can intensify the process by consciously countering negative thoughts straight away. For example, if your first thought upon entering a room is that you hate the colour of the wall, push yourself to notice 5 things you like in the room (e.g. nice view from the window, lovely lampshade etc).
It’s a type of talking treatment that combines cognitive therapy (examining your beliefs, attitudes and thoughts) with behavioural therapy (examining your feelings and actions). By focusing on how the way you think about situations and experiences affects your feelings and behaviours, CBT can teach you coping skills to break the cycle.
Negative thinking patterns may have developed a long time ago and, if allowed to continue, may influence how you feel about yourself many years later. The continuous cycle can look like this:
Diagram from www.mind.org.uk. Click here to read more.
Working with an experienced CBT therapist can help you identify and address your particular negative thinking patterns so that they cease to dictate your behaviour in the future. CBT can be a very effective treatment to help with a wide range of mental health issues including:
CBT is typically a short term treatment of, say, 12 weekly sessions that can take place one-to-one, in a group setting or online. Within the setting of a supportive, non-judgmental relationship between yourself and the therapist, you may feel comfortable to open up to talk about difficult personal issues. As your therapy progresses, CBT will teach you new and more successful ways of coping with different situations, feelings, thoughts and behaviours that put you on a much healthier path.
The strong feelings of fear, unease and worry that are hallmarks of anxiety can have a very negative impact on your life. Making the decision to get help for anxiety is a positive step. At the same time, it merits the question: what treatment should you choose?
Two of the most popular treatments for anxiety are Cognitive Behavioural Therapy (CBT) and certain types of medication. This is due to the fact that both methods demonstrate good evidence in the successful treatment of anxiety.
However, is CBT more effective than medication in treating anxiety? How can you choose between the two, and when should you use both? (more…)
It happened again. One minute you were trying to fall asleep, and the next thing you knew, you were sitting up straight in your bed struggling to catch your breath. You started to pace, opened up a window, lay down, and sat back up again, but nothing seemed to help. As your heart pounded rapidly, your anxiety grew to the point that you wondered if this was the end for you. About 20 minutes later, however, you were still alive and able to see the incident for what it really was: another panic attack.
There are few things in life that are more frightening than experiencing a panic attack. This might be something you can brush off if it happens once or twice, but if you suffer from regular panic attacks, you need to find a good solution so you can take control of your life and not live in fear over when the next attack will occur. One way that a lot of people are successfully dealing with panic attacks is by turning to cognitive behavioural therapy.(more…)
Anxiety disorders can seriously affect your quality of life. If you worry nonstop, have obsessive thoughts or panic attacks, or suffer from a debilitating phobia, you might be one of the many people who suffer from an anxiety disorder.
Although this diagnosis might sound worrying, it can be helpful to identify the problem so that you can then take the necessary steps to start enjoying your life again.
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