“Men are disturbed not by things, but by the view which they take of them.” (Epictetus, The Enchiridion).
CBT explores the relationship between how we interpret what happens to us (cognitive), how we feel and how we then respond (behaviour) as a consequence of our interpretations. Our interpretations are often biased, leading to depression or anxiety, difficulties in our relationships with others and how we deal with life in general.
CBT teaches skills to recognise that what we think may just be a perspective, that there are other ways of seeing what happens to us and therefore we can respond differently and feel differently, by challenging our perspective and behaviour.
A typical cycle
Negative thoughts like “I’m not good enough”, can lead to feelings of anxiety, that has a strong reaction in the body. When we feel anxious we might feel tense, on edge, sweaty, sick and we may worry a lot. These body sensations and worry causes us to focus more on whether or not we are going to make a mistake, or on other reasons that tell us we are not good enough. We may try extra hard not to make mistakes like spending long hours on work, checking things again and again, or even avoiding situations that we could possibly make mistakes in. When focused on whether or not we make mistakes, we become hyper-alert to any small error, and when, as is natural, an error is made, this is taken to confirm the original thought. ” See! I knew I would make a mistake, I can never get anything right, I’m not up to this.” We may feel low or depressed as this thought seems truer than ever.
Learning to spot negative thoughts and our responses before we get dragged into the pattern, helps us to challenge them and try new ways of thinking and behaving that are more helpful to us.
What to expect from therapy
CBT aims to develop more helpful thoughts and behaviours that can guide us to happier, more fulfilling lives.
CBT is a collaborative approach. You and the therapist work together to become more aware of how you think and interpret events (cognitions). Together, you become aware of how these interpretations may not be helpful. You develop the skills needed to challenge thoughts and then how you respond, to bring about lasting behavioural and emotional change. The skills learnt in therapy are tools for life, helping you to challenge any future obstacles that may arise. The therapy offers a safe, confidential and supportive space.
What does CBT look like?
A typical course of CBT lasts between 6-20 sessions, depending on the nature of the problem. After the initial consultation you will set some goals to work towards in therapy. Your progress towards achieving these goals will be regularly reviewed to ensure treatment stays on track and that you are getting best value from the sessions.
The therapy involves active work in and between sessions. Out of session work would be generated by you and the therapist, and it would be with your full participation, at your own pace.
This may range from reading, keeping short records about the problem, to setting yourself some experiments to try new ways of approaching difficulties. The out of session work is a chance to really see the problem in context. Research shows shows that people who do out of session work get better results from treatment.
What can CBT treat?
The National Institute for Clinical Excellence (NICE) guidelines recommend CBT as the treatment for:
- panic attacks
- phobias (including needles, blood, animals, heights, driving)
- inability to stop worrying about lots of different things
- excessive worry about health (health anxiety)
- body image (BDD)
- obsessions and compulsions (OCD)
- post-traumatic stress (PTSD)
- social and performance anxiety
- antenatal depression and anxiety
- postnatal depression and anxiety
- low self-esteem
- chronic fatigue/chronic pain
The therapist will explore how the particular difficulties affect you as an individual on a day to day basis, and how you have been attempting to best cope. The therapist will work with you to find the best solutions for you.