If you are struggling with symptoms such as stress and depression, it’s important to stop and consider the question: What are you thinking?
What are the thoughts going around in your head? What is your self-talk like, in a situation like this one:
You had planned to meet your friend at the cinema at 7pm but they have just phoned to say they’re running an hour late.
Person 1 thinks: “They don’t like me”; “No one wants to spend time with me”; “I’m a boring person.” They feel saddened and low.
Meanwhile Person 2 is thinking: “What if she is seriously ill?”; “I have to travel back on my own – what if I get mugged?”. Person 2 feels highly anxious and worried.
Person 3 on the other hand, thinks: “This is typical – my friends are always late!”; “They don’t care”; “People are so inconsiderate!”; “I can’t believe she didn’t leave on time!!”. This person feels very angry and annoyed.
The good news is, that if any of these sound familiar, Cognitive Behavioural Therapy (or CBT) can be very effective.
CBT: what you are thinking and how it affects you
CBT is a form of psychotherapy that alleviates distress, by examining what you are thinking, and how it influences your feelings and behaviours – and vice versa.
It is an active form of therapy in which both the client and the therapist should be motivated to work together, to understand the client’s thinking and emotional patterns. Practising skills and agreed activities between sessions, is essential to its effectiveness.
A key feature of CBT is identifying unhelpful thinking patterns.
Unhelpful thinking patterns often occur prior to, and during, times of high emotion or distress. Below is a simple example of how CBT might identify any unhelpful thinking patterns that could be interacting with your mood:
Remembering that thoughts are not facts, and starting to curiously question them is a useful strategy; asking ‘Am I jumping to conclusions or catastrophizing?’ can often be a good starting point. Click the link for more information on unhelpful thinking habits: https://www.getselfhelp.co.uk/docs/UnhelpfulThinkingHabitsWithAlternatives.pdf
CBT is also interested in identifying how our behaviour drives and reinforces certain feelings and thought processes. As a consequence of our mood we might find ourselves behaving in a way that creates vicious cycles of unhelpful thoughts, feelings and behaviour. These cycles can occur in a range of mood disorders including anxiety and depression.
Below is an example of how CBT might represent one such vicious cycle and where you and your therapist might develop interventions to disrupt the cycle:
Examples of interventions that you might develop and practice with your therapist include:
- Strategies targeting your thoughts by raising awareness of them and using Thought Challenging.
- Strategies targeting your physical sensations by using Relaxation Techniques.
- Strategies targeting your behaviour through Problem Solving or graded management to face your fears.
CBT has become an umbrella term for a wide range of treatment protocols that have been developed for various disorders (eg depression and an overload of stress, panic disorder, generalised anxiety disorder, social anxiety, and obsessive compulsive disorder). When you and your therapist tailor the approach to your disorder, and individual experience, it can be very useful.
If you have realised that your thinking patterns may need some work, then CBT might be a useful approach for you.
While it can be hugely beneficial it might not be the right approach for everyone given their particular difficulties and experiences. Some people can find aspects of CBT helpful to give them strategies to manage their symptoms, but continue to report rigid thinking and patterns of behaviour that are difficult to change. If that’s the case a different approach (eg Acceptance and Commitment Therapy or Schema Therapy) might be more suitable.
The approach taken should be discussed and agreed with your therapist.
Author: Dr Anna Woodall, B Psych (Hons), D Psych (Clinical), MAPS.
Dr Anna Woodall has a Doctorate in Clinical Psychology from the University of East London, and over 10 years of experience delivering psychological support and mental health research in Australia and the United Kingdom. Anna has recently returned to Brisbane from England.
To make an appointment with Brisbane Psychologist Dr Anna Woodall, try Online Booking – Mt Gravatt. Alternatively, you can call Vision Psychology (Mt Gravatt) on (07) 3088 5422.