Cognitive Behavioural Therapy
As humans, our perceptions of the world, of people and of situations and events are being formed from the moment we are born. Throughout our childhoods and our adult years, the experiences that we have and the influences that we are subjected to all contribute to how we think, feel and behave. In some cases we might grow up with healthy and positive thoughts and emotions which spiral upwards towards healthy and positive behaviour, and in turn to more healthy and positive thoughts. In other cases, however, our thinking can become derailed and we find ourselves unable to deal with situations and events which others seem to handle with ease. As our confidence and self-esteem drain away, we come to see ourselves as unworthy of happiness and success, and our faulty thinking leads us to making unhealthy decisions in our lives and to adopting sometimes harmful coping mechanisms. Effectively, we subconsciously create and perpetuate our own problems.
Most of us are probably familiar with the centuries-old concept that it is not the situations and events in our lives which have the potential to cause us so much distress, but how we view them. We can see this in situations where two separate individuals experience exactly the same event but react in entirely different ways with entirely different outcomes. Cognitive Behavioural Therapy (CBT) essentially works with our thoughts, beliefs and attitudes (the cognitive aspects), as well as our behaviour, to modify both at the same time and in such a way that positive and lasting change is the result.
Who might benefit from Cognitive Behavioural Therapy?
Cognitive Behavioural Therapy is a perfectly safe treatment which has been used to successfully treat a whole range of emotional and psychological illnesses over the years.
Although often the symptoms present themselves in a physical sense, because they stem from dysfunctional thoughts and beliefs, the following have all been found to respond extremely well to CBT:
Depression
Obsessive compulsive disorders
Anxiety
Panic attacks
Phobias
Chronic fatigue
Eating disorders
Schizophrenia
Substance abuse problems
Post Traumatic Stress Disorders
Psychosomatic problems
Relationship problems
Sexual dysfunctions
Personality disorders
How does Cognitive Behavioural Therapy work?
CBT begins by getting to the root of faulty thinking and understanding how unhealthy coping mechanisms originated in the context of the individual’s own personal history and life experiences. By appreciating how their thought and behaviour patterns developed in the first place, they come to understand how their current means of dealing with situations and interacting with the world around them may be contributing to their difficulties and actually making matters worse.
This cognitive aspect of the therapy helps the client to recognise the particular ways of thinking which lead to anxiety, depression, anger and other negative emotions, encourages them to question their formerly-held beliefs and to apply evidence and logic in such a way that they are able to replace unrealistic, unhelpful or even harmful thoughts with more balanced interpretations, predictions and assumptions. Because the focus of the treatment is on changing the cognitions and behaviours which are perpetuating a problem, however, it is not limited to talk therapy and is very much action-oriented.
Based on the client’s own strengths and resources, a plan is developed which involves such things as practising different techniques, taking part in behavioural experiments and completing cognitive-monitoring diaries, all with the aim of bringing about the desired change. The behavioural aspect of the treatment is important because new thoughts generally need to be accompanied by new experiences in order for old emotional feelings and reactions to be replaced with healthier and more positive ones. Under the guidance of the therapist, the individual is able to experiment with new ways of doing things and to evaluate the outcomes. Mind and body are, of course, inseparable, and because our thinking can trigger or fuel certain unwanted and sometimes harmful physical reactions, CBT also uses various techniques which are aimed at reducing tension in the body and promoting relaxation.
Why does it work so well?
There are three key reasons why CBT is such an effective and successful treatment. First of all, recovery comes from understanding the root cause of the problems that the individual has experienced in the past. Unlike using medication, therefore, it does not just deal with symptoms and it does not act as a sticking plaster.
Secondly, the treatment is not one which is imposed on sufferers, but is one in which they play an active role. Throughout the treatment, they are learning healthy and positive new methods which are relevant to their lives and which work for them. Thirdly, and perhaps most importantly, CBT provides clients with what are effectively tools for life. Their new levels of understanding allow them to spot instantly if former unhealthy thinking or behaviour starts to creep back in, but this time they are consciously aware of what is happening and they have the tools at their disposal to deal with the situation. For this reason, CBT has the power to bring real and lasting change which can improve the quality of life, literally for a lifetime. Once they have learned, it becomes very difficult to ‘unlearn’.
How long does Cognitive Behavioural Therapy treatment Last?
CBT is designed as a brief intervention, but it can also work for longer treatments. Typically, it would be offered as a package of 10 to 20 weekly sessions of one hour’s duration, although the duration, frequency and format of the sessions will of course depend upon the nature of the problem as well as on other factors. Structured homework assignments are an important component of both behavioural and cognitive treatments. While the bulk of the sessions tends to concentrate on teaching, reviewing and applying new strategies, the homework assignments allow patients to practise their new skills in the outside world whilst still having the support and guidance of a trained therapist.