Cognitive Behavioral Therapy is a type of talking therapy that can be used to treat a wide range of psychological problems.

These include anxiety, panic attacks, and depression through to obsessive compulsive disorders, eating disorders and phobias. Cognitive Behavioral Therapy targets the way we think about our world which then creates our feelings and behaviours. We generally believe our thoughts to be true all of the time – because after all they are our creation and we must be right! Wrong! They are simply our personal thoughts based on our own personal life experiences.

In a nut shell problems aren’t caused by situations themselves, but by how we interpret them in our thoughts.

I.e. it’s not what happens to us in life it’s how we learn to deal with it.

So the way we think about any situation can effect the way we feel about it and then react to it.

For example, if a friend passes you by without speaking to you, what would your first thought be?

The thought could be that you have done or said something to upset this friend so they are ignoring you. You may feel upset/guilty/rejected. This could then lead you to avoid that friend in future or to behave in a cool manner when you see them next. This could then create bad feeling between you both and lead to more rejection confirming your initial thought.

Underlying this if you have a core belief about yourself that tells you, you are for example “not good enough” this situation and your thoughts could be used to support that belief and cause you further difficulties.

There may have been many valid reasons why your friend did not speak to you. They may have simply not seen you that day, or were in a hurry, worried and preoccupied.

So how well do you think you would interpret this situation in the first place? Many people engage in “unhelpful thinking” styles. Unhelpful thinking styles are very common and include:

  • Mental filtering – e.g. noticing my failures more than my successes
  • Discounting the positive – e.g. positives are dismissed on the grounds that “Anyone could have done that”
  • Should statements – e.g. demands placed upon self or others that things must be a certain way
  • All-or-nothing thinking – e.g. if I’ve not done it perfectly, then it’s absolutely useless
  • Jumping to conclusions – e.g. if I go into work when I’m feeling low, I’ll only feel worse
  • Magnification – e.g. shortcomings are exaggerated such as forgetting a name and thinking “I am useless with people”
  • Emotional reasoning – e.g. I feel guilty so I must be guilty
  • Over generalising – e.g. nothing ever goes well in my life
  • Labelling – e.g. I’m a loser
  • Personalisation – e.g. holding yourself responsible for events outside your control
  • Mind reading – e.g. guessing you know what other people are thinking
  • Crystal Ball gazing – e.g. predicting a negative future

Do you recognise yourself doing any of these?

Cognitive Behavioral Therapy aims to disrupt negative vicious cycles by identifying these unhelpful thinking styles. Cognitive Behavioral Therapy then attempts to replace these unhelpful thinking styles with more useful ones based on actual evidence.

So this is not just a form of positive thinking!

Underlying this we can then go on to challenge any negative core beliefs you may hold about yourself.

How do we believe cognitive behavioural therapy works on the brain?

Primitive survival instincts like fear are processed in a part of the brain called the limbic system. This includes the amygdala, a region that processes emotion, and the hippocampus, a region involved in reliving traumatic memories.

Brain scan studies have shown that over activity in these two regions returns to normal after a course of CBT in people with phobias.

What’s more, further studies have found that CBT can also change the prefrontal cortex, the part of the brain responsible for higher-level thinking.

So it seems that CBT might be able to make real, physical changes to both our “emotional brain” (instincts) and our “logical brain” (thoughts).

Intriguingly, similar patterns of brain changes have been seen with CBT and with drug treatments, suggesting that psychotherapies and medications might work on the brain in parallel ways. (BBC 2014)

What are the longer term effects of cognitive behavioural therapy?

Of all the talking therapies, CBT has the most clinical evidence to show that it works. This may be because it has been thoroughly researched.

However this is not to say that other therapies can’t be as effective when used appropriately by an experienced therapist and further research is suggesting this. There is also ongoing research that suggests an important factor in therapy is a strong therapeutic relationship where a client is helped to feel safe to explore their thoughts, feelings and behaviours in a safe confidential place.

Ultimately, as with many types of treatment, some people will benefit from CBT more than others which is why I work to fit the therapy offered with the client needs and not try and fit the client to the therapy!.