Cognitive Behavioral Therapy (CBT)

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Practical Psychology

Have you ever considered therapy?

That’s not a rude question. I’m genuinely asking if you’ve ever considered visiting a Cognitive Behavioral Therapist. Therapy may be viewed by some as “weak” or a sign that you’re “crazy.” (Just watch the first season of The Sopranos if you don’t believe me.) But often, those views come from people that don’t understand the process of therapy.

In this video, I’m going to explain the basic ideas behind Cognitive Behavioral Therapy, a popular form of talk therapy that is used throughout the world. It’s not always an easy process, but it can help you identify what is causing anxious feelings or problems within your relationships. By identifying negativity, you can begin to move forward and live a happier, more productive life.

What’s weak about that?

patient and therapist engaged in CBT

History of CBT

Some of the stereotypes of “therapy” come from Freud’s psychoanalysis process. The patient lies down on the couch, talks about their problems, and eventually learns that they have issues with their private parts and their childhood. These embarrassing and often phallic-related revelations were all the rage in the 1950s and 60s. Not surprisingly, not all psychologists loved this approach.

One of these psychologists was Aaron Beck. Beck noticed that his patients weren’t just affected by events that happened in their childhood. These patients were having a dialogue with themselves that seemed to shape the way they shaped the world, even as an adult.

He noticed that the thoughts that popped up during this dialogue had a huge impact on how his patients felt about themselves and the world around them. More notably, these thoughts were often automatic. Patients didn’t notice that these thoughts were something that they could control. They didn’t notice that many of these thoughts weren’t even based in reality. 

How Thoughts Affect Our Feelings and Beliefs

I talk about this a lot in my Psychology of Beliefs course. Our beliefs and thoughts really do shape our reality!

Let’s say, for example, that you are upset about being single. You get anxious when you think about going on dates or even striking up a conversation with someone who you think is attractive. Every time you see an opportunity to meet someone new, you tell yourself that you’ll just get shut down or laughed at. This anxiety is keeping you from meeting the love of your life or just enjoying a night out with friends.

The more you tell yourself that you’re setting yourself up for rejection, the more you will believe it. The more you tell yourself that you are not worth anyone’s time, the more you will believe it. Even if these thoughts are completely made up, they will start to overrun your life.

CBT can help you recognize and put a stop to these thoughts.

patient and therapist engaged in CBT

How CBT Works

The stereotypical picture of talk therapy involves someone sitting down and spilling their heart out to a therapist for an hour. That’s not exactly how CBT works. Instead, the therapist typically uses an action-based approach.

At first, this involves gathering information and context. The therapist may ask about the patient’s family, but only to understand where negative thoughts may be coming from. CBT practitioners may be more focused on the goals that the patient has and how their thoughts are preventing them from reaching these goals.

Once the therapist understands the patient’s goals, they try to uncover the thoughts that are inhibiting the patient. In the example I used above, the patient may complain about the anxiety involving their love life. The therapist will ask questions to uncover the thoughts that contribute to anxiety. They might learn that the patient thinks that they are setting themselves up for rejection. Or that everyone is laughing at them.

Through this process, the therapist tries to get the patient to recognize these limiting beliefs. They may try and uncover how or when the patient uncovered these feelings, but it’s not always necessary. Simply showing the patient that their negative thoughts are influencing their negative feelings may be enough for the patient to start making a change. And this change happens not just through going to sessions, but also by taking action after the session is over.

These actions are crucial to the CBT approach. Therapists may give patients homework or action items to do in between sessions. The actions could be as simple as the patient tracking their mood or meditating on certain thoughts.

therapist looking through materials

Who Can Benefit From CBT?

To be frank, a lot of people can benefit from cognitive behavioral therapy. Anyone who finds themselves limited by negative thoughts or experiencing anxiety can benefit. Even if you do not think that you need to be on medication or have a diagnosable condition, you may be able to benefit from the process of assessing your thoughts and behaviors and having more control over negativity in your life.

Studies have shown that cognitive behavioral therapy can help to treat more serious conditions, including:

  • Depression

  • Anxiety

  • Posttraumatic stress disorder (PTSD)

  • Tics disorders

  • Substance abuse and addictions

  • Eating disorders

  • Borderline personality disorder (BPD)

  • Schizophrenia

Can This Be Used Along With Medication?

If you make an appointment with a therapist, does that mean you’ll get a prescription alongside your “homework?”

It’s not for me to say. Not all mental health professionals can write prescriptions. Only trained psychiatrists are able to diagnose and prescribe medication to patients. They may not offer counseling or CBT.

In some states, a clinical psychologist can provide CBT and prescribe medication. But not all psychologists practice in this way. The mental health professional that you see may also feel that medication is not necessary in your situation. You may also have reasons not to be on medication, and that is okay. For non-psychotic disorders, CBT may be able to provide the same results as medication without the risk of side effects.

Want to Try CBT?

If you are interested in counseling, reach out to a professional in your area. Ask them about CBT and the way that they approach talk therapy. Look for a few different options before making a decision - some therapists even offer a 15-minute free consultation to help you make a decision.

Therapy isn’t weak. Seeing a psychiatrist doesn’t make you a wimp. By using CBT and other forms of talk therapy, you may become stronger than ever.

Reference this article:

Practical Psychology. (2020, March). Cognitive Behavioral Therapy (CBT). Retrieved from

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