Questions About Therapy:
What is Cognitive Behavioral Therapy?
Different kinds of therapy lead to different outcomes. Not all therapists are equally effective. If you’re thinking about getting involved in therapy, or wondering, “How does therapy work?” it’s smart to educate yourself so that you can make informed decisions. One of the best ways that you can ensure your work in therapy will be helpful and productive is to find a therapist who practices evidence-based approaches to therapy — like cognitive behavioral therapy.
What is cognitive-behavioral therapy? Whether you’re wondering if you need therapy or you’re already in the process of getting a therapist, you may already have come across the term “CBT,” which is short for “Cognitive Behavioral Therapy.” You can find therapists practicing cognitive behavioral therapy online, or “CBT near me.” But what is CBT? Let’s unpack this together!
What does CBT mean?
CBT stands for “Cognitive Behavioral Therapy” but to truly understand what it means, we need to break this down further: In short, cognitive behavioral therapy is a powerful and direct method that helps you slow down and understand the actual mechanics of the way you think, feel, and behave. The “cognitive” part of CBT refers to your cognitions (i.e., your thoughts), which influence your feelings. Feelings inform your behaviors (the “behavioral” part of CBT). And of course, the way you behave (because of the way you think and the way you feel) creates your outcomes, which in turn lead to more feelings and thoughts. Learning how to change your thoughts and behaviors is the most direct route to changing the way you feel. And feeling good is what we all want!
Cognitive and behavioral aspects of your inner experience are all related. Cognitive-behavioral therapy helps you tease them apart in order to gain self-awareness and practical skills that can lead to significant positive changes in many aspects of your life. How do we know this works? Because cognitive behavioral therapy, unlike many other therapeutic modalities, has literally decades of research that show it to be legitimately effective in helping people resolve mental health symptoms.
Cognitive Behavioral Coaching
Furthermore, the science-backed strategies of CBT form the foundation of evidence-based cognitive-behavioral coaching. What’s the difference between CBT Therapy and cognitive behavioral coaching?
Cognitive-behavioral therapy is a form of psychotherapy designed to treat mental health conditions. Cognitive-behavioral coaching helps you use the principles of CBT therapy but applies them to personal development goals like having a better relationship, building emotional intelligence, professional growth, building more healthy friendships, or goal attainment. If you’re interested, you can learn more about the difference between therapy and coaching here.
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CBT: The “Gold Standard” of Therapy
It is no accident that “CBT” and “Cognitive Behavioral Therapy” appear so often while you research the various mental health treatments available. While there are numerous different types of therapy offered by numerous different types of mental health professionals, Cognitive Behavioral Therapy is one of the few evidence-based approaches to therapy. When we say that an approach is “evidence-based,” we are referencing the substantial body of evidence and data that backs up that approach’s efficacy.
Indeed, Cognitive Behavioral Therapy has been accepted by the psychological community at large and is recognized as an effective treatment for a number of issues including (but not limited to):
- Cognitive Behavioral Therapy For Depression
- Cognitive Behavioral Therapy For Anxiety
- Substance-Use Disorders
- Post-traumatic Stress Disorder
- Plus many others
A key takeaway here is that if you’re considering finding a therapist (or you’re already working with a therapist) who utilizes CBT, you can have at least some degree of confidence that they know what they’re doing. Of course, there are a number of factors that will influence any therapist’s competency and ability, but the simple utilization of an evidence-based method is a great sign.
CBT Therapy vs. Talk Therapy
You might be shocked to learn how many mental health professionals out there do not use coherent, and evidence-based approaches to therapy. Standard talk therapy, where you’re just relating your feelings to a therapist is often not enough to move the needle. If you’re feeling like you’re spinning your wheels in therapy and not really getting anywhere, finding a therapist who uses cognitive behavioral therapy techniques may get you better results.
Definition of Cognitive Behavioral Therapy
“Great,” you think. “CBT has been proven to be effective. But what is Cognitive Behavioral Therapy, really?”
I’m glad you asked!
Let’s provide a Cognitive Behavioral Therapy definition by breaking the phrase up into two parts: “Cognitive” and “Behavioral Therapy.”
“Cognitive” is the operant word in Cognitive Behavioral Therapy. “Cognitive” refers to internal thought processes.
“Behavioral Therapy” is an umbrella term that covers a variety of mental health approaches and treatments for the main purpose of helping people change unhealthy behaviors and create a good place for themselves mentally.
With these two definitions in mind, we see that Cognitive Behavioral Therapy is a type of mental health treatment that seeks to change peoples’ unhealthy behaviors by focusing on their internal thought processes. And that’s exactly right. We’ll cover this in more depth a bit later, but to broaden our understanding of Cognitive Behavioral Therapy, let’s take a look at where it came from first.
A Brief History of CBT
The earliest hints of CBT can be traced all the way back to Stoicism, the Greek philosophy dating back to the 3rd century BC. The Stoic philosophers identified the way in which unhealthy and unproductive emotions could be attributed to false patterns of thought. In fact, Aaron Beck – considered by many to be the “father” of Cognitive Behavioral Therapy – credited Stoicism for the origins of CBT.
Despite the ancient Stoic ideals identified in CBT, Cognitive Behavioral Therapy as we know it today dates back a few decades to the 1950s and 1960s when Behavioral Therapy and Cognitive Therapy were merged. A number of psychologists and ideas ultimately influenced CBT, but the basic framework of the approach can be explained quite simply:
- Our emotions and behaviors are often dictated by our thoughts.
- If our thoughts are faulty, negative, or simply unhealthy, our emotions and behaviors may become unhealthy, leading to issues like depression and anxiety.
- If we suffer from unhealthy emotions and behaviors, we may be able to heal by first focusing on our disordered thought processes.
Since its emergence to modern psychology in the 1950s and 1960s, CBT became widely adopted and used to treat a variety of mental health issues.
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The Big Burden of Our Big Brains
While we, as humans, owe our thriving success in this world in large part to our amazing cognitive abilities, we may also owe a large part of our emotional suffering to these same cognitive abilities.
As creatures, humans aren’t particularly physically dominant compared to other species we share this earth with. While there are a number of factors that may have led to us climbing the food chain, one largely undisputed factor is our superior cognitive ability. We aren’t stronger or faster than lions, for example, but we’re better at predicting the future than them. Our imaginations and creativity exceed those of any feline.
And while our imagination and creativity serve us in many valuable ways when they’re required, they are simply not always required – especially in modern times. The basic truth about modern life for most of the people you personally know is that they’re not faced with any specific life-or-death threats on a daily basis. This truth, however, does not stop our brains from identifying and looping on imagined threats.
Negative Thought Loops: Modern Day “Predators”
Since most of us today do not have to worry about being attacked by lions – or any other real predators – our brains keep themselves busy by imagining other threats. So instead of worrying about the animals just a few miles away that might come and attack us, we find ourselves worrying about being rejected by our coworkers or being cheated on by our partners or any one of countless other imagined scenarios.
The problem is that the part of our brains that process emotions cannot tell the difference between something that’s actually happening and something that we’re simply thinking about. And when we’re faced with threats, both real and imagined, our bodies create physiological responses to them. Sometimes, a physiological response like this can be as small as a tiny pang of sadness or anger. Other times, they can result in anxiety or a full-on fight-or-flight scenario that can trigger a panic attack.
Empathy and Awareness
None of us are robots. Our thoughts, emotions, and actions are not strictly logical. We do our best to navigate our lives in the ways that we believe will maximize our happiness and minimize our pain, but it’s very easy for us to become illogical. For this reason, we need to have empathy for ourselves if we find that our thoughts haven’t been serving us. Of course, we should have empathy for others, too.
Every day, your consciousness is bombarded by countless different thoughts and emotions. Even if you’re a master of mindfulness, your mind still won’t be conscious of many – or most – of them. Some of these thoughts are logical and logistical in nature; they help you plan your day and prioritize your actions. Many of your other thoughts, however, are purely emotion-based.
Events and Meaning are Perceived and Filtered
As I teach in my online “happiness class” which is based on CBT principles: from a strictly logical standpoint, nothing that happens throughout your day is inherently good or bad. We can perform thought experiments that allow us to see any single thing through both positive and negative filters of perception. Let’s say, for example, you get a flat tire on the way to work.
Unhelpful thoughts: “Oh no, I’ve got a flat tire. I’m going to be late for work. This is terrible. I know my boss hates me anyway and now I’m definitely going to get fired.”
Helpful thoughts: “I’ve got a flat tire and I might be late for work, but if I communicate with my boss about what’s happening, they’ll understand. This might even give us a point of personal connection. I can also let them know I’m aware of the impact of my lateness and find some other ways of contributing to the team today. This might even wind up being positive if I can show them how much I do care about our team.”
Neither the negative nor the positive perception of the flat tire is inherently logical or correct. They are simply different ways that a single event might be perceived.
Depending on your own personal beliefs and values, you might perceive daily events (and non-events) in a variety of ways. Some of these beliefs and values have served you well for your entire life. Some change with time. Again, we’re not even aware of many of these internal processes. If your thoughts have become distorted and no longer serve you well, though, they can create many unfavorable and even unhealthy emotional states.
For example, let’s take the same example of the flat tire.
Negative Thought Loop: “Oh no, I’ve got a flat tire. I’m going to be late for work. I’m so unlucky. Bad things always happen to me. I’ll probably get fired. My boss doesn’t like me anyway…” and on and on and on. Thoughts like this create negative emotions that lead to not just more negative thoughts, but negative behaviors too. Left unchecked, negative thought loops can chip away at your self-esteem, and make it more difficult to trust others.
As you can probably see, this negative thought loop is not helpful – and though it’s understandable and most people have probably experienced something like it, it’s not entirely logical, either. This is just one small example of a distorted knot of thinking that Cognitive Behavioral Therapy might be used to untangle.
Examples of “Distorted Thinking”
At this point, we’ve covered the basic mechanisms that explain how we end up suffering from distorted lines of thinking. Now, let’s take a look at some specific types of particularly unhelpful thinking so that we can better understand ourselves and some of the specific thought patterns that Cognitive Behavioral Therapy can help with.
- Black and White Thinking: While everything in life can be very nuanced and complicated, Black and White Thinking can lead us to think of people (including ourselves) and other things as simply “good” or “bad”, for example.
- Overgeneralization: Overgeneralization happens when we apply logic from one specific experience or idea to every experience or idea. For example, if your last partner cheated on you and you decide, “Everyone cheats,” that is an overgeneralization that can make it hard for you to trust again.
- Perfectionism: While perfectionism is sometimes viewed as a positive trait in modern times, it can be the source of great emotional distress. People who suffer from perfectionism feel the obsessive need to do things perfectly. They often have trouble tolerating loss of control, and often can’t stop beating themselves up over mistakes.
- Discounting the Positive: Can be a form of perfectionism. Let’s say, for example, you gave a one hour presentation for work. Even if everyone in attendance tells you you did a great job, discounting the positive might lead you to think that you could have done better. Quite simply, discounting the positive stops us from appreciating things in life.
- Focusing on the Negative: In the same example from above, let’s say you got through your one hour presentation by making coherent points and even getting some laughs in the audience – but you stuttered during one sentence. If you can’t stop thinking about that one stutter, you’re both discounting the positive and focusing on the negative. Over time, this pattern can lead to trouble with self-compassion and self-love.
These are just a few specific types of distorted thinking. Any one of these distorted thought processes – and others – can lead us to feel very badly about ourselves, our lives, and other people.
Even worse, when we fail to recognize and correct distorted thinking, looping can cause it to grow in strength. E.L Doctorow once said,
“When ideas go unexamined and unchallenged for a long enough time, they become mythological and very, very powerful. They create conformity. They intimidate.”
Of course, as we’ve already explained, it’s quite normal to have distorted thought processes. In fact, it would be nearly impossible to live a full human life without suffering from at least one distorted line of thinking. At the same time, however, when we become aware of our distorted thought processes, we have the opportunity to focus on them and possibly correct them. This is the goal of Cognitive Behavioral Therapy.
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Cognitive Behavioral Therapy Techniques
Through decades of implementation and refinement, Cognitive Behavioral Therapy has taken a number of different forms and can be applied in various different ways by psychologists with different leanings and ideologies. When practiced effectively, however, CBT will always be about identifying unhealthy or harmful thought patterns, challenging them, and if possible, replacing them with healthier, more empowering thought patterns that build self-esteem, put an end to excessive worry, and make room for personal growth.
Many modern-day psychologists see Cognitive Behavioral Therapy as a process with six distinct phases:
- Psychological Assessment
- Skills Acquisition
- Skills Consolidation and Application
- Generalization and Maintenance
- Post-Treatment Assessment Follow-up
Cognitive Behavioral Therapy is also often used alongside other evidence-based techniques, and it happens in the context of solid therapeutic relationships. Of course, each individual application of Cognitive Behavioral Therapy will be unique based on each unique therapist, and situation.
Cognitive Behavioral Coaching
While “life coaching” has a dubious reputation, given that most life coaches do not have any formal training or education whatsoever, the truth is that there are also highly effective life coaches — typically therapists and psychologists who practice coaching in addition to therapy.
Coaching psychology is a newer field than counseling psychology, but draws from well-established therapeutic modalities and principles, including that of cognitive-behavioral therapy, in order to help people create positive change in themselves, and attain their personal and professional goals. Evidence-based coaching, in the hands of a skilled and qualified practitioner, is highly effective — often more so than therapy, for individuals who are seeking to make positive changes in their day-to-day lives.
The biggest difference between cognitive behavioral therapy and cognitive-behavioral coaching is not so much the actual work itself: Both seek to help people understand the relationships between the way they think, feel, and behave, and learn how to intentionally manage them all for their own benefit. However, cognitive-behavioral therapy is considered behavioral healthcare. It is an effective form of treatment for mental health disorders including anxiety, depression, and more.
Cognitive-behavioral coaching uses the same ideas and techniques, but applies them for a different purpose. Coaching is not treatment — it’s a system for helping healthy people grow, and create desired outcomes in themselves, their relationships, or their careers. Learn more about the differences between therapy and coaching here.
How Cognitive Behavioral Coaching Works
Cognitive-behavioral coaching uses a similar approach to help you first understand how you’re thinking in order to develop “metacognition.” (i.e., the ability to think about what you’re thinking about!) through a variety of methods including thought logs, identification of core beliefs and mindfulness training. From there, you can then identify the thoughts that are limiting you or creating less than ideal outcomes in your life. With the support of your coach, you can begin to practice new ways of thinking that will not just help you feel more confident and capable — they’ll support the behaviors and action steps you need to take, in order to get where you want to go.
Cognitive Behavioral Therapy and Coaching: Powerful and Effective
Thoughts are powerful. Cognitive-behavioral therapy and cognitive-behavioral life coaching are both methods of helping you understand the relationship between your thoughts, feelings, and behaviors in a new way, in order to help you make positive changes in your life. Cognitive-behavioral therapy is used in the mental health realm, and cognitive-behavioral coaching is used for the purpose of personal growth and goal attainment. Both are excellent, effective ways of getting you to where you want to be in your life!
If you feel that cognitive behavioral therapy or cognitive behavioral coaching could be beneficial for you, we invite you to request a first free consultation meeting with one of our experts. Just be sure to mention that you’d like to be matched with one who utilizes a cognitive-behavioral approach (as well as your hopes for this) and we’ll be back in touch with recommendations about who on our team might be the best fit for you.
More questions? Continue browsing through the articles below, or if you’d like to speak with someone on our team about the specifics of your situation you’re welcome to get in touch anytime by phone, email or chat. We’re all here for you!
Dr. Lisa Marie Bobby is the founder and clinical director of Growing Self. She is a licensed psychologist, a licensed marriage and family therapist, and a board-certified coach, as well as the author of “Exaholics: Breaking Your Addiction to Your Ex Love,” and the host of The Love, Happiness & Success Podcast.
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