CBT – Cognitive Behavioural Therapy

What is CBT (Cognitive Behavioural Therapy)

Cognitive Behavioural Therapy (CBT) is an approach to working with human problems.  It emerged in the late seventies and is a blended approach.

Two main schools of thought had prevailed. These were 1) the behaviourist approach and 2) cognitive theories. The behaviourists focussed on reinforcement versus punishment, conditioned and learned behaviours etc. Cognitive theorists focussed on our learning and experiences and how they impact our thoughts. These thoughts sometimes lead to strong emotions. The strong emotions can lead to particular reactions and sensations and ultimately certain behaviours.

When working with problems in our lives, we need to combine the cognitive and the behavioural aspects.  CBT has been used with success to help people change their thinking and behavioural patterns.

What we must remember is that we are all unique.  Your experiences have been different to mine, and therefore your interpretation of a situation is different to mine.

A worked example of CBT

Let’s say that you are having lots of arguments with your wife because she likes nothing more than hosting dinner parties.  But you don’t like parties at all, including dinner parties.  Your wife thinks you’re selfish and lacking social skills and this has put a great deal of pressure on your marriage.  You seek counselling.

You visit a CBT practitioner and they ask you to explain the problem as you see it.  Next you together begin to look at the causal factors.  What are the triggers?  You realise that whenever your wife suggests a dinner party or similar (trigger), you feel anxious (emotional response), your stomach flips (bodily sensation), and you feel sick (bodily sensation).  So you say “no” to the dinner party (behavioural output).  And the arguments begin.  Your wife calls you self-centred and boring and this hurts, because you don’t feel that you are.

Your practitioner works with you on your ‘interpretation’ of the trigger.  You begin to flesh out the thoughts.  You track back and realise that you feel fear.  As your work together unfolds, you realise that the fear you feel is familiar. The anxiety is connected to this.

Further discussions with your therapist uncover your past.  You reveal that you are the child of an alcoholic.  As a child, you saw your mother behave in confusing and upsetting ways when she drank and you felt unsafe and unsettled.  Your reaction to your mother’s behaviour was appropriate at the time, but now no longer serves you.

Our earlier experiences and the lessons we’ve been taught all create cognitions. These are often unconscious.

CBT requires commitment but with effort and determination it is a very effective tool for change.

So now you have enough knowledge to begin challenging those Negative Automatic Thoughts (NATs).  How else might you think about the dinner party?  What little thing could you do differently?

Cognitive Behavioural Therapy helps people to uncover the source of their behaviours and to ‘re-wire’ their thinking. This is achieved through challenges to the thoughts and small but incremental changes to behaviour.  When we experience the familiar situation but without the original internal response, we can make change happen.