Cognitive Behavioural Therapy (CBT)

Below is a summary of some of the core elements of CBT. Please don't hesitate to contact me for an informal chat and/or signposting to other resources if you would like further information about CBT.

Cognitive Behavioural Therapy is a highly effective treatment for Depression and Anxiety related issues and is recommended by the NHS in their guidelines as an evidence based effective treatment for such issues.

CBT is based on the principal that it is not what happens to us that governs how we react, but it is our response to what happens to us, and how we interpret it that governs how we react. (This is not to negate normal human emotions and feelings and behaviour; when we are bereaved for example, or experience a traumatic situation or event such as a relationship break up; it is perfectly normal and healthy to be distraught and upset in certain situations). However; there can be other situations that may cause us disproportional levels of distress, or fear or anxiety that impact on our functioning and quality of life which CBT can help a person to have more understanding and control of.  

How we think about something affects how we feel emotionally, how we feel physically, and will also affect how we behave. Each of these areas; our thoughts; our emotions; our physical symptoms; and our behaviour can at times all interact with each other in a negative way and cause vicious circles and cycles. For example; if someone were walking down the street and passed someone they knew who proceeded to ignore them, different people will have different responses to this situation. One person might think 'What a cheek; how rude' which might cause them to feel angry which might cause them to physically tense up which might cause them to behave in an irritable manner to a shop keeper. Another person might think 'I knew they didn't really like me after all' which might cause them to feel sad, which might cause them to feel physically  sick or depleted in energy which might cause them to engage in behaviour such as cancelling a lunch meeting they are on their way to. Another person might think 'That's not like them to ignore me; I hope they are ok?' which might cause them to feel concern; which might cause them to physically feel a little tense which might cause them to engage in behaviour such as ringing the person later to check if they are ok.

The above is just one fairly simple example of how one situation can create many different responses according to how we interpret it. In CBT the therapist and client work together to identify unhelpful patterns of thinking and behaviour and where these cycles may be creating vicious cycles, which serve to maintain the problem rather than solving it. CBT can be helpful for a variety of mental health issues and there are different treatment protocols according to the presenting issue. There are maintaining factors and cycles that are common to certain presenting issues, and a CBT therapist will offer psychological education about some of the maintaining factors common to the issue presented. This often helps the client to make sense of why the problem can often feel insurmountable and as if they will never recover. The therapist and client will then work together in a collaborative way to identify the main problems, to establish the clients goals, and to work together to devise a treatment plan in order to reach these goals. 

Cognitive Behavioural Therapy also takes into account that beliefs about ourselves, others, and the world are learned and often (although not always) rooted in childhood experiences. Sometimes it is necessary to do work with these underlying beliefs. They often have their roots in past experiences. Beliefs about ourselves are conclusions that have been drawn on the basis of what has happened to us. However some of these beliefs may be outdated and might have been learned in very early life, but still operate and form rules that we live our lives by as adults. For example, if a person receives a lot of criticism as a child, they may develop a belief about themselves as a failure. They may then operate a rule in their lives that if they work as hard as possible and aim to do everything perfectly, then they will be successful. If something comes along to interrupt this rule, such as illness, or redundancy, the person may then feel exposed to their underlying belief of being a failure. So; these kinds of beliefs about the self can have an enormous impact on how a person feels about themselves, and lives their lives, and may often go unrecognised by the person themselves until a major stressful event happens and the person finds themselves struggling to cope. These underlying beliefs often feel completely factual. CBT can help if appropriate to identify some of these underlying beliefs and to also identify the effects that these may be having, and help the person to recognise that this belief may not actually be fact. The person can then begin to learn ways of challenging and changing these beliefs.