I’ve been a Cognitive behavioural therapist for so long now that I sometimes forget that many people don’t know that much about Cognitive Behavioural Techniques.
Cognitive Behavioural therapy doesn’t work all the time but in many instances it helps change lives for the better. Cognitive behavioural techniques can’t make stress and anxiey disappear completely but it can help you to manage stress and anxiety more easily.
Here are a few of the cognitive behavioural techniques used to help reduce anxiety and depression and improve quality of life:
Identifying cognitive distortions
Cognitive distortions are faulty ways of thinking. For example, when we assume that we know what someone else is thinking, it is seen as a thinking process that a CBT therapist can challenge. Therapists call it “mind reading” because we don’t know for sure what someone else is thinking.
If someone doesn’t say hello to us in the morning when we arrive at the office, we might ‘mind read’ and assume that the other person is annoyed with us. We might wonder what we have done wrong. The reality is that we don’t have any evidence when we make these assumptions. The reality could be completely different. Perhaps the other person didn’t hear you, maybe they are tired as they had a bad night’s sleep and they are grumpy. Our faulty thinking can cause up to feel upset- an emotion that we feel that comes from an error in thinking.
Another common example of an error in thinking is when we catastrophise and imagine the worst case scenario. We upset ourselves needlessly and cognitive behavioural therpy helps you to notice when you are thinking things that might have little bearing on reality.
Cognitive restructuring basically involves looking at your existing beliefs and correcting some of the outdated and unhelpful beliefs. We are born a blank slate but as we grow older we incorporate messages from others and the world around us. Perhaps as a young child you received negative messages from your parents that you are a nuisance or fat or ugly (god forbid, but some parents really are clueless!), CBT would help you to review your core beliefs and look at whether they are helpful and accurate. Usually they are neither and cognitive behavioural techniques help you to update your belief system and develop a healthier view of yourself and the world around you.
Keeping a diary
CBT often involves writing your thoughts down. This is a good start in downloading what I call your “mental diet”. What do you tell yourself everyday? Once we can see where you focus your attention we can begin to look for unhealthy patterns and help you to focus on more productive useful areas of your life. It’s important to know the difference between what we can and can’t control. Keeping diary also helps with identifying unhelpful thoughts and errors in thinking.
This is where we get you to actively challenge your beliefs and rules for living. Rules for livng often take the form of “If this…then that”. Recently I had a client state that one of her rules for living is: “If I don’t please others and wo what they want, they will abandon or reject me.”
We put together a behavioural experiment whereby she would be assertive with her husband over something. She tries too hard to please him and in order to shift the way she thinks, she needs to test it out and see what happens. As expected, her husband hasn’t rejected her. It’s vital to reality-test our assumptions and beliefs. When we avoid we never get a chance to check whether the thought is accurate or not.
Exposure and response prevention
This is mainly used when a client engages in Obsessive Compulsive behaviour. For example, I had a client that would avoid touching door handles etc because of fear of contamination. The basic idea here is to get the client to feel comfortable touching items they feel are contaminated. Once they do this regularly, they will realise that their fears don’t come true. Nothing bad happens to them. So they need to expose themselves to the threatening situation and stop themselves from then doing the compulsive behaviour eg. washing hands.
Playing out the scenario
At times, going to the place you fear through a visualisation process can help you face the fear and come out the other side safely. This technique is often used for Post-traumatic stress disorder. It can also be used to face a fear on an emotional level whilst having a therapist to keep you ‘grounded’ and provide a safe place when you are accessing frightening emotions. This can help to break the scary association your mind has created.
CBT can help with sleep issues such as insomnia. Cognitive behaviourl techniques can help you create a better sleep environment. These techniques are based on Classical Conditioning principles.
Progressive muscle relaxation
This is part of the grounding process used to help relax a person. CBT therapists also use breathing techniques and mindfulness as a way to help a client relax and reduce anxiety symptoms.
Problem solving and goal setting
CBT can help generate healthy solutions to life’s problems. CBT also helps with values – what are they? and helps clients find ways to live a life more inline with their values. The more intune you are with your values and live according to them, the better your quality of life will be.
CBT has many many virtues and the above techniques are only a few of the many interventions a CBT psychotherapist can offer you.