cognitive behavioral therapy

So, what is it you practice anyways?

This first in a multi-part series exploring the types of therapy I practice.

I've been a big believer in Cognitive Behavioral Therapy (CBT) since studying it in graduate school. The simple premise behind CBT is that your thoughts influence your feelings, which influence your behavior. Understanding this pattern allow you to change it, right at the core.

Say you're in a meeting with your boss and she's not saying much. 'Is she annoyed with me?' you think. 'Maybe what I'm saying is totally off base.' These thoughts might make you anxious and start second guessing everything you're saying. These emotion-filled thoughts are called automatic thoughts, and they pop up based on beliefs about ourselves and the way the world works. Instead of automatically thinking your boss was annoyed, wondering if your boss was tired or preoccupied may change how you behave.

Automatic thoughts rely on perceptions about yourself and others called core beliefs. Core beliefs are developed from childhood experiences, cultural influences, your environment and more. Common core beliefs often follow themes of abandonment, un-lovability, defectiveness, helplessness, and entitlement.   

I have to be in control to be ok.

I'm unsuccessful.

If I don't succeed, I am worthless.

It's not ok to ask for help.

I'm stupid.

I'm bound to be rejected.

Challenging these automatic thoughts is the key to accessing and changing these core beliefs. Asking yourself questions like "Am I jumping to conclusions?" or "Am I condemning myself as a total person based on a single event?" or "Am I using all-or-nothing thinking?" can help challenge these thoughts. 

Noticing these automatic thoughts and changing them to a more realistic view can relieve distress. Changing the thought pattern from 'My boss is thinks I've done a terrible job; I'm worthless' to 'She's had a busy day and isn't saying much; Can I ask for feedback?' will change your behavior.

CBT is effective in treating:

  • alcohol use and abuse
  • substance abuse
  • depression
  • anxiety
  • chronic pain
  • chronic fatigue
  • eating problems
  • health problems
  • relationship problems
  • sleep problems

It's a short-term, problem-focused therapy that aims to systematically change the way you think about yourself and the world. 

What I'm Reading

There's never a shortage of great reading material on mental health. I recently stopped at the store to pick up a couple things:

Buddha's Brain: The Practical Neuroscience of Happiness, Love & Wisdom by Rick Hanson. A great read on how contemplative practice can help harness your mind to cultivate happiness, love, and wisdom.

And Baby Makes Three: The Six-Step Plan for Preserving Marital Intimacy and Rekindling Romance after Baby Arrives by relationship expert John Gottman. Relationship satisfaction plummets after the arrival of the first child, and Gottman offers six steps to keeping the relationship spark alive during the most difficult first months of a child's life.

The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn. Introducing practices of mindfulness and cognitive behavioral therapy, four experts provide meditations and tools to sit with uncomfortable feelings. It's not just "thinking your way" out of depression, but developing a practice that works. 

Drink: The Intimate Relationship Between Women and Alcohol by Ann Dowsett Johnston. Part memoir, part journalistic investigation, Drink explores contemporary trends with women's relationship to alcohol. 

The Gifts of Imperfection: Let Go of Who You Think You're Supposed to be and Embrace Who You Are by shame expert Brene Brown. Brown offers ten guideposts challenging us to change our thinking from "What will people think?" to "I am enough."

Hope and Other Luxuries: A Mother's Life With A Daughter's Anorexia by Clare B. Dunkle. A memoir about a mother's struggle with her daughter's anorexia. Too often we're consumed with focus on the individual struggling with illness, but the entire family suffers.