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Cognitive behavioural therapy (CBT) is a type of talking therapy that is used within many clinical settings across the world. This type of therapy assumes that a person’s thoughts, feelings, emotions, and physical sensations are all connected, and that negative thoughts can trap you in a vicious cycle of feeling anxious or depressed or generally emotionally unwell.
CBT is underpinned by a combination of behavioural and cognitive psychology and the way CBT works can be explained in terms of a theoretical triad that links our feelings, thoughts, and behaviours to our innermost core beliefs. A core belief can be a belief that you have about yourself, for example: ‘I am worthless’ or ‘I am weak’and if these core beliefs are negative, this can have a huge impact on the way we feel and behave in our everyday lives. Sometimes these core beliefs can form because of negative experiences or trauma, or they can be formed from friends and family who have directly said negative things to you (albeit they may not be true). For me, one of my core beliefs was that ‘I am not in control’, and this is one thing I have worked on during my own therapy sessions.
CBT has been shown to be effective in treating a range of conditions, such as helping individuals who have an eating disorder, a phobia, a sleep disorder such as insomnia, schizophrenia, or in my case, posttraumatic stress disorder. I originally undertook CBT to help with my daily anxiety levels, but it soon became apparent that there was much more going on in my mind than just those anxious thoughts, and my therapist suggested that I was displaying symptoms of PTSD. On a daily basis, I was anxious; I would avoid being in really busy places as I felt panic and I would just generally have a low mood. Because of this, I felt as though I was not getting out of the house as much as I used to, and because we were then hit with COVID-19, this just emphasised the need to stay at home.
While I am not a clinician myself, I do have a psychology background and part of my psychology degree and lecturing career has been to learn and teach people about different psychological therapies. As I am a cognitive psychologist myself, I tend to discuss areas of CBT because this is one of the therapies that is heavily underpinned by our cognitions (thoughts) and how our own behaviour may have changed due to negative thoughts. The aim of CBT is to help a client understand those negative (or sometimes known as distorted) thoughts. By understanding why the negative thoughts occur, this allows an individual to challenge the thoughts, and in turn encouraging thoughts and behaviours to become more positive.
If an individual has negative thoughts about themselves (so negative core beliefs), then this may encourage the individual to engage in more negative behaviours. Sometimes we can call these maladaptive behaviours as they are perfectly normal to the individual themselves, but anyone in the outside world can see that these behaviours are not quite right. Examples of maladaptive behaviours could be over-checking (so checking lists before holidays) or over-planning your working day. There is also the case of using work as a distractor and while this in itself is not a maladaptive behaviour, it can very quickly become one if an individual does not give themselves time to rest. Severe maladaptive behaviours could be things such as alcohol and drug misuse, and in some cases these behaviours could be in the form of self-harming behaviours. Each individual is different in terms of their core beliefs and subsequent behaviours and CBT can be tailored to the needs of each individual.
One of the things that I have found difficult with CBT is the need to keep up the work in-between sessions as a cognitive behavioural therapist will set homework tasks. I lead quite a busy life and I would often find that life got in the way and I would forget to complete the homework tasks set by my therapist. As time passed through the therapy sessions, I knew that this would be an issue, so I would set aside 15 minutes per day to work on my CBT related things. This really helped me keep track of my own progress and make the most out of each CBT session.
Over the course of the 12 weeks of therapy, I did not just receive support in dealing with my anxiety issues and lack of confidence. I was given a lot of support in terms of using grounding and mindfulness techniques and also progressive muscle relaxation techniques. Although my CBT sessions are now over, I have continued to use these techniques a few times a week as they provide me with some space to relax and reflect.
My advice for anyone attempting Cognitive Behavioural Therapy is to be very open-minded with what CBT entails. There are some CBT tasks that may work for you and some that may not. As part of my therapy sessions, I was encouraged to use reliving techniques to try and process traumatic events from my past. While this worked for one traumatic event, it did not work for them all, and I was very honest with my therapist about this. We came to a mutual decision that another type of therapy may be more appropriate in helping me process traumatic events and that type of therapy is EMDR. So although I have finished with CBT for now, the tools and techniques I have learnt over the past few months will help me in the long-run, so I am thankful for the support I have been given.