Cognitive Behavioral Therapy (CBT) is a well-known, scientifically validated therapy modality. It is a common therapeutic orientation used by many therapists around the world.
Feelings, thoughts and behaviors are inextricably intertwined. Cognitive behavioral therapists believe that our thoughts play a primary role in determining our feelings and behaviors. The theory holds that if we have problematic or distorted thought patterns, these can cause and perpetuate suffering and even lead to behaviors that are not beneficial. According to the theory of CBT, if you change your thoughts, you can change the way you feel and respond.
Our minds are very active and never without thoughts. Many of these thoughts occur automatically. If we do not take the time to evaluate our thought patterns, we often make mistakes in assessing ourselves and others. If we mislabel our thoughts as facts, we can increase our own distress and suffering.
CBT therapists help clients to notice their automatic thoughts and patterns of thinking to become aware of thought distortions. A few examples of distorted thoughts include:
- All or nothing thinking – “if I don’t get an A on my test, I am a horrible student and might as well drop out of school altogether”
- Overgeneralizing – the words always, never, everything and nothing are clues that we might be overgeneralizing, such as the thought “nothing EVER goes my way”
- Catastrophizing – automatically going to the worst-case scenario, such as “if I’m late to this meeting, my boss will think I’m irresponsible and I will never get promoted”
- Should statements – just stop and notice how often you think or use the word “should”. CBT therapists often refer to this as “shoulding” on yourself or others. Thoughts like “I should just get up at 5 am everyday to fit in a workout” or “he should just stop procrastinating and he’d be able to succeed in life.” Should statements tend to be simplistic and overlook the complexities of the lives we lead. While having goals or high standards is not a problem, constant should statements indicate that we are making harsh judgments and are likely to lead to feelings of guilt and shame.
While strict behavioral therapists place emphasis on changing behaviors first (i.e. making behavioral contracts to use planning and accountability to create change) and letting thoughts and feelings be impacted by this, cognitive therapists put primary emphasis on changing thought patterns. Cognitive behavioral therapists see both as critical and focus on changing thoughts as well as behaviors.
While Cognitive Behavioral Therapy has many benefits, it is also important to realize that there are some limitations. Not all of our struggles are the result of distorted thinking. Certain life experiences, such as encountering prejudice and discrimination, traumatic events, or loss of a loved one cannot necessarily be healed by CBT alone. While it may be useful to gain awareness of our maladaptive thoughts and how these negatively impact us, some clients will want more than just a focus on thoughts alone. CBT is a powerful resource yet CBT alone may not be all a client needs in therapy.
In our experience as therapists, we have found that almost all therapists use some aspects of CBT in their work, regardless of theoretical orientation. Even if they do not define themself as a strict CBT therapist, your therapist’s work very well may involve concepts of cognitive behavioral therapy.