How does CBT work?
Cognitive means our thinking process, and cognitive therapy helps us to understand and change ours. But the way we think often has a profound impact on our behaviour – so CBT aims to help us recognise the interplay between the two, and how we can stop one having a negative impact on the other.
Let’s take a common situation – your other half is late home from work. Normally, your reaction might be ‘poor chap, traffic must be dreadful again’. Your reaction? Put the kettle on so he has a cuppa waiting. If you’re feeling depressed, it might be ‘maybe he’s staying late at the office to avoid seeing me – he must hate my company’. Your reaction? Start wondering if everyone hates your company, and start avoiding social situations. If you’re anxious, you might start to panic that he’s had an accident. Your reaction? Frantically switch between TV stations, looking for news of a traffic pile-up.
Your therapist helps you break down your thought processes – situations, thoughts, emotions, physical feelings and actions. They help you understand how one can influence another, and teach you how to recognise what’s causing your feelings or behaviour. Then they help you to challenge unhelpful or negative thoughts. They also aim to help you recognise and break vicious cycles of negative thoughts and behaviour, when one concern leads to another and another. These can worsen, or stop you recovering from, anxiety or depression.
Your GP can refer you for counselling if you need it. You’ll usually have an assessment to see if CBT is the best option for you. CBT can be done one-to-one or in a group, usually for 5-20 sessions. You’ll be given ‘homework’ to practice what you’ve learnt between sessions.
CBT doesn’t delve into what has gone on in your life before, to help come to terms with past traumas and understand how your past influences how you feel now. There are other talking therapies that work like this, and your therapist can advise if this is what you need. Instead, CBT focuses firmly on the here and now, helping you understand your subconscious thought processes and how they affect your behaviour and mood.
CBT treatment for other conditions
As well as depression and anxiety, CBT can help with a host of other less common conditions. Obsessive Compulsive Disorder, or OCD, happens when you have repeated thoughts you dwell on, and feel an overwhelming desire (a ‘compulsion’) to take certain actions to deal with them. For instance, some people are constantly convinced they’ve left the door open to burglars, and have to go round the house checking every door 30 times before they go to bed. Others are terrified of germs, and ‘have’ to wash with bleach every few minutes. Others still are obsessed with the idea that if they ever step on a crack in the pavement, someone they love will come to harm.
CBT can also be extremely helpful for phobias. It’s natural to be scared about some things – otherwise we’d all throw ourselves into dangerous situations all the time. But a phobia is about a specific thing – spiders (arachnophobia), confined spaces (claustrophobia), being in a situation you can’t escape from and embarrassing yourself (agoraphobia) etc. If you have a phobia, you go to extreme lengths to avoid whatever you’re scared of and this can severely limit how you live your life.
In OCD and phobias, treatment may be more focussed on the behaviour than the thought (cognitive) process. A type of CBT called exposure therapy involves very gradually exposing you to your fears in a safe environment, helping you control your anxiety and react more logically. For instance, if you’re terrified of spiders, they might start with a photo of a tiny spider, talking you through your fears and helping you challenge illogical fears.
Is opening yourself up scary? Sometimes, although you’ll be supported all the way. Is it worth it? Absolutely – because it works. What’s more, it can give you the tools to avoid mental health problems in the future, too.
With thanks to ‘My Weekly’ magazine where this article was originally published.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.