Cognitive behavioural therapy is a practical treatment based on the theory that our thoughts, behaviours, emotions (mood) and some physical symptoms all influence each other. According to CBT, you can change the way you feel by changing your thoughts and behaviours.
For example, if you feel depressed, you are likely to have all sorts of negative thoughts about yourself and other people. These make you feel even worse. Then you might stay in bed all day because you can’t face the world, and you hate yourself because you didn’t do any of the things you were supposed to do. Physical symptoms like trouble sleeping and loss of appetite can also feed into the cycle. You’re trapped in a vicious circle where you just go on feeling worse and worse.
Similarly, if you’re afraid of public speaking, you are likely to feel very anxious or even panicky at the thought of doing this. You might find yourself thinking, “I’ll mess it up. Everyone will laugh at me.” Then you might get physical symptoms like shaking hands or trouble concentrating, and these make it more likely that you will make a mistake, deepening your fear. You might start avoiding situations where you have to speak in public, but the longer you put it off, the more terrified you feel – and you never have an opportunity to build up your confidence or learn how to cope. Again, you’re trapped in a cycle.
However, if you can break the cycle at any point, you can start to feel better. Medication is one way of breaking the cycle, but what if you don’t want to wait for it to kick in, or you’re looking for something you can do yourself? CBT teaches you to identify the thoughts and behaviours that feed into the cycle and change these so that your mood will improve. (If your problems are severe, it can be a good idea to use medication and CBT together, so that you have the best possible chance of breaking the cycle.)
Changing Your Thoughts
The word “cognitive” in CBT refers to thoughts, and changing the way you think is the first way that you can improve your mood. This part of CBT is very similar no matter what your problem is. It involves identifying thoughts that are causing you distress or feeding into your issues, and then challenging them with an alternative, more balanced way of looking at things.
The following links show you how to identify and challenge problem thoughts.
Challenging Thoughts
Sirius Project’s own step-by-step exercise.
The Ten Forms of Twisted Thinking
Helps you spot when your thoughts are irrational and just making you feel worse.
Ten Ways to Untwist Your Thinking
Some ideas on how to challenge your thoughts.
Changing Your Behaviour
While the cognitive side of CBT is similar for everyone, the behavioural side varies depending on what your problems are. This part of CBT involves identifying the behaviours that feed into your cycle and trying to change them.
For example, if you have depression, it could involve spending more time on activities that you enjoy or that give you a sense of achievement. For a phobia, it could involve gradual exposure to the things that make you anxious. For BPD, it could involve learning healthier and more effective ways of coping, so that you don’t swing from crisis to crisis and end up feeling more and more distressed (that’s what DBT is all about). And if your problem is a behaviour in itself, such as an addiction or eating disorder or of course self-harm, any practical steps you take to stop this behaviour could be considered CBT.
The following links show you how to use the behavioural side of CBT to overcome various problems. (For more information on practical ways to stop self-harming, see the Stopping SI section.)
CBT for Depression
Finding activities that lift your mood and making time for them. (NB. This is quite a labour-intensive exercise and is probably better for milder depression.)
How I Cope with Depression
One sufferer’s account of what she does to help herself.
Anxiety – A Self-Help Guide
Problem-solving and relaxation techniques together with how to stop avoiding situations that make you anxious. Also covers the cognitive side of things.
Using Rational Emotive Therapy to Control Anger
Good for all forms of freak-out – anger, panic or just feeling like you can’t cope! Includes an example of how it can be applied to self-harm.
The Five Steps
A simple coping technique for people who tend to make impulsive decisions, including those with BPD.
Self-Help Leaflets
Free downloadable leaflets covering a range of problems including bereavement, eating disorders, OCD, PTSD and sleep problems.
A Note on CBT
Some CBT resources seem to give the impression that negative thoughts and unhealthy behaviours are the cause of any mental health problem. I don’t agree with this. Brain chemistry, life experiences and so on are also part of the cycle. Thoughts and behaviours can trigger off emotional problems, or they can be a symptom that only came later. But the important thing to remember is that your thoughts and behaviours are the part you can change, so they are the key that unlocks and can change your mood.
Sources
- Mind Over Mood by Greenberger and Padesky
- Feeling Good by David Burns