What is CBT?

If you are considering seeing a therapist, it is important to be aware of the philosophical background and modality that are used. Though I draw from several modalities, I would say that CBT is foundational in my approach to therapy. "What is CBT?" you asked. I'm glad you asked. Cognitive Behavioral Therapy is one of the most researched and empirically supported forms of therapy. According to the Beck Institute, there are over 2,000 research articles that demonstrate the effectiveness of CBT for problems such as depression, anxiety, PTSD, just to name a few. The approach has its philosophical roots in ancient Greek philosophers such as Plato and Aristotle, as well as the Stoics, but was developed for psychotherapy by Aaron Beck in the 1960s. The main idea is that CBT helps the person see the connections between thoughts, behaviors, and feelings with the hope that it will provide insight for the individual to make the desired changes.

A simple example would be this: Let’s say you are depressed and not in the mood to do many of the activities you once enjoyed. In addition, you are noticing that you have feelings of sadness and it is beginning to get in the way of relationships at work and at home. Using a CBT approach would be to first explore the event. What is going on? Or in CBT terms, what is the antecedent (A)? This could be many different things—something from your past or present, internal or external, anything that might trigger this depressive reaction. For the sake of this example, let’s say the trigger is a recent job loss. Once there is a good idea of the antecedent or trigger, you look at the beliefs (B). Thinking about thoughts helps lead to a better understanding of what you believe. So, in your case, you are thinking, “This always happens to me” and “I can't handle this.” Both of these thoughts are unhelpful and untrue and can be leading to the symptoms being experienced of depression which would be the (C) or consequence of the unhealthy belief. Let’s focus more on the unhealthy belief of “I can't handle this”. Using Socratic questioning (see, I wasn’t joking when I mentioned this approach was old), you would challenge the belief that this job loss is not manageable. What have other people done when they lost their job? Did they survive? What makes your situation different? How have you handled other setbacks? Did you survive? Once doubt is introduced that this job loss is not completely unmanageable and maybe there is something that you can do about the situation, the next part would be living in accordance with those healthy beliefs. This would be where the behavioral part comes in and you replace the depressive behavior with something new based on the healthy belief that “this is hard, but I can handle it”. Those who believe they can handle a job loss apply for new jobs, still spend time with friends and family, they ask for help, etc. The more you do the healthy things, the more confidence grows and a shift in thinking and mood begins.

There are many, many layers to this, much more than can be covered in a short blog post, but this is the gist of the approach. Oftentimes there are a myriad of factors at play that can make walking out of depression a long, grueling process. CBT is an approach with a long history of helping people alleviate all sorts of mental health symptoms and work towards achieving progress towards a healthy lifestyle.