Using CBT to Think, Act and Feel Differently.
Cognitive Behavioural Therapies are the most researched of all the talking therapies. The term has come to encompass various approaches which work primarily with thoughts (cognitions), behaviours or both. These approaches have a good evidence base to support their use in the treatment of anxiety and depression and are approved by NICE. (The National Institute for Clinical Evidence)
This sort of approach has a number of advantages. Firstly it tends to be bring about change quickly thus courses of treatment tend to be shorter than is the case with many other approaches. Secondly, because this sort of approach is very structured, the techniques are capable of being standardised. This is helpful in a service where care is provided by a number of different providers. Another advantage is that you the client can learn to utilise the techniques on your own. This means that once you address one problem using these techniques it is likely that you will be able to go on to use the same approach in addressing other issues. In other words it teaches you how to be more psychologically resilient, to be, if you like your own therapist.
The cognitive element of CBT is about looking at thought processes and identifying and challenging thought patterns which are illogical, irrational or unhelpful. Once these have been identified and challenged they are replaced with with versions which are perhaps more balanced, true and most importantly helpful to you. Recognising this faulty thinking is called cognitive insight but it is only the beginning of change. The real challenge is to start to feel differently. This is sometimes described as knowing with our heart rather than our head. The behavioural part of CBT is about this shift. It is often only as we start to behave inline with our healthier thoughts and beliefs that we start to feel differently.
CBT is not a panacea though and it has also been criticised. A client has recently told me that CBT to her seemed only to be about changing behaviour and not emotion. Certainly there is a emphasis in this approach to looking at behaviour and thoughts. This can leave some clients feeling that this approach allows them little opportunity to explore their emotions.
Whilst changes in emotional state often follow from changes in behaviour and thinking sometimes clients find that ‘acting differently’ doesn’t translate into ‘feeling differently’. It is as if a part of them isn’t fooled and hasn’t changed. Though we might know in our head what would we should think or do our emotion be it anxiety, panic or depression is just too overwhelming for us to think or act differently. This is when other approaches such as hypnosis can be very helpful when used with CBT and I will explore this in future blog.