Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is the standard, most well-accepted treatment for many problems–anxiety included.  Here’s how it works:  CBT encourages looking at our experience as being divided into three categories, Thoughts, Feelings, and Actions, which all interact with each other all the time. When something difficult happens, we’re often aware of how we feel (e.g., anxious, sad, angry), but not about how what we think and what we do contribute to that feeling.  That’s where CBT comes in.

Here’s a very simple example:  Say you have an event to go to and think, “I’m not going to know what to say to anybody, I’ll make a fool of myself, this will be a disaster.” You’re likely to feel terrible and behave accordingly–that is, skip the event–and then, perhaps, feel even worse.  If, on the other hand, you think, “Wow, this is hard, but I might meet some people, at the very least this will be a new experience,” you’re likely to feel less terrible and more likely to show up.  You may even feel some pride for having overcome your fears.

This may seem simple, but what we think isn’t always clear to us.  Or our thinking seems to be based upon indisputable truth.  A big part of Cognitive Behavioral Therapy is slowing down, learning to identify thought patterns, and checking the evidence for our Automatic Negative Thoughts. A list of what are called Cognitive Distortions (see pdf) can help.  As you become more aware of your thinking, you may notice certain traits repeating again and again–catastrophizing, fortune telling, all-or-nothing thinking (all on the Cognitive Distortions list).  After a while, instead of buying into a thought and clinging to it as truth, you may find yourself able to challenge thoughts and detach from them, “There I go again.”

To help this process, clients in Cognitive Behavioral Therapy fill out Thought Logs. Taking a moment each day to fill out a Thought Log (or several) helps build that sense of awareness and objectivity about Automatic Negative Thoughts and develop an ability to challenge and detach from those thoughts.

Thoughts Logs come in many different forms.  The ABCD Thought Log is especially clear and helpful.  Here’s an example of how a Thought Log might be filled out.  CBT clients bring the week’s Thought Logs into therapy to discuss and explore.  Among questions often addressed in therapy:  Where do my Automatic Negative Thoughts come from and do they check out?  How can I move forward in my life, symptoms or no symptoms?

CBT also addresses our daily behaviors to help improve mood and lessen anxiety.  Working with a therapist to come up with a list of behaviors that increase your anxiety and making a plan to gradually replace these behaviors with others can be extraordinarily helpful.  (For another behavioral approach to CBT, see Exposure and Response Prevention.)

Research strongly supports using CBT to address problems with anxiety–stress, fears, worries, phobias, repetitive behaviors, avoidance, and so on.  Working with an experienced CBT therapist can bring about significant symptom relief, helping you begin to feel better and live the life you want to lead.

For a more in-depth look at Cognitive Behavioral Therapy and for CBT workbooks addressing your specific symptoms, check out the CBT section of the Anxiety Treatment L.A. Bookstore.

To discuss what you’re going through and schedule an appointment, write or call: (323) 739-4322