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CBT Common Themes
Anxiety is ubiquitous to the human condition. From the beginning of recorded history, philosophers, religious leaders, scholars, and more recently medical scientists have attempted to unravel the mysteries of anxiety and to develop interventions that would effectively deal with this pervasive and troubling condition of humanity.
Cognitive behavioural therapy (CBT)is the form of therapy most widely used therapy for anxiety and is the approved form of therapy by NICE (The National Institute for Health care excellence) https://www.nice.org.uk/guidance/qs80/chapter/quality-statement-2-cognitive-behavioural-therapy#quality-statement-2
Research has shown it to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder, among many other conditions. CBT addresses negative patterns and distortions in the way we look at the world and ourselves. As the name suggests, this involves two main components:
- Cognitive therapy examines how negative thoughts, or cognitions, contribute to anxiety.
- Behaviour therapy examines how you behave and react in situations that trigger anxiety.
The basic premise of CBT is that our thoughts—not external events—affect the way we feel. In other words, it’s not the situation you’re in that determines how you feel, but your perception of the situation.
For example, imagine that you’ve just been invited to an event or party and consider these three different ways of thinking about the invitation, and how those thoughts might affect your emotions.
- Thought 1: The party sounds like a lot of fun. I love going out and meeting new people! Emotions: Happy, excited.
- Thought 2: Parties aren’t my thing. I’d much rather stay in and watch a movie. Emotions: Neutral
- Thought 3: I never know what to say or do at parties. I’ll make a fool of myself if I go. Emotions: Anxious, sad.
As you can see this can lead to completely different emotions in different people. It all depends on our individual expectations, attitudes, and beliefs. For people with anxiety and sometimes their negative ways of thinking fuel the negative emotions of anxiety and fear. The goal of cognitive behavioural therapy for anxiety is to identify and correct these negative thoughts and beliefs.
The idea is that if you change the way you think, you can change the way you feel.
In cognitive therapy for anxiety and depression patients are taught a very basic idiom: “The way you think affects the way you feel.” This simple statement is the cornerstone of cognitive theory and therapy of emotional disorders, and yet individuals often fail to recognize how their thoughts affect their mood state. Given the experience of intense and uncontrollable physiological arousal often present during acute anxiety, it is understandable why those who suffer with it may not recognize its cognitive basis. Notwithstanding this failure in recognition, cognition does play an important mediational function between the situation and affect, as indicated I below:
Triggering Situation ➡️ Anxious Thought/Appraisal ➡️ Anxious Feeling
Individuals usually assume that situations and not thought are responsible for their anxiety.
Take, for example, how you feel in the period before an important exam. Anxiety will be high if you expect the exam to be difficult and you doubt your level of preparation. On the other hand, if you expect the exam to be quite easy or you are confident in your preparation, anxiety will be low. The same holds true for public speaking. If you evaluate your audience as friendly and receptive to your speech, your anxiety will be lower than if you evaluate the audience as critical, bored, or rejecting of your talk. In each example it is not the situation (e.g., writing an exam, giving a speech, or having a casual conversation) that determines the level of anxiety, but rather how the situation is appraised or evaluated. It is the way we think that has a powerful influence on whether we feel anxious or calm
How does CBT work:
Cognitive restructuring
Thought challenging also known as cognitive restructuring is a process in which you challenge the negative thinking patterns that contribute to your anxiety, replacing them with more positive, realistic thoughts.
This involves three steps:
- Identifying your negative thoughts.
With anxiety thought can be perceived as more dangerous than they really are. To someone with a germ phobia, for example, shaking another person’s hand can seem life threatening. Although you may easily see that this is an irrational fear, identifying your own irrational, scary thoughts can be very difficult. One strategy is to ask yourself what you were thinking when you started feeling anxious. Your therapist will help you with this step.
- Challenging your negative thoughts.
This is how to evaluate your anxiety-provoking thoughts. This involves questioning the evidence for your frightening thoughts, analysing unhelpful beliefs, and testing out the reality of negative predictions. Strategies for challenging negative thoughts include conducting experiments, weighing the pros and cons of worrying or avoiding the thing you fear, and determining the realistic chances that what you’re anxious about will actually happen. Replacing negative thoughts with realistic thoughts.
- Identify the irrational predictions and negative distortions.
Your anxious thoughts, you can replace them with new thoughts that are more accurate and positive. Your therapist may also help you come up with realistic, calming statements you can say to yourself when you’re facing or anticipating a situation that normally sends your anxiety levels soaring.
Replacing negative thoughts with more realistic ones is easier said than done. Often, negative thoughts are part of a lifelong pattern of thinking. It takes practice to break the habit. That’s why cognitive behavioural therapy includes practicing on your own at home as well. CBT may also include: Learning to recognize when you’re anxious and what that feels like in the body Learning coping skills and relaxation techniques to counteract anxiety and panic Confronting your fears (either in your imagination or in real life).
Emotions play an important role in how we think and behave, compelling us to act and influence the decisions we make about our lives. Exploring these emotions within an educational context our play Head stuff illustrates the concepts of CBT Where young people process and understand themselves and the world around them.
Watch this short play on https://www.youtube.com/watch?v=Kc57wLNoYP8&t=13s and visit our website to learn more at https://www.therapypartners.co.uk/projects/head-stuff
