Cognitive-Behavioural Therapy or CBT is a type of therapy that provides people with ways to work towards changing their negative thoughts thereby improving how they feel and how they relate to the world around them. The foundation of CBT, which was first discussed by the psychologist Albert Ellis and then specifically applied to depression by Aaron Beck is that the thoughts we have about a situation we’re in influences our feelings or emotions and how we react to that situation, i.e. how we behave.
So, if we have negative thoughts about what’s happening we will tend to experience emotions that make us feel sad, angry, bitter, fearful or hopeless, depending on the situation. This, in turn leads us to behave in unproductive ways that only reinforce the negative thoughts and feelings we had in the first place-around and around we go into what seems like an abyss with no way out. The opposite is true if we think positively about what’s occurring in that we will tend to have positive feelings and do productive or proactive things in response to the circumstances.
When we look at people with emotional or psychological concerns like depression, anxiety, low self-esteem or chronic unhappiness, for example, not only are their thoughts about their life situations negative but they are also unrealistic or irrational. In my experience over the years, the negative thoughts of clients who are depressed or anxious or who have low self-esteem etc. tend to be very similar. In other words, their thoughts tend to follow certain negative and unrealistic patterns, for instance, taking things personally or to heart, jumping to conclusions, having perfectionist standards or comparing themselves to others and coming up second best.
The main reason for this is that people who are susceptible to developing emotional or psychological difficulties appear to have a deep-seated, self-critical personal belief system; an underlying view of themselves that makes them judge themselves in negative or self-defeating ways throughout each day. Judgements like "I'm a failure", "I'm a loser", "I'm unworthy" or "I'm unloveable". This has been described by Tara Brach as the trance of unworthiness.
Their whole sense of themselves, that is, how they think or feel about themselves is closely linked to whether they are getting approval from others and how successful they are in life as well as how well they’re coping in life; whether they feel they’re being weak or strong.
So, when they face someone’s disapproval or don’t achieve a particular goal or feel they’re not on top of things they tend to fall apart and feel very unhappy and then experience low self-esteem and blame themselves for it all. A vicious circle of sadness, hopelessness, despair and feeling unworthy.
Cognitive-Behavioural Therapy is a therapeutic strategy that allows clients to find out more about the way they think and the ways they interpret the world around them. As CBT progresses, clients also become better able to recognise their underlying personal belief system and are instructed in how to challenge both their thoughts and beliefs. CBT tends to be a short-term therapy process and is useful for a wide range of clinical problems and a wide cross-section of people.
One of the main difficulties with CBT, however, is that relapses can occur following a period of relief from previous troubling symptoms resulting in clients returning to therapy for more help. Now this doesn’t happen with all clients but it does for quite a few. So much so that psychologists and other health practitioners are now looking at new ways to assist people to make long-term, life-long changes. There is one therapeutic innovation that is known as the third wave in psychology. It is a very exciting advance in the treatment of psychological concerns and has the potential of revolutionising how we relate to mental health issues; their assessment and treatment.
This therapy is best known as Mindfulness Therapy(link to mindfulness therapy) and its most important component is Mindfulness. The essence of Mindfulness is also being used in Mindfulness-Based Cognitive Therapy as well as other psychological treatment strategies. Initial research on these new treatments for emotional concerns are showing some very promising indications that they could provide clients with the necessary life and coping skills to make deep, long-term changes, which would be fantastic.
Radical Acceptance by Tara Brach, Bantam, 2003.
Reason and Emotion in Psychotherapy by Albert Ellis, Lyle Stuart, 1962.
Cognitive Therapy and the Emotional Disorders by Aaron Beck, International Universities Press, 1976.