What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) differs from the the stereotype of talk therapy. Unlike many traditional talk therapies, CBT is designed to be a short-term process focused on learning skills to practice and apply. It combines awareness of unhelpful or inaccurate thinking with individually tailored practice work. Though everyone is different and some will take longer than others, many people notice improvements in how they think and feel within two to three months of consistent CBT.

CBT is used in the treatment of a variety of problems, the most common of which are anxiety and depression. Though this is not an exhaustive list, other applications include bipolar disorder, obsessive compulsive disorder, life stress, relationship struggles, problems with body image, addictions, and even sleep disorders.

The word “cognitive” refers to your thoughts. CBT often begins with the therapist assisting you in identifying which thoughts you are having that are causing you emotional pain or distress. Once you learn how to catch yourself when you think those thoughts, you then have the opportunity to second guess or outright change them. For some, this awareness alone is enough to drastically improve their wellbeing.

Imagine you see a friend walking down the street in your direction. You wave to him, but he passes by without stopping to acknowledge you. What might you think about what just happened? Some people may think, “he must be really angry with me.” Believing someone is angry with you could lead to distress. A CBT therapist might explore this thought further by asking what it would mean to you if that person truly was angry. For someone experiencing depression or anxiety, you might say “if someone is angry with me, I must be a bad person.” This could certainly be an upsetting thought.

Cognitive behavioral therapy teaches how to take a second look at those thoughts. Where is the flaw in the thinking that the friend is angry because he did not wave back? What else could have been going on that you may not know about? Ultimately what we find is that we do not know what a person is thinking unless they specifically tells us. Recognizing this and other similar common flaws is a central component of CBT. We often refer to these flaws as cognitive distortions.

The next step brings you to the behavioral component of CBT. Once you begin catching yourself when you experience cognitive distortions, you have a choice: Do I react to this thought as if it were true, or do I find a way to challenge the thought? If the thought were true, you might avoid the friend; however, CBT would suggest finding a way to verify what that friend was truly thinking. Perhaps a phone call to ask how his day was going could offer some important information. That friend could have received bad news and was distracted, or was late to an appointment and failed to notice you.

Challenging our thoughts helps us transition from “head knowledge” to “heart knowledge.” We can know in our thoughts that we do not know what a person is thinking, but until we hear it straight from them, we may still feel worried or upset. Experience is often the most powerful and effective way to learn.