This blog is for anyone who is interested in psychology and well being. It will tackle questions about how therapy works and what are the differences between various approaches to therapy. I will be looking at key factors that help families and couples stay happy and connected with each other and will also look at some of the major stresses of life, offering thoughts on the pitfalls to be avoided.

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Friday, October 1, 2010

Cognitive Behaviour Therapy: What is it and how does it work?

“The mind is its own place, and in it self can make a Heaven of Hell, a Hell of Heaven.”
~John Milton, Paradise Lost

Many of you reading this blog will hear a ring of truth in the quotation above. Perhaps you are plagued by negative thoughts that circle almost constantly in your head. Perhaps moments of creeping anxiety or even sheer panic make your life unliveable.

CBT (Cognitive Behaviour Therapy) was devised to get to the heart of each individual’s personal hell. It provides a method of changing the way we look at things and of changing our experience of life as a whole. I use it to work with anxiety where it has shown to be a useful approach.

Its central philosophy is that beliefs about ourselves, about others, or about life in general have a direct impact on what and how we feel and on how we behave. CBT describes how this can create a kind of a feedback loop, where a person’s beliefs and their physiological, emotional and behavioural responses all interact with each other in ways, which perpetuate and maintain the problem.

Imagine for example that you are walking into a bar one day and a man turns to look at you. What do you think?
“He’s noticed how I look.”
“What does that guy want with me?”
“This does not look like a safe bar.”
“That guy must be waiting for someone. He must have wondered if I was that person walking in”

On the surface, it’s impossible to judge which of the above thoughts might be true. However they each reveal something about our general outlook towards life, towards others or towards ourselves.

Supposing one were to think “He’s noticed how I look.” This thought may come from a variety of different outlooks. Someone, for example, who generally sees the world as an unfriendly place might be prepared for the possibility that others will laugh at him. If he then goes out and sees people looking at him, he might automatically think that they are judging him.

At this point there is often a physical response. The person might go red, they might feel a lump in their throat, a tightness in the chest, or feel short of breath. Their heart might pump harder. They might shake or sweat. They might experience stomach pains or a sense of unreality. This in turn emphasises the impression that others are looking and leads to feelings like, embarrassment, shame, anxiety, sadness or anger.

In response, he might start a fight or duck into a corner. He may attempt to deflect attention by having a loud conversation with the bar man. According to CBT, the way we behave in response to these events only goes to reinforce the beliefs that caused such a reaction in the first place.

It sparks a vicious cycle that can lead to spiralling negative thoughts and escalating psychological and physical discomfort.

Although we all have beliefs that guide our general outlook in life, we are rarely aware of them. This is because they are always acquired when we are very small and don’t have the language to question them.

So they get hardwired to a part of the brain, which operates automatically. CBT is about gaining control through finding these beliefs and making them conscious.

Cognitive behaviour therapists help their clients to examine their beliefs either through carefully devised questions or through behavioural experiments.

Behavioural experiments involve exposure to the events that elicit the discomfort. The theory goes that by facing up to our beliefs in a concrete way we reach parts of the brain that other therapies can’t reach rewiring our belief system and creating possibilities for long term positive change.

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