Cognitive Behaviour Therapy
Cognitive behaviour therapy (CBT) is an evidence-based psychotherapy with a clear theoretical framework. CBT aims to relieve emotional distress and interpersonal difficulties in a supportive and collaborative manner and to impart a set of skills that enables those in need of help to become their own therapists. Focus on skills is in addition to and not at the expense of honoring individual human experiences.
CBT can assist with difficulties of living such as indecisiveness or procrastination. It can help us adjust after painful events and loss. I think that there is a lot of wisdom in its simplicity.
CBT has been around for many years and generated a large body of research that produced a range of effective interventions to target depression, generalized anxiety disorder, panic disorder, social phobia, post-traumatic stress disorder and obsessive compulsive disorder. Research has shown that our common coping habits tend to maintain our difficulties. These habits include our tendency to engage in ruminative thinking, desire for certainty and postponing of distress-inducing tasks to achieve short-term respite. In CBT we might not always discover the root cause of our current difficulties. Instead, we target the stuck cycle that keeps us in pain (see picture below). Changing any one of its components, will have impact on our wellbeing.
The theory behind CBT is simple. We react to triggers around us. Anything can be a trigger, be it a difficult conversation, getting cut off in traffic or watching a TV show. As people react to their circumstances, their thoughts, emotions, body responses and behaviours are synchronized. It is easy to feel overwhelmed when contemplating a surgery or layoff. Yet the sense of dread is not as severe when you learn to put your thoughts in perspective and recognize that the pending surgery has a high recovery rate or that you have a sufficient set of marketable skills to look for a new position. Perspective taking can create enough emotional relief to allow you to enjoy whatever life still has on offer.
Of course not everything is a faulty perspective. Bad things do happen. In such case it is important that your own thoughts don't stop you from doing what is needed to change your circumstances. Thoughts, emotions and body reactions influence behaviour. Behaviour is the only thing that can change life circumstances. A detailed stuck cycle is depicted below. Change is not easy but might be necessary, especially at times of adversity. What happens to a student with history of bullying who gives up on studying, a war refugee who confuses faulty muffler for gunfire or victims of domestic violence who believe themselves to be fully at the mercy of their abuser?
Some people view CBT as too cold, too methodical or a “therapy by numbers” that misses the human element. Nothing is farther from the truth. The underlining philosophy of CBT is that therapeutic relationship is as important as the knowledge that the therapist brings to the table. However warmth without expertise is not sufficient for therapy to be effective. Neither is expertise without warmth and collaboration. Questions and challenges are welcome. A cognitive behavioural therapist will not label anyone as resistant to change. Instead we will look at things that make the desired change difficult as problems to be understood and solved. Nobody stays distressed on purpose.
