CBT? What’s that? And what do you mean, magic?
Cognitive Behavioral Therapy (CBT) is one of the most evidence-based, well-researched psychotherapies out there. Honestly, if you search it, you will be bombarded with an insane number of results. Having so much information available on such a life-changing topic is actually a fantastic thing! However, it can be problematic for a consumer, as it might simply be too much. It may be overwhelming to figure out where to start or what you even want to know about it. That’s where this easy-to-digest piece on the basics behind CBT, what it is and how it works comes in.
What is Cognitive Behavioral Therapy?
CBT is a type of therapeutic intervention that focuses on thoughts, feelings, behaviors, and physiological sensations. Any time we experience a situation, we have thoughts and feelings associated with it. Then, we may also notice, or not, physiological sensations in response. Once our body very quickly processes these pieces of information, we react/respond (behavior). This sounds extremely simple because it really is. It is not a complicated process once we understand it, but that does not mean that if we are stuck in a maladaptive cycle that it is easy to get out of it. Let’s run through an example to give real-life context. We will use the same situation and go through it with two different “people” to show just how much a person’s internal CBT cycle plays a role, even when the situation is the exact same.
CBT Cycle in Action
The Situation
Someone is holding a dog in their arms. Picture a dog in someone’s arms; there are no obvious signs of aggression and the dog is small enough that it is possible for their owner to hold it.
Person A: Adaptive/Positive Experience
Person A sees this dog in the arms of its owner and has an automatic thought about it. This thought could be something like Oh, look at that cute dog, Isn’t that sweet, or even I hope that dog is okay. These thoughts will elicit some type of feeling, which could be happiness, joy, care, or others. Along with these more positive emotions, Person A probably wouldn’t notice anything physiological; however, they’d likely have calm muscles, a normal heart rate, regular breathing patterns, etc. Behaviorally, Person A may want to approach the dog/owner and ask to pet it or tell the owner they have a cute dog, but at the very least, they may have a slight smile (yes, that’s also a behavior). Because they left this situation in a positive mood and mindset (and potentially positive feedback from the dog or owner), they are likely to repeat this cycle the next time they encounter a similar situation. Not a problem; there’s nothing wrong with this cycle.
Person B: Maladaptive/Negative Experience
Person B sees the exact same situation and their initial thoughts might be What if they put the dog down?, Did it try to hurt someone and that’s why they picked it up?, or It doesn’t look friendly. Based on the nature of these thoughts, you can probably assume that they would likely have a different set of emotions. Person B likely experiences fear and anxiety. Based on this, they may notice physiological symptoms of an increased heart rate, sweating, muscle tension, upset stomach, etc. It is highly unlikely that Person B will respond with the same behaviors as Person A. Instead, they may try to quickly walk past the dog/owner, cross the street if that’s possible for them, or even turn around and escape entirely. When they leave this situation, they will no longer be experiencing fear or anxiety; instead, they will experience a sense of relief and safety. Because they experienced this relief, they will also be more inclined to repeat this cycle when they encounter a similar situation. This, however, can turn into a problematic response if this happens every time they see a dog.
What’s wrong with escaping an anxiety-provoking situation?
It is sometimes encouraged to escape certain anxiety-provoking situations. In fact, there are absolutely certain situations that escape is necessary for survival! However, when our need to escape less threatening situations starts interfering with our lives, it becomes problematic and we need to learn how to respond differently.
How does CBT help?
The whole idea behind CBT is learning how to respond differently, while challenging the negative thoughts along the way. When we do this, we start to learn that our thoughts are not always facts and may or may be true. We also begin to learn that those negative emotions and unpleasant physiological sensations we’re experiencing, don’t stay around forever! Once this is understood and learned, a person becomes much more empowered and can look at various unpleasant situations through a new lens. Not sure what I mean? Let’s get back to the example of Person B to show it more clearly.
Person B: Breaking the maladaptive/negative cycle
Person B will still see the dog and begin their initial thought process. In turn, they will experience the distressing emotions and physiological sensations. However, instead of running away or escaping, they respond differently and approach the situation. At this point, Person B makes a conscious decision to go toward the dog/owner. As they approach, their anxiety and fear may temporarily increase; however, if they stop to chat and/or even keep moving at a calm pace past the dog/owner, their anxiety will slowly begin to decrease. Now, this might not seem like a big deal at all, but it was actually a great educational moment. Instead of avoiding something they feared, Person B chose to actively approach it and they were able to learn a few things.
- Their emotions ebb and flow and they can tolerate those changes
- Their physiological symptoms ebb and flow as well
- They can respond in a different way
- Their thought was just that…a thought!
The dog didn’t get down, the owner didn’t “sick” the dog on Person B and everything turned out okay. This would not have been experienced had Person B resorted to avoiding the situation like they usually do. Instead, they are starting to put some cracks in the thought that this situation (and others like it) are threatening. If they continue to use an approach strategy as often as they can, they will soon learn that their fears about this type of situation may have been exaggerated compared to the actual threat of a situation.
That’s great, but what if something bad does happen?
I won’t go into significant detail here, but I’ll do a quick explanation and example. One could easily argue that driving in a car is dangerous and threatening, but most adults of driving age take that risk daily. However, if we end up in a car accident (as many of us have or will), why don’t we stop driving? After all, the danger was just proven to us and something bad did happen! Well, for a few reasons. One is that we have had many more times driving when we didn’t get into an accident, so we’re able to see that, although it’s possible, it does not mean it is highly probable. A second reason is that we may lose our job, social life, family, etc. if we allow this anxiety to prevent us from driving. Another reason is that we learned that, although it was unpleasant and uncomfortable, we tolerated it! We were able to handle the situation, problem-solve as necessary and move forward with the understanding that what happened was the exception and not the rule. So, if Person B experienced the dog getting down, barking at them, or even biting them, they would have learned that they can handle the situation, even if they didn’t like it. Scary things happening to us doesn’t have to be a bad thing. They are wonderful learning experiences, even when it’s hard to see that in the moment.
So, where’s the magic?
Well, that’s just it…there isn’t any. We don’t need any magic wands or smoke and mirrors; rather, we simply need to make an adjustment in our actions to make the magic happen! We are retraining our body and our brain by responding differently and approaching situations instead of avoiding them. This process alone begins building new pathways in your brain, getting you closer to taking control of your anxiety and fear. Even though it is a simple process, it can be difficult depending on the severity of the negative emotions and thoughts. It will take time, patience and practice, but with those things, CBT can do wonders for making significant life changes toward a happier lifestyle! My challenge to you is this: the next time you’re faced with a fear that you would usually avoid, try looking at it from a new perspective and approaching it instead of avoiding it. Maybe it’s a phone call you’ve procrastinated, or an assertive discussion you’ve been debating, or even looking at a bug outside. Whatever it is, see what happens if you approach it. Good luck!
