• Eleanor

What is Cognitive Behavioural Therapy? (CBT)


Simply put, cognitive is what we think, and behavioural is what we do

The theory behind Cognitive Behavioural Therapy is that what we think and what we do can influence how we feel. CBT is focussed on the connections between thoughts, emotions, feelings and behaviour.

There are common misconceptions that CBT can help to stop feelings, this is not true. CBT is not about stopping thoughts, or switching off feelings, it is about managing them and changing your relationship to them when they are shown to be unhelpful. In CBT we look at patterns, learnt ways of doing and thinking, and see what could be different. 


How does CBT differ to other therapies?

CBT is less focussed on the past than psychoanalysis and psychodynamic therapy. Having said that, the origins of us and our issues is always relevant in therapy and will be here, too. Often in CBT we might draw a formulation that includes the history of an issue to help us understand how this is being repeated, or enacted in the present. We need to understand the root of an issue to be able to change it. If you can identify a negative voice or belief as belonging to an unhelpful person or situation from the past, then you can choose whether you want to keep listening to it in the present, and catch it when it is activated.

What does it look like?

In CBT I will be asking you to do some of the heavy lifting, that means that rather than therapy being just about what we talk through in the room, there will be exercises and things to try outside of sessions. To help you form new healthier habits, thoughts, and perspectives will often mean pushing you outside of your comfort zone. Gently, letting you experience situation that make you a little anxious to allow you to build up your experience of yourself as someone who is able to cope.

In sessions we will look at what you have been able to do outside of the sessions to build up a picture of how things are, and how you want them to be. I will be actively guiding you in line with the goals we set out and adjusting these with your feedback, week by week.

What kinds of issues can CBT help with?

CBT is very effective with many different forms of anxiety and issues where there is a pattern or habitual way of being or thinking that needs to be changed. CBT for social anxiety can support you to understand why you find it hard to be around people, to understand and manage your anxiety, and to gently guide you towards taking social risks and chances, to prove the negative thought cycles wrong.

CBT for health anxiety can explore the historical reasons for worrying about health and look at the behaviours in the present which reinforce worry, such as checking or googling symptoms. CBT for performance anxiety can tackle fear and avoidance which reinforce feelings of not being able to cope. CBT for alcohol and drug addiction looks at the patterns and behaviours that keep substances actively in your life to allow you to make choices towards change. CBT for depression can support you to take steps back towards an active life, and challenge the negative thought cycles that keep you stuck, when that feels too overwhelming to do alone. CBT for low-self esteem tackles negative thoughts and beliefs about yourself, and supports you to form new narratives about who you are.

What is an example of this kind of work?

Perhaps you have been dealing with anxiety for years and you don’t know why. It affects many aspects of you life, from travel, to meetings at work, to being able to go to new places. In therapy we look back to find out when you first felt it. We find you were travel sick a lot as a child, then, as a teenage you had a panic attack on a bus which was overcrowded on a very hot day. Since the panic attack we release you have slowly reduced travelling on public transport, first of all avoiding rush hour, then when the bus looks too busy, until it feels difficult even to wait at the bus stop. During the course of therapy I guide you to start challenging yourself, to slowly and surely build your confidence. We start small and easy, and build up to the biggest fear, you grow in confidence along the way. As confidence grows, you feel more able to tackle the other areas of life that had been causing you worry, your core beliefs about yourself become stronger and more confident.


In conclusion

Cognitive behavioural therapy can be helpful for many issues. It takes a pragmatic approach, looking at what is affecting you now and promoting change through understand and challenging fears. CBT is an active therapy, we work on formulations and experiments together and you carry this on between sessions, too. CBT can be very effective for anxiety, self-esteem, insomnia, substance misuse, and much more.

Get in touch to find to how CBT could work for you