Dr. Maria D. Reyes
Whether you suffer from depression, anxiety, Obsessive-Compulsive Disorder, Attention Deficit Hyperactivity Disorder, or another mental health condition, the techniques found in CBT could provide a breakthrough for you.
What is Cognitive Behavioral Therapy?
American psychiatrist Aaron T. Beck is considered the founder of cognitive therapy and Cognitive Behavioral Therapy. During his practice in the 1960s, Dr. Beck observed his patients changing their feelings during their sessions with him. When he questioned the patients, he learned that each one ran an inner monologue with positive or negative thoughts.
These thoughts would create feelings within the individual. The patient would then act on those feelings, changing their behavior. Even if the patient’s thoughts were not a true representation of the facts (ex: the patient thinks the psychiatrist is unhappy with their progress), the patient’s thoughts would form a belief. These beliefs would cause a negative feeling, creating a new behavior (ex: the patient becomes tearful or aggravated during the session).
Beck realized that his patients, who he was treating for depression, thought negative thoughts in continuous streams. He named these negative thoughts “automatic thoughts” and stated that the thoughts generally were about the person, the world as they saw it, or of the future.
Beck explained that the different mental health disorders were caused by these negative thoughts, which he termed distorted thinking, and vary between disorders. For example, someone with Obsessive Compulsive Disorder will have a different distorted thought pattern than a person suffering from depression, although the thoughts of both patients will reveal their core beliefs about themselves. According to many researchers, these core beliefs originate during childhood and throughout life.
What to Expect with Behavioral Therapy
Since CBT is a personal therapy, most likely you will receive treatment one-on-one with your mental health care provider. Unlike other psychotherapies, cognitive therapy is a short-term treatment that can last anywhere from 10 to 20 sessions depending on the severity of the condition. In some cases, patients may receive behavioral therapy for a little less than one year. Although the treatment is short-term, the techniques you learn can help you for a lifetime.
Typically, patients meet with their psychiatrist once a week for a session that lasts less than one hour. The provider will help the patient to identify problems and goals they want to work on during CBT.
For example, if a recently divorced single mother is suffering from depression and isolation, her goal may be to step out of her comfort zone and do things with friends away from home and her children. She may practice reaching out to a friend, scheduling a date, and securing a sitter for the evening. At her next session, the mother and her therapist will analyze what worked and what didn’t that week, then create a new assignment.
Each cognitive therapy session is structured to discuss the new week’s plan, homework assignments to complete outside of the session, and progress or setbacks the patient may have faced during the week. Depending on your condition, your therapist may include other treatments such as medications or family counseling.
There may be times that your therapist believes you will benefit from group therapy. Certain conditions respond well to sharing the struggles and successes with others. Your therapist can see more patients at once and develop a peer program. Group therapy works well for those patients recovering from substance abuse or other addictions, and those with eating disorders.
The sessions and homework assignments can become emotionally charged as you break through certain obstacles and out of your comfort zone. Homework assignments could include readings, journaling, or other activities. You should try to complete the homework assignment for each week, so you can discuss the results with your therapist at the next session.
After several sessions, if you feel that Cognitive Behavioral Therapy is not benefitting you, speak to your psychiatrist about changing the mental health care plan or switching psychotherapies. However, remember that Cognitive Behavioral Therapy techniques may take time to root out deep-seated beliefs and change behaviors. Give yourself grace during each session and with the homework activities.
Cognitive Behavioral Therapy Exercises
Therapists may employ several CBT exercises based on each individual’s condition. The goal of the exercises and homework assignments for a person suffering from an eating disorder will probably differ from those activities the patient with depression follows in their treatment.
What types of exercises can you expect during behavioral therapy? The following are a few of the most common CBT exercises:
- Cognitive Restructuring exercises
- Exposure exercises
- Successive Approximation exercises
- Mindfulness exercises
- Body Relaxation exercises
- Breathing Relaxation exercises
- Journaling exercises
Cognitive restructuring exercises identify negative automatic thoughts and reframe them to elicit a different and positive belief. In this exercise, you may identify those negative thoughts as always geared towards a catastrophe, assumptions of what another person is negatively thinking about you or notice patterns of all-or-nothing thinking.
Exposure exercises come in many forms but are safely led by a therapist. In graded exposure, the patient is exposed to the thing they fear repeatedly to reduce their overwhelming anxiety as they learn to desensitize from the experience. If you struggle with compulsions, you can use exposure exercises to learn to withstand the trigger without giving in to the compulsive behavior.
If you experience nightmares, your therapist may suggest nightmare exposure. With this activity, you will allow yourself to bring on the nightmare and confront your emotions about it. Eventually, with your therapist’s help, the nightmare and its representations will take on a different meaning in your mind, becoming less scary.
Successive approximation exercises help reduce anxiety when faced with large, insurmountable goals. Instead of allowing the goal to become debilitating, you learn to break it into smaller goals, and then into bite-size tasks and milestones. This can be extremely helpful to patients with eating disorders, obesity, and Obsessive-Compulsive Disorder.
Mindfulness exercises bring you back to the present moment instead of reliving the past or worrying about the future. This technique is the opposite of multitasking as you need to focus on one activity at a time. Children with Attention Deficit Hyperactivity Disorder may benefit from the calm brought on from mindfulness techniques.
Body relaxation exercises can help you to let go of stress and anxiety. You can learn how to relax your body in specific muscle groups or as a head to toe practice, releasing each body part one at a time. By connecting your brain with your body, your mind has a chance to focus and destress. These relaxation techniques can help relieve the physical tension patients with anxiety feel in their shoulders and upper back.
Breathing relaxation exercises can be combined with the body relaxation exercises to bring your symptoms of anxiety or panic attacks under control. By focusing on your breath, you can reduce the fear you feel from shortness of breath or rapid heart rate during an attack.
Journaling exercises are helpful to identify automatic thoughts and distorted thinking. You can reflect on thoughts, feelings, and your reaction to those emotions. You may want to share some or all of your journal entries with your therapist.
How Cognitive Therapy Can Benefit Your Mental Health
Cognitive therapy has been known to successfully help patients suffering from:
- Eating disorders
- Chronic pain
- Obsessive-Compulsive Disorder
- Attention Deficit Disorder
- Attention Deficit Hyperactivity Disorder
- Panic attacks
- Anger management
- Post-Traumatic Stress Disorder
- Childhood Abuse/Trauma
- Mood swings
- Sleep disorders
Since cognitive therapy changes how a patient processes their thoughts and emotions, the principles of CBT can be applied to non-mental health issues as well, such as solving complicated problems.
Using cognitive behavior techniques combined with your Christian counseling can help you remember who you are in Christ and uncover the truth of what God thinks about you, cutting through the distorted thinking.
“Don’t Give Up”, Courtesy of Dan Meyers, Unsplash.com, CC0 License; “Head Rush”, Courtesy of Joel Naren, Unsplash.com, CC0 License; “Mindfulness”, Courtesy of Lesly Juarez, Unsplash.com, CC0 License; “Breathe”, Courtesy of Tim Goedhart, Unsplash.com, CC0 License