In the 40-something years since its introduction, cognitive behavioral therapy (CBT) has been studied extensively and proven to be highly effective in treating a wide range of disorders; ranging from alcohol and drug addiction disorder to psychiatric disorders, psychological problems and medical issues with a psychiatric component.
When patients change their underlying beliefs about themselves, their world and relationships with people through CBT, it can result in a long-lasting change in their character and behaviour. There’s a reason so many doctors and therapists regard CBT as the gold standard of psychotherapy and we’ll share some of them in this article.
What is cognitive behavioral therapy?
Cognitive behavioral therapy (CBT) is based on the idea that our thoughts, emotions and actions are all connected; and the way we think and feel about something can affect how we behave. The other key concept of CBT is that our thought and behavior patterns can be changed.
This involves a combination of multiple treatment approaches that help you recognise negative and destructive thought and behavior patterns and then equip you with the tools to reframe your thoughts in a more positive and helpful way.
Does Recovery Centre at White River offer cognitive behavioral therapy?
Yes, Recovery Centre at White River does offer cognitive behavioral therapy. It’s the cornerstone of our addiction treatment programme and is done in a group setting or in individual therapy sessions.
Why cognitive behavioral therapy is important for your recovery
Cognitive behavioral therapy is a valuable psychotherapy approach that can help you overcome alcohol or drug addiction as well alleviate crippling symptoms of depression, anxiety disorders and other mental disorders.
CBT helps you learn to identify negative, destructive and self-defeating thoughts that lead to poor life choices and risky behavior that often involve substance abuse. In the short-term, the therapeutic approach can help people with an addiction become abstinent. Over the long-term, the tools you’re given as part of CBT can help you live a happier and more fulfilling life free of the burden of your addiction.
How do negative thoughts and behaviour affect your wellbeing
From childhood to adulthood, we experience a cycle of thoughts and behaviour that have both a positive and negative impact on our lives. Stress, traumatic events and negative relationships can create inaccurate or negative perceptions or thoughts that eventually underpin emotional distress and mental health concerns.
If left unchecked, these unsettling thoughts and the distress they cause can lead to risky or harmful behavior. Eventually these thoughts and resulting behaviour can become a pattern that repeats itself in the form of substance abuse, gambling addiction, sex addiction and aggression.
Cognitive behavioural therapy teaches you to identify these destructive thought and behaviour patterns and helps you deal with risky temptations in a constructive way as they arise, which helps reduce more distress.
CBT is different from other types of therapy that focuses on talking about your past. CBT does not discount thoughts and feelings that have become part of your core beliefs. Instead, the goal is to make you a happier, less anxious person despite events and situations that have shaped how you view yourself, the world and the future.
Examples of cognitive behavioral therapy
|Self-defeating thought||Reframed thought|
|I’ll never have a lasting relationship||None of my previous relationships have lasted very long. Reconsidering what I really need from a partner could help me find someone I’ll be compatible with for the long term.|
|I am worthless and stupid||I am smart but I didn’t study for the test. I can do better next time.|
|I am a failure. I’m not cut out for this job.||Failure at this job does not define who I am. I have other strengths that I can concentrate on and I’ll find a different job where I can apply those strengths.|
|He doesn’t love me. He doesn’t want to spend time with me.||I know he loves me but he is busy, and he’ll will make time for me when he is finished what he’s doing.|
|Something bad is going to happen||Something bad is going to happen but I can cope. I am strong and resilient and I have people who love me and will help me cope with whatever happens.|
How does cognitive behavioral therapy work?
Cognitive behavioral therapy involves a combination of therapy techniques. Your therapist will work with you to find the type of therapy that works best for you.
Homework is a big part of CBT, regardless of the therapy techniques you use. During your treatment programme at Recovery Centre at White River, you’ll get a lot of homework that you’ll be asked to do in your own, private time.
It’s highly recommended that you do the CBT homework your therapist at the Recovery Centre at White River gives you because these therapy assignments are designed to help you become familiar with the tools you need to reframe destructive thought patterns. The more you practice the skills you learn in cognitive behavioural therapy, the greater your chances of ridding yourself of self-criticizing thoughts and meeting your recovery goals.
Here are some examples of CBT techniques that your therapist will use as part of the process of replacing unhelpful and self-defeating thoughts with positive, encouraging and realistic ones.
|SMART goals||SMART goals are Specific, Measurable, Achievable, Realistic and Time-limited|
|Guided discovery and questioning||When you question the assumptions you have about yourself or your current situation, your therapist can help you learn how to challenge them and consider different viewpoints.|
|Journaling||You’ll be asked to keep a journal where you write down negative beliefs that come up during the week and then your therapist will help you find positive ones to replace them with.|
|Self-talk||You therapist may ask you to repeat typical conversations you have with yourself about certain events, situations and relationships and then will challenge you to replace negative or critical self-talk with compassionate, constructive self-talk.|
|Cognitive restructuring||CS involves looking at any cognitive distortions affecting your thoughts. This is known as black-and-white thinking, jumping to conclusions or catastrophising. Your therapist will help you unravel these cognitive distortions and reframe them in a more balanced light.|
|Thought recording||This CBT technique involves coming up with unbiased evidence that supports your negative beliefs and evidence against it. Your therapist helps you to restructure this evidence to develop a more realistic thought.|
|Positive activities||Your therapist helps you identify a rewarding activity for each day that can help increase your overall positivity and improve your mood. Examples include walking in the park, buying yourself fresh flowers or listening to music that makes you happy.|
|Situation exposure||This involves identifying situations, events or relationships that cause you distress. You list them in order of the level of distress they cause and slowly expose yourself to the things that make you uncomfortable and create negative thoughts. Your therapist walks you through the situation and helps you reframe it in a positive way.|
|Systematic desensitisation||This technique is similar to situation exposure but it involves learning relaxation techniques that help you cope with the feelings and negative thoughts that bubble up when you’re in a particular situation.|
Brief history of cognitive behavioral therapy (CBT)
What is known today as CBT was a therapy technique pioneered by Dr Aaron Beck in the 1960s. Beck was a psychiatrist at the University of Pennsylvania and had tested several psychoanalytic concepts for the treatment of depression.
Failing in some areas, Dr Beck looked for other ways of conceptualising depression. He found that depressed patients experienced streams of negative thoughts that seemed to occur spontaneously. He called these “automatic negative thoughts (ANTs)”. Dr Beck found that the patients’ automatic negative thoughts fell into three categories:
- negative ideas about themselves
- negative ideas about the world
- negative ideas about the future
Dr Beck adopted a new clinical approach to helping patients identify and evaluate these ANTs. He found that by doing so, patients were able to think more realistically about certain situations. As a result, they felt better emotionally and were able to behave more functionally.
Dr Beck found that when his patients changed their underlying beliefs about themselves, the world and other people; therapy resulted in long-lasting change. Dr Beck initially called this approach cognitive therapy. It later became known as cognitive behavioral therapy or CBT.
Source: Beck Institute
Core principles of cognitive behavioral therapy
In 1976, Dr Beck outlined three levels of cognition. This is the way we think about things and the content of these thoughts. These three levels make up the triad of cognition and are dealt with in CBT using multiple techniques to identify, unpack and reframe beliefs and assumptions that are preventing you from living your best life.
- Core beliefs or schemas
Core beliefs are deeply held beliefs about your self, others and the world. They are generally learned early in life and are influenced by childhood experiences. Core beliefs are seen as absolute (not qualified or diminished in any way; total).
Negative views about oneself: “I am worthless”
Negative views about the world: “Everyone hates me because I’m worthless”
Negative views about the future: “I’ll never be good at anything because I’m worthless and everyone hates me”
- Dysfunctional assumptions
Dysfunctional assumptions are rigid, conditional rules that people adopt and live by. These may be unrealistic and maladaptive, meaning not adjusting adequately or appropriately to the environment or situation.
Dysfunctional assumptions arise from the deep well of core beliefs or schemas. They’re often expressed in terms of “if” or “should”.
Key characteristics of dysfunctional assumptions
- they do not reflect the reality of human experience
- they are rigid, over-generalised and extreme
- they prevent rather than facilitate goal attainment
- they are relatively impervious to ordinary experience
“It’s better not to try than risk failing”
“If someone is better at something than me, it means they are a better person than me”
“If I can’t do something perfectly, it’s not worth doing at all”
“If you don’t like me, there must be something wrong with me”
“If you don’t love me, I cannot be happy”
3. Negative automatic thoughts (NATs)
NATs are thoughts that are involuntarily activated in certain situations. Over time, NATs can become so totally familiar and ingrained in your thinking that you don’t even realise they are there.
NATs are the silent assassins of confidence, creativity and success. They guide your beliefs and perceptions and control how you respond to a situation.
In depression, NATs often affect your positivity, your self-esteem and sense of worth.
In anxiety disorders, NATs often include overestimating risk and underestimating your ability to cope.
“This is too difficult, I’m going to make a fool of myself and people will laugh at me”
“I’m going to fail, it’s not worth trying, I feel worthless”
“I’m not good enough, I’ll never get that promotion, I’ll be stuck in this position forever”
“My partner’s not talking to me, he must be cross with me, he doesn’t love me anymore”
“My friend went to the movies and didn’t invite me, our friendship was never serious, it’s over”
How is cognitive behavioral therapy different from other psychotherapies?
CBT differs from other therapies because of its emphasis on the core theory that how we perceive a problem or a situation causes negative or dysfunctional emotions. What makes this type of therapy different is it does not concentrate on your past and it does not attempt to interpret your negative thoughts and perceptions.
CBT purely deals with reframing what Dr Beck termed automatic thoughts and correcting patterns of negative thinking. It involves therapy methods such as free association, accessing the unconscious and understanding defense mechanism.
For example, if someone stands you up for a date, it’s not the act of being ‘stood up’ that can make you angry and hurt but rather, how you view the entire situation. If you are prone to anxiety or depression, you may look at the event as somehow “your fault” and it’s reflection of your inadequacy or worthlessness.
CBT teaches people to immediately stop that kind of thinking and to instead, view what is happening as “having nothing to do with your worthiness”.
CBT can be done in group therapy but considering the intense individual nature of CBT, a one-on-one environment with a trained CBT therapist is best. As mentioned previously, CBT involves homework where you benefit from practicing the skills you’ve learnt outside of the therapy environment.
Can you learn cognitive behavioural techniques by yourself?
Yes, it is possible to learn cognitive behavioural techniques without the help of a CBT therapist. If you are interested in CBT and you don’t have access to a CBT therapist, there are multiple options for doing CBT on your own. Find a good resource book on CBT or an Internet-based treatment.
Many studies have shown that self-directed CBT can be very effective. Obviously, it’s recommended you have a few sessions of CBT with a trained therapist at treatment centre like White River. A one-on-one session with a CBT therapist will be very helpful if you’re living with an anxiety disorder, depression or an addiction.
How can cognitive behavioural therapy help you overcome alcohol or drug addiction?
Negative automatic thoughts (NATs) are often a root cause of anxiety and depression which are both common co-occurring disorders with alcohol or drug addiction. And often, people self-medicate with prescription drugs or deal with their NATs by drinking alcohol or abusing hard drugs which eventually leads to a dependence and risky or life-threatening behaviour.
If you are living with an addiction, CBT can be very helpful in three ways:
- It can help you dismiss false beliefs and insecurities that lead to substance abuse
- It can provide you with tools to eliminate or reduce NATs that fuel your addiction
- It can teach you effective communication skills which you will need on your path to recovery
How can we help?
CBT is the cornerstone of our addiction-care treatment programme at the Recovery Centre at White River. If you or a loved one believe you could benefit from the healing power of CBT, please contact us for further support and assistance.