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What is CBT and How Does it Work?

Mental health treatment has come a long way in the last decade or so. Many of us now understand the full impact of knowing that ¼ of us will go through mental illness at some point in our lives. This has led to a greater awareness amongst everyone and a determination to develop methods and therapies that do not always include (or require) medication. Mindfulness is one such treatment, useful for low-level anxiety and blues. CBT, or Cognitive Behavioural Therapy, is another.

What is CBT?

CBT, or Cognitive Behavioural Therapy, is actually a rather simple concept. It takes the basic idea that talking through your thoughts and feelings are required in mental health treatment. Like visiting a counsellor, you talk through your difficulties. We underestimate the importance of talking therapy in treatment, even for physical medical condition, in making people feel better.

Essentially, CBT combines two much older treatment methods:

  • Cognitive Therapy – the idea that a therapist or counsellor listens to what you are thinking or feeling and helps you to make sense of them by analysing them
  • Behavioural Therapy –examining behaviours and providing analysis. Sometimes, these two things go hand in hand

When analysed, the therapist or counsellor will make alternate suggestions to the negative self-perception and negative behaviour. By challenging these thoughts and actions with logic, alternate scenarios, alternate ways of looking at things and simply providing “but what if…” suggestions, the idea is that the patient will be much kinder on himself or herself.

CBTThe Tools of CBT

The great thing about Cognitive Behavioural Therapy is that it does not necessarily require a therapist. CBT is something that a person may use as a form of self-help. I you do use CBT software or a book you should ensure it is either on the NHS recommended list or seek direct medical advice about it from your GP. The tools are simple and useful, and when applied properly and effectively, can provide lifelong assistance. It does require disciplined and regular use.

  • It encourages you to create diagrams of negative thoughts, feelings and actions (such as a flow chart) and then to “break” the vicious circle by first understanding and then challenging it
  • By asking difficult questions that you may have been avoiding, and then encouraging you to write out several answers to the question (such as “best likely outcome”, “worst likely outcome”, “most reasonable explanation” and “least reasonable explanation”)
  • By helping you to identify the negative thought patterns for what they are and giving them names “avoidance tactics”, “catastrophising” and so on

The Conditions for Which CBT is Most Useful

CBT is not helpful for all mental illnesses. It works best for those conditions that centre on thoughts, feelings and actions. We are talking about conditions such as:

  • Anger: This can sometimes have an underlying cause such as depression and anxiety. Anger is a common depression symptom in men, but is rarely recognised as such
  • Anxiety / panic attacks: Anxiety is often the result of strong negative thoughts and feelings about one’s ability to cope (as one example)
  • Depression: Similarly, one symptom of depression is spiralling into negative thoughts about what one deserves or does not deserve. It treats some symptoms, but is not a treatment for all symptoms. Medication may be needed
  • Alcohol, drug and eating disorders: Addiction is complex and in many cases, is a mental health issue. Where there is an underlying mental health cause, substance abuse and eating disorders can benefit greatly from some forms of CBT
  • Sleep difficulties: Anxiity and depression can sometimes be a root cause of lack of sleep (although there may be other explanations too). CBT may help you understand what it is and how to alleviate it