What is Cognitive Behavioural Therapy?

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What is Cognitive Behavioural Therapy? 2017-05-18T15:19:09+00:00

What is Cognitive Behavioural Therapy (CBT)?

(Short-term therapy with long-term results)

CBT at Hope Rehab, explained by Henk Nagel

Cognitive-Behavioural Therapy (CBT) is concerned with the relationship between thoughts and behaviour. One of the assumptions here is that the way you feel about a situation will depend on your beliefs about it. It also means that the way you act in any given situation is going to be influenced by your beliefs, so changing these beliefs is going to impact your behaviour. CBT is an evidence-based practice, and this means that reputable research backs its effectiveness.

Cognitive-behavioural therapy is now the most popular and widely used form of “talk-treatment” or counselling in the world, used for every type of problem. It is quite simple. It’s like learning a new language, however, it does take practice, which is not easy unless you are in a helpful environment, like a rehab.

In a nutshell, the cognitive model proposes that dysfunctional thinking…is common to all psychological disturbances…When people learn to evaluate their thinking in a more realistic and adaptive way, they experience improvements in their emotional state and in their behaviour.

– Judith S. Beck & Aaron T. Beck

CBT for People Dealing with Addiction Problems

CBT is one of the pillars of the treatment program offered here at Hope Rehab (the other three pillars are mindfulness, 12-step work, and wellness therapy). This approach helps you understand how your thoughts affect your behaviour, and it provides you with tools to help you stay sober and live more effectively.

Two important ways in which CBT can help your recovery is by teaching you to recognise high-risk situations, and by providing you with tools for coping and dealing with potential threats.

How does Cognitive Behavioural Therapy work?

CBT is known as a psychological intervention that includes many helpful written assignments, similar to school work but the subject is you.

CBT-therapists call your thoughts self-talk.

The A-B-C Model of CBT that Psychologists use to look at your thinking

The ABC model is a tool that you can use to better understand how your beliefs impact your behaviour.

Activating Event

Beliefs

Consequence

Dispute

Effective New Philosophy

Trigger

Self-talk

What…

Changed attitude

Affirmations & Actions

What happened?

Write down all your thoughts?

Feelings & Behaviour e.g. drinking?

Can you change your thinking?

New way forward

The ABC model is going to be easier to understand if we use an actual example. John’s girlfriend has told him their relationship is over (activating event). He reacts badly to the news, and he decides that this means his life is over (belief) and that he has lost his only chance of happiness. John becomes depressed and turns to alcohol for comfort (consequences).

During your time at Hope Rehab, you are going to be encouraged to use the ABCs to rid yourself of dysfunctional beliefs. This simple tool is not only effective at helping you deal with addiction thoughts but any belief that is holding you back. With practice, applying the ABCs to situations becomes a habit, and this is going to boost your self-esteem and increase your ability to behave effectively in life.

Clients can change the way they think about any issue and reprogram themselves with new helpful and healthy thoughts and beliefs. Below is an example of an addict’s possible beliefs system:

Other examples of distorted thinking are:

  • I can’t live without it

  • I deserve it

  • I am weak

  • I need it

  • It helps me

  • I can’t say no

  • Everyone does it

  • gambler might need money yet by gambling he is highly likely to lose financially.

  • An alcoholic may trigger episodes of depression by drinking to improve mood.

  • sex addict may be unable to experience real intimacy because of an obsession with the sex act.

For everyone that comes to Hope and changes their life, I know a lot more people’s lives are improved – The three steps to change are

1) summoning the courage needed to look at yourself and make the change

2) to unload the burdens you are carrying, and

3) getting in touch with the innocent child within and resolving your inner conflicts.

Recovery is an adventure, a hero’s journey.

Impaired or distorted thinking

CBT-therapists have classified different types of distorted thinking that most humans engage in from time to time. It is unhealthy when it’s rigid and irrational, or emotional thinking that does not stand up to reality testing.

  • Black or white thinking – can induce anger

  • Emotional reasoning – feelings are not facts

  • Catastrophising – can induce anxiety

  • Futurising – produces lack focus

  • I cant-stand-it-it is – lack of confidence

The originator of this form of therapy was the psychologist Albert Ellis and his Rational Emotive Behavioral Therapy REBT, later the psychiatrist Aaron Beck developed what is now called Cognitive Behaviour Therapy CBT and used to treat almost every disorder thinkable.

Obsession is when we take a little reality and add our fantasy to it – as Shakespeare said ‘There is nothing either good or bad, that thinking makes better.’ I find using CBT is the safest work through my difficulties.

Cognitive Behavioural Therapy: ABCDE – a more in-depth explanation

A = Activating events or triggers

Basically speaking most human beings will have two primary goals, to survive and to be happy. Events can activate negative thoughts, feelings and behaviour that threaten these goals.

For example, not all people will develop the same thinking and reactions around the same events. Why? Because we all have different thresholds, which are mainly based on our biological make-up, culture, life experiences, levels of education and so on. Therefore, knowing your A’s will help you to know where your threshold lies, and what pushes your buttons.

Events activate our core beliefs about ourselves, and also our supporting or reinforcing beliefs about the world and other people.

B = Core beliefs & self-talk

Beliefs are about what you consciously and unconsciously believe about daily events in your life and your subjective interpretation according to your viewpoint. They manifest as assumptions, automatic thoughts (hotwired) and rigid personal life rules.

For example, you may have lost your job or a relationship, and in order to make sense of this event, you may interpret it as an act against you. Now you are left with the choice between believing that your interpretation is true or untrue, e.g. “because you are bad or the others are bad” this leads to consequences for you, reinforcing your old negative belief system or getting angry, acting out, drinking and so on.

Remember our belief system is laid down during our early development and sits mainly in the unconscious; our conscious adult mind filters it out (the denial system) unless we do this work and look for it. Basically, when it comes to beliefs, we need to know if our beliefs are:

Rational = usually flexible, realistic, undemanding and objective

OR

Irrational = rigid, unrealistic, demanding and subjective.

We find our beliefs by listening to and working through layers of our thoughts (self-talk).

C = Consequence (emotional & behavioural)

As stated earlier, the way we “feel and act” after experiencing a difficult activating event will be heavily dependent on our personal interpretation and our beliefs about our interpretations.

In CBT we see two kinds of negative emotions:

healthy negative emotions: sadness, concern, healthy anger, regret, disappointment, and concern about a relationship.

OR

unhealthy negative emotions: depression, anxiety, unhealthy anger, shame, hurt, jealousy and envy.

Also, if an activating event triggers our fight or flight defence mechanism and our negative thinking about the event makes it worse, we tend to lose control in the short term.

D = Disputing old beliefs and self-talk

At this stage, you will start to identify what your core beliefs are and now you need to test them to see if they are rational, healthy and up-to-date.

One way is to dispute your layers of negative self-talk by matching it to types of distorted thinking, catastrophizing, black and white thinking, self-downing (see the list).

Another way is Socratic questioning; being your own detective looking for the facts and evidence.

  1. Empirical” disputing, where you ask yourself questions such as;

Where is the evidence that shows that my beliefs are true?

  1. Logical” disputing, where you ask yourself questions such as:

Is it logical to turn my desires into demands?

  1. Pragmatic” disputing, where you ask yourself questions such as:

Have my beliefs helped me so far?

E = New effective philosophy

This kind of therapy is not a quick fix. In order to feel the therapy’s full rewards, you will have to work on yourself by using this tool daily.

Self-fulfilling prophecy: We go on manifesting what we believe, and this works positively also. So when you know you negative core beliefs create an affirmation to counter it. We tend to limit ourselves with our own beliefs in life.

Additionally, we take actions, paradoxical behaviours, we don’t just try and stop doing negative things we force ourselves into new positive behaviours by practising what we call exposure therapy, facing our fears.

People are not disturbed by things, but by the view, they take of them.

– Epictetus, 55 AC to 135 AC

At Hope, we use Cognitive Behavioural Therapy in combination with 12-Step therapy, mindfulness & exercise.

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