13) What is CBT ?

A Series of "short introductions" to Mental Health.

By Peter Thompson Dip.Couns. MNCPS (Acc.)

13) What is CBT?

Some people refer to CBT as a quick fix. This is certainly how employers and emergency services use it when offering counselling to employees and service people.

It causes the client to re-learn how to process their thoughts, so that scenarios and events that currently cause them issues such as anxiety are reduced in effect.

Although Pavlov and his dogs may have paved the way, it came about in the mid- 50's when Albert Ellis developed REBT (Rational Emotive Behaviour Therapy) and Aaron Beck developed Cognitive Therapy . With these two leading the way and others following in their wake new approaches were introduced to assist people with damaging thought processes such as living with life challenges, disabilities, alcohol, fear, anxiety and depression as well as many more.

It asks the client to become more aware of the difference between Rational and Irrational thoughts on which we based our outcomes. For instance if you slipped on some ice 30 years ago why after all the times since that you have remained upright do you still fear walking to the shops in the winter.

Or if you have a fear of heights that prevents you from a walk in the mountains, your thought processes can be changed to overcome the anxieties and enjoy more of life.

The work involved in CBT is very much in the present. It doesn't often spend time in the past other than to possibly identify a trigger.

It will include challenging yourself to attempt a small percentage of the feared action over a period of time by considering the rational versus the irrational outcomes and then committing to the action.

It also requires the individual to congratulate themselves after each step has been taken successfully or to at least understand why they were unable to overcome the challenge when unsuccessful.

The need to think positively about your actions is required and the client benefits from the weekly improvements that they hadn't considered themselves capable of previously.

Depending on the embeddedness of the triggers behind the initial self defeating thoughts, issues can range from Life threatening experiences to the sight or smell of alcohol or as previously stated, slipping on the ice.

For instance someone afraid of heights may challenge themselves to visit a mountain or climb a ladder, but over a period of weeks make the task a little more each time. Walk the mountain path until it becomes too uncomfortable or climb the ladder a rung each week. This is called phased exposure. Like the runner who pushes to the next lamp post each run. Until you are more at ease with how far you can go. Each time reward yourself with positive words when finished.

However there are obviously more battles to fight when "say" a firefighter has witnessed the loss of a colleague or the alcoholic is trying to absent themselves from the regular habits that satisfy their need for the effects of the alcohol.

The common task in all these is to weigh up Rational v Irrational - Logical v Illogical and Good v Bad.

This can be done in the mind as well as committing to paper by way of  Debit and Credit ledgers.  Journal writing. Worksheets breaking down our reactions physical and emotional. Always challenging the negative outcome that the mind is conditioned to go to by asking WHAT IF? 

We always know the outcome we really want and how we can obtain it but the fear or the habit / addiction has proven to be too strong for us to challenge in the past. Until we really try to take it on using CBT.

So CBT has its important uses but does it prevent a relapse. Yes preventative work was done in therapy to keep the initial triggers at arms length. But has the route cause really been investigated as to why the trigger exists in the first place. Why the vulnerability actually exists.

For these to be addressed fully in order to defeat them work between client and counsellor must be at a more relational depth. And the individuals life history must be looked into to assess the damage different negative experiences have had on the person since the age of the incident to the now.  In my experience people can allow these triggers to control their lives for decades.

The person who at the age of 8 was told by their mother that they were selfish and has now spent 50 years overcompensating by developing a self-damaging giving personality. 

Or the person who was brought up in a male dominated 70's household who has spent 40 years with a lack of respect for women.

Please look into how Cognitive Behaviour Therapy works because it is very interesting how the mind can be manipulated for good and bad. 

How we can change into a helpful member of society or into a threat to those around us and further.

Cheers