Welcome back to our “Types of Therapy” series, our way of helping you navigate potential avenues of treatment as you pursue therapy. Today, we’ll be covering one of our staples at bareWell - Cognitive Behavioral Therapy, or CBT.

What is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy (CBT) was developed in 1960 by Aaron Beck while working with depression patients. He noted that most of their experiences were based on cognitive distortions or incorrect assumptions about their experience based on exaggeration. This led to him studying his patients in a new way that factored cognition, emotion, and behavior, which paved the road for what CBT has become today. Much like what we described in our blog about narrative therapy, our perceptions, expectations, and narratives can shape our day-to-day experiences. When these perceptions take on a negative tinge due to cognitive dissonance, they can often negatively affect us in many ways. Cases like this are where cognitive behavioral therapy may be helpful to you or someone you love. Going forward, we’ll give you more insight into what CBT practice entails, what to expect when beginning CBT, and whether cognitive behavioral therapy might be a good fit for you. 

Cognitive Behavioral Therapy Focal Points

Cognitive behavioral therapy focuses on addressing unhelpful thought patterns in three main aspects: automatic, cognitive, and underlying beliefs or schemas.

Automatic Thoughts: are surface-level reactions to events. Think of them as your gut or knee-jerk reaction. They are often based solely on our impression of an event without any meaningful processing or emotional stabilization. Though shallow, automatic thoughts inform an individual's emotional state and response. For example, those with automatic distortions might take something like a friend not responding to a text as a sign they're angry at them or don’t like them anymore. As a response to this negative perception, they may feel disappointed or choose to be distant with the friend the next time they meet. This behavior further reaffirms the cognitive dissonance and creates a negative feedback loop.

Cognitive Distortions: are a general descriptor for unhelpful thought patterns and happen on a deeper level than automatic thoughts. Our surface perception, or automatic thoughts, filter through cognitive distortions and can produce an unsavory outlook of ourselves and the world around us. Cognitive distortions are fallacies or gaps in logical thought. Cognitive behavioral therapy can address all of the following types of distortions:

• Overgeneralization: Taking one situation and using it as a marker for all other decisions and perceptions. Making issues black and white with no space for grey in between.

• Selective Abstraction: Uplifting negative aspects, while ignoring the rest or discounting positivity to vindicate a negative perspective.

• Mind-Reading: Assuming the thoughts or perceptions of others, or assuming an outcome.

• Emotional Reasoning: Basing decision-making on how you feel as opposed to rationality.

• Attribution: Assumption that you or another person is entirely responsible for a negative outcome.

All of these can make it difficult to see things for what they really are. Failure to address the truth of the situation can lead an individual to act rashly and hurt themselves or others. 

Underlying Beliefs or Schemas: are at the deepest and most personal level. These distortions are deeply personalized and often have to do specifically with the individual who is struggling with their mental health.  Schemas fall into one of two categories: core beliefs and intermediate beliefs. Core beliefs represent central ideals that directly apply to the person or their world, whereas intermediate beliefs are more like general rules someone feels they must follow for survival. These two inform each other and regularly overlap. You can better understand by looking at an example: if someone has the core belief “I am unsafe” then a likely intermediate belief is “I have to look out for myself”. When negative or unhelpful mentalities affect the core of your beliefs or your sense of self it can feel nearly impossible to remove those stigmas. This is why having a cognitive behavioral therapist is deeply helpful in changing these ways of thinking.

What to Expect in Cognitive Behavioral Therapy

Cognitive behavioral therapy at its core seeks to address these cognitive distortions and asserts that by addressing unhelpful patterns in thought and behavior you can heal from various mental health struggles. This form of talk therapy allows patients to work through unhelpful thought patterns and personal beliefs and replace them with more regulated and realistic ones. It addresses inflexibility of thought, deeply held negative self-perceptions, and problematic or damaging interactions with others. By choosing to begin with cognitive behavioral therapy, you will work collaboratively with your therapist to address your feelings and patterns of thinking. Then formulate a constructive way of coping that is unique to your needs. Though everyone will have a different journey, a standard cognitive behavioral therapist will likely employ the same base techniques while working with a patient, such as recognizing and rewriting distortions, facing your fears in a safe environment, developing coping skills, and developing a positive self-image. CBT places an emphasis on clients being able to use what they learn in therapy to real-world situations they may face. Due to this, most of the work is around learning to identify potential triggers and common distortions, and learning techniques to reframe and self-soothe when they arise. There is also an emphasis on “homework” between sessions, where patients can exercise and reinforce the lessons that they have learned to greater effect. CBT also focuses primarily on the patient's current life and proactive methods of moving forward in a healthy way. Though some types of therapy focus heavily on formative events, CBT addresses what is presently happening. 

Is Cognitive Behavioral Therapy Right for You?

Now that we’ve addressed the focus on cognitive behavioral therapy and the treatment that is available, we can ask the important question: Is it right for you? CBT is one of the most widely practiced, and researched forms of therapy. It can be extremely beneficial for those who struggle with excessive negativity in their thoughts or self-image. Those with depression, anxiety, eating disorders, substance abuse, marital issues, and other severe mental health challenges might benefit from Cognitive behavioral therapy, as it’s well-documented to improve those conditions. It is also highly recommended as a pairing to those who are utilizing pharmaceutical therapy, as it can improve outcomes compared to medicating alone. To learn more about bareWell’s approach to CBT, or to learn more about what therapy you might benefit from you can contact us. Whether you choose to pursue CBT, narrative therapy, or another type we can connect you to a certified clinician or therapist within our branching network, so long as you are a resident of California. As always, thank you for joining us for this iteration of the blog. We hope that it has provided you with valuable insight to help you along your wellness journey.