What’s “CBT” Anyway?

You may have heard about CBT, or cognitive behavioral therapy. After all, it’s been around for a while. The main components of modern CBT were created around the 1960’s — over 70 years ago.

CBT is so very different from standard supportive therapy. If you’re used to a therapist sitting back and letting you chit chat through sessions, CBT will feel very different. Therapists doing high-quality CBT get there in the trenches with you. They work to use their skills to help you identify and organize the problem and actively work toward a resolution using science-proven tools and strategies.

The main idea in CBT is that our thoughts, feelings, and behavior are intricately linked.

Let’s think about depression as an example. Many people with depression struggle with thoughts of their own unworthiness. Their minds may say things like, “No one likes you,” and “You’ll never succeed at the things you try.” Depressed people often believe these thoughts, and then — they act on them. They change their behavior. A depressed person might start withdrawing from social interactions out of fear of rejection, and they might give up on the things they try because they believe they will fail.

Believing and acting on these thoughts creates a vicious cycle. Now, the thoughts may be more true than they were before. Your friends may like you less when you flake on their parties. You may not succeed in your career if you give up quickly on new tasks out of fear of failure. This is the spiral of depression.

People often come to therapy because they want to feel better. They want to feel less sad, have fewer nightmares of past trauma, overcome fear, feel less insecure. But feelings are challenging to change directly. Have you ever tried to cry on command? Or feel genuinely happy to receive a disappointing gift? Feelings arise in response to our experiences, and in response to our interpretations of those experiences.

Luckily, we do have some influence over our feelings, because we have some ability to 1) reconsider our interpretations, and 2) change the kinds of experiences we have, through changes in our behavior. And this, my friends, is why CBT works.

Let’s come back to this person with depression, struggling with the thought, “No one likes me.” They may receive a text message from a friend, inviting them to a party, and what does their brain say? “Don’t go. They don’t really want you to come.”

A CBT therapist would see if there is a way to consider this interpretation of the situation. “Does someone invite you to their party if they really don’t want you to come?” CBT involves a careful exploration of this interpretation and what might be a more helpful and accurate assessment of the text message.

It doesn’t necessarily help to be overly rosy.

“Gosh darn it, people like me” just might not be true. But maybe rather than “they don’t really want you to come,” it would be more fair to say, “our friendship isn’t as close as it used to be, but if they invited me to the party, they probably want me to come.”

That little window of new perspective may be enough to get that depressed person out the door. And if they have a good time? The spiral of depression starts to unwind.

CBT tends to look different depending on the specific problem you’re coming to therapy for. Makes sense, right? People’s struggles with their mental health are as complex and varied as any human experience. There are even different names for different forms of CBT (e.g., ERP, PE, and DBT are all forms of CBT), adding to the confusion. But the core of CBT is the same:

1) Are there unhelpful interpretations, conscious or unconscious, that are contributing to the way you are feeling?

2) Is there a way to change your behavior in order to give you more access to new experiences that might help you feel better and form new perspectives?

If this approach sounds like it could be helpful for you, you should find a true CBT specialist. Many therapists say they do CBT, but may have only taken a weekend course in how to do this therapy, whereas CBT specialists may have spent many years of training focused specifically on deepening and honing their CBT skills. CBT specialists often keep profiles in the following search engines:

ADAA’s Find a Therapist Directory: https://members.adaa.org/page/FATMain

ABCT’s Find a Therapist Directory: https://services.abct.org/i4a/memberDirectory/index.cfm?directory_id=3&pageID=3282

IOCDF’s Directory: https://iocdf.org/find-help/

And, of course, we are committed to offering the highest quality of CBT at the Anxiety and Trauma Clinic of Atlanta (anxietytraumaclinic.com).

Below you can find an infographic summing up some other essential parts of CBT. Feel free to share this infographic online!