What Is Cognitive Behavioral Therapy, and Can It Help You?

Sometimes, when life gets tough, you may hear a little voice in your head telling you, "You are not worthy," or "You are not good enough." Of course, we don't want to listen to it, but sometimes, this mysterious voice just doesn't seem to want to let us go. At first, you may not even be aware of it. You may think that if you ignore it, it’ll eventually go away on its own. But the truth is, that voice will still be there lurking in the back of your mind and affecting the way you think, feel, and even act. When you let down your defenses and give up on fighting it, chances are that it can mislead you into thinking that whatever it’s saying is true. And the result? It can negatively affect your self-esteem and self-worth, by making you start questioning them. In psychology, this mysterious voice is known as negative self-talk, and it can make people feel trapped in a cycle of negative thoughts.

One of the most commonly-used approaches in psychology-based therapy is Cognitive Behavioral Therapy (CBT). It suggests that what you are feeling is influenced heavily by what you think and how you behave. CBT operates under the idea that our thoughts, feelings, and behaviors are all interconnected. Originally developed as a method of treating depression, its usage has now expanded to become one of the most effective means of psychotherapy for a wide range of mental health challenges. You can also incorporate some of its techniques into everyday life, by using it to train your mind to process more positive thoughts on a regular basis一and in doing so, changing the way you feel for the better. Read on to learn about how CBT works, how it was developed, and how to use it to live a more joyful life by teaching your mind to generate more positive feelings.

Cognitive behavioral therapy, commonly known as CBT, is an evidence-based psychological therapy method that has been found to be effective in treating a wide variety of mental health challenges. The approach is heavily based on scientific studies and clinical expertise. CBT was developed based on the idea that what we think can influence how we feel. It is a modality that focuses on the relationship between thoughts, feelings, beliefs, and behaviors, proposing that these aspects are all connected and can influence each other. For this reason, CBT therapists treat clients by guiding them to evaluate the accuracy of their thoughts, and helping them gain a more realistic picture of the actual situation. For instance, people with depression tend to perceive events irrationally, which can make them more likely to experience more negative feelings. 

CBT tends to be used as a treatment option for a wide range of mental health issues. It is one of the most commonly-used methods in treating depression, anxiety, eating disorders, panic attacks, and addictions, to name a few. CBT therapists support people recovering from mental health issues by teaching them to recognize how they interpret various events in life. And by educating them on the power of thoughts, and how to develop new ways of thinking, clients can eventually feel more positively and recover from these issues.

First introduced by Dr. Aaron Beck in 1964 ー who is now known as “The Father of CBT” ー this method was initially developed as a means for treating depression. Dr. Beck was a psychiatrist and a clinician of the psychoanalysis approach. At the time, he primarily worked with clients who suffered from mental health issues, and most of them had depression. 

Dr. Beck recognized that many of his depressed clients had a common characteristic: indulging or giving in to their own self-talk. His findings suggested that not only were these thoughts very negative, but they were also usually invalid and lacked evidence. He called them automatic thoughts, and postulated that these thoughts may lead to negative emotions.

From these findings, Dr. Beck proposed a model: The Negative Triad (also known as The Cognitive Triad) and claimed that people with depression tend to hold negative views in three key aspects of life:

• Self: “I am worthless.” 
• World: “This world is unfair.”
• Future: “Nothing will work out for me.”

CBT is based on this theory, and the idea that by paying attention to these thoughts, people can feel more positive and finally recover from the mental health issues associated with them simply by changing the way they think.

Negative Triad

CBT aims to replace negative thought patterns with positive thinking styles through cognitive restructuring. It is a “here and now” approach that considers how a person thinks about themselves, the world, and other people. Not only do CBT therapists help clients to understand how past experiences have shaped their thinking styles, they also help people improve their present and future situations by encouraging them to think more positively.

Under CBT’s theory that how we think can influence how we feel, the concept can be further illustrated by two important theories: the ABC model and The Vicious Cycle.

The ABC model, founded by Dr. Albert Ellis ー a psychologist who influenced Dr. Beck’s work ー plays an important part in CBT. It proposes that it is not a situation that results in one’s feelings and behavior, but rather, how we interpret the event that leads to the emotions surrounding it. In other words, the same event can have different meanings for different people. There are three components in the model: 

• Activating Event: This is the fact of what actually happens in the events people experience. For example, this may include where the event took place, who was involved, one's role in the situation, and the circumstances. 
• Belief: Belief is what people think about the event. Different people can hold different viewpoints around the activating event. Belief can happen unwittingly, so the people in question may not be aware of it. Individuals with depression tend to hold negative automatic thoughts. Oftentimes, these thoughts may exaggerate the actual event.
• Consequence: Consequence results from belief, and it includes how we feel and act. For instance, emotions such as sadness or anger can be consequences people encounter when maintaining negative beliefs about the actual event. 

ABC Model

Another model that underpins CBT is The Vicious Cycle, which is the concept that thoughts, feelings, and behaviors are all interrelated. Simply put, thoughts can trigger behaviors and emotions, influencing how we feel. The cycle can play out differently for each person. If someone thinks “he or she hates me” when they are ignored by a friend, they are more likely to experience feelings of worthlessness. When someone thinks “I am going to screw up this test” when they have an exam coming up, this can lead to more worrying feelings. 

These automatic thoughts or negative thought patterns are a key part of The Vicious Cycle. CBT therapists guide people to break this cycle by teaching them new and more positive ways of thinking and, ultimately, helping them be more likely to experience positive feelings.

The Vicious Cycle

In trying to alter thought patterns by rethinking and reevaluating the way one views the world, CBT uses the following techniques:

• Psychoeducation: This supports a person’s recovery journey by providing knowledge and information about their mental health issues. As a result, the person can become more aware of their thoughts and the reasons behind the way they feel. In identifying them, these thought patterns can be broken down and reconstructed.
• Cognitive Reconstruction: This involves breaking the old thought patterns and rebuilding new ones. By identifying unproductive thoughts ー known as cognitive distortions ー a new way of thinking can then be established, by replacing irrational thoughts with logical and positive ones.  
• Reevaluation of Beliefs: In this step, a person will evaluate their own beliefs and work on separating and eliminating the irrational ones, such as those exaggerating the actual event, helping to provide and maintain a more accurate perception of reality. By working on these thoughts, improved feelings can follow, leading to a more optimistic view of reality and increased self-esteem. 
• Use of Tools: CBT uses various tools to help identify and change these thought processes, such as take-home assignments and worksheets. For example, automatic and negative thought patterns can be discovered through a diary of sorts, in which someone would write down their thoughts as they come up, along with any emotions associated with them. Mood diaries are also used to increase one’s awareness of their mood state. 

Different states of Mood

• Setting Goals: One of the most essential aspects of CBT is goal-setting. CBT therapists help people defend themselves from being attacked by their own negative thoughts. Goal-setting allows people to develop a sense of hopefulness, building the positive belief that “the situation can be improved.” It also helps the person be more committed to the therapy. 

As an evidence-based psychotherapy approach, CBT is beneficial for treating mental health issues. It can be done either one-on-one or in a group setting, depending greatly on the person and the type of issue they are facing. Below are some challenges that CBT is often used for treating: 

• Depression: The original purpose for which CBT was developed, when using this method to treat depression, a therapist may apply techniques and tools such as mood diaries and worksheets. This helps the person uncover their unhealthy or irrationally negative thoughts, and find out how they can lead to negative feelings. It’s commonly combined with medications such as antidepressants. 
• Anxiety: Similarly to its use in treating depression, when using CBT to deal with anxiety, it is also intended to help change negative thought patterns. However, one major difference is that people with anxiety tend to be struggling with anxious and worrying feelings, rather than prolonged periods of sadness. For instance, CBT may help someone see presentations or testing situations as a good challenge, rather than a negative assessment to dread. CBT therapists also teach strategies for coping with anxiety. 
• Eating Disorders: CBT is one of the most effective treatment options for eating disorders. For example, it may help people with bulimia learn to stop unhealthy binge eating by developing a more regular eating habit. It also assists them in recognizing how their maladaptive thoughts can lead to negative feelings in The Vicious Cycle. 
• Panic Attacks: The use of CBT for panic attacks works in a similar fashion to that for anxiety, but it tends to place more emphasis on how someone’s thoughts may cause bodily sensations. Panic attacks tend to occur unexpectedly and usually involve intense feelings of fear in a very short timeframe. When treating panic attacks, CBT therapists may explore the fight-or-flight (or freeze) response and focus on someone’s thought response when they feel anxious. They can also teach relaxation techniques, aimed at replacing maladaptive thoughts with more productive beliefs. 
• Addiction: Addiction is a broad term that involves compulsive dependence on certain substances or behaviors. It can be destructive to one’s well-being as the reliance becomes extreme and affects one’s daily life. Common types of addiction include alcohol consumption, smoking, and gambling. When used in treating addiction, CBT explores one’s excessive reliance on certain substances or behaviors, and how their negative thought patterns can contribute to the addiction. For example, people with addiction may be seeking pleasure in the specific stimuli to escape from responsibilities or intense stress. CBT therapists aim to reduce these addictive behaviors by switching one’s thoughts of hopelessness to becoming more confident in how they handle challenging situations. 

• Choose A Therapist That Suits Your Needs: It is important to see whether your therapist is a good fit for you. Understand what areas they specialize in, check their background and professional qualifications, or even look for reviews and recommendations to see if they are someone who is well-suited to your specific needs, and who you would be comfortable trusting and working with. Some therapists also offer a trial session, so don’t be afraid to let them know what you’re struggling with, and ask them questions to help gauge if they’ll be able to provide what you’re looking for.
• Don't Be Nervous:  It is completely normal to feel nervous when you need to share your inner thoughts with a stranger一but there is no need to feel anxious and ashamed about going to therapy! Try to stay relaxed when sharing your thoughts, and acknowledge that going to therapy doesn’t mean that there’s anything wrong with you. After all, a therapist’s role is to help you, so there’s no shame in allowing your vulnerabilities to show, and allowing them to help you with them. 
• Stay Committed: CBT typically lasts for about five to 20 weekly sessions, and you are likely to receive assignments and worksheets from the therapist to facilitate your learning. Just like picking up any new skill, don’t assume that you will instantly become happier and think more positively after attending only one or two sessions. Remain committed to the therapy and complete your assignments as diligently as you can. Even if it might get a little tough along the way at times, quitting in the middle of the process won’t help your current situation. Staying committed to the process will help you get the most out of CBT.
• Understand Your Goals: CBT isn’t only a helpful treatment for those suffering from mental health issues: some other common objectives for seeking it may include becoming more self-compassionate, increasing your skills for coping with anxiety, and becoming more positive in general. Think about what you would like to improve. What are your expectations for how CBT will help you? Reflecting on your goals can motivate you in being committed to the process, and get the most out of it. 

Other than its wide applications in clinical settings, there are many other mental health benefits of learning CBT. By incorporating the concepts of CBT into everyday life, you can become more self-aware and even more mindful by understanding how you think or behave, and making positive changes where you’d like to see improvement. Here are a few ways you can use it in the day-to-day:

1. Identify The Way You Think: Although it might not be easy to directly change our feelings, CBT has shown that changing the way we think can influence how we feel and behave. Identifying how you think, and finding any negative belief systems that you may hold, can help you get rid of negative thought patterns that can cause you to ruminate, feel anxious or depressed, or hold you back in achieving success. Understanding the ABC model can help us be more aware of our thoughts and recognize what kind of thoughts are destructive and unhelpful. Replacing these negative thoughts with positive ones can be an effective way to trick your mind into feeling better on a regular basis.
2. Challenge Your Negative Thoughts: If you identify negative thought patterns, don’t be afraid to challenge them. Ask yourself: “Is there any evidence to support this belief?” After all, feelings aren’t always tied to facts, and misinterpretations may lead us astray, potentially causing us to doubt our self-worth and affecting our self-esteem. Another way of challenging these negative thoughts can be to give yourself a healthier perspective by speaking to yourself the same way you’d talk to a friend encountering a similar problem. Sometimes, we tend to be better at helping our friends than ourselves. Ask yourself what advice you’d give to a friend who could use a more realistic, third-party perspective of a negative situation, and try to do the same thing for yourself.
3. Behave First, Feel Later: While CBT emphasizes how thoughts can lead to feelings, one major part of its longer-term success is applying the changes we can make in our behaviors. After all, if our thoughts, feelings, and behaviors are all interrelated, the latter can also contribute to your mood or state of mind. Sometimes, taking action can instigate a behavioral change that will lead to better thoughts and feelings. For instance, if you don’t feel like exercising because you’re tired, but you know that you’d feel better if you got up to work out rather than skipping it, try to stand up and get moving before you can talk yourself out of it. If you need a push, convince yourself to get going by reminding yourself that you will feel better after having done it, that you don’t want to fall into a cycle of regret afterwards, and that by doing so, you’ll feel healthier and better for having taken care of your body. Chances are that after you’ve finished the exercise, you’ll feel better mentally and emotionally as well. It’s ultimately about finding the right balance between the mental and physical.
4. Keep a Journal: CBT therapists often require clients to complete assignments and a mood diary to facilitate their learning and track their progress. Developing a habit of journaling about your thoughts and moods every day can be a great and affordable way of gaining some of the benefits of CBT on your own. Doing so can give you a clearer picture of what you’re feeling, how you think, when you’re more susceptible to negative emotions and thoughts, and what your triggers for them may be. Keeping a gratitude journal may also train your mind to think more positively. Get creative with how you journal your thoughts! It doesn’t have to be a physical journal: simply jotting down your feelings on your phone notepad can also work. Whatever method you choose, this increase in self-awareness can help you set goals that can either tackle your mental health challenges, or if you’re already in a relatively positive state of mind, start thriving.

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All of the content on our website is thoroughly researched to ensure that the information shared is evidence-based. For more information, please visit the academic journals and other resources that influenced this article: Cognitive Therapy: Basics and Beyond; What Are Cognitive Distortions and How Can You Change These Thinking Patterns?; Cognitive Triad; What Is the ABC Model in Cognitive Behavioral Therapy?; Cognitive Behavior Therapy in Nursing Practice; An Effectiveness Study of Individual vs. Group Cognitive Behavioral Therapy for Anxiety Disorders in Youth; The Efficacy of Cognitive-Behavioral Therapy for Eating Disorders: A Systematic Review and Meta-Analysis; Bulimia; What’s the Difference Between a Panic Attack and an Anxiety Attack?; Types of Addiction; How It Works - Cognitive Behavioural Therapy (CBT); Mental Health Mobile Apps for Preadolescents and Adolescents: A Systematic Review.