Cognitive Behavioral Therapy

Dr. Aaron Beck and the Dalai Lama
Dr. Aaron Beck and the Dalai Lama

A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying everyday thoughts and behaviors, with the aim of positively influencing emotions. The basic CBT is based on the idea that how we think (cognition), how we feel (emotion), and how we act (behavior) all interact together. Specifically, our thoughts influence our feelings and our behavior. Therefore, negative and unrealistic thoughts can cause us distress and result in problems.

An example will illustrate this process:

Someone who, after making a mistake, thinks “I’m useless and can’t do anything right.”
This impacts negatively on mood, making the person feel depressed;
The problem may be worsened if the individual reacts by avoiding activities.
As a result, a successful experience becomes more unlikely, which reinforces the original thought of being “useless.”
In therapy, the latter example could be identified as a self-fulfilling prophecy or “problem cycle,” and the efforts of the therapist and client would be directed at working together to change this. This is done by addressing the way the client thinks in response to similar situations and by developing more flexible ways to think and respond, including reducing the avoidance of activities. If, as a result, the client escapes the negative thought pattern, the feelings of depression may be relieved. The client may then become more active, succeed more often, and further reduce feelings of depression.

Cognitive Behavioral Therapy is not an overnight process. Even after patients have learned to recognize when and where their thought processes go awry, it can take months of concerted effort to replace an irrational thought process or habit with a more reasonable, salutary one. The cognitive model says that a person’s core beliefs (often formed in childhood) contribute to ‘automatic thoughts’ that pop up in every day life in response to situations.

While similar views of emotion have existed for millennia, the earliest form of Cognitive Behavior Therapy was developed by Albert Ellis (1913-2007) in the early 1950s. Ellis eventually called his approach Rational Emotive Behavioral Therapy, or REBT, as a reaction against popular psychoanalytic and increasingly humanistic methods at the time. Aaron T. Beck independently developed another CBT approach, called Cognitive Therapy, in the 1960s. Cognitive Therapy rapidly became a favorite intervention to study in psychotherapy research in academic settings. In initial studies, it was often contrasted with behavioral treatments to see which was most effective. However, in recent years, cognitive and behavioral techniques have often been combined into cognitive behavioral treatment. This is arguably the primary type of psychological treatment being studied in research today.

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