Cognitive Behavioral Therapy
March 19, 2014
Cognitive Behavioral Therapy (CBT) is a well-tested specialized type of psychotherapy shown to be effective for certain types of psychiatric illnesses. CBT connects a person’s thoughts, usually maladaptive or distorted, with his or her emotions. Studies show that deeply entrenched maladaptive thoughts can lead to negative emotions, such as depression or anxiety. In CBT sessions with patients, we first try to identify the maladaptive thoughts and then use logic and data to rethink those thoughts. For example, a person may think, “I’m worthless. I’m a terrible person. I’m going to get fired from my job.” By using CBT skills, a patient would first identify the thought and then figure out what emotion that brings up. In this case, if a person were to lose his or her job, he or she may be depressed or anxious. After identifying the emotion, we look at the validity of the thought by collecting data. For example, we ask the individual, “How have you done in the past?” and “What are your supervisor reports?” After collecting data, we look at the probability of that event actually happening and realize the unlikelihood of it taking place. By using CBT skills to evaluate the situation, the individual becomes less despairing, depressed and anxious.
Cognitive Behavioral Therapy works well for individuals diagnosed with depressive disorders and anxiety disorders. Within the anxiety disorders, CBT treats obsessive compulsive disorder and obsessive compulsive personality traits. In addition, CBT treats phobias, fears, generalized anxiety and, to some extent, it treats post-traumatic stress disorder. CBT is also good for individuals who have social anxiety, which is a fear of being in front of people – feeling like the spotlight is on you and magnifying all of those things.
When a patient enters the CBT track, I explain that his or her treatment will include psychotherapy and medication therapy. Oftentimes, when I mention the psychotherapy, patients roll their eyes and say, “I’ve been there and done that. I’ve talked to five different therapists; we have looked at my childhood, I’ve cried about it; I’ve reviewed everything in my past and I’m still depressed. So, I don’t have much faith that psychotherapy is going to do anything for me.” Then, I explain to them the specifics of Cognitive Behavioral Therapy – it is a scientific, evidence-based type of therapy that has been studied. CBT focuses on what a person is experiencing here and now; it is not focused ongoing back and reviewing the hurts of your childhood, although that can and should be part of it. This form of therapy is time-limited, meaning there are a certain number of therapy meetings that an individual will have, in which patients learn a new skill set and how to incorporate it in their own life. In a sense, a patient can learn how to become his or her own therapist on a day to day basis in between scheduled visits with a mental health professional, by learning the skills of CBT.
Mary Burns, MD