What Is CBT?

CBT stands for cognitive behavioral therapy, a form of talk therapy that helps people identify unhelpful or negative thought patterns that affect their emotions and behaviors.

The goal of CBT is to investigate the relationship between your thoughts, feelings, and behaviors. By identifying negative or unhelpful thought patterns, you can learn to interrupt cycles of anxiety, depression, or other forms of mental distress.

With CBT, you can equip yourself with tools and techniques to navigate stress in a healthier, kinder way.

Thoughts, Feelings, Behaviors: The Cognitive Triangle

The main concept behind the cognitive triangle is that our thoughts, emotions, and behaviors are interconnected and shape our experience of the world. Often, people suffering from anxiety, depression, posttraumatic stress disorder (PTSD), or other mental health disorders feel stuck in specific patterns of this cognitive triangle. These patterns may be so ingrained that people aren’t even aware of them until they engage in CBT.

Distressing Thoughts → Overwhelming Emotions → Unhelpful Behaviors

For example, let’s say you struggle with anxiety in the workplace. Your boss sends you an email out of the blue asking you to come to her office after lunch. Your anxiety may take you down a familiar pattern of thoughts, feelings, and emotions:

• • Thoughts: “This can’t be good. My boss knows I don’t belong here. I am so fired.”
  • Emotions: Panic, fear, dread, shame
  • Behaviors: You start crying at your desk and skip lunch completely, too afraid to eat. You spend your lunch time searching for other jobs online, convinced you’re going to be fired and there’s nothing you can do about it.

This anxious pattern of thought isn’t helpful in the workplace. It’s difficult to maintain a job if a harmless email can spark such an extreme reaction.

CBT can help you interrogate this pattern of thought and turn it on its head.

Distressing Thoughts → CBT Techniques → Steadier Emotions → Healthier Behaviors

The guiding principle of CBT is that you can learn new behaviors to deploy when distressing thoughts arise, resulting in calmer emotions and healthier reactions. Over time, unhelpful thoughts will have less power over you or may disappear entirely.

Let’s return to that email from your boss. With CBT treatment, your thoughts, feelings, and behaviors may look something like this:

• • Thoughts: “I feel a little anxious. That’s okay. This meeting might be about something good, challenging, or trivial. Whatever happens, I know I can handle it.”
  • Emotions: Brief anxiety followed by calm, steadiness, self-assuredness
  • Behavior: You take some calming breaths, and then you go enjoy your lunch.

What Is Cognitive Behavior Therapy Used For?

Therapists use CBT for anxiety, depression, and a number of other mental health disorders. Psychologists also use CBT to help people without mental illness who may be going through stressful situations or challenging transitions.

CBT is particularly useful because it does not require expensive equipment or lengthy courses of medication. Depending on the frequency of your therapy sessions, you can make great progress in just a few weeks or months.

You can use cognitive behavioral therapy techniques to treat:

• • Anxiety
  • Depression
  • Bipolar disorder
  • Posttraumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • Eating disorders
  • Substance abuse
  • Grief
  • Phobias

Types of Cognitive Behavioral Therapies

CBT combines cognitive therapy and behavioral therapy into one approach. It teaches you to challenge unhelpful thoughts (cognition) so you can choose healthier responses to stress (behaviors).

However, CBT is also an umbrella term that includes many different types of therapies that strive to influence your thoughts, feelings, and behaviors for the better. Types of cognitive behavioral therapy include:

• • Dialectical behavior therapy (DBT)
  • Relapse prevention (RP)
  • Mindfulness-based cognitive therapy (MBCT)
  • Prolonged exposure therapy (PE)
  • Integrative behavioral couples therapy (IBCT)

How Does Cognitive Behavioral Therapy Work?

1. Identify a Problem/Set a Goal

The first step in CBT is to figure out what problems you’re facing and how you hope to solve them. It’s important to be specific in both identifying your issues as well as in setting goals to address them.

For example, a patient struggling with an eating disorder may tell his therapist that he is losing weight at an unhealthy rate (problem). Together, he and his therapist can discuss ways to help him nourish his body in a healthy way (goal).

2. Discover Your Thoughts, Emotions, and Beliefs

Once you have identified a problem, your therapist will help you discover your existing thoughts, emotions, and beliefs about it. They’ll also help you identify the base assumptions that are at the center of most of your thoughts and feelings. These are known as your core beliefs.

You can discover your beliefs, thoughts, and emotions through a number of cognitive behavioral therapy exercises, such as:

• • Guided questioning
  • Journaling
  • Self-talk
  • Other forms of “homework” (activities done at home before your next therapy session)

3. Identify Distortions

Once you’ve discovered what sorts of thoughts and beliefs are driving your emotions and actions, it’s time to investigate them with the help of your therapist. Your goal is not to judge your thoughts and beliefs as “good” or “bad,” but instead to identify whether they are true/helpful or untrue/unhelpful.

Untrue or unhelpful thoughts and beliefs are known as cognitive distortions. These patterns of thought may have served a useful purpose before but no longer do so. Indeed, for many patients, cognitive distortions are often the legacy of past protective measures or coping strategies used to survive trauma.

Examples of cognitive distortions include:

• • All-or-nothing thinking
  • Overgeneralization
  • Mental filtering
  • Discounting the positive
  • Mind reading
  • Fortune telling
  • Emotional reasoning
  • “Should” statements
  • Blaming
  • Labeling
  • Catastrophizing

It’s important to identify which thoughts and beliefs are no longer serving who you are in the present moment. Only then can you learn to reshape these distortions into truer, more helpful ways of thinking.

4. Reshape Your Thoughts and Beliefs with CBT Techniques

Now it is time to employ a cognitive behavioral approach to help combat your negative distortions. Examples of CBT exercises include:

• • Mindfulness: Mindfulness practices can keep you from “spiraling” into negative thought patterns that get more overwhelming over time. With mindfulness, you can ground yourself in the present moment by using your five senses. You can then bring your awareness to your thoughts and feelings without passing judgment over them.
  • Exposure: People struggling with PTSD, phobias, or OCD may have triggering objects, images, or situations. These triggers are perfectly safe in reality but bring up feelings of stress, fear, and anxiety. By exposing yourself to what you fear with the help of your therapist, you can learn to disconnect your negative emotions or memories from that trigger.
  • Self-questioning: When you have a negative or unhelpful thought, you can learn to interrupt your thought pattern by questioning it. CBT interventions can help you identify the cognitive distortions behind these unhelpful thought patterns, such as all-or-nothing thinking, labeling, or blaming.
  • Self-compassion: Many people struggling with their mental health feel like they can offer grace, love, and forgiveness to everyone in their life except for themselves. Self-compassion techniques can help you treat yourself like you would a friend. This helps you learn to see yourself as a person worthy of love and connection.

What to Expect in Cognitive Behavioral Therapy

During your first appointment, your therapist will ask you questions so they can learn more about you and what sorts of problems you may be facing. Feel free to ask your therapist questions as well. It’s important to make sure your therapist is a good fit for your specific situation.

Your sessions will mostly consist of you and your therapist talking about the problems you’re facing and different ways for you to identify and disrupt any distortions. It can be uncomfortable or even distressing to learn the negative beliefs you may hold about yourself. That’s why it’s important to choose a therapist you can trust. You need someone who can encourage you to continue with your therapy even when it’s hard.

Eventually, you’ll begin to make progress and experience improvement in your daily life. Although your distorted thoughts may never disappear entirely, you will now have the tools you need to respond to them in a healthy way.

Additional Resources

Find a CBT Therapist Near You

Ready to get started with cognitive behavioral therapy? There are CBT therapists available for in-person appointments or virtual sessions. Click here to find CBT therapists in your area.

CBT at Home

If you want to try CBT at home, there are apps available on your smartphone to help guide you through common CBT techniques. These may help in the short term if therapy is not an option for you at this time. There are many helpful apps out there, including:

• • Happify
  • MindShift™ CBT
  • Headspace®
  • WoeBot