What is cognitive behavioral therapy?
Cognitive behavioral therapy (CBT) is a type of talk therapy that has been shown to be quite effective for a range of mental health problems, such as anxiety, depression, eating disorders, alcohol and drug use, etc.
It works on the principle that a person’s negative actions or feelings come from their present thought processes and belief systems instead of some unconscious forces from the past. Hence, this form of therapy focuses on identifying negative thought patterns and behavioral responses and replacing them with healthier and realistic ones.
Sometimes, CBT is also used in combination with other forms of treatment, like antidepressants or drugs to improve the functioning and quality of life.
Cognitive behavioral therapy (CBT) is an effective treatment for depression. Unlike any other psychotherapy CBT is short term (time limited) and treatment focused. Problem behaviors and thinking are identified, prioritized, and are addressed.
People with depression commonly have a strong negative belief about:
- Self: People with depression tend to have an unfavorable attitude towards themselves in general.They are prone to feel worthless and unlovable this kind of negative thinking patterns is called negative self-labeling
- World: Depression can lead people to see the world in a negative light. They blame the world to a great extent for their tough situations and find it hard to trust anybody.
- Future: People with depression are usually not hopeful that their future could be better. They overgeneralize the situation and believe that their present suffering is proof of how their future is going to be.
Research finding says that the negative core beliefs and thoughts are the main reason for depression.
The goal of the therapy is to help a person to recognize his/her negative patterns of thought, evaluate their validity, and replace them with healthier ways of thinking, in a way it changes the patterns of behavior that come from dysfunctional thinking.
Behavior and negative thoughts predispose an individual to depression and make it more impossible to escape its downward spiral. According to CBT practitioners and researchers, changes in mood can be seen automatically when patterns of thought and behavior are changed.
How does cognitive behavioral therapy work?
Cognitive behavioral therapy uses a short-term approach to treating mental health problems than other types of therapies like psychodynamic therapies and psychoanalysis. Unlike such therapies, CBT for depression usually takes only 10 to 20 sessions.
In those sessions, your therapist focuses on finding out current life situations, stressors, and distorted perceptions that may be contributing to depression. As a part of the cognitive treatment for depression, you may be asked to maintain a journal to note down your life events and your reactions to them.
Your therapist can study those thoughts and reactions, which can fall in some of the following categories:
- All-or-nothing thinking: having a perspective in absolute black and white terms
- Automatic negative reactions: having habitual negative thoughts
- Disqualifying the positive: having the opinion that positive experiences don’t count
- Overgeneralization: reaching unduly conclusions from a single event
- Magnifying or minimizing an event’s importance: finding a moment or event bigger or smaller than it actually is
- Personalization: taking things too personally
- Mental filter: dwelling on a negative details until the focus on reality is lost
Once the thoughts and perceptions are identified, your cognitive therapy for depression will involve making efforts to change the thinking and behavior patterns.
Some of the strategies used to change thinking patterns include:
- Learning to identify and control one’s distortions in thinking, and then re-evaluating them according to reality.
- Trying to understand the behavior and motivation of others.
- Developing problem-solving skills and using them to cope with challenging circumstances.
The therapy involves efforts to change the behavioral patterns as well, which may include:
- Practising a healthy, balanced and accurate self-talk
- Doing things that appear to be intimidating instead of avoiding them
- Learning to calm and relax the body and mind
- Preparing to deal with potentially problematic interactions with others by using roleplaying
- Learning to assess situations, reactions and emotions accurately and comprehensively
Your cognitive behavioral therapy may not include all of the mentioned strategies. Your psychologist and therapist will work together with you collaboratively to understand the problem and come up with a treatment strategy.
CBT for anxiety and depression also emphasizes on making individuals capable of being their own therapist. The exercises inside and outside of sessions can help patients develop coping skills and change their own thinking, problematic emotions and behavior.
CBT is based on two specific tasks: One is the cognitive restructuring, where the therapist and the patient work together to change the thinking patterns, and the other one being behavioral activation — where the patients learn to overcome the obstacles and participate in enjoyable activities.
Cognitive restructuring is the process in Cognitive Behavioral Therapy of identifying and as well changing the inaccurate negative thoughts that contribute to the development of depression.
The major focus of the therapy is to learn to recognize the negative thoughts whenever they surface and find a better and healthier perspective to look at the condition.Behavioral activation is another goal of CBT that aims to help clients engage more often in pleasurable activities and help them in developing problem-solving skills.
One major symptom of depression is the loss of interest in things that were once found enjoyable. A person with depression stops doing things because he or she thinks it’s not worth the effort. But this only deepens the depression.
Generally, depression causes people to lose interest in things that they once found enjoyable. They stop doing things because they think that it’s not worth the effort, but that only worsens the symptoms.
In CBT, the therapist usually helps the patient to schedule their enjoyable experiences, often with the other people who can reinforce the enjoyment. Part of the process is looking at obstacles to taking part in that experience and deciding how to get past those obstacles by breaking the process down into smaller steps.
Following is a case study on how CBT works for depression. (Note: This is just an example for better understanding)
A woman called Anamika walked into the therapist X room with complaints of decreased sleep, loss of interest in daily activities and tried to run away from family.
Anamika was 42 years aged lady who was a mother of two children and she was working in the same IT firm where his husband was working too.
Anamika did not have a very good childhood. Her mother was a lawmaker and father was an alcohol addict. While she was growing up she missed her mother’s love and care very much, as her mother’s work demanded to be away from home most of the times. From then she decided that she should be a perfect mother for her kids and always be around then when they needed her.
Anamika was doing very well in her profession and won many awards for the same. But after her son was born she realized that she was not able to spend more time with her kids as she got busy with her work. She had a strong belief about being a perfect mother has to be and when she could not meet her own expectation, she blamed and labeled herself as the worst mother.
As days passed she stopped going to work, but could not be happy with her kids too, because she loved her work which is missing now and started hating herself saying she was a failure and good for nothing. This scenario worsened as the day passed by.
She was diagnosed with depression
Here the role of a CBT therapist is to help the client identify her negative core belief i.e to be a perfect mother, distort(shoulds, self-blame, and labeling) and restructure them with more desirable ones i.e I shall try to be a good mother to my kids. I will find ways to find a balance between work and life.
It is the role of the therapist to take the client through this journey. Here the therapist might use many techniques to achieve the goal. Like encouraging the client to maintain a thought record daily, including Socratic questioning, role playing, imagery, guided discovery, and behavioral experiments.
Anyone with mild or moderate depression can potentially benefit from CBT, even without taking medication. A number of studies have shown CBT to be at least as effective as antidepressants in treating mild and moderate depression.
Wake up before it’s too late….
Start the journey to wellness from depression today! It is only one call away to change your life. If you or someone you know is depressed, it is advisable you have them diagnosed with a good psychologist who can treat depression.