Updated: Oct 27, 2020
Cognitive behavioral therapy can seem like magic — it’s also very scientific.
Many people have heard of cognitive behavioral therapy, or CBT. It’s sometimes used by counselors to help with depression, anxiety, and trauma, but it can be helpful for almost anyone. When it works, it can seem a lot like magic!
I agree it is magic-like, and it’s also scientific. I find it amazing myself that something like changing our thoughts can help us with physical symptoms like feeling tired, queasy, or shaking in fear!
CBT therapy techniques, especially when practiced over time, actually rewire the brain to think differently. This can change your mood in the short-term as well as long haul. CBT has been shown to help with the following areas, among others:
Calming anxiety, and anxiety disorders
Fighting and preventing depression
Treating past trauma and post-traumatic stress (PTSD)
Common medical disorders, like diabetes and fibromyalgia
I often use this thought-changing strategy often when helping people process past trauma. For that, we use a targeted version of cognitive behavioral therapy that focuses in on the difficult thoughts relating to the trauma. In trauma-focused therapies, the negative thoughts that occur are often based on shame about what happened.
Even if you don’t need or want counseling or cognitive behavioral therapy treatment, you can use this same process just to deal with everyday stresses. Many people think of our negative thoughts as our “inner critics” or “inner bully.”
These thoughts are a part of ourselves, even coming from a specific location in the brain, and they are typically trying to protect us in some way. However, they often miss the mark, instead making us feel worse rather than better. So, we can reprogram them to work differently!
If you know the thought isn’t really rational, but you are having trouble changing it, these steps from cognitive behavioral therapy can help. Complete this 7-step process for a few of the strongest negative messages that come up on a regular basis. You can also try some of the follow-up techniques to reframe your thoughts in general.
Cognitive Behavioral Therapy Steps and Questions
1. Identify a common negative message you often say to yourself. (Example: I’m a failure.) Write it down on a sheet of paper. Notice if this comes from a particular struggle, stressor, or situation. (Example: When I try something new and it’s not going well, I think this.)
2. Ask yourself if there's a purpose for this thought or message continuing. For example, question:
Is it trying to help or protect you in some way?
How is it protecting me? (Example: It keeps me from being vulnerable and taking too many risks.)
Honor that you've had this thought in the past for a reason.
3. Ask yourself if there's evidence against your thought.
(Example: Actually, I have a couple of hobbies that I’m really good at. Or, actually, I remember that one project that I did really well with. I always forget about the good ones.)
If there's also evidence for your thought, can you question it?
Is that the whole story?
Is it based in habit, or fact?
(For example, maybe you're only remembering your failures and not all the times you've done well.)
4. What would my wise self or spiritual say about this? (Example: I'm a capable, smart person who does my best.)
5. Can I give this internal protector/critic a new job? (Example: You can protect me by motivating me to do my best, but let’s not discourage me with this mean thought.)
6. What's a more helpful thought I can tell myself and believe right now?
(Example: I always do my best, and although I sometimes fail, I also have great successes. Or, everyone fails at times, and that means I’m trying harder than a lot of people.)
7. Once you have a more helpful thought that you can believe, follow up with it.
Write it down somewhere, or store it on your phone, and remind yourself of it often.
Make it a habit to notice the old thought and correct yourself with the new thought as much as you can.
Over time, you will gradually get better at the new thought, and if you are committed and keep it up, you will actually start to go straight to the positive thought and skip the old one entirely!
Cognitive Behavioral Therapy Triangle
For a simpler everyday version of the 7 questions, you can use the cognitive behavioral triangle above. It has three points, as you might imagine, containing thoughts, feelings, and behaviors. As you change your thoughts, your feelings and behaviors will change with them. This simple version is best used with smaller, everyday annoyances.
Before practicing with the triangle, it’s helpful to notice the difference between natural and manufactured emotions. This is a strategy taught in cognitive processing therapy , a type of cognitive behavioral therapy. The developers of CPT describe natural emotions as those that come up naturally, that most people would experience.
You could also label this as a “normal” or typical emotion. Human beings are programmed to have feelings, just as many animals have. (Notice how your dog reacts sometimes when you leave the house, or when you get home?) Natural feelings should be allowed to happen, well … naturally. Don’t try to change or stop them. They’re not good or bad, they’re just a natural body response that gives us good information.
Manufactured emotions are a little different. These emotions aren’t a natural response, but rather created by the story we tell ourselves about what’s going on. This might include thoughts along the lines of, “I can’t believe the boss is treating me this way. Every time I try to help someone criticizes me. I can never do anything right.” This is a story we tell to protect ourselves, but the result is that it makes us feel worse, and keeps us unhappy a lot longer.
So, the lesson is to allow our natural feelings to come up, and to accept, notice and process them if needed. However, when we notice ourselves telling the “story” that’s making things worse, we can change that.
An easy way to do that is with the cognitive behavioral therapy triangle. Here’s how that works.
Typical thought example
Everyday Event: Someone cuts you off in traffic
Natural Emotion: Annoyance, fear
Typical Thought/Story: What a jerk! I hate it when people do that! Or, I’m so bad at driving. I’m horrible in this traffic!
Resulting Feelings: Ongoing anger, resentment, guilt
Resulting Behavior: Complain to others once you get to work
This is a typical cycle of negative thinking. Now consider an alternative way.
New, more helpful thought example:
Same Everyday Event: Someone cuts you off in traffic
Natural Emotion: Annoyance, fear
New Thought: It’s normal to be annoyed by that. But at least I’m okay. I just avoided an accident! I’ve done that before myself. I guess we all do at times. Maybe they didn’t see me, or they panicked. New Feelings: Relief, calm, gratitude (You’ll probably forget the incident fairly quickly.)
New Behavior: Happily greet people when you get to work
Try your own sample here, filling out your usual responses, then fill in your new possibilities.
Everyday Event: Natural Emotion:
Resulting Ongoing Feeling:
Now, practice, reframing it!
Same Everyday Event:
Natural Emotion: New thought/story:
New resulting feelings:
New resulting behaviors:
Complete this for as many everyday events as you like. I recommend picking one to three at a time and focusing on each for several days or weeks. Eventually you’ll begin to reroute your brain mapping to generally think more positively about small, annoying things.
Life will become a little less stressful and you’ll notice more positive things. In cognitive behavioral therapy, you can get help to use this strategy for more damaging, shaming thoughts.
An alternative, but harder version of the above, is to have less attachment to our thoughts and “stories” in general. This is a bit harder, and takes more practice. Many people work on this in a regular meditation practice. This version might look like this with the traffic incident:
Same Everyday Event: Someone cuts you off in traffic
Natural Emotion: Annoyance, fear
New Thought: Interesting. I notice myself getting annoyed by this traffic. New awareness: I can feel this tension in my body. My hands are clenching the steering wheel. I’m just going to be aware of this for a minute or two. (Simply noticing our bodies and feelings can take the edge off them.)
New thought: I notice myself having these thoughts and feelings. I don’t have to believe the thought is true. In other words, “I don't have to attach to this thought,” or "I am not my thought." Resulting behavior: Going about the day as normal, or continuing this exercise.
Acceptance and Commitment Therapy, which also stems from cognitive behavioral therapy uses a meditation called Leaves on a Stream, that helps practice this principle of not attaching to our thoughts. Check it out here.
How Can I Access CBT Resources and Therapy?
There are many self-help and professional resources that can assist you if you're wanting to change your thoughts, feelings, and behaviors. Here are a few ways to find help:
Reach out to a local or telehealth therapist in your state who practices CBT. Many therapists offer local sessions, or are currently providing therapy online. Look for a therapist licensed in your state. Ask about their experience and success with CBT.
Find a qualified online therapist. Many online CBT programs, like Online-Therapy.com offer packages, weekly rates, or free programs to help you learn the steps of CBT. However, not all programs are alike, so research these options and check out reviews.
Use self-help resources to practice the steps of CBT, such as the questions above. My recently published book also includes the steps and questions specific to healing from recent trauma and PTSD. Check out PTSD Quest here on Amazon.
What are Supplements to CBT?
CBT is one of the most proven therapies to help with nearly any life struggle or mental health issue. However, sometimes supplemental practices can be of help. They can assist you to calm your thoughts, and relax you enough to make use of the steps of CBT. Here are some helpful practices that can help support your CBT work.
Meditation. Mindfulness and meditation practices can be incorporated into cognitive behavioral work, and/or can be used instead of them. In many ways they are similar, helping you notice and calm your thoughts.
Yoga. Practices like yoga also allow you to slow down, and incorporate purposeful movement, which can help boost both therapy and mindfulness practices.
Tai chi is an ancient practice, but has plenty of modern day research to back it up. Through the intentional movements and sometimes spiritual practices of Tai chi, you can learn to focus and calm restless thoughts and feelings.
Diet, supplements, and exercise. We all know a healthy diet can help with many areas of health, including mental health. However, sometimes we have missing vitamins or nutrients that affect mood. Or, depression or anxiety may be getting in the way of being more active. If you're struggling with this area, find a doctor or other health practitioner who can help you get to the bottom of any medical or nutrient issues affecting your mental health.
Cognitive behavioral therapy is one of many ways to improve your overall health, mood, and satisfaction in life. It's one of the most effective therapies, partially because you can continue to use it for years after you learn it.
If you feel stuck in your thoughts, a qualified CBT therapist can help you look at where your stuck points are, and begin to break free of them.
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Jennie Lannette, LCSW, is a licensed therapist, author, and mental health educator.