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Jennie Lannette, LCSWHow the CBT Triangle Connects Thoughts, Feelings, and Behaviors
Updated: Aug 21
The cognitive triangle connects thoughts, feelings, and behaviors. Learn how.
Thinking negatively is a common human trait. We look for problems so we can be ready for them. We beat ourselves up because we don’t want to repeat the same patterns.
However, this tendency to think negatively typically does the opposite of helping. Instead, it makes us more likely to feel down about ourselves, and therefore less happy in general.
The CBT triangle, or cognitive triangle, is a tool used by therapists and others to teach the concept of changing negative patterns of thought. The points of the triangle show how thoughts, feelings, and behaviors are all connected. By changing one of these three points, you can change the others for the better.
Looking for an interactive way to teach or learn CBT skills like the triangle? Check out our CBT worksheet bundle here, or our new, fun, 75-prompt CBT Bingo-like game.
Article Highlights
Triangle Diagrams
While the triangle is drawn in different ways, it typically shows thoughts at the top, with feelings at the bottom right point, and behaviors on the left. The visuals included throughout the article depict the steps of using the tool. First, you can recognize the pattern that’s occurring and then start to change it. Details of that process are further outlined below.
History of This Approach
The thought triangle is a simplified tool based on the ideas of cognitive behavioral therapy, or CBT. This particular therapy tool is incredibly popular, often used by therapists aiming to help people deal with all kinds of problems.
The original practice of CBT was developed by Dr. Aaron Beck and colleagues in the 1960s. Since then, the basic ideas have been adapted to treat multiple conditions including anxiety, depression, trauma responses, lack of confidence, eating disorders, physical illness and much more. Thousands of studies have validated this approach.
Since the tools of this therapy are so straightforward, many people find the practices are helpful even when learned outside of therapy. Self-learning CBT programs are also found to be effective, although in some cases a therapist is needed to help with more difficult thoughts. Many of the programs start with the basic CBT triangle to lead up to more complicated techniques.
Using the Tool
Since changing thought patterns is the most common technique used, we’ll start there. Let’s take a look at this in practice.
Maria is an English teacher at a local high school. She used to enjoy acting in local productions, and really wants to try out for the local community play. The last two times she auditioned she got cut at the last call-back. Although the director encouraged her to come back next time, she started to doubt herself.
After this disappointment, Maria told herself that she must not be talented or attractive enough. While she still wants to be in the play, she is repeatedly telling herself she won’t be successful. She feels discouraged, so she decides not to go.
She uses this decision to beat herself up and again tell herself she’ll never be an actor. The cycle continues.
Here’s how this would fit into the CBT triangle diagram:
Thought: I am not good enough to be an actor
Feeling: Discouragement, self-doubt
Behavior: Not trying at all
Giving up may be a way for Maria to protect herself against more disappointment. And by not challenging her thoughts, she stays in this negative cycle.
Maria has come to a conclusion she doesn’t know to be true, and hasn’t considered any alternatives. In order to challenge the old way of thinking, she’ll need to consider new ideas about her situation. Here are some things we know about what’s going on, which could challenge her conclusion:
The director of the local theater was encouraging when she tried out before, although he didn’t pick her for any previous parts
Maria knew she would be a stretch for those parts in the past because she didn’t really fit the characters
The new play is much more suited to her strengths
Maria knows other good actors that don’t always get cast, depending on the play
Maria has only tried out a couple of times, and she knows most actors get turned down a lot before they get cast
In college, Maria got consistent feedback that she was a solid actor
Maria can consider all of this information as a whole. After some thought, and talking to a friend about it, Maria decides to consider a new thought.
New thought: I’ve had good feedback about my acting in the past. The director encouraged me to try out again.
New feeling: Excited, anticipation
New behavior: Preparing for the part and going to the audition
We don’t know for sure if Maria will get the part. It’s scary to put ourselves out there and try something new. But we also know if she stays in her negative pattern she’ll never know, and she’ll likely regret not trying.
Of course, using the CBT triangle isn’t a one-time process. Maria will likely have other self-defeating thoughts she’ll need to challenge as well. However, with practice Maria can actually start to change her pattern of actively discouraging her own dreams and goals.
Eventually, her brain won’t go automatically to the negative thought. She’ll become a more naturally positive thinker.
Even if acting isn’t in her future, this can lead Maria to find things she does enjoy which make her happy. Or, she could actually end up the star of the play! She decides it’s worth the risk.
The Thought Highway
Humans have thousands of thoughts per day -- perhaps in the range of around 6,000. That’s a busy brain.
Think of your brain as not just one consciousness, but multiple ones. We have the instinctual areas of the brain which randomly churn out ideas and thoughts. Then we have other parts of the brain that organize this information, make sense of it, filter it, and make decisions.
Rather than simply accepting each automatic thought as fact, we could choose to observe and release certain thoughts.
This idea is a psychological, sometimes spiritual, concept often used in therapies like CBT, DBT (dialectical behavioral therapy) and ACT (acceptance and commitment therapy). It’s also consistent with brain science.
We know certain parts of the brain act more on fear instinct, while other areas are more balanced and intentional. We need each of these functions to live a balanced life. However, we need them working together, rather than independently.
In recent years, scientists have found that those who are more anxious, and/or those with PTSD may have an interruption in communication between these different areas of the brain. While the instinctual, reactionary portion of the brain is awake and active, the area that processes and makes sense of this instinctual reaction may be cut off.
Researchers are hoping this new information will lead to medications to help get these networks in the brain working together again. In my experience, we already have a behavioral technique that gets this highway moving again. The technique is CBT.
Combining the Three Points
When I work with people who have high anxiety, post-traumatic stress disorder (PTSD), or even depression, we work with each area of the triangle. Here’s how.
1. Validating Emotions
It does no good to dismiss, minimize, or ridicule our own feelings. While it’s common, it’s entirely unproductive, and unfair to ourselves. Feelings are a biological function, which most likely evolved to keep us safe.
When we are constantly told our feelings aren’t accurate, aren’t allowed, or are childish, we then form negative feelings about our feelings. (These even have a name -- they’re called meta emotions.) Even these feelings about our emotions are normal!
Counterintuitively, the best way to change an emotion is to accept it. Have you ever noticed that you felt better when someone finally “got” what you were saying, or how you felt about a situation? Simply feeling understood, which helps you validate your own feeling, can relax emotions.
Feelings are connected to the body. This seems particularly true for difficult feelings like fear, hurt, or disappointment. Next time you feel this way, notice how you know what you’re feeling. It’s most likely because your stomach is sinking, your body is shaking, or you feel a flutter in your chest.
Although feelings originate in the brain, we feel them in our body.
That’s because emotions are about protecting us. Your body alerts you that something is wrong. (Or in the case of positive feelings, that a situation is desirable.)
By learning to accept and validate your own feelings, you can create a better relationship with them. They will actually have less control over you, rather than more.
When I’m dealing with difficult feelings, or coaching clients about them, I look for a balance. This doesn’t mean feeling neutral, or even calm. It means giving yourself time to feel first, and then to work towards feeling better.
Even allowing yourself to have a tough feeling for a few minutes can be helpful. Try to relax into it, even if it’s painful, and accept it as is.
In some cases, you’ll already find relief through this acceptance. If you are still struggling after that, then you can return to your thoughts to look for a negative pattern. Your emotions may be persisting because your thoughts are keeping you stuck there.
2. Challenging Thoughts
Given we have thousands of thoughts per day, we can’t possibly moderate them all. Fortunately we don’t need to. However, we can zone in on the thoughts that are making our life more difficult.
These negative thought patterns tend to center around a theme. You’ll be quite familiar with them. Common ones are along these lines include:
I’m not good at a _______ (a certain thing)
There’s something wrong with me
I should be doing or feeling something that I’m not
I shouldn’t be doing or feeling something that I am
My life never goes well
People are against me
I don’t measure up to others
See? I told you this would happen
These thoughts can lead to very painful feelings that can make it difficult to function sometimes. However, consider this -- these thoughts are so common you just read it on a list written by a therapist.
That tells you how many other people must think the same way, at least some of the time. (In my experience it’s pretty much everyone.)
It also tells you that these thoughts may come from an inherent pattern in the human brain, and are quite often not based in fact. Perhaps they’re actually based on a confused instinct, or habit, and not in truth?
In CBT therapy, we take these thoughts one at a time and begin to challenge them. Over time, it becomes more natural to do so. The brain essentially reprograms how it naturally thinks. It’s pretty incredible.
3. Trying New Behaviors
The final point of the triangle is behavior. Remember Maria’s option to simply go to the audition, regardless of what she thought or felt about it? This is an example of how changing a behavior can interrupt the negative cycle.
First, Maria might get the part! This would certainly challenge her thoughts about it.
Or, she could not get the part, but be glad that she at least tried. Maybe she can ask for more specific feedback from the director so she can keep practicing for next time. She might decide to take an acting class, or try out for entirely different roles than she normally would.
Or, maybe Maria will decide to move on to something else, which would be okay too. Maybe she thought she wanted to be an actor but realizes she actually just enjoyed hanging out with the cast and crew. That could lead to a new role behind the scenes that she would enjoy more.
If she hadn’t tried something new (changing her “behavior”) then Maria may have still felt stuck, at home beating herself up for being bad at something.
Gradual Exposure
In my practice with those who have anxiety or PTSD, we often try a specific type of behavior change called gradual exposure. This involves taking small steps to challenge the body’s response to benign triggers.
For example, say Jack avoids driving since his accident a few months ago. Jack is sick of depending on friends, so he decides to gradually start driving again, despite how afraid he is of it.
Over time (quite possibly just a few weeks), Jack feels more confident and his driving gets back to normal. He interrupted the cycle at the behavior point by facing his fear.
Behavioral Activation
With anxiety and PTSD, I tend to start at the thought point and work into changing behaviors once the feelings are more neutralized. However, when it comes to depression I find that starting with the behavior works best.
When people are depressed, the negative thought patterns seem to go on overdrive. I find it is particularly difficult to change thoughts in the midst of depression. So instead, we can start with what’s called “behavioral activation.”
This could be as simple as going for a walk after isolating at home for several weeks. Just the act of getting outside, doing something different, and having a positive experience can be powerful. By making small behavioral changes, you can naturally begin to challenge your negative thoughts.
The activities of changing activities and environments can also have numerous biochemical effects, which are also connected to our thoughts and emotions.
As you may have noticed, the simple three-point CBT triangle represents quite a complicated process in the human brain and body.
However, you don’t need to understand all of the details for it to work. You can simply start by changing one small thought or behavior. That one step could lead to a whole new outlook in life.
Worksheets
CBT therapists l-o-v-e worksheets! These helpful tools can reinforce the concepts and allow you to walk through your specific thoughts. You can practice this in therapy, or do it outside of sessions or on your own.
The CBT triangle is a good foundation for learning the concepts. You can get a worksheet that includes the steps above for free by signing up for our updates. Check it out here.
You can also build upon the triangle. The CBT worksheet bundle includes 30+ pages of methods based on this approach.
Moving Forward
Do you want to work on changing your thoughts, feelings, or behaviors? These resources can help.
Look for a therapist who uses CBT strategies. To find therapists in your local community or state, check out SAMSHA, Open Path, or private therapy listings like Psychology Today or Therapy Den.
Try self-help CBT techniques. I’ve put all of the practices I use with my clients into a worksheet bundle you can purchase at an affordable price and use with yourself or your clients as much as you like. Check it out here.
Make small changes. It can feel overwhelming to change your entire life at once. Don’t try. Every big change starts with a tiny first step. Try just one new thought or behavior today to get rolling.
Jennie Lannette, LCSW, is a licensed, practicing therapist in Missouri, specializing in trauma, anxiety, and related mental health issues. She writes for numerous national mental health sites and publications, and recently published the book, Finding Peace from PTSD, available on Amazon.
Sources
Beck Institute (2020) https://beckinstitute.org/about/dr-aaron-beck/
Shim, M., Im, CH. & Lee, SH. Disrupted cortical brain network in post-traumatic stress disorder patients: a resting-state electroencephalographic study. Transl Psychiatry 7, e1231 (2017). https://doi.org/10.1038/tp.2017.200