To understand cognitive behavioural therapy, you have to know what cognitive thinking is:

Definition of cognitive thinking:
Cognitive thinking is a process of conscious reasoning, evaluation and judgement, based on observation, knowledge, logic, deliberation and analysis to achieve rational understanding, in contrast to untested or volatile thoughts.

In simple terms, a cognitive thought is the opposite of hasty, untested or misleading thoughts.

Fast thinking helps us when a quick response is needed, while instinct, intuition, theory and emotion can guide our decisions. Though these serve us well in some situations, none of them are reliable. Sometimes they can even get us into trouble. Cognitive thinking, on the other hand, is based on proper consideration of realistic facts, bringing more clarity and better long-term solutions.

If we constantly allow self-defeating thoughts and negative assumptions to dominate our reasoning, we surrender ourselves to a lifetime of suffering.

Cognitive thinking is a pragmatic way to view a problem from a different angle, empowering us to feel better, take control and solve the problem more efficiently.

Although it seems simple, cognitive skills are not so easy to acquire or maintain. Our minds are powerful, yet vulnerable, and we can easily become emotionally compromised. In modern society, where exposure to high levels of frustration ensue, it is common to develop a pattern of pessimistic thinking and to start believing in misperceptions.

Negative thought patterns cause distressing emotions, which lead to a broad range of other problems. Many people try to cope with mental discomfort by adopting negative ways of dealing with it, such as taking drugs or exploring other unhealthy avenues to find temporary satisfaction or to escape from the anguish. Easy access to questionable temptations adds to the fray.

Often, negative thinking becomes a way of life for many of us. It has, in fact, become one of society’s most common problems. We may not have the power to change the world, but we can learn to cope better by reshaping the way we think and react – and that is what cognitive behavioural therapy is for.

What is Cognitive Behavioural Therapy?

 

Cognitive behavioural therapy, also called CBT, is one of several types of psychotherapies based on cognitive thinking. It differs from the analytical approach of looking for hidden emotional wounds, but it is often used in conjunction with such therapies.

As part of our natural protective instincts, we tend to focus on negative thoughts, which we perceive as threats, and we pay scant attention to the positives. Guarding against threats is natural, but it becomes a problem when we allow pervasive negative thoughts to overwhelm us.

People suffering from mental distress tend to have distorted or false views about themselves, their predicaments and environments. Cognitive therapies challenge these unrealistic, invasive thoughts by restructuring a person’s thought processes. The goal is to enable the person to adopt a more balanced outlook, relieving their anguish and improving their ability to deal with problems.

During CBT treatment, the patient is evaluated by a professional therapist who identifies the problem areas, informs the patient about all aspects of the problems and the proposed solutions, designs a treatment plan, discusses it with the patient and then proceeds with the treatment.

In the primary process, patients are not given rigid instructions about how to reach the desired objective (or outcome). Instead, they are assisted to plan their own route and to set their own goals along the path leading to the objective. This allows them to discover what is most important to them in their lives (the goals they set) and also empowers them to heal and sustain themselves.

Mindfulness and living in the present are concepts that form part of the treatment plan. Mindfulness and “living in the present” enable patients to see their thoughts for what they really are, not what they seem to be and, also, how to avoid being unnecessarily tortured by nagging thoughts from the past and the future.

Patients also learn how to control their immediate reactions to events, or triggers, that unexpectedly crop up in daily life.

The Basics of CBT

When people suffer from mental distress, temptations or addictions, it dominates their thoughts and actions. CBT empowers them to take control of their thoughts and to determine their own priorities. Often, we form our own distorted ideas of what others think, how events may turn out or how the world functions in general. CBT teaches us to think logically rather than making assumptions.

CBT assumes that behaviours are learned and can, therefore, be unlearned. Patients can learn new behaviours to replace the unhealthy ones. CBT does not tell a person how to feel but gives them the skills to determine how they want to feel and how to achieve and maintain it.

CBT is not just useful for rectifying a negative thinking habit. It is also used as a complementary therapy, in conjunction with other therapy techniques, for the treatment of addictions, other behaviour problems and diverse emotional disorders.

In many cases, CBT can be just as effective as medication and often a better solution, as it eliminates the dependency issues and other side-effects of prescribed drugs.

Vital components of CBT

Mindfulness: Not a therapy in itself, but a concept used in various cognitive therapies. Being mindful of intrusive thoughts allows us to stop, dismiss or control them. By being aware, we can arrest the thoughts, rather than allowing them to nag us. Helps us to see thoughts for what they actually are, rather than the distorted, insistent perceptions that the mind imposes.

Living in the present: A concept used in cognitive therapies. Anxiety and depression are created by thoughts about the future and the past. Living in the present means ignoring thoughts from the past or future and accepting thoughts created at this moment, here and now, as the only reality. Enables you to step aside, as if you are an observer, and to evaluate the intrusive thoughts from a neutral point of view.

Remedial learning: By applying the basic cognitive concepts of mindfulness and living in the present, we can transform overwhelming thoughts into more manageable ones. It enables us to prevent anxiety, stress, panic, depression and to formulate clear, more efficient responses and behaviours. We can then, by means of repetition, unlearn old behaviours and learn new ones.

Is Cognitive Behavioural Therapy necessary?

Restoring cognitive thinking and healthy behaviour involves more than simply deciding to be more positive about things. It requires changes in our mindsets, identifying and dismantling established defective thought patterns, acquiring new ways to identify and separate reality from delusion and learning how to deal with intrusive thoughts and events that trigger negative feelings and reactions.

Our minds are complex and our backgrounds and circumstances differ greatly. Usually, a negative temperament has several underlying issues and requires a specialised, multi-faceted treatment program. There is no simple or “one-size-fits-all” test or solution.

Because we are so over-exposed to negative influences in modern society, sombre thoughts and tainted actions can easily become an overwhelming way of life. It becomes so embedded that people find it almost impossible to break free, but properly applied CBT can turn that around and restore your quality of life.

The nature of modern life can instil gloomy thought patterns, but more often it is rooted in deeper emotional issues. It does not make you a weakling – it simply means you are more vulnerable, in the same way, that some people are more vulnerable to diabetes. Trying to prove the strength of character by fixing it yourself, will most probably not work and failure can result in even more negativity.

Every action starts with a thought, so adopting a positive outlook is a good start, but we also have to ensure that our actions align with our thoughts. Very often a good decision is wasted because we renege and, instead, spend the allocated time doing something less worthy. Similarly, we may resolve to ignore minor events that usually upset us, yet react fiercely the next time it happens.

Because our own thoughts and feelings are so close and intimate to us, it clouds our judgement and makes it difficult to heal ourselves without proper coaching. This is why mental health professionals undergo CBT training and spend a great deal of their time teaching patients to master it.

It is reasonably easy to spot a negatively-minded person, but identifying all the factors and designing an efficient remedial programme requires extensive knowledge and experience. Over the decades, the mental health professions have developed various therapies that can be shaped into specialised programs to fit the specific requirements of individual patients.

It is best to ask a mental health worker for advice when you suspect that someone needs CBT. Keep in mind that it is not just drug abusers who suffer. Often sober people are taking the immense emotional strain, as reflected in the increasing suicide rate and other violent tragedies, and they need help just as urgently.

Your brain has the ability to adapt (it’s called neuroplasticity) and it will if you want it to, but for proper guidance and long-term security, you need that professional touch.

Examples of Other Cognitive Therapies

Many cognitive therapy techniques, targeting different types of disorders, have emerged since the introduction of CBT. Though the basic principle of cognitivity remains the same, the various techniques cater for specific conditions where certain symptoms are too prominent for a generalised treatment module. Here are some examples of the many cognitive treatment variants:

Acceptance and Commitment Therapy (ACT)

Instead of combating distorted thoughts, ACT proposes that we freely accept them, but then strip them of any importance. Useful for people who find it hard to avoid or reverse negative thoughts. Read more about ACT Here.

Cognitive Emotional Behavioural Therapy (CEBT)

Originally for patients with eating disorders but now used for a variety of problems, such as depression, anxiety, obsessive compulsive disorder, anger management, post-traumatic stress disorder. Patients learn to understand and tolerate their emotions.

Cognitive Processing Therapy (CPT)

Repairs emotional damage caused by a traumatic event. Helps people to recover from post-traumatic stress disorder by deconstructing traumatic events to reduce ongoing negative effects.

Compassion Focused Therapy (CFT)

Reduces high levels of shame, anger, self-criticism and lack of kindness to themselves and others due to historical abuse, bullying, neglect, anxiety, lack of affection.

Dialectical Behaviour Therapy (DBT)

Originally for suicidal people with borderline personality disorder. Later adapted for disorders like substance abuse, hair pulling, eating disorders, explosive anger, depression and anxiety.

Exposure and Response Prevention (ERP)

For obsessive compulsive disorders and other anxiety disorders. Patients are exposed to situations they fear. Continued confrontation with the objects they fear gradually desensitises them.

Functional Analytic Psychotherapy (FAP)

For interpersonal relationship problems, panic, trauma, anxiety, obsessive compulsive disorder, depression, etc. The therapist provokes patients during sessions to expose and, simultaneously, heal their problems by building a state of awareness in the patient.

Habit Reversal Training (HRT)

Developed to treat repetitive behaviour disorders, including tics, hair pulling, nail biting, thumb sucking, skin picking and stuttering.

Integrative Couples Behaviour Therapy (ICBT)

For changing behaviour and conflict resolution issues of couples. Includes communication, empathy, understanding, acceptance, expectations, assumptions, preferences, irritations and other issues.

Mindfulness Based Cognitive Therapy (MBCT)

Integrates mindfulness with cognitively to deal with chronic pain, hypertension, gastrointestinal disorders and other medical conditions, as well as chronic depression.

Moral Reconation Therapy (MRT)

Helps to overcome antisocial personality disorder and narcissism to decrease the risk of committing criminal and civil offenses.

Prolonged Exposure Therapy (PET)

For post-traumatic stress disorder, depression, anxiety and anger due to traumas like abuse, rape, assault, accidents, war and other disasters. Includes substance abuse cases. Reduces chronic fear and restores ability to distinguish between safe and unsafe situations.

Relapse Prevention (RP)

Teaches how to pre-emptively identify and avoid risks that trigger substance abuse, obsessions, compulsions, offenses, obesity and depression. Important part of treatment for alcoholism and drug abuse.

Schema Therapy (ST)

Teaches patients how to decrease the intensity of emotions and body sensations with new coping skills. Useful for treatment of personality disorders and cases where patients failed to respond or relapsed after completing other therapies.

Stress Inoculation Training (SIT)

A blend of cognitive, behavioural and humanistic training to help patients cope with stress or anxiety. It trains them to adapt skills that they already have and adds additional skills to enable them to control the stressors.

Structured Cognitive Behavioural Training (SCBT)

Intended to produce a specific result within a set period of time. Mainly used for addictions and behaviours related to alcohol, smoking, stress, anxiety and the management of diabetes.

Common Effects of Detrimental Thoughts

Examples of unhealthy thoughts

A prime example of a negative thought is the use of extreme words, as though the problem is infinite and inescapable, for instance: “My ideas never work, everything I do always fails.”

Other common examples of unhealthy thoughts are:

  • Telling yourself that nobody wants, likes or needs you.
  • Comparing yourself to a glorified perception of someone else.
  • Judging with your emotions, instead of looking at the facts.
  • Feeling unappreciated, undervalued, neglected, left out.
  • Catastrophising, always expecting the worst possible outcome.
  • Predicting negative results and subconsciously making it happen.
  • Exaggerating negative opinions and diminishing the positives.
  • Always attaching a negative side to every positive observation.
  • Hammering on minor problems, raising it to irrational importance.
  • Reading other peoples’ minds, imagining how lowly they rate you.
  • Replaying past events in your mind to confirm your poor conduct.
  • Holding yourself back, because you fear you will be rejected.
  • Avoiding any challenging task because you are “not good enough”.
  • Seeing the success of others as a failure by you to achieve the same.
  • Rating yourself as “lower class” because of parental home problems.
  • Wanting to avoid responsibility, supervisory or management roles.
  • Clinging to your “comfort zone”, because you doubt your abilities.
  • Wanting to avoid the spotlight, because you feel undeserving.
  • Avoiding the spotlight, because you fear being judged by others.
  • Over-focusing on ways to gain the approval of other people.
  • Sacrificing or inconveniencing yourself to impress other people.
  • Accepting the role of caretaker in an abusive relationship as a duty.
  • Unfairly blaming yourself for the failures of other people.
  • Setting rigid, high personal goals, not allowing yourself error space.
  • Rejecting your own work, because it is not perfect enough.
  • Expecting rigid, high standards of conduct from all other people.
  • Inventing excuses to avoid sharing strong emotions with others.
  • Taking things too personally, feeling every remark is aimed at you.
  • Believing that a positive attitude is risky, dangerous or exploitable.
  • Wanting to hurt, harm or punish yourself to earn forgiveness.
  • Focusing on quick fixes, like drugs, to ease mental discomfort.
  • Fixating on overeating, weight loss, pornography, gambling, etc.
  • Believing you cannot live without drugs or similar escape routes.
  • Feeling that others are overreacting to your negative behaviour.
  • Always procrastinating, putting off or delaying things.

Disorders treated with CBT

A vast number of psychiatric disorders are treated with CBT, often in conjunction with other therapies.
These are some of the examples:

Cognitive behavioural therapy (CBT) is a well established therapy technique used to treat the many mental and emotional issues. Cognitive behavioural therapy or CBT has been successfully used in treating many conditions, including addiction, depression, phobias and post traumatic stress.

Treatment options and rehabilitation facilities in South Africa

Attempting self-help CBT procedures at home is not a practical option. When someone is overwhelmed by intrusive thoughts or mental distress, expecting them to apply complicated mental therapy without assistance, is like telling someone with a broken leg to climb a ladder.

It is also quite common to hear people telling someone to stop being negative. Unfortunately, the process of changing a person’s intrinsic thought patterns involves much more than simply adopting a more positive attitude. It sounds simple, but it involves much more than the average person realises. People who are prone to pessimism or vulnerable to emotional distress, will most probably fail if they attempt self-healing without professional assistance and end up with even worse feelings of failure, frustration, negativity and anguish.

When one considers that problematic thought patterns severely affect almost every aspect of a person’s life, then the accumulated lifelong benefit derived from attending a professional treatment programme is clearly the best option. South African mental health professionals are highly trained in the intricacies of CBT treatment and the country offers world class rehabilitation centres where cognitive thinking techniques are successfully applied on an ongoing basis.

Main causes of negative thinking

  • Dysfunctional families (especially for their children).
  • Traumatic experiences (abuse, rape, assault, etc.)
  • Other traumas (death of loved one, betrayal of trust, etc.)
  • Abuse of alcohol/drugs or lengthy exposure to an addict.
  • Phobia (irrational/excessive fear of something).
  • Mental disorders (depression, stress, anxiety, etc.)
  • Debt, unemployment, poverty, unsuitable environment.
  • Boredom, loneliness, isolation, illness, physical pain.
  • Total loss of substantial material property/possessions.
  • Caretaking of chronically or terminally ill person.
  • Over-exposure to other negative or cynical people.
  • Sensitivity to societal influences (culture, politics, etc.)
  • Racial, gender, religious or class discrimination.
  • Sensitivity to negative media reports, rebelliousness.
  • Overthinking, ruminating about negative aspects.
  • Seeing positivity as unrealistic, misleading, reckless.
  • Conditioning the mind to automatically react negatively.

Behaviours caused by negative thinking

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