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Cognitive Behavioral Therapy (CBT)
AND WHY EVERYONE NEEDS IT
WATCH THE VIDEO:
You may have heard of the therapeutic practice known as CBT, or cognitive behavioral therapy. But the word therapy leads a lot of people to think this practice is only necessary for those who are struggling with mental illness.
The truth is that the practices found within CBT are among the most essential life skills a person can have. A human being without CBT tools is like a software developer who can’t code. This deficit leaves you with little ability to go in and edit the faulty programming in your own mind, fix the bugs in your thoughts and emotions, and keep your psychological software running smoothly.
Some people view therapy as a sign of weakness, but in reality, it’s a sign of health insurance. You don’t actually need a therapist to apply these principles effectively, and you’ll be shocked by how much they affect your life, no matter where you currently fall on the well-being scale. In this video, I’m going to cover all the essentials for using CBT to master your own mind.
No clear line separates healing from upgrading. Medicine almost always begins by saving people from falling below the norm, but the same tools and know-how can then be used to surpass the norm.
—Yuval Noah Harari, Homo Deus
Hello psychitects! I really enjoyed all the comments the Eckhart Tolle video got, and it’s good to see I’ve gotten people thinking, and potentially challenged some perspectives. And challenging our perspectives just happens to be the critical component of today’s video on CBT. I am deeply passionate about teaching the ideas in CBT – I have emphasized their importance in every book, product, and program I have created – so I hope you’ll watch to the end.
Cognitive behavioral therapy is the single most effective treatment for mental disorders like depression, consistently beating out a full course of antidepressants over the long term, both in its efficacy and lack of side effects. CBT will show you how your distorted beliefs and automatic thoughts are responsible for the majority of your negative emotions and bad moods. And it will teach you exactly how to eliminate them for good.
Though it was officially developed in the 20th century by Aaron Beck and Albert Ellis, CBT’s roots run far deeper than that. The ancient Greek philosophy of Stoicism held that we should refrain from all qualitative judgment of events or circumstances and view them with total objectivity. The Stoics were some of the first to point out that our environmental stimuli seem not to have direct control over our emotional experience, and that our thoughts must be complicit in any emotional reaction. Epictetus said,
Remember, it is not enough to be hit or insulted to be harmed; you must believe that you are being harmed. If someone succeeds in provoking you, realize that your mind is complicit in the provocation.
—Epictetus, Enchiridion
This perspective was reexamined in the late 20th-century and has come to represent a core principle of our current psychological understanding. Despite the prevailing therapies at the time, which focused on hidden, unconscious forces behind our neuroses, psychiatrist Aaron Beck proposed that we may be looking right past the real source of our negative moods.
Let us conjecture, for the moment, that a person’s consciousness contains elements that are responsible for the emotional upsets and blurred thinking that lead him to seek help. Moreover, let us suppose that the patient has at his disposal various rational techniques he can use, with proper instruction, to deal with these disturbing elements in his consciousness.
—Aaron Beck, Cognitive Therapy and the Emotional Disorders
As you introspect, you will find that your feelings are always preceded or accompanied by thoughts. A thought that interprets an event to be good will result in a positive emotion, and one that interprets it to be bad will result in a negative one. Cognitive therapy says that the cognitive catalysts for our emotional reactions are called negative automatic thoughts. What you may not realize is just how much power you have to choose your interpretation of these events. Dr. David Burns says:
Our research reveals the unexpected: Depression is not an emotional disorder at all! The sudden change in the way you feel is of no more causal relevance than a runny nose is when you have a cold. Every bad feeling you have is the result of your distorted negative thinking. Illogical pessimistic attitudes play the central role in the development and continuation of all your symptoms. Intense negative thinking always accompanies a depressive episode, or any painful emotion for that matter.
—David Burns, Feeling Good
CBT is centered around the process of cognitive restructuring, which identifies distorted and maladaptive thoughts and beliefs, and replaces them with healthier and more accurate ones. Now I know the advice to think happy thoughts is just like Marvel movies – we’re all sick of it at this point. But I want to emphasize that this process is not the same as simple positive thinking.
Forced optimism and suppression have been found largely ineffective, or even counterproductive. But cognitive restructuring has been consistently found to result in more positive and sustainable moods, less depression, and greater life satisfaction.
And in order to create these changes and alter our thought patterns, we first need to become aware of them, which brings us to step one of the restructuring process:
- Notice and log your “hot thoughts”
Our first task is to start noticing and writing down the thoughts that are relevant to our moods. For those who aren’t used to noticing their own thoughts, this can be a difficult and unnatural practice at first. It can be helpful to identify negative automatic thoughts using questions like this:
• What was going through my mind just before I started to feel this way? • What images or memories do I have in this situation? • What does this mean about me? My life? My future? • What am I afraid might happen? • What is the worst that could happen? • What does this mean about how the other person(s) feel(s)/think(s) about me? • What does this mean about the other person(s) or people in general?
– Mind Over Mood
Then, decide whether you want to use a notebook, an excel doc, or better yet a Notion board for your log. For Mindform members, I actually offer a really useful interactive logging tool. Then start paying careful attention to any negative emotions or bad moods that arise in your mind.
As soon as you catch one, fill out three columns in your record:
Column 1: Mood (the emotion you felt, and its intensity, on a scale from 1-10)
Column 2: Situation (the actual event or environment that triggered the feeling)
Column 3: Automatic Thought(s) (the phrases or images that popped into your head when the bad mood came on).
Anytime you experience a negative mood, whether it’s sadness, guilt, or anger, add it to the mood field on your log, and add the situation that seems to have triggered it all into the Situation Field.
Then, try to remember what was going through your head when that mood came on. Sometimes these thoughts come in the form of words. So you can put things like “he did that just to upset me” or “I’m never going to find someone.” Other times, they are images you visualize inside your head. So you can say “image of my boss yelling at me” or “image of my friends all laughing at me.”
Over time, you will start to find patterns in the thoughts you come across. You will notice that a certain type of thought seems to come up a lot, and that it’s in some way linked to your negative mood spirals. And best of all, you will find that this recognition in itself will start the process of improving your mood. Identifying patterns in your negative moods is a clear step toward understanding and changing them.
- Question Your Cognitions
The restructuring process we are going through requires us to question and evaluate the contents of our thoughts, much like a scientist would evaluate evidence for a hypothesis. We need to identify and document the evidence for and against our beliefs and self-evaluations. We need to observe and write down our evidence that we lack an important strength, and the counter-evidence that we have that strength.
As you continue adding thoughts and moods to your log, you’ll want to complete the next two columns on your thought record.
Column 4: Evidence for (Evidence that supports the automatic thought), Column 5: Evidence Against (evidence that does not support the automatic thought)
For example, let’s say you get turned down for a job at your local video rental company, and you think to yourself “I’m never going to get a good job.” You could write down the one rejection as evidence for your negative belief. But as evidence against your negative belief, you could write down the fact that you have a master’s in data science, have gotten several recent job offers in your field, and were specifically told this company is bankrupt and not hiring. Honestly, I have no idea what you saw in that job in the first place, Sarah.
It’s usually pretty easy to find the evidence that supports your thought (my friend rolled her eyes at me, my coworker made a terse comment about my presentation). But coming up with evidence against your conclusions can be more difficult. A few questions you can ask to try to generate evidence:
“What is the evidence that your thought is true? What is the evidence on the other side?” “What is an alternative way of viewing this situation?” “What is the worst that could happen, and how could you cope if it did? What’s the best that could happen? What’s the most realistic outcome of this situation?” “What is the effect of believing your automatic thought, and what could be the effect of changing your thinking?” “If your [friend or family member] were in this situation and had the same automatic thought, what advice would you give him or her?” “What should you do?”
- Judith Beck, Cognitive Behavior Therapy: Basics and Beyond
The evidence you write down must consist of objective facts, not opinions or interpretations. Your friend giving you a weird look is a fact; your friend hating you is an interpretation of that fact, and does not belong in the evidence category.
Now after some practice, it will become an automatic habit for you to compile the evidence related to your negative thoughts. But for now, you want to be very deliberate about logging this evidence and make sure to write all the evidence for and against your thoughts. This logging practice is only going to get more and more powerful as we add to it, so get excited!
- Cognitive Restructuring
You may feel like you are unique in your problems – that no one else understands what you’re going through. But just like people who say their least favorite word is moist, it turns out that we’re usually not nearly as unique as we think we are! There are several extremely common distortions underlying our negative automatic thoughts. They tend to center around forming warped conclusions about our worth or competencies.
Here are ten of the most common distortions:
1. All-or-Nothing Thinking
The tendency to think in extremes like “always” and “never” without considering nuanced degrees between.
“My boyfriend broke up with me; I always ruin my relationships.”
2. Overgeneralization
The tendency to make broad assumptions based on limited specifics.
“If one person thinks I’m stupid, everyone will.”
3. Mental Filter
The tendency to focus on small negative details to the exclusion of the big picture.
“My A+ average doesn’t matter; I got a C on an assignment.”
4. Disqualifying the Positive
The tendency to dismiss positive aspects of an experience for irrational reasons.
“If my friend compliments me, she is probably just saying it out of pity.”
5. Jumping to Conclusions
The tendency to make unfounded, negative assumptions, often in the form of attempted mind reading or fortune telling.
“If my romantic interest doesn’t text me today, he must not be interested.”
6. Catastrophizing
The tendency to magnify or minimize certain details of an experience, painting it as worse or more severe than it is.
“If my wife leaves me, then I will never be able to recover from my misery.”
7. Emotional Reasoning
The tendency to take one’s emotions as evidence of objective truth.
“If I feel offended by someone else’s remark, then he must have wronged me.”
8. Should Statements
The tendency to apply rigid rules to how one “should” or “must” behave.
“My friend criticized my attitude, and that is something that friends should never do.”
9. Labeling
The tendency to describe oneself in the form of absolute labels.
“If I make a calculation error, it makes me a total idiot.”
10. Personalization
The tendency to attribute negative outcomes to oneself without evidence.
“If my wife is in a bad mood, then I must have done something to upset her.”
Identifying these distortions in your thoughts doesn’t have to be a painful process. It can actually be fun! It can be genuinely exciting to examine one of your thoughts and say “aha! Disqualifying the positive!”
The next goal is to form an alternative balanced belief. So look at your original thought, look at the evidence supporting and conflicting with it, and look at the distortions that might be skewing it. Ask yourself whether this thought was realistic, or if there is a more reasonable, accurate conclusion to form, and write that thought down.
Now to be clear, you don’t have to write down the opposite of your negative thought. If you thought “everyone hates me,” you don’t necessarily need to write “everyone loves me” for your alternative thought. Both of these are likely to be unrealistic and distorted. But you might conclude that “my close friends and family love me, most people who meet me like me, but there are probably a few people who dislike me.”
After you’ve formed an alternative, balanced belief, the last step is to write down your updated mood, along with an intensity rating. If you felt despair and loneliness with a 60% intensity rating, perhaps it has gone down to 30% now. This shift will likely correspond to how much you believe your alternative, balanced belief. So if your mood hasn’t changed, it probably means you aren’t convinced of the new belief, and you may need to return to the evidence.
So add the following columns to your log:
Column 6: Distortion (which of the ten distortions, if any, are characteristic of the thought)
Column 7: Alternative/Balanced Thoughts (with credibility rating)
Column 8: Updated Mood (with intensity rating)
Now on occasion, our negative beliefs do turn out to be true. And to be clear, yes, all the people you went to high school with really are all still thinking about that time you tripped and your braces got stuck in the carpet, because let’s be honest, that was hilarious. But you’ll find that this is extremely uncommon, and when it is the case, it usually indicates that you need to change your actions.
Then, revisit the mood and emotions you experience when you think about this balanced belief. Do you still feel the same way as before, or has this evaluation caused your emotions to change? Write down the mood and give it a new intensity rating (and be sure to let us know how it changed).
Here is an example from a patient named Ben’s thought record:
After looking several times at the evidence in column 5, Ben concluded that the evidence did not consistently support his thought, “The kids and grandkids don’t need me anymore.” Ben decided that a more accurate and balanced way of understanding his experiences was: “Even though my children and grandchildren don’t need me in the same ways they used to, they still seem to enjoy being with me and asked for my advice a few times. They paid attention to me, although the attention was not the same as it has been in the past.” After Ben wrote this balanced thought, he noticed that the intensity rating of his sadness decreased from 80% to 30%.
Now it may be hard to believe, but logging and restructuring your thoughts really does give you a shocking amount of power over your moods. We know this, both because of the impressive first-hand results we get when we go through this process, and because of the towering data backing it up.
The magic of this practice is that it will allow you to start finding the common themes and patterns of your moods very quickly. Just a week or two of logging and restructuring will likely result in profound insights and the sense that your emotional struggles are far more solvable than you have assumed.
Now I’ve tried to pack as much value into this video as I could, but inevitably, I can’t cover the entire process of CBT. But if you’re interested in learning more, I did create a full-length 30-day program teaching these principles and a lot more ideas that have helped people get out of depression and build toward a flourishing life, so you can learn more in the description.
Have you been able to identify any distorted beliefs in your own thoughts? How has your mood changed when you’ve changed the way you interpret a situation?