Cognitive behavioral therapy, or CBT, is an evidence-based approach that helps change negative thinking patterns. Many studies show it is effective for treating anxiety. CBT works by helping you become aware of your thoughts and beliefs, identify your harmful thinking patterns, and learn new ways of thinking and behaving.
If you’ve ever experienced anxiety, you know that it can easily take over your thoughts. Your worries about a future event can spiral, subside, and spiral again. These fears and worries are often about potential negative events which may not happen or be true. This anxiety cycle can create feelings of panic in our body, causing physical symptoms such as an increased heart rate, shaking, shortness of breath, or dizziness. A CBT therapist will teach you to identify where your views may be negative or distorted. Once you recognize these patterns, you can learn to replace these thoughts with an alternative.
What will you learn with CBT?
In cognitive behavioral therapy, the goal is to help you change your thoughts and behaviors. In order to do this, you must first recognize that not all of your thoughts are true or helpful. In fact, some of your thoughts are likely cognitive distortions — an irrational, inaccurate, and often negative thought patterns. During cognitive behavioral therapy, you’ll learn how to identify cognitive distortions, including some of the following:
- Jumping to conclusions/Catastrophizing. Even if you lack the evidence, you imagine or conclude the worst possible outcome.
- Example: Lately, my boss has been slow to respond, and his tone in his emails is short. What if he’s planning to fire me?
- Overgeneralization. You tend to think in “always” or “nothing” terms and often make sweeping generalizations based on one or a few events.
- Example: The last few times I’ve gone to social events and put myself out there, I’ve felt really awkward. I’m never going to be able to build more friendships.
- Mind reading. You make assumptions or interpret others’ behavior as being connected to you, even if it may not be related.
- Example: My friend hasn’t responded to my text from two days ago. She must be upset at me. I’ve done something wrong and offended her.
- Fortune telling. Even if you can’t know how the future will play out, you believe you know a situation will turn out badly.
- Example: There’s no point in asking for a promotion. I just know I’m not going to get it. Better not even get my hopes up.
- Polarization/Black and white thinking. You think in absolutes and only see things in black and white, struggling to see how some issues can be more complicated.
- Example: My partner ate my leftovers that were in the fridge. He’s always so selfish and inconsiderate of me.
- Personalization. You tend to attach personal meaning to the words of actions of others, or believe that you are targeted.
- Example: I saw on social media that several of my friends got brunch this weekend. No one ever reached out to invite me. They must secretly dislike me and didn’t want me to be there.
These are just a few examples of how our thoughts can influence our feelings and actions. In session, you’ll start to become aware of when you may be believing cognitive distortions. Your therapist will give you homework to help you create alternate thoughts. As you learn to reframe your thoughts, your anxiety symptoms will decrease as you feel more comfortable with uncertainty and not knowing the future.
How can you reframe your thoughts?
One of the first steps in reframing your thoughts is to evaluate the evidence. Often, your brain is biased to be hard on you and assume the worst. Your brain is trying to protect you from hurt. While it’s important that your brain responds this way when you’re in real danger, it’s not so helpful in day-to-day life. A CBT therapist will help you recognize that not every thought that goes through your mind is necessarily true. You’ll learn to evaluate whether that thought is true by assessing the evidence, like:
Do you know if you’ll get turned down for a promotion?
Do you know, for certain, why your friend hasn’t replied to your text?
In this process, a CBT therapist may have you fill out a worksheet identifying the thought, looking at evidence, and coming up with an alternate thought. For example, perhaps the situation is that you fear going to social events because you feel awkward. Your therapist would then help you identify your thoughts, which is where cognitive distortions may come in: “I’m always going to feel this way” or “I’m never going to make friends.” Next, you identify emotions. In this situation, perhaps some emotions would be loneliness, fear, embarrassment, and nervousness. Then, you notice how you behave after experiencing these thoughts and feelings. In this scenario, your behavior would likely be that you avoid any social events because your brain has convinced you that it will be a negative experience. Lastly, your therapist will help you come up with an alternate thought: “Maybe I will meet a new friend if I go to this event tonight” or “I might feel a little nervous about social events, but if I go, I may end up enjoying it.”
In the process of CBT, you’ll learn how to acknowledge that your anxiety is trying to protect you from hurt. You’ll also learn to respond to yourself with kindness and to practice self-compassion. With practice, you’ll tell yourself, “I know how hard I’ve been working, and that can give me the confidence to ask for a promotion.” Or, “It’s okay, I’m going to risk of putting myself out there, even if I fear rejection!”
How can you get started with CBT?
Search for a therapist who is trained in CBT and specializes in anxiety. We offer CBT and look forward to helping you with your anxiety. If you’d like to get started with us, you can learn more here.