Cognitive Behavioral Therapy (CBT) is a treatment that is notorious for its benefits in treating many types of mental disorders, most notably anxiety and depression. The premise of CBT is that the way we think influences our mood, and thus our actions. When unhelpful thinking patterns plague us day in and day out, we are bound to experience lower self-esteem and increased stress. In my work, I frequently use a metaphor to describe how CBT eventually helps shift these thought spirals. First, I think it’s necessary to provide an overview of CBT in order to understand how those changes will occur.
There are a number of different words for negative thoughts in CBT. I prefer to use the term ‘automatic thoughts’ because that’s exactly what’s so damaging about them—we’re thinking them without even realizing what’s happening. It can feel as automatic as breathing or blinking. This is where CBT comes in. The first step is simply to bring awareness to negative automatic thoughts. So for example, if you’re at a social event and it seems like everyone else is having a good time and chatting away, notice if you are thinking:
“Nobody wants to talk to me.”
“Everyone else is happy and I’m the only one who feels anxious.”
“I might as well just leave.”
These thoughts are full of distortions. By thinking that nobody wants to talk to you, you’re jumping to conclusions. By thinking that everyone else is having fun, you’re overgeneralizing and engaging in a form of mind-reading. And by thinking that you might as well just leave, you see how negative thoughts lead to unhelpful behaviors.
Thoughts Aren’t Facts
I like to remind my clients that you don’t have to believe every thought that you have. When you bring awareness to the automatic thoughts that are causing depression or anxiety, the work to shift them begins. In the beginning stages of CBT, many people become frustrated that they notice the persistence of their negative thoughts, but they still struggle so much to alter them.
I use what I call my “sledding metaphor” to explain why it takes so much consistent practice and effort to change the thoughts. Most of us remember how much fun it is to go sledding down a big hill after a snowstorm. When the snow is all packed down into a nice pathway, the sled absolutely flies down the hill. But when you try to make a new pathway in the snow, it’s usually hard and the sled gets stuck in the deep, powdery snow. You certainly aren’t flying.
In order to make a new trail, you have to push the sled down again and again, in a much more effortful and purposeful way than with the well-worn path. Automatic thoughts are like the well-worn sledding path. It’s easy and natural to go down and doesn’t take much conscious effort. As with sledding, it’s not easy to create a new pathway in the brain. But here’s the great thing about our brains—we can rewire them so that eventually our automatic thoughts are healthier and more balanced. Through repeated practice, you create new automatic thoughts.
This doesn’t mean that instead of thinking “everyone hates me,” you automatically think “everyone loves me.” Instead you become curious about whether or not it’s actually true that everyone hates you. Again and again you find the evidence that you aren’t as bad as you think you are, until eventually you might automatically think you could stay at a party and have fun talking to others. It takes persistence and dedication, but CBT has the power to help you make lasting changes in mood, anxiety, and behavior.