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Therapy isn’t always what it looks like in movies and movies, with a despondent client sprawled across an old couch while a stoic therapist asks prying questions.
In reality, therapy looks a little different for everyone. For people who think therapy is just “talking about your feelings” or “analyzing your past,” cognitive behavioral therapy, or CBT, might offer a more focused and goal-oriented approach.
CBT is about becoming aware of your thought patterns and learning how to respond to them in healthy ways.
“The most central principle in CBT is that our thoughts and feelings influence our behaviors,” says Liz Witmer, PhD, a licensed clinical psychologist and adjunct professor of counseling at George Washington University. “When we examine our patterns, we can break the links between negative thoughts and negative behaviors.”
This type of therapy is particularly effective for depression, anxiety disorders, addictions, and eating disorders, according to the American Psychological Association. CBT can help people with these mental health issues learn to disrupt the pervasive and destructive thought patterns, and it might empower them toward recovery.
But anyone can probably benefit from the philosophies of CBT. You likely feel agitated, defeated, or stressed from time to time, and you’ve probably made at least a few iffy choices based on those feelings. As an added bonus, incorporating CBT principles into your life can help keep garden-variety anxiety from festering into a full-blown anxiety disorder.
Even if you’re OK with your current mental health status, here are life lessons cognitive behavioral therapists wish everyone knew and practiced.
Typically, you base your thoughts on a combination of your previous experiences, your five senses, and logic. This helps you learn, say, not to touch a hot stove, to go inside when you see lightning, and to turn down your music when your coworker starts giving you the side-eye.
But not every thought lines up with facts. “Negative thoughts pop into our heads that are faulty,” says Amanda Petrik, LCPC, a therapist who specializes in CBT for anxiety disorders. In CBT, these faulty thoughts are known as cognitive distortions. “If we can recognize when these thoughts are not realistic, then we have a better chance of reframing them.”
Common cognitive distortions that people engage in:
The best weapon against destructive thoughts is seeking evidence to the contrary. For example, if you get to work five minutes late and begin to panic that you’re definitely going to be fired or that you’re a failure or a horrible person, you’re making a stress-inducing assumption before gathering evidence.
Being late to work is a fact. But worries about getting fired or being a failure are assumptions. “I would suggest slowing down,” says Sweta Venkataramanan, PsyD, licensed clinical psychologist in New York City. “Where did you find information to support the conclusion that you’re a horrible person? Did anyone say this to you? Are all people who are late ‘horrible people’?”
Ever find yourself feeling a little blue, and the next thing you know you’ve spent hours sulking in bed, watching Sleepless in Seattle, eating Frosted Flakes straight from the box, and wondering why you can’t just feel better?
“Even if we do have negative emotions and thoughts,” says Petrik, “it does not mean we have to behave in an unhelpful or unhealthy manner.”
It’s often easier said than done, but feeling down doesn’t mean you need to act down. “We can choose to engage in helpful activities even if we are feeling depressed, which could ultimately improve our mood and thoughts,” says Petrik.
Angry? You don’t have to yell. Sad? You don’t have to withdraw from your friends. Stressed? You don’t have to pour a glass of wine. Your next choice is always up to you, and it doesn’t have to be influenced by the siren call of a negative emotion.
You might dump criticisms on yourself so naturally that you don’t even realize you’re doing it. Thoughts like “You can’t do this well, so why bother trying?” or “Nobody here actually likes you” are examples of negative self talk, and it’s devastating to your mental health.
Negative self talk is “a way we talk to ourselves that we most likely wouldn’t talk to anyone else,” says Urszula Klich, PhD, licensed clinical psychologist, and president of the Southeast Biofeedback and Clinical Neuroscience Association.
Imagine uttering those same thoughts aloud to a loved one while they were going through a rough time. It’d feel pretty awful, right? Not surprisingly, this inner communication leaves a mark after a while.
“Negative self talk is associated with anxiety, panic, depression, stress, low self-esteem, lack of self confidence, decreased motivation, and low energy levels,” says Jodi J. De Luca, PhD, a licensed clinical psychologist at Erie Colorado Counseling.
Negative thoughts don’t necessarily disappear. CBT isn’t about “curing” bad thoughts, but learning how to react when you have them.
“I try to practice mindfulness and to notice my thoughts for what they are without judgment,” says Julie Williamson, LPC, NCC, RPT, a therapist who specializes in Acceptance and Commitment Therapy (a subtype of CBT).
If you hear yourself having negative thoughts, don’t get mad at yourself for “falling down this loop again.” That’s just more negative self-talk. Instead, recognize the thought for what it is: more cognitive distortion.
“If you can reframe a negative thought or look at it from a neutral perspective, you may be able to avoid certain uncomfortable emotions—anxiety, fear, anger, etc,” says Meghan Renzi, LCSW-C, a therapist who specializes in CBT and mindfulness.
Instead of judging your thoughts as good or bad, consider whether they are productive or unproductive. An unproductive thought doesn’t say anything about your character, but it doesn’t do anything to make your day more enjoyable.
“Train yourself to stop each negative thought as it hits your brain,” says Cali Estes, PhD, specialist in addiction therapy and founder of The Addictions Coach and The Addictions Academy.
Thoughts like “I hate that song” or “I can’t believe this store does not carry my size” don’t make you a bad person, but stewing on these thoughts are ultimately unproductive. “Work on the positive solution [instead of] focusing on the problem,” says Dr. Estes.
You may have spent decades “training” your mind to think in a specific way. CBT demands that you actively retrain instead of relying on old thinking habits.
The key to disrupting negative thoughts is practice, says Steven M. Sultanoff, PhD, clinical psychologist. “The negative thoughts are running on autopilot and are corrected—consciously—by new thoughts.”
Dr. Sultanoff compares this to learning to use your backhand when playing tennis. At first, you may have just run around to swing the racket with your forehand only. This becomes second nature, but eventually, your coach would train you to use the backhand.
Just like with your thought patterns, it will take time to break the instinct of only swinging the racket in a specific way. It takes a conscious effort to retrain an ingrained habit, and nobody expects you to master it instantly.
“I tell my clients to first, start being more aware of what’s going through their head, and second, jot down the negative thoughts they catch themselves thinking,” says Maria C. Inoa, LCSW, owner at Full Potential Counseling in Florida. “There’s so much power in writing things down … to see negative thought patterns that need to be addressed.”
You have the power to change only your next move. Not your previous move. Not someone else’s move. Not the weather. Just your next move. That’s it.
“One could argue that every situation is neither good nor bad,” says Renzi. “It just is what it is. As humans who overthink things, we give meaning to situations and assign labels: positive or negative, failure or success.”
This leads to a common cognitive distortion known as “shoulding,” which is when you are ruminating over what you shouldhave done, or what should happen, or what your friend should be doing, to the point where you can’t focus on your reality and come to comfortable decisions.
“When we tell ourselves something ‘should be,’ ‘ought to be,’ or ‘must be,’ but it isn’t, then we have set up a situation where we are backed up into a wall,” says Dr. Klich.
Even if something seems “bad” in the moment, it’s still possible to step back and look at it objectively. Renzi suggests asking yourself, “Will I be thinking about this situation [or] event a year from now?” For the vast majority of your worries, the answer is “probably not.”
Accepting your situation is one thing, but you also have to accept that other people are allowed to be who they are, no matter how much you disapprove of their actions, according to Dr. Sultanoff. So instead of getting annoyed with your partner for sleeping in during your trip to Rome, lace up your shoes, go and grab an espresso and biscotti, and take a stroll through the local market.
“If everything feels as if it is going wrong, I stop what I am doing, take a walk, come back, and view the day from fresh eyes,” says Dr. Estes.
You can’t necessarily recognize if you’re using black-or-white thinking or jumping to conclusions if you’re in the midst of a negative thought spiral. One of the key symptoms of anxiety disorders is racing thoughts, where one panicky thought leads to another at rapid speeds.
“We can easily find ourselves going down the rabbit hole based on a lot of assumption-based, fear-based, or shame-based thinking,” says Megan Gunnell, LMSW, psychotherapist who specializes in CBT, self care, and mindfulness.
Sometimes, disrupting that thought spiral requires a physical, deliberate pause. “We move so quickly as a society that we forget to take consistent pauses in our day to check in with our anxiety levels and try to do something active to change them,” says Dr. Witmer.
Dr. Witmer teaches her clients ways to relax their bodies in these moments, like square breathing, belly breathing, or progressive muscle relaxation (when you flex and then relax one muscle group at a time, starting from the feet and working your way up the body). “Once clients learn how to insert the pause or stop sign and objectively look at the thought they’re having,” says Gunnell, “they can slow down the tailspin they may have fallen into.”
Your mental health and physical health are anything but mutually exclusive. Practicing CBT philosophies works best when combined with other self-care practices. “If we are tired, not eating well, not exercising, and not finding healthy outlets for stress, our ability to be in clarity with our thoughts can be challenging,” says Gunnell. “Our tolerance for distress slips and our coping strategies wane.”
Support your mental self-care with physical self-care: Eat a nourishing diet, exercise, and get enough sleep at night. Here are other lifestyle habits doctors recommend for a healthy body.