What is cognitive behavioral therapy?
This method of therapy is about becoming more aware of one's own thoughts, feelings, expectations, attitudes, and behavior. It is assumed here that the psychological problems have their origin in learned ways of experiencing and behaving, which you have acquired in the course of your life. The goal is to create new experiences and thought patterns and thus overwrite the old patterns. The focus is on the so-called cognitions. This includes your perception, your thoughts, your attitudes and beliefs and your imagination. It is believed that our thinking has a great influence on our feelings and the feelings in turn influence how we behave. It's all about the meaning we attach to a situation. Our experience of a situation is very much shaped by our individual experiences and as a result we sometimes feel emotions that may not be appropriate to the situation. With cognitive behavioral therapy, you can learn to evaluate these situations differently internally, which can also change your feelings in the situation and you no longer feel any pressure to suffer at that moment.
Procedure of a behavioral therapy
Take your time to find a suitable psychotherapist. Sympathy and trust are important for the success of the therapy. In the initial consultation, you will look together at the difficulties and problems for which you would like support. At the same time, your wishes and expectations of the therapy will be clarified. Afterwards you will discuss your individual goals and the way to reach them. The following sessions will consist of discussions and exercises. You will also check again and again whether you are getting closer to your goals or whether other exercises are needed. Even if your goals change during the course of therapy, you will reformulate them and adapt the exercises accordingly. At the end of therapy, you will be able to use the exercises on your own and you will discuss what is needed to prevent relapse.
Behavioral therapy takes different amounts of time. Sometimes only a few sessions can be enough. But it can also take several months until the goals are reached. Usually, sessions take place once a week.
Behavior therapy can take place individually or in a group setting.
Examples from practice
So that the whole thing does not remain so theoretical, I would like to give you a few examples. A person with an obsessive-compulsive disorder believes that something bad will happen as soon as he touches the color red. Therefore, he avoids everything that contains the color red. He cannot sit on red chairs, cannot touch red books, cannot ride red buses, and cannot eat red jam. All of this would cause him extreme stress internally. If he does touch the color red, he has to wash and shower for hours to make sure nothing bad happens. He is convinced that this is the only way to counteract the impending misfortune. Behavioral therapy focuses here mainly on the current issues and looks only conditionally in the past for the causes. It could be helpful here to learn conscious relaxation techniques and breathing techniques. On the other hand, one could try a so-called confrontation therapy, where one consciously exposes oneself to the stress-triggering event and realizes through joint endurance with the therapist that nothing bad happens when one sits down on a red chair. Through this exercise, after a period of time, one can overwrite the old fearful thought pattern and replace it with the new experience.
Cognitive behavioral therapy can also be helpful for people with depression.
Cognitive behavioral therapy can also be helpful for people with depression. In depression, thinking is shaped by a great many negative assumptions. "Everything is going wrong right now. I just can't do anything right. In fact, I've never been able to get anything done. I'll never find a job." or "No wonder nobody likes me. I'm fat and ugly. Why did I eat that bag of chips last night. I'm so weak if I can't even hold myself together over a bag of chips. I'll never find a partner like this." Depressive thinking is characterized by negative beliefs, circling thoughts, guilt and self-reproach. Negative thinking also affects behavior. For example, people are less motivated to try something because they believe that everything will go wrong after all and that it won't do any good. Thus, depressed people withdraw more and more. In behavioral therapy, one would look at where these negative assumptions come from, in which areas things are not working well at the moment, which intermediate steps are needed, how one can reward oneself and which exercises could be helpful on this path. One exercise could be a gratitude journal, in which you write down two things every day that went well and for which you are grateful. Rephrasing negative thoughts into more neutral phrases can also be helpful. Let's take the example of a grandmother who wants to say goodbye to her granddaughter after 3 days of visiting. However, the granddaughter waves to her only very briefly and then runs away to her friend. The grandmother has the negative thought: "My granddaughter doesn't like me because I'm too boring for her. A more neutral formulation might be, "The little girl is already full of anticipation for the afternoon with her friend after they haven't seen each other all vacation. We've also had a lot of fun playing together over the past few days. A long goodbye might have made her sad.". This rephrasing leads to a completely different basic mood in the grandmother and subsequently to different behavior.
Behavioral therapy can also help you deal with anxiety. Are you so afraid of exams that your studies come to a standstill because of them? Or do you no longer dare to take the bus because you are afraid of an accident? Do you only retreat to your apartment because you are afraid of viruses such as Covid-19? In the initial phase of therapy, you work with the therapist to find out how your fears arose and what keeps them going. In a second step you slowly confront yourself with your fears. First only in your thoughts and then also outside in the environment. Here you start with the situations that trigger the least fear. In the beginning, you look for these situations together with your therapist. Later you can continue to practice on your own. Of course, this is a big effort at first, but as soon as you have succeeded a few times, most people are very motivated to continue practicing. You can gain the experience that your fears do not come true. These confrontations are then combined with conversations about why you think the situations are so dangerous. For the above example, you need to find out: Why are you so afraid of a bus accident, although statistically not so many bus accidents happen? In the course of therapy, the catastrophizing thoughts should be replaced by a more realistic view.
Making dysfunctional beliefs conscious and changing them
Because our thoughts have such a big impact on our well-being, it is important to find out why certain basic assumptions prevail. Although behavioral therapy is very much based in the here and now, it is still important to take a nuanced look at all cognitive levels (thoughts, feelings, attitudes, behaviors, physical reactions). When we become aware of the emergence of the problematic basic assumptions, we get the opportunity to change them. Thus, not only a change on the behavioral level is achieved (as through above mentioned exercises), but a change on all levels. New thinking patterns, stress management methods, social skills, self-control methods, relaxation techniques and confrontational methods are developed.
Become your own therapist!
This is an important goal of behavioral therapy. By using the exercises and techniques together in the beginning, you will be able to use them later on your own. You are then the expert for your disease and can use these skills whenever it seems necessary. Thus you can also prevent some relapses on your own. Towards the end of the therapy, you will work out together what your early warning signs are and what measures you can take to counteract them on your own. Become your own therapist' means that your active help is required. In medicine, you simply take a medicine and wait for the effect to set in, without having to do anything yourself. Psychotherapy is fundamentally different. Here you need to be active even outside the sessions. Because only you can change something. Our experts at WePractice are happy to support you in becoming your own expert.