Cognitive Behavioural Therapy


Cognitive Behaviour Therapy is a way of talking about how you think about yourself, the world and other people.   It seeks to examine how what you do affects your thoughts and feelings.

CBT can help you to change how you think (‘Cognitive’) and what you do (‘Behaviour’). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the ‘here and now’ problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

When does CBT help?

CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue.

How does it work?

CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:

  • A Situation – a problem, event or difficult situation

From this can follow:

  • Thoughts
  • Emotions
  • Physical feelings
  • Actions

Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it. There are helpful and unhelpful ways of reacting to most situations, depending on how you think about them.

For example:

Situation:   You’ve had a bad day, feel fed up, so go out shopping.   As you walk down the road, someone you know walks by and, apparently, ignores you.Thoughts:
Situation: You’ve had a bad day, feel fed up, so go out shopping. As you walk down the road, someone you know walks by and, apparently, ignores you.

A. Thoughts

  • Unhelpful thoughts: “He/she ignored me – they don’t like me”
  • Helpful thoughts: “He/she looks a bit wrapped up in themselves – I wonder if there’s something wrong?”

B. Emotions

  • Unhelpful emotions: “Low, sad and rejected”
  • Helpful emotions: “Concerned for the other person”

C. Physical

  • Physical (-ve): Stomach cramps, low energy, feel sick
  • Physical (+ve): None – feel comfortable

D. Action

  • Action (-ve): Go home and avoid them
  • Action (+ve): Get in touch to make sure they’re OK

The same situation has led to two very different results, depending on how you thought about the situation. How you think has affected how you felt and what you did. In the example in the left hand column, you’ve jumped to a conclusion without very much evidence for it – and this matters, because it’s led to:

  • a number of uncomfortable feelings
  • an unhelpful behaviour.

If you go home feeling depressed, you’ll probably brood on what has happened and feel worse. If you get in touch with the other person, there’s a good chance you’ll feel better about yourself. If you don’t, you won’t have the chance to correct any misunderstandings about what they think of you – and you will probably feel worse. This is a simplified way of looking at what happens. The whole sequence, and parts of it, can also feedback like this:

This ‘vicious circle’ can make you feel worse. It can even create new situations that make you feel worse. You can start to believe quite unrealistic (and unpleasant) things about yourself. This happens because, when we are distressed, we are more likely to jump to conclusions and to interpret things in extreme and unhelpful ways.

CBT can help you to break this vicious circle of altered thinking, feelings and behaviour. When you see the parts of the sequence clearly, you can change them – and so change the way you feel. CBT aims to get you to a point where you can ‘do it yourself’, and work out your own ways of tackling these problems.