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  1. #1

    Introduction to Cognitive Behavior Therapy (CBT)

    Introduction to Cognitive Behavior Therapy (CBT)
    David Burns, The Feeling Good Handbook

    Many people believe that their bad moods result from factors beyond their control. They ask, "How can I possibly feel happy? My girlfriend rejected me. Women always put me down." Or they say, "How can I feel good about myself? Iím not particularly successful. I donít have a glamorous career. Iím just an inferior person, and thatís reality." Some people attribute their blue moods to their hormones or body chemistry. Others believe that their sour outlook results from some childhood event that has long been forgotten and buried deep in their unconscious. Some people argue that itís realistic to feel bad because theyíre ill or have recently experienced a personal disappointment. Others attribute their bad moods to the state of the world Ė the shaky economy, the bad weather, taxes, traffic jams, the threat of nuclear war. Misery, they argue, is inevitable.

    Of course thereís some truth in all of these ideas. Our feelings undoubtedly are influenced by external events, by our body chemistry, and by conflicts and traumas from the past. However, these theories are based on the notion that our feelings are beyond our control. If you say, "I just canít help the way I feel," you will only make yourself a victim of your misery Ė and youíll be fooling yourself, because you can change the way you feel.

    If you want to feel better, you must realize that your thoughts and attitudes Ė not external events Ė create your feelings. You can learn to change the way you think, feel, and behave in the here-and-now. That simple but revolutionary principle can help you change your life.

    To illustrate the important relationship between your thoughts and your moods, consider the many ways you might react to a compliment. Suppose I told you, "I really like you. I think youíre a neat person." How would you feel? Some people would feel pleased and happy. Others might feel sad and guilty. Some people would feel embarrassed, and some would react with anger and annoyance. What explains such different reactions? Itís because of the different ways they might think about the compliment. If you feel sad, youíre probably thinking, "Ah, Dr. Burns is just saying that to make me feel good. Heís just trying to be nice to me, but he doesnít really mean it." If you feel annoyed, you might be thinking, "Heís flattering me. He must be trying to get something from me. Why isnít he more honest?" If you feel good about the compliment, youíre likely to be thinking, "Gee, Dr. Burns likes me. Thatís great!" In each case the external event Ė the compliment Ė is the same. The way you feel results entirely from the way you think about it. Thatís what I mean when I say that your thoughts create your moods.

    This is also true when something bad happens. Suppose someone you respect criticizes you. How would you feel? You may feel guilty and inadequate if you tell yourself youíre no good and the problem is all your fault. You will feel anxious and worried if you tell yourself that the other person is looking down on you and is going to reject you. Youíll feel angry if you tell yourself that itís all their fault and they have no right to say such unfair things. If you have a good sense of self-esteem, you might feel curious and try to understand what the other person is thinking and feeling. In each case, your reaction will depend on the way you think about the criticism. The messages you give yourself have an enormous impact on your emotions. And whatís even more important, by learning to change your thoughts, you can change the way you feel.

    The powerful methods described in this book have helped thousands of people take greater charge of their emotions, their careers, and their personal relationships Ė and they can help you. Itís not always easy. Considerable effort and persistence are sometimes required to snap out of a bad mood. But it can be done! The techniques are practical and straightforward, and you can make them work for you.

    This new approach is called "cognitive behavior therapy" because you can learn to change the way you think, the way you behave, and the way you feel. A "cognition" is simply a thought. You may have noticed that when you feel depressed or anxious you are thinking about yourself and your life in a pessimistic, self-critical way. You may wake up feeling discouraged and tell yourself, "Ugh! Whatís the point in getting out of bed?" You may feel anxious and inferior at a social gathering because you tell yourself, "I donít have anything witty or interesting to say." Cognitive therapists believe that these negative thinking patterns actually cause you to feel depressed and anxious. When you think about your problems in a more positive and realistic way, you will experience greater self-esteem, intimacy, and productivity.

    If you want to break out of a bad mood, you must first understand that every type of negative feeling results from a specific kind of negative thought. Sadness and depression result from thoughts of loss. You think you have lost something important to your self-esteem. Perhaps you were rejected by someone you cared a great deal about. You might have retired or lost your job or missed out on an important career opportunity. Frustration results from unfulfilled expectations. You tell yourself that things should be different from the way they really are. For example, "That train shouldnít be so late when Iím in a hurry! Darn it!" Anxiety and panic result from thoughts of danger. Before you give a speech in front of a group of people, you feel nervous because you anticipate that your voice will tremble and your mind will go blank. You imagine that youíll make a fool of yourself. Guilt results from the thought that you are bad. When a friend makes an unreasonable request, you may feel a twinge of guilt and think, "A really nice person would say yes." Then you may agree to something that isnít really in your best interest. Feelings of inferiority result from the thought that youíre inadequate in comparison with others. You think, "Sheís so much better looking than I am" or "Heís so much smarter and more successful. Whatís wrong with me?" Anger results from feelings of unfairness. You tell yourself that someone is treating you unjustly or trying to take advantage of you.

    The list on the next page illustrates the connection between your thoughts and your feelings. Study this table carefully. It will help you understand why youíre in the mood youíre in, and this can make it easier to change the way you feel.

  2. #2

    Re: Introduction to Cognitive Behavior Therapy (CBT)

    Your Thoughts and Your Feelings
    Emotion Thoughts that lead to this emotion
    Sadness or depression Thoughts of loss: a romantic rejection, the death of a loved one, the loss of a job, or the failure to achieve some important goal.
    Guilt or shame You believe that youíve hurt someone or that youíve failed to live up to your own moral standards. Guilt results from self-condemnation, whereas shame involves the fear that youíll lose face when others find out about what you did.
    Anger, irritation, annoyance, or resentment You feel that someone is treating you unfairly or trying to take advantage of you.
    Frustration Life falls short of your expectations. You insist that things should be different. It might be your own performance ("I shouldnít have made that mistake"), what someone else does ("He shouldíve been on time!"), or an event ("Why does the traffic always slow down when Iím in a hurry?").
    Anxiety, worry, fear, nervousness, or panic You believe youíre in danger because you think something bad is about to happen Ė "What if the plane crashes?" "What if my mind goes blank when I give my talk in front of all those people?" "What if this chest pain is the start of a heart attack?"
    Inferiority or inadequacy You compare yourself to others and conclude that youíre not as good as they are because youíre not as talented, attractive, charming, successful, intelligent. "Sheís really got what it takes. Sheís so cute. All the men are chasing her. Iím just average. Thereís nothing very special about me."
    Loneliness You tell yourself that youíre bound to feel unhappy because youíre alone and you arenít getting enough love and attention from others.
    Hopelessness or discouragement You feel convinced that your problems will go on forever and that things will never improve. "Iíll never get over this depression," or "I just canít lose weight and keep it off," or "Iíll never find a good job," or "Iíll be alone forever."


    What you will learn in Cognitive Behavior Therapy (CBT) here is that even though you are convinced they are valid, most of the negative thoughts that make you feel bad are distorted and unrealistic. Example: Following a romantic breakup or divorce you tell yourself, "Itís all my fault. I must be unlovable. Iíll never be close to anyone." You feel so rotten that it seems absolutely true, and you think your life is over. Months later you begin to date and you start to feel close to people again. It suddenly dawns on you that you are lovable after all, that you werenít entirely responsible for the breakup of your relationship. You wonder how in the world you could have believed all the put-downs you were heaping on yourself. But at the time, your negative thoughts seemed completely valid.

    Thatís one of the peculiar things about bad moods Ė we often fool ourselves and create misery by telling ourselves things that simply are not true. And the strange thing is that we usually donít have the vaguest suspicion that weíre being conned by our misery and self-doubt.

  3. #3

    Re: Introduction to Cognitive Behavior Therapy (CBT)

    The ten forms of distorted thinking that lead to negative moods are listed here. Study this list carefully, because you will refer to it frequently as you do the exercises in this book. Many people have told me that this list changed their lives.

    One disclaimer is necessary. There are many times when negative feelings are healthy and appropriate. Learning when to accept these feelings and how to cope with a realistically negative situation is just as important as learning how to rid yourself of distorted thoughts and feelings. If a loved one is seriously ill, you will feel concerned. These sad feelings are a sign of caring. If the house you had your heart set on is sold to someone who made a slightly higher offer, it is natural to feel disappointed. If you’re having an argument with your spouse, you will probably feel angry and hurt. If you have to give a speech or start a new job or ask your boss for a raise, you will probably feel a little nervous. It’s often best to accept these negative feelings.

    I don’t believe that you should try to be happy all the time, or in total control of your feelings. That would just be a perfectionistic trap. You cannot always be completely rational and objective. Certainly I’m not! I have my share of shortcomings, my dark moments of self-doubt, my periods of irritability. I believe these experiences give us the opportunity for growth, for intimacy, and for a deeper comprehension of what it means to be human.


    The Ten Forms of Twisted Thinking
    All-or-nothing thinking You see things in black-or-white categories. If a situation falls short of perfect, you see it as a total failure. When a young woman on a diet ate a spoonful of ice cream, she told herself, "I’ve blown my diet completely." This thought upset her so much that she gobbled down an entire quart of ice cream!
    Overgeneralization You see a single negative event, such as a romantic rejection or career reversal, as a never-ending pattern of defeat by using words such as "always" or "never" when you think about it. A depressed salesman became terribly upset when he noticed bird dung on the windshield of his car. He told himself, "Just my luck! Birds are always crapping on my car!"
    Mental filter You pick out a single negative detail and dwell on it exclusively, so that your vision of all reality becomes darkened, like the drop of ink that discolors a beaker of water. Example: You receive many positive comments about your presentation to a group of associates at work, but one of them says something mildly critical. You obsess about his reaction for days and ignore all the positive feedback.
    Discounting the positive You reject positive experiences by insisting they "don’t count." If you do a good job, you may tell yourself that it wasn’t good enough or that anyone could have done as well. Discounting the positive takes the joy out of life and makes you feel inadequate and unrewarded.
    Jumping to conclusions You interpret things negatively when there are no facts to support your conclusion. Mind reading: Without checking it out, you arbitrarily conclude that someone is reacting negatively to you. Fortune-telling: You predict that things will turn out badly. Before a test you may tell yourself, "I’m really going to blow it. What if I flunk?" If you’re depressed you may tell yourself, "I’ll never get better."
    Magnification You exaggerate the importance of your problems and shortcomings, or you minimize the importance of your desirable qualities. This is also called the "binocular trick."
    Emotional reasoning You assume that your negative emotions necessarily reject the way things really are: "I feel terrified about going on airplanes. It must be dangerous to fly." Or "I feel guilty. I must be a rotten person." Or "I feel angry. This proves I’m being treated unfairly." Or "I feel so inferior. This means I’m a second-rate person." Or "I feel hopeless. I must really be hopeless."


    "Should statements" You tell yourself that things should be the way you hoped or expected them to be. After playing a difficult piece on the piano, a gifted pianist told herself, "I shouldn’t have made so many mistakes." This made her feel so disgusted that she quit practicing for several days. "Musts," "oughts" and "have tos" are similar offenders.
    "Should statements" that are directed against yourself lead to guilt and frustration. Should statements that are directed against other people or the world in general lead to anger and frustration: "He shouldn’t be so stubborn and argumentative."
    Many people try to motivate themselves with shoulds and shouldn’ts, as if they were delinquents who had to be punished before they could be expected to do anything. "I shouldn’t eat that doughnut." This usually doesn’t work because all these shoulds and musts make you feel rebellious and you get the urge to do just the opposite. Dr. Alber Ellis has called this "musterbation." I call it the "shouldy" approach to life.
    Labeling Labeling is an extreme form of all-or-nothing thinking. Instead of saying "I made a mistake," you attach a negative label to yourself: "I’m a loser." You might also label yourself "a fool" or "a failure" or "a jerk." Labeling is quite irrational because you are not the same as what you do. Human beings exist, but "fools," "losers," and "jerks" do not. These labels are just useless abstractions that lead to anger, anxiety, frustration, and low self-esteem.
    You also label others. When someone does something that rubs you the wrong way, you may tell yourself: "He’s an S.O.B." Then you feel that the problem is with that person’s "character" or "essence" instead of with their thinking or behavior. You see them as totally bad. This makes you feel hostile and hopeless about improving things and leaves little room for constructive communication.
    Personalization and blame Personalization occurs when you hold yourself personally responsible for an event that isn’t entirely under your control. When a woman received a note that her child was having difficulties at school, she told herself, "This shows what a bad mother I am," instead of trying to pinpoint the cause of the problem so that she could be helpful to her child. When another woman’s husband beat her, she told herself, "If only I were better in bed, he wouldn’t beat me." Personalization leads to guilt, shame, and feelings of inadequacy.
    Some people do the opposite. They blame other people or their circumstances for their problems, and they overlook ways that they might be contributing to the problem: "The reason my marriage is so lousy is because my spouse is totally unreasonable." Blame usually doesn’t work very well because other people will resent being scapegoated and they will just toss the blame right back into your lap. It’s like the game of hot potato – no one wants to get stuck with it.

  4. #4

    Re: Introduction to Cognitive Behavior Therapy (CBT)

    If you want to feel better, you must realize that your thoughts and attitudes – not external events – create your feelings
    The most important sentence...

  5. #5
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    Re: Introduction to Cognitive Behavior Therapy (CBT)

    So my conscience creates all these emotions within me, the question is why? It's like my conscience emotions and my ego are my worst enemies? These things are spiritual and yet they create these feelings, I can understand the physical creation of these feelings, but how can our spiritual side effect our emotional side? Can this be a spiritual side I have and do not understand it from the spiritual side? If my spiritual side is moral I must belief it for it to create the belief of it. It is written "man is wonderfully made" and "you are what you believe".

    How can my spiritual side create within me these feelings which are negative and is in conflict with God unless it's Satan doing it? My kidneys shut down along with my bowels, what does that have to do with sugar diabetes? My emotions create in me every negative thought I have. Consider, is my emotions alive within me or is Satan trying me as he did Adam and Eve? If my emotions are human to a spiritual thought then they can be manipulated by a spiritual condition. My body parts to must play a part in this kidney and bowel shutdown as well, the question is how and why?

    If I stub my toe I am to blame. If someone calls me a bad name, it hurts my feelings. One is physical pain the other is spiritual pain. There's got to be something to spiritual feelings spiritually. I also have the gift of sensual feeling, I can sense people by there facial expressions and attitudes. That's spiritual as well. I have a appointment Tuesday with my doctor and I will get back to you when i come home. High Strung

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    Re: Introduction to Cognitive Behavior Therapy (CBT)

    I am beginning to understand. But my questions will always be, how does our emotions control us, it's like they have a mind of their own. If so who gave us them and their power over us? High Strung

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    Re: Introduction to Cognitive Behavior Therapy (CBT)

    Quote Originally Posted by Highstrung
    how does our emotions control us, it's like they have a mind of their own.
    I believe this is where working with a behavioural therapist, you can learn strategies to manage thought patterns, behaviors and reactions that may seem uncontrollable to you on your own.

    Behavior therapy requires some work on your part, where you practice a new behavior over and over in order to learn a new skill.

    You may have heard that the brain is plastic. As you know the brain is not made of plastic! Neuroplasticity or brain plasticity refers to the brain’s ability to CHANGE throughout life. The brain has the amazing ability to reorganize itself by forming new connections between brain cells (neurons).

    In addition to genetic factors, the environment in which a person lives, as well as the actions of that person, play a role in plasticity.

    Neuroplasticity occurs in the brain:

    1– At the beginning of life: when the immature brain organizes itself.

    2– In case of brain injury: to compensate for lost functions or maximize remaining functions.

    3– Through adulthood: whenever something new is learned and memorized Source for this quote
    Behavior therapy changes the brain, thereby giving you the opportunity to take control of issues currently challenging you, so that can improve your quality of life.

    You may find further insights in this online article: Cognitive behavioral therapy (CBT): how does CBT work? - MNT
    Steve

    Dum spiro spero....While I breathe, I hope

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    Re: Introduction to Cognitive Behavior Therapy (CBT)

    "Behavior therapy changes the brain, thereby giving you the opportunity to take control of issues currently challenging you, so that can improve your quality of life."
    Excellent answer. I allowed my emotions to overtake me, how and why is another question. According to ones belief I think it's possible for that action to happen. But how does the mind convince the brain to change? high strung

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    Re: Introduction to Cognitive Behavior Therapy (CBT)

    how does the mind convince the brain to change?
    By training yourself to react to a given situation in another way through practice and learning new behaviors.

    I am not a medical professional nor a neuroscientist, but in connection with support work I do for another disorder, I have studied how behavior therapy can change the brain, and here is my understanding of that process:

    Our brain is complex, with areas of the brain involved in managing the physical aspects of our life, as well as the cognitive and emotional parts.

    Some parts of our brain function outside of our awareness, subconsciously so to speak. Other parts of our brain function within our conscious control.

    As an example, suppose you're driving along in your car, eager to get to your destination, and suddenly you hear a siren and see flashing lights and get pulled over by a police man who tells you that you were speeding. In your mind you don't think you were speeding and your first impulse is to give him the finger and call him a nasty name....but instead you stop yourself and smile, speaking softly and politely.

    That's an example of how you can use the conscious part of your brain to control what your impulse would have had you do or say.

    In behavior therapy, your therapist would help you uncover the reactions you would like to modify, and would help you learn ways to inhibit that behavior and replace it with another more appropriate behaviour, by doing specific exercises.

    You are never too old to learn new things. All you need is the admission that you need to modify certain behaviors, seek the appropriate help and do the work required to make those modifications....your brain plasticity will do the rest.

    Behavior therapy changes the brain.
    Steve

    Dum spiro spero....While I breathe, I hope

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    Re: Introduction to Cognitive Behavior Therapy (CBT)

    Is it possible to talk to your mind/brain into helping you change your behavior? Somebody also told me talk to the mirror at who's looking back at you, seriously. I agree with what you are saying. Thank you for your time and understanding. Use to be high strung.

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