CBT (Cognitive Behavioural Therapy) is all the rage at the moment for a few reasons. It has had research backing its efficacy (ooh-err, yes, the sciency kind). It aims to help you feel better quickly (you would typically have eight sessions with a therapist = cheap for the NHS). This is because it doesn’t go into your background, childhood, or what brought you to this point. It deals with the way you think and feel now, asks whether it’s rational for you to think the thoughts you do and offers the opportunity to challenge the thoughts if they are not rational. It also offers the opportunity to discover how behaviours can feed the vicious cycle and keep the illness going.
This is the therapy that, in my experience, you’re most likely to be offered if you go to your G.P. with mild-moderate depression. NICE (National Institute of Clinical Excellence) are an independent organisation that provide national guidelines for treatment of various conditions – you can look at their information on depression here.
I thought I’d have a go at explaining CBT (in the way I understand it) from the sessions I’ve had with various therapists and reading too many self help books. This is just how I explain it to myself so don’t hesitate to consult a professional therapist or self-help manual for a ‘proper’ explanation.
Cognitive Behavioural Therapy (CBT) involves analyzing the thoughts you have (the cognitive side), looking at the feelings these thoughts bring up, and what you do as a result (the behavioural side). It’s easiest to understand as a flow diagram (shown in most CBT self-help books), where you can see each aspect – thoughts, feelings, behaviour – and the interlinking nature of each component.
Louise’s Example (That’s me- hello . Here’s an example from my life:
About a year or so ago a friend stopped calling me and didn’t text me to see if I wanted to meet up.
“She doesn’t want to be my friend anymore.”
“Maybe she thinks I’m boring.”
“Maybe no-one will want to be my friend.”
Not surprisingly, following those negative thoughts I felt:
sad, anxious, depressed, hopeless.
The feelings led to these behaviours:
Not going out for a while
Not contacting other friends in case I was rejected
Not making the best of myself e.g. not bothering with make-up because I felt depressed.
The interlinking bit:
Because I now felt depressed and wasn’t going out, this in turn led to more negative thoughts about myself and my confidence plummeted. Negative thoughts and feelings led to negative behaviour and, in turn, negative behaviour led to more negative thoughts and feelings.
CBT aims to break this negative cycle or vicious circle. You can break the circle by changing one or both of the the thoughts and behaviours that are feeding the cycle.
In my case I worked on thinking more positively (I wasn’t ‘worthless’ because one friend hadn’t been in touch for a while) and I also changed my behaviour by going out of the house (shopping, gym, another friend’s house), which gave me the opportunity to experience positive things and lift my mood.
Final Thoughts (Jerry Springer-esque)
- CBT can work very well for many cases of depression and a host of other disorders.
- You need to be prepared/well enough to complete ‘homework’, writing down thoughts etc.
- I found that rapport with the therapist is as important as the therapy. If you feel you aren’t getting anywhere consider whether a change of therapist might be worth a try (if possible)
- Allow at least four weeks before you decide if it’s helping – it does take time to work.
- CBT doesn’t help everyone. It didn’t help me when I was at my most depressed but did help a bit when my depression had lifted a little.
- If you don’t feel any benefit don’t blame yourself. There are loads of other options to try, some of which I’ll discuss on this blog.