Therapy = Cognitive Behavioral Therapy

First there was B.F. Skinner, the behavioral conditioning guru. A few years later, the rat in the maze concept didn't sit so well with the intelligentsia and Albert Ellis's rational emotive therapy got the nod.

On Ellis' heels, Aaron T. Beck engineered a fusion of the two that he called cognitive behavioral therapy or CBT, the Lexus of all individual therapies. We now feel that ALL talk therapies are really forms of CBT because talking is a behavior and listening is cognition.

But there are forms and there are forms. Is a dodo bird a dodo bird a dodo bird?

The relationship therapy I push here on the blog is heavily laced with old fashioned CBT. Using a relationship therapy to reinforce cognitive behavioral therapy is like having a freaking Rolls Royce.

I like driving the Rolls, but totally will accept CBT, the Lexus, if that's all they've got at Avis Rent-A-Car.

The National Institute of Mental Health knocked off the big study on affective disorders and determined that the best way to treat depression is to use a combination of psychotropic medication and cognitive-behavioral therapy (CBT).

Of course.

So you should learn it. You'll get better. You'll stop spleening me, Why aren't I better?

It's an interactive therapy that requires the patient to think and behave differently. One would think they're all like that, all therapies require you to think and behave differently, but this one has a nice structure to it, so anyone can learn it. No huge amount of psychobabble, no tricks. I use it to manage emotions. Yeah, mine, too.

So it can't hurt you to know the basics of CBT to help control your anxiety, anger or depression.
Everyone needs help with at least one of those. Tell me you don't.

The emphasis in CBT is on rationality.

Rationality is not nearly as sexy as emotionality so people resist it like crazy. But at some point you have to grow up.

The path to staying rational is countering irrational beliefs that make us emotional, especially those nasty core beliefs. Irrational core beliefs are deep. They're what makes us deep, all of us. People discover them in therapy, or if they're lucky, when their significant others and friends wriggles them out in intimate conversation.

Sometimes it's perfectly obvious to us, that a negative core belief is disabling, dis-empowering us. They're the windows that slow down our computers, the ones we forgot to close years ago. There may be only one or two programs running back there, using the ram we need for other things, but they're a real pain to shut down. They slow up the whole works.

Sample core beliefs: I'm a loser, I'll never amount to anything, I'm a charlatan, a fake, I'm not a good person.

Such beliefs (thinking) trigger automatic negative feelings. The feelings (always bad) don't let up. They feel unmanageable.

So there you are, feeling down and looking for something to do to feel better, searching for some coping strategy, some behavior to make you feel better. The chosen behavior, unfortunately, driven by uncomfortable arousal (anger or anxiety) or grinding depression, and negative thoughts, tends to be dysfunctional.

Sample dysfunctional behaviors: drinking, over-eating, sending a letter that shouldn't have been sent, having a tantrum, missing work, beating the spouse or kicking the dog, buying a boat.

The dysfunctional behavior fuels a feedback loop. STAY WITH ME HERE. IT'S NOT THAT HARD.

I'm a loser (thought). I feel bad because I'm a loser (feeling). I'll eat a pint of ice cream (behavior). I'm such a loser (thought for having eaten it), I feel bad I'm such a loser (feeling). . .repeated over and over, reinforcing the core belief.

The therapy is as simple as A-B-C.

A stands for affective, or feeling.
B stands for behavior,
C stands for cognition, or thinking

Intervene ANYWHERE, but intervene.

Docs like me have you go home and analyze the events of the day using the A-B-C s. I make you write stuff down, go over it, argue with your thoughts, think twice about your default behaviors. The doc's your worst nightmare, the new program in that computer.

But the doc disappears over time and you take charge of your life pretty soon. You do the therapy yourself. You won't just do it in your head, by the way, you'll have to put the ice cream back into the freezer and find something else to do. But you will challenge your beliefs, become your own advocate, the best lawyer in the hood. Your own best friend.

That said, it helps to have someone else, a friend or a family member help you. Or get a therapy doc. I'll give you some more examples in future posts, I hope. I'll leave out the ice cream, go for the nail biting, pen smashing. Maybe.

The therapy is always about thinking, feeling, and behaving, and how these processes constantly reinforce one another.

Doesn't matter where you begin. Begin anywhere. It'll be work. Sorry about that.

Any questions?

Copyright 2007, therapydoc