CBT Basics

  • In a nutshell

    The basic premise of cognitive therapy (also called CBT, or cognitive-behavioral therapy) is that one’s interpretation of a situation, rather than the situation itself, determines the feelings and behaviors that follow. These interpretations take the form of super-fast, knee-jerk fleeting thoughts, called “automatic thoughts.” Over time, as we accumulate life experiences and interpret them in consistent ways, we develop patterns of understanding ourselves, other people, and the world around us.

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  • What goes wrong

    While most of our automatic thoughts are rational and adaptive, contributing to generally successful patterns of functioning, others are apt to be somewhat exaggerated, or to contain some inaccuracies, and therefore lead to unnecessarily distressing emotions and dysfunctional behaviors. Eventually, we can get stuck in negative cycles of feeling and behavior. Because cognitive therapy recognizes the centrality of thoughts in developing negative states like depression, anxiety, and relationship difficulties, it initially addresses these problems by directly targeting the inaccuracies in our cognitions.

  • How to change it

    Given the focus on thoughts that are, by definition, fleeting, the first step is to develop some skill at catching these thoughts as they fly by in particular situations. This takes some practice, but once you begin to notice automatic thoughts, you’ll see how central they are in the development of your distress. Next, we engage in a systematic evaluation of these havoc-wreaking thoughts, identifying their inaccuracies so that we can consider alternative, more realistic views of the triggering situations.

  • The big picture

    Note that the strategy is not to eradicate negative automatic thoughts. Not only is that an unattainable goal, but it wouldn’t make sense; sometimes anxious or sad thoughts are appropriate, useful, and crucial to healthy human experience. It is only when our range of cognitions is too restricted that we develop emotional distress. So, our basic strategy in cognitive therapy is to open up biased thinking patterns, allowing better functioning to flourish when we rely on more realistic cognitions. Then we also target the behaviors directly, as they are the other entry point for changing these patterns.