Cognitive Behavior Therapy

What is Cognitive Behavior Therapy?

Cognitive Behavior therapy (CBT) is a form of therapy that focuses on examining the relationships between thoughts, feelings and behaviors.

Many people attribute their emotions to events that occur. For example, let’s say that you work in a large office. On your way to the elevator, you pass your boss in the hall and say hello. Your boss looks at you and keeps walking past you without saying anything. You immediately start to feel depressed.

In cognitive behavior therapy, your boss not speaking to you would be called the activating event (or A). Your reaction (depression) is called the consequence (or C). In our minds, A caused C to happen.

Suppose the same thing happened to a coworker David with the same boss. When David’s boss doesn’t speak to him, David gets angry.

And let’s say the same thing happened to another coworker Susan with the same boss. When Susan’s boss doesn’t speak to her, Susan doesn’t react emotionally at all but remains in a neutral state.

In these 3 examples, the activating event (A) was the same, but the consequence (C) was different. If A caused C to happen, then your reaction should have been the same as David and Susan’s reaction. But it wasn’t.

What’s missing in this equation is B or one’s belief about A.

You may have the underlying belief that if someone doesn’t talk to you, that means there is something wrong with you and you don’t deserve to have people like you. When you have evidence that people don’t like you, it makes you feel bad.

For David, he may have the belief that if a person doesn’t respond to him, that person is rude. David believes that he deserves respect from everyone he interacts with, and when that doesn’t happen he gets angry.

In Susan’s case, she has no expectations of how others should respond to her, either positive or negative. She attributes her boss not responding to her as due to her boss being preoccupied or thinking about something else. She doesn’t take the lack of interaction personally, particularly since she doesn't know why her boss behaved that way.

If A always caused C, then you, David and Susan would have all reacted the same way. The A = C equation must be modified to A ← B → C. It is your thoughts and beliefs (B) about people, situations and events (A) that lead to emotional and behavioral consequences (C).

Most of the time, C happens almost instantly after A. If we start to examine our underlying beliefs and assumptions about life and ourselves more closely, we start to understand why we react the way we do to events and to our own thoughts. If we find that our belief system is based on unrealistic expectations (such as Everyone must love me, Life must be fair, I must never make mistakes), cognitive behavior therapy can help us challenge those beliefs and replace them with more realistic ones.

What can Cognitive Behavior Therapy help with?

Clinical studies of CBT have demonstrated its usefulness for a wide variety of conditions including anxiety disorders, depression, eating disorders, personality disorders, sleep disorders, substance abuse disorders, and trauma and PTSD. Changes in brain activity for individuals receiving this therapy have been documented, suggesting that the brain actually improves its functioning as a result of the treatment.