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Cognitive Behavioral Therapy (CBT)

“There is nothing either good or bad, but thinking makes it so.”


Cognitive behavioral therapy is based on the central idea that you can change your life, and feelings about life, by changing your thoughts and behaviors. 

Our thoughts, feelings, behaviors, and circumstances are interdependent, each one affecting the other.  Cognitive behavioral therapy is typically aimed at altering thought (cognitions) and action (behavior) directly, to create change.  It is based on the assumption that is easier and more effective to change our thoughts and our behaviors directly than to change our feelings or life circumstances directly.

CBT Concepts

Automatic thoughts

Before we can change our thoughts, we need to first recognize them.  Many times, we simply don’t feel good for some reason, and we act on these feelings, saying or doing unhelpful things.  Automatic thoughts are usually operating “behind the scenes” in these situations, controlling us at a subconscious level.  “Automatic” thoughts happen just outside of our awareness.  I use the word subconscious rather than unconscious because often people can identify the automatic thoughts that immediately preceded a difficult emotion or unhelpful action when they are asked something like, “what were you thinking when …”

In more tense cases, we don’t even recognize the feelings, and the only thing we experience is our behavior.  Sometimes it seems like we are watching the behavior from an outside perspective, just happening, as if in a movie, rather than being present and in control.  Expressions such as “tunnel vision” or “going from 0 to 60” try to capture this experience.  In such cases, the automatic thoughts are even more hidden from conscious awareness, and more disentangling needs to happen, by slowing down.  Talking to someone (e.g. a therapist or coach) and writing (e.g. journaling) are helpful for retracing our thoughts back to the triggering event.  

Often we are aware of our thoughts before they cause our feelings, but the thoughts are ill-defined and automatic.  These automatic thoughts tend to be fragmented into short phrases such as “I’m no good”, “that’s not fair”, “or “they don’t care.”  It is helpful to expand on these little packages of meaning, spend time with each one, exploring what they really mean to us.  For example, a therapist or coach might say, “say more about ‘not fair’”.  And the automatic thought gets talked about, becoming less automatic and subconscious.  This is a means toward the end of discovering our needs, feelings, and any creative helpful action, or wise acceptance.

Automatic thoughts are highly habitual.  Because they happen largely outside of our awareness, we don’t take the time or energy to refine them.  Until we make them conscious, they operate in the background, repetitively producing the same, harmful outcomes.

Cognitive distortions

Cognitive distortions are like warped mirrors or lenses.  They produce inaccurate images of the world from raw world data.  They tend to be judgmental and simplistic.

It wouldn’t be too far off to say that virtually everything we think is skewed to some degree.  Situations and stimuli enter our senses (vision, hearing, touch, etc) and then are processed into experience and imbued with meaning by our complex minds, full of previous history.  This history will infuse with the stimuli to create a subjective interpretation.  Get 100 people into the same situation, and you’ll get 100 unique interpretations. Although some people’s will be closer to others’, no two people will have the exact same experience.  We are all walking funhouses of mirrors.

A cornerstone of CBT is a list of cognitive distortions.  These lists generally range from about 7 to 15 distortions.  The reason the lists differ in number is that many of the distortions overlap with each other, so can be simplified, or separated.  Simplified lists are easier to remember, and longer lists are harder to remember but add some nuance.  After seeing many such lists, I’ve compiled my own, ranked from what I see as the most fundamental and common, to more nuanced and subtle.

  1. Overgeneralization.  Creating a general rule from one or just a few isolated events.  To me, this is the granddaddy of all cognitive distortions, and one might even say that all other distortions could be a form of overgeneralization.  Our minds aren’t set on a perfectly accurate picture of reality, which is impossible (reality is infinitely complex and our minds aren’t).  We are thus overgeneralizing machines.  Our minds have to simply the world with models to get by, but there is always a cost associated (information is lost) with any simplified model.  CBT is largely about rectifying the problems that result when our models become too overgeneralized in various ways.  Examples of overgeneralizations would be “no one loves me,” “I can never catch a break,” “I fail at everything,” etc.
  2. Polarized thinking.  Polarized thinking is also called black-and-white thinking, all-or-nothing thinking, binary thinking, or dichotomous thinking.  All of these names point at the way we classify reality into two poles, or opposites (which is why I like the word “polarized”).  We remove the “gray area” of reality.  Few things in reality are in fact categorical, but lay along a continuum.  You might recognize polarized thinking as a type of overgeneralization (it is).  Politics become “polarized” based on this distortion (our side is correct/good/moral and the other side is bad/immoral).  People can become polarized into traits (nice/mean, smart/dumb, pretty/ugly, happy/depressed) etc.  A common polarization that is associated with Buddhism is craving/aversion (I like this, I don’t like that).  
  3. Filtering.  Selectively paying attention to only certain parts of reality.  Selective attention is a part of human cognition, so it isn’t bad in itself.  In fact, it’s necessary because we don’t have the infinite bandwidth we would need to pay attention to everything.  But it does lead to distortions, and that creates a constant challenge to remain broad enough to take in enough richness of the world to navigate it, but not so much richness that we become overwhelmed and confused.  Usually in CBT, we work on recognizing that we are filtering out a lot of positive things and taking in the negative.  But sometimes people filter out the negative, in a sort of denial.  Filters can be general (e.g. filtering out the positive) or specific (e.g. filtering out signs of being loved or signs of being loved in a specific way).
  4. Labeling.  Labels are part of human language and cognition, but they also in a way divert our attention away from the object or event being labeled.  If we see a sunset and think, “oh, there’s a sunset” we might just move on to the next thing, thinking we’ve attended to the sunset by categorizing it.  But to really attend to the sunset, we’d need to watch it with full awareness and presence for its full duration.  Even then, we’d probably get distracted by thoughts now and then and miss some of the sunset experience.  We walk around the world mentally and verbally applying labels to people, animals, objects, and events, not fully experiencing most of them.  In CBT, labels cause suffering the most when they create negative images of ourselves and others.  Examples of obviously damaging labels include “failure,” “jerk,” “coward,” etc.  But more subtle pain can be caused by labels that oversimplify us (e.g. “sensitive,” “tough,” “bubbly,” “moody,” “happy,” “rebel,” “rule follower,” “talker,” “introvert,” “extrovert,” etc).  You might notice that labels are verbal and mental tags that lead us to overgeneralize, filter, and polarize the world and people.
  5. Catastrophizing: Essentially, worrying.  Thinking the worst can and will happen.  Also known as “what-if” thinking.  It’s not that we shouldn’t ever consider things that could go wrong.  It’s when we do this without a balance for what could go right, and also go to the extreme of what could go wrong.  Catastrophizing is a form of filtering (we filter out the positive possibilities and even the less pronounced negative ones).  It’s also a form of polarized thinking (focusing on the far end of the pessimism continuum).  Catastrophizing fuels not only anxiety but also depression, since we tend to feel immobilized when we imagine that any action is going to produce very negative results, and immobilization is a hallmark of depression.
  6. Control fallacies are when we believe that we have responsibility for things outside of our control, or we believing that we have less influence than we do over other things.  I might in fact also call these “influence fallacies” or “responsibility fallacies.”  They go in both directions.  A common example is believing we have control over what someone else thinks, feels, says, or does.  This would be an external influence fallacy.  Conversely, we could believe that we don’t have control over what we think, feel, say, or do.  That is an internal influence fallacy.
  7. Mind reading is when we assume that we know what others are thinking and feeling, more than we in fact do.  As humans, we are gifted with intuition and empathy, made possible by our mirror neurons and complex nervous systems.  But we are also not clairvoyant or omniscient, and often tend to think that we know more about what is going on in someone else than we do.  Sometimes, we do block out our intuitions of what might be going on in another person.  This too might be considered a distortion, because we are seeing less information than is actually available to us.  But usually that information is general and emotional, not specific.  The key point is realizing that, when we are interacting with another, we are never totally in touch with their experience, nor are they in touch with ours.  We are both walking around with a model of the others’ experience, and those models have missing, extra, and inaccurate pieces. The mirror image version of this distortion is assuming that others can read our own minds.
  8. “Shoulds” are inflexible, rigid, out-dated rules for living that cause shame or feelings of deprivation.  They cause shame when we decide that we have failed (e.g. “I should be more successful”), and cause deprivation when we decide that the world, or others, have failed (e.g. “This shouldn’t be this hard.”).  Whenever we think or speak in a way that sounds like, “it should be like this” “they shouldn’t have…” or “I should have…” we are distorting our reality.  Why?  Because the very fact that we are saying things “should” be different than they are, suggests that reality isn’t in line with the fantasy in our mind.  If it was, we wouldn’t have a “should” statement.  This took me a while to wrap my head around at first, because I was confusing what I thought “should” be with what actually “should” be.  Every should statement does this.  It’s of course fine to have ideas about the way the world, others, or ourselves “should” be, but when we don’t remember that they are just that – ideas, fantasies of ours – then we create an distortion by projecting our ideal world onto the actual world.  Who are we to argue with the universe?  Think about it logically and objectively and the absurdity becomes clear.  The overused therapy joke about shoulds goes, “oh, don’t should on yourself” (said whenever someone is being hard on themselves, as in “I should have known better”). The “fairytale fantasy” is a variation on “shoulds” in which we demand the ideal from life.  For example, “that’s not fair!” reflects a belief that the world “should” be different than it is.
  9. Personalization is assuming that you are causing more than you are.  In particular, we tend to overattribute others’ behavior to us, especially when we know them well or were around when they said or did things.  But we tend to overestimate our influence and underestimate the extent to which others are consistent in their actions, worldviews, responses, and mannerisms.
  10. Emotional reasoning is assuming that things are the way you feel about them.  It is making judgments and drawing conclusions based too heavily on feeling, rather than a combination of intuition and rational thinking.

The above list is a moderate number of distortions.  Some have more, some less.  The number doesn’t really matter as much as the concept.  These distortions are like out-of-focus lenses, through which our raw sense information is twisted, to create inaccurate perceptions and meanings.  Simply remembering a few of the big ones, like overgeneralization, filtering, and shoulds, will help you correct the focus to represent reality more accurately.

I sometimes think about cognitive distortions as glitches in an imperfect, unfinished software update of human cognition.  They are ways of simplifying reality to prevent cognitive fatigue, since we all have limited energy with which to parse unlimited information into meaning.  In many cases, our distorted perceptions are plenty good enough to accomplish what we need to.  Polarized thinking might be fine for deciding between dinner items on a menu.  But for any complex situation or issue, it tends to lead to missed opportunities and poor decisions.

It may be that cognitive distortions are more of a problem because of the mismatch between our evolutionary environment and our modern environment.  Frankly, this leads to a lot of our personal problems, from a tendency to want to eat too much sugar and too much in general, to a lack of needed movement, to people experiencing high rates of isolation.  It may be that our cognitive lenses fit our simpler, more natural environments better than they do modern environments.  For example, personalizing and “mind reading” others’ behaviors might have been more accurate when we spent our lives with the same group of kin for decades, and were very in touch with each others’ behaviors over a lifetime of more focused attention on each other.  Catastrophizing could have been a switch that was rarely triggered when living in a less eventful, more natural setting.  And perhaps generalizing and polarized thinking was good enough to apply to most situations in a less complicated world.  In other words, we live in interesting times, and in some ways we might be trying to catch up to them by correcting our ways of modeling reality.

Irrational beliefs

If automatic thoughts are like rain drops that fall in our minds, then distorted beliefs are like puddles that form over time.

Every therapist, early on in their training, will be given a list of “irrational beliefs” (a term coined by Albert Ellis).  Here are some examples:

  • We must have approval from all people we find significant
  • When people behave obnoxiously or unfairly, we should blame and damn them and see them as bad, wicked, or rotten.
  • Our past remains all important, because if something once strongly influenced our life, it has to keep determining our feelings today.
  • We can achieve maximum happiness via inaction or inertia.

You get the idea.  Some people use the terms “cognitive distortion” and “irrational belief” interchangeably, but I think there is a difference.  The cognitive distortion is like an irrational belief machine, cranking them out.  Distortions are like the warped lens or funhouse mirror, and the irrational belief is the result of seeing the distorted images over and over again.  The distortion creates a warped image in the moment (the automatic thought) and over time those images create an internal image inside our minds (the irrational belief), when we actually start to mistake the warped image for how we, others, and situations actually are.

Core Schemas

Core schemas add another level of nuance to CBT theory.  A core schema is similar to an irrational belief, only they are very deep-seated, emotionally charged, and simplistic.  Like with cognitive distortions, there is no consensus about how many core schemas there are, since their division is somewhat arbitrary.  There are various models that range from simple to complex.  A simple model that I like, because it is easy to remember, only has 3 basic schemas:

  1. Lovable vs unlovable (shame)
  2. Competent vs incompetent (impotence)
  3. Safe vs unsafe (victimhood)

People can “have” 1, 2, or all 3 of these.  By “have”, I mean that we tend to feel unlovable, impotent, and/or unsafe to a greater degree than we actually are.  That greater degree part is key.  For example, if you are in actual danger and feel unsafe, that is not a core schema at work, that’s an accurate perception.  Also, it’s important to realize that no one feels any of these core schemas 0% or 100% of the time across circumstances.  The idea that we fall into schema categories is an example of polarized thinking.  But people do vary to the degree that they feel lovable, competent, safe, etc relative to their actual circumstances.  In that way, we could say that core schemas are operating to some extent.

There certainly are more complex models of schemas, and perhaps the most well known is actually labeled as a theory in itself, Schema Therapy.  This theory really gets detailed, listing 18 different schemas, 11 “maladaptive coping responses”, and 10 “schema modes.”  It’s an interesting classification worth checking out.  I consider it a sub-theory of CBT.

If you dig into the etymology of the word schema, you find roots such as “a program of action” and “diagram,” which point at something important about core schemas.  They are similar to computer programs that run through instructions automatically once executed, or blueprints from which multiple copies of a thing can be manufactured.  When a core schema is triggered in us, it has an automatic nature to it, operating largely outside of conscious awareness.  It is a time when we’ll tend to think automatic thoughts and build up our irrational beliefs.  For example:

  • Someone with a strong shame schema might go into a downward spiral when someone significant to them judges them harshly or disapproves of them.  In those moments they’ll notice automatic negative thoughts about themselves (e.g. “no one loves me”), and will temporarily be more sensitive to slights or possible rejection, until they recover.
  • Someone with a strong impotence schema may become very afraid to try new, even simple things for a while after a significant setback or failure in which they did not meet a goal they’d set.  While their schema is running, they will tend to think automatic and distorted thoughts like “I can’t do anything right.”

Once a schema is running, we should try to terminate it, like when we close a software program that is stuck in a loop and has crashed.  There are many ways to do this, including introducing thoughts and behaviors, and mindfully observing the thoughts from a distance, which I’ll cover in the techniques and intervention section below.

Techniques and interventions used in cognitive behavioral therapy

CBT interventions aim to help you see reality more accurately and behave effectively.  Any examination of automatic thoughts, cognitive distortions, irrational beliefs, or core schemas tends to correct them, because once we see how these sub-conscious phenomena are inaccurate, we naturally correct them with conscious awareness.

Examples of techniques of cognitive behavioral therapy:

  • Weighing evidence for and against our thoughts
  • Practicing intentional replacement or “disputes” of untrue / unhelpful thoughts
  • Using “thought journals”
    • Writing down alternative, conscious thoughts that challenge our automatic, semi-conscious thoughts
    • Visualizing desired outcomes and specific goals
    • Imagining best case and worst-case scenarios, and estimating the probability of each occurring
  • Purposefully worrying for a set amount of time in order to desensitize yourself to your worries
  • Practicing stopping unwanted thoughts and replacing them with desired thoughts
  • Evaluating various options and their probable consequences
  • Examining core beliefs, their origins, and their accuracy
  • Breathing and relaxation exercises
  • Working on planning and time-management

CBT Resources

If you’d like to learn more about CBT and how to apply it, here is some media you could check out:

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