One way to reshape your negative thinking and reduce stress

(CNN) — Don’t you want to put an end to your stressful, anxious thinking? It turns out you can, and while you’re at it, you can feel better about yourself and act too.

This is the basis of cognitive behavioral therapy, which pushed onto the psychological stage in the 1960s and has received a lot of attention since then.

According to the National Alliance on Mental Illness, CBT, as it is known, is designed to “expose unhealthy thought patterns and how they can cause self-destructive behaviors and beliefs”.

It may not be for everyone. Therapists typically give “homework” so there is active involvement of the client and no underlying issues such as childhood trauma or systemic family problems are addressed.

But for those ready to get down to work, cognitive behavioral therapy can be just what the doctor ordered. CBT has been shown in randomized clinical trials to relieve depression, anxiety, obsessive-compulsive thinking, eating and sleeping disorders, substance abuse, post-traumatic stress disorder, and more.

What happens during CBT that can cause change in such a wide variety of conditions?

CNN spoke separately with two experts in the field: Jay Fournier, professor and director of the Mood and Anxiety Program at Ohio State University’s Center for Cognitive and Behavioral Brain Imaging; and Kristen Carpenter, a women’s behavioral health psychologist at Ohio State University’s Wexner Medical Center.

These conversations have been slightly compressed and edited for the sake of clarity.

CNN: In short, what is cognitive behavioral therapy?

Jay Fournier: It is a structured psychotherapy that is very different from the form of therapy that is often depicted on television or in films. The focus is on helping people get well as soon as possible by reducing their symptoms as soon as possible.

CBT tends to focus more on the present than the past and is usually a more short-term treatment. The first few sessions with a cognitive behavioral therapist are aimed at your goals: what is bothering you and what do you want to change? Then we create a treatment plan that achieves these goals within a certain period of time.

My job as a cognitive behavioral therapist is to make myself unemployed. I try to teach a person to do all the things I can in their own life so that when we stop meeting they can move on without my help.

CNN: How do our thoughts affect our actions and feelings in CBT?

Fournier: Most people go through life thinking that the way they feel or what they end up doing is directly influenced by what happened to them in their life. One of the core elements of cognitive behavioral therapy is that there is an intermediate step: how we interpret these situations. It is our interpretations of these events that make us feel certain things and act in certain ways.

One of the first things we make people do is notice their thinking. If you notice your mood changing, ask yourself, “What was on my mind before I got worse?”

The goal is not to think happy thoughts, because happy thoughts are fun. The goal is to help people think more carefully and precisely about their circumstances, especially people who tend to think more negatively when things get difficult.

Take the example of someone who gives you a name. You may be thinking, “This person saw through me, she is exactly right, I am exactly that.” And you will likely feel pretty awful. Or you might be thinking, “Wow, that person is such a bad person. I really have to weigh up whether I want her in my life. “

CNN: Most of us are not particularly aware of these negative thoughts, only of bad feelings. How does CBT help people become more insightful?

Kristen Zimmermann: We do a lot of training around identifying automatic thoughts and the beliefs that underlie them. It starts with identifying self-talk – literally, the things you say to yourself in a moment of need.

For example, the thoughts we typically see in depressed people revolve around these beliefs: “I am not lovable; I am unworthy; the future is bleak and there is very little I can do about it. “

For those who are fearful, these core beliefs tend to deal with threats: “The world is scary; the world is threatening; I am not equipped to face these challenges. “

As therapists, we will help you analyze your self-talk with a series of questions: “How true is this thought? What evidence do you have for and against this thought? How realistic is it? Are there errors in reasoning that we can identify? And it’s not just people with a clinical diagnosis who make mistakes – we all do.

Some of these thoughts could be logical fallacies. Others we call “should” statements: “I should be able to work full time and also help my child with homework every night, have a rich and engaging social life, and be well-read and come to any event that it has ever occurred and preparing healthy meals. “

We help the person question some of these statements and assess how realistic they are. Many of us have higher standards than others: “Why does every other mother on the block get a break, but you don’t?”

But it doesn’t shift negative thinking to “pink glasses” because that doesn’t really help either. It’s too far. What you want to do is get centered, towards a mindset that is compassionate for yourself, that is more realistic, and not tied to assumptions that may be wrong.

Ultimately, in CBT, we help modify false, exaggerated beliefs so that people learn the skills they need to overcome negative self-talk.

CNN: I understand that CBT has a lot of homework to do. What kind of homework do you give?

Fournier: Cognitive behavioral therapy involves homework, and a lot of that homework consists of looking in new and different ways about what you are doing, how you are feeling, and what is going on in your head.

As therapy progresses, we would have certain worksheets that we could hand out to people, and there are apps that they can download to do the same. After all, we want people to learn to use these tools themselves. We see CBT as a collaborative relationship in which we work together to make the changes in the life of the person they want to see.

An important tool we use is an automatic mind recording, where participants keep track of what they do, think, and feel in the days between sessions. You bring it back to the session and we go through it together and evaluate the thinking. What makes little sense? What are alternative ways of thinking or how to deal with the situation?

We also ask people to keep track of their stress and anxiety levels. And then we look for tips together: “When were you most stressed? Least Stressed? What did you do and think? ”And then those would be the things we would concentrate on in the treatment.

CNN: We’ve talked a lot about the cognitive side of CBT. What about the behavioral side?

Carpenter: CBT is based on the assumption that thoughts, behaviors and emotions are intertwined: “My thoughts influence my feelings, my emotions influence my behavior and everything is interrelated.”

As a therapist, this gives me three avenues that I can use with individuals to bring about change – through thoughts, emotions, and behaviors.

Take depression, for example. Depressed people withdraw from the world and stop doing things that they used to find pleasant and enjoyable. For someone with such challenges, we would encourage them to plan positive activities, contact friends and family, and try to do things that make them feel a sense of belonging or success.

CNN: Can these behavior changes be applied to stress, such as the stress and anxiety that the pandemic caused?

Fournier: When people struggle with anxiety, they tend to avoid the things that they worry about. It’s pretty natural behavior. But avoidance can affect life, it can interfere with your goals for yourself, and you can ultimately worsen anxiety. In the case of anxiety, treatment will help them gradually come back to the situations they were previously avoiding.

For people with high levels of stress, some of these things in people’s lives are changeable, but others are not, especially during the pandemic. Depending on the circumstances, we can encourage people to make the changes they might make.

But even for the fear-inducing moments in life that they cannot change, we can look at how they experience these situations.

Sometimes bad things happen in life and that’s just part of it. But sometimes people experience more depression or more anxiety than the situation absolutely requires. We can help them review their thoughts and behaviors during these phases to see if there are ways to change those thoughts to reduce their stress levels.

While I’m not an expert on post-traumatic stress disorder, CBT has been shown to be very helpful with symptoms. Of course we cannot change the past; We can’t change what happened to the person. But we can help them change their relationship with what happened to them by changing their thinking about the traumatic experience. In this way, we will hopefully help them experience less life-threatening symptoms associated with the trauma.

CNN: How can a person find a trained CBT counselor?

Carpenter: I always recommend the Society for Behavioral and Cognitive Therapies. They have a list of therapists who are CBT trained and you can search locally by zip code. The American Psychological Association also lists CBT-trained therapists under “Treatment Methods” in their “Find a Psychologist” mechanism.

Be persistent. Try several therapists before deciding on one. You want to find the person who suits you best.

This story was first published on, “CBT: A Way To Reshape Your Negative Thinking And Relieve Stress”

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