Ace in the Hole: Cognitive Behavioral Therapy

Recently I have talked a lot about various forms of therapies for anxiety disorders. Some of which are considered somewhat fringe or unorthodox. There is one therapy however that is widely accepted as being extremely effective and more in line with old school psychoanalytical techniques. It’s called Cognitive Behavioral Therapy or CBT for short.

I have sprinkled CBT throughout my blog as a reference point for how to cope with your anxiety. But today I wanted to actually go into detail about what it is, how it works and how it can help you. CBT is actually a collection of different therapies that are very similar. According to The National Association of Cognitive Behavioral Therapists there are five (I reference 4) different types of therapies that makeup CBT, which is a classification and not a single type of therapy. CBT is generally used to treat anxiety, depression and other mood disorders.

1. Rational Emotive Behavior Therapy : Known as ‘REBT’ this therapy was the first type of cognitive therapy and states that people are primarily focused on survival and the pursuit of happiness. It also holds that people develop irrational beliefs that block their ability to reach their goals, particularly that of reaching a state of happiness. It also states that the development of persistent irrational thought is what causes unhealthy emotional reactions, which in turn leads to emotions like depression and anxiety. This can also be thought of as; negative event, irrational belief, creates unhealthy negative emotion. The solution to this problem is to teach you how to become more flexible in your interpretation of a negative event. To make your reaction less extreme about some perceived horrible event.

To become more flexible you must be responsible for your own emotions since only you can upset yourself. Understand that your bad emotions are because of irrational thinking. Be more realistic in your reactions and develop a deep sense of acceptance from your realistic viewpoint about your emotions and behaviors. It’s tough love for your anxiety.

2. Rational Living Therapy : This form of CBT is rooted in the therapist’s ability to “sell the patient philosophy and techniques of rational self-counseling”. According to its originator Dr. Aldo Pucci it’s a combination of Rational Emotive Behavioral therapy, Rational Behavior Therapy and Cognitive Behavioral Therapy.

3. Cognitive Therapy: This approach to anxiety therapy is very similar to REBT. Developed in the 1960′s by psychiatrist Aaron T. Beck, cognitive therapy sought to treat patients by changing their perception of meaning (about any act or event) rather than trying to delve deeply into their subconsciousness as was the case in more old school methods of psychotherapy. And like REBT Cognitive therapy also set out to change the patients thinking patterns with respect to unnecessarily negative modes of thought which could affect mood and behavior.

The goal then is to rebuild how you see things, particularly negative things, and use the new perspectives gained to alter and hopefully improve how you feel. For a detailed explanation of how this is accomplished click here . Now the difference between REBT and cognitive therapy is, in my opinion, razor thin and really comes down to approach. REBT is reliant on the therapist to make the patient see things from a rational perspective and in so doing help the patient alleviate negative emotions like anxiety. The cognitive therapists on the other hand has a somewhat more gentle approach. With cognitive therapy it’s more about leading the way, guiding and suggesting. The difference between REBT and cognitive therapy is debatable, but very small nonetheless.

4. Dialectic Behavior Therapy: First developed as a means of treating borderline personality disorder, it has also been shown to be effective for patients with various types of mood disorders – like anxiety disorder. This type of therapy has two parts. The first involves keeping a diary of weekly events and discussing those in detail. Then there are sessions to train the patient how to disrupt certain negative behaviors. The second phase involves the application of various types of skills taught to the patient, such as core mindfulness skills, regulation of emotions, people skills, and distress tolerance.

Cognitive Behavioral therapy is widely accepted as an effective means of treating anxiety disorders (read about 1999 study ) such as Generalized Anxiety, Panic disorder, Agoraphobia, OCD, PTSD and Social anxiety disorder. In his book entitled Anxiety Disorders and Phobias: A Cognitive Perspective, Dr. Aaron Beck states that “individuals with anxiety disorders have cognitive biases toward threat which make them hyper vigilant… it causes them to exaggerate minor threats (magnification). Research has demonstrated that underlying these cognitive errors is a system of dysfunctional beliefs relevant to danger” (Preface). CBT is all about changing your beliefs about those magnified fears and reactions.

In effect, CBT states that thoughts are what drive your negative emotions. Therefore, you must change how you think to change how you feel. That is a very basic summary of a very innovative approach to helping you see things a little clearer. In order to strengthen the effect of CBT there are patients who combine it with drug therapy. Some say the combination works better and others say it doesn’t (surprise, surprise) but this article is intended to fill you in on what CBT is, we can tackle this drug combo question another day.

CBT can serve as an effective form of therapy to help you cope with your anxiety. Remember that not all therapies are equal and you may have to try several before you settle on one that you think helps – this however could be your ace in the hole. My view on therapy is that you should learn and expose yourself to as many legitimate therapies as you can and take a little from all of them for maximum effect.

P.S. If you enjoyed this post don’t forget to subscribe to my blog at the top right of the screen. It’s 100% free.

Related posts: