What is Cognitive Behavioural Therapy (CBT)?

Cognitive Behavioural Therapy (CBT) is a well-established and highly effective form of talking therapy. It is recommended by the National Institute for Health and Care Excellence (NICE) to treat depression and anxiety disorders. CBT can also be used to treat a range of other difficulties such as stress, burnout and perfectionism. You do not have to wait until you are struggling to seek help though. CBT can help you achieve a range of goals, learn how to better manage negative thoughts and stressful situations, and can even help you to just maintain your emotional health and well-being.

How does it work?

CBT combines Cognitive Therapy (examining the things you think) with Behavioural Therapy (examining the things you do) and is based on the theory that our thoughts, feelings, bodily sensations and behaviours are all interconnected, and that negative thoughts and feelings can keep us trapped in a vicious cycle. The idea is that if we work on changing one of these, then we can alter the others.

Unlike some other talking therapies, CBT is primarily focused on helping you deal with your current problems, rather than focusing on issues from your past. It can also help you to learn practical ways to improve your state of mind on a daily basis.

What are the benefits of CBT?

The benefits of CBT include:

• Self-awareness. You will develop a better understanding of the way you think, feel and behave. You will also develop a greater understanding of others around you.
• Reduced symptoms. A reduction in symptoms associated with a range of difficulties such as anxiety, stress, burnout, low self-esteem and perfectionism - depending on what you come to therapy for.
• Coping strategies. You will learn a range of coping strategies to help you deal with your current problems - enabling you to cope with a range of situations, thoughts, emotions, bodily sensations and behaviours.
• Achieve goals. CBT is effective in helping individuals achieve personal and professional goals.
• You will learn how to identify and challenge unhelpful thinking styles (e.g. catastrophising) and behaviours (e.g. avoidance).
• Time. CBT is a relatively short-term yet highly effective and evidence-based therapy. 
• The effects of CBT are long-lasting. You will be able to use what you learn in CBT to cope with any future difficulties you come across. 

Practical tips and recommendations on how to use it in daily life

Lorna Devine shares a few tips and tools to manage and improve your wellbeing on a daily basis below:

1. Self-monitoring – a tool designed to help you capture information about situations relevant to your current problems
Self-monitoring is a powerful tool used in CBT which essentially means gathering information to help you better understand your thoughts, feelings, bodily sensations and behaviours. The aim of this tool is to improve your awareness of your experiences and the contexts in which they occur. This will help you gain insight into your current problems.

There are a range of ways to self-monitor. For example, if you find yourself feeling anxious, you could start by recording specific instances in which you notice anxious thoughts, feelings or responses. Write down what you were doing when you started to feel anxious. It can be helpful here to write down specific details such as who you were with, what happened and where you were. Then, write down how you were feeling at that moment, what you were thinking, and what you did in response to your anxious thoughts and feelings. See if you can identify any patterns or links between your thoughts, feelings, physical sensations and behaviours. Once you have gained this awareness, you can then begin to take steps to manage how you are feeling such as reframing your thoughts (see below instructions).

2. Reframe your thoughts
We all have thousands of thoughts that pop into our minds every day (also known as automatic thoughts). Sometimes these thoughts are accurate and helpful but sometimes they are inaccurate and unhelpful and can have a negative impact on how we feel. The idea behind CBT is that we can change the way we feel by changing how we think. Reframing your thoughts is one way to help you think differently. Reframing is a technique used in CBT that helps you to change the meaning of something and therefore the way you feel about it and thus your experience. The aim is not to think happy thoughts, rather, it is to think more accurately.

The first step in changing what you think is to know what you are thinking in the first place. The best way to catch your thoughts is to use a thought record to monitor your thoughts, feelings and the situations in which they are experienced. In the first column, record the situation (Where were you? Who was there? What happened? When did it happen? What were you doing?). In the second column, record your feelings (What did you feel?) and in the third column, record your thoughts (What thoughts or images went through your mind?).

You can then begin to work on reframing your thoughts. There are various ways to reframe your thoughts. Below is an example:

• Situation. What was happening? Where were you? Who was there? When did it happen? 
• Feelings and bodily sensations. How did you feel at that moment? How strong was that feeling on a scale of 0-100? What did you feel in your body? 
• Thoughts. What thoughts or images were going through your mind?
• Evidence that supports the thought. What facts or evidence support the truthfulness of the thought? What makes you think that the thought is true?
• Evidence against the thought. What evidence suggests that the thought may not be 100% accurate?
• Alternate thought. Knowing what you know now (taking into account the evidence for and against the original thought), what would be a more accurate way of responding to the situation/event?
• Feelings (post-reframing). How do you feel after reframing and changing the way you think about the situation now? How strong is that feeling on a scale of 0-100?

By reframing your thoughts, you should be able to learn to view a situation through a clear lens and therefore change the way you feel.

3. Reconnect with your body – breathe! 

One way to improve your wellbeing is through the body-mind connection. One way to reconnect the body to the mind is to use the breath. If you are feeling anxious or stressed, deep breathing will help you to feel calmer as it will activate your parasympathetic nervous system, also known as the ‘rest and digest’ system and take you out of the ‘fight or flight response’.

Instructions:

• Start by making sure that you are either sitting, standing or lying comfortably
• Breathe in through your nose (4 seconds)
• Hold your breath (7 seconds)
• Exhale slowly through your mouth (8 seconds)
• Repeat this exercise for 3-5 minutes or until you feel calmer

TOP TIP: Make sure that you are breathing from your abdomen and not your chest. To check, place one hand on your abdomen and one hand on your chest. As you breathe in, feel your belly rise. As you breathe out, feel your belly lower. The hand on your belly should move more than the one that is on your chest.

To make it even more powerful, you could combine breathing with affirmations.  As you breathe in, you could say in your mind, “I breathe in calm and relaxation.” As you breathe out, say, “I breathe out stress and tension.” You may want to come up with your own affirmations so that they are meaningful to you.

About The Author Lorna Devine is a Cognitive Behavioural Therapist and Holistic Coach for high achieving professionals and entrepreneurs, where she helps them overcome a range of difficulties including high-functioning anxiety, stress; burnout; panic attacks; perfectionism; imposter syndrome; low self-esteem; and relationship difficulties. In addition to offering 1:1 online therapy and her signature holistic coaching programme, Lorna delivers a range of master classes, emotional wellness workshops and group programmes; and consults for companies, start-ups, wellness brands and teams. She has worked with and been featured in leading brands such as BBC News London, Harper’s Bazaar, Sweaty Betty, Sheer Luxe, Hip and Healthy, Heartcore, Rituals and many more. Website: www.lornadevine.com Instagram: @lorna_devine