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The Clinic on Dupont Toronto

What is CBT and how does it work?

cognitive behavioural therapy

Thoughts, emotions, and behaviours are all dynamically intertwined. However, because of the way that the brain is wired, it’s easier to change our thoughts and behaviours than it is to change our emotions. That’s because emotions are partially generated in an old reptilian part of the brain, and because of this, they can be processed instantaneously, making them very difficult to change. These quick, gut-level, emotional responses color subsequent thoughts, decisions, and actions, often without our conscious awareness. Our core beliefs about the world, which develop from past experiences, shape these emotional responses. When core beliefs are inaccurate and overly negative, they may have a pervasive negative impact on one’s mental health.

Cognitive Behavioural Therapy (also known as CBT) is a method of psychotherapy aimed at helping individuals to change how they feel by training them to intentionally challenge negative thoughts and beliefs, and, by purposefully changing their behaviours so that their emotions follow-suit. Over time, repetitively changing thoughts and behaviours may effectively rewire emotional tendencies, creating lasting emotional change, helping individuals to feel more confident, secure, optimistic, and in control.

How can CBT help you change your thoughts?

CBT provides clients with specific strategies to help them to recognize and challenge insidious negative thoughts. People frequently engage in “cognitive distortions” in which they overgeneralize, catastrophize, and generally magnify negatives while minimizing positives. Challenging negative thoughts allows clients to gain a more realistic, big-picture view of their realities. For example, anxiety will often lead individuals to over-estimate their chances of failure versus success. A commonly used cognitive strategy for gaining objectivity is to imagine what you’d think if someone else were in a similar situation. This strategy tends to help individuals to see the discrepancy between what feels true for them, versus what they objectively think is true for any other person. Other cognitive strategies that often help individuals to notice when their thoughts are biased include asking questions such as: “what’s the evidence for and against this thought?”, “what’s the worst thing that could realistically happen and how would I cope?”, “how would the worst case scenario affect my life in a week, a month, a year?”, and “is this situation really in my control?”. By using these types of cognitive strategies when negative automatic thoughts arise, clients can become increasingly adept at noticing the discrepancy between what feels true and what is true. Reminding oneself of the “big picture” and adopting a more realistic thinking style helps individuals to rewire their emotional systems, allowing them to eventually change how they feel, and ultimately minimizing future instances of emotional bias.

How does CBT help you change your behaviours?

Very commonly, negative emotions lead us to engage in unhealthy behaviours that reinforce problematic mental states. For example, individuals who struggle with anxiety frequently try to avoid contact with their feared stimulus — whether that might be speaking up during a big meeting, approaching conflict assertively, going on a date, flying in an airplane, driving on the highway, etc. Avoiding situations that elicit anxiety prevents anxiety in the short-term, yet inevitably maintains – and often increases – anxiety in the long-term. Those who feel depressed, as well, very commonly engage in behaviours that maintain – and often prolong – that feeling of depression such as isolating themselves, staying in bed for long hours, and avoiding exercise. For this reason, CBT involves coming up with a tailored plan that will encourage clients to engage in behaviours that will ultimately allow them to feel more secure, confident, optimistic, etc. Even if these behavioural changes are difficult in the short-term, they tend to effectively help individuals to rewire their emotional systems, facilitating lasting positive change.

What types of issues are well-suited to CBT?

CBT has been found to be effective for a wide range of mental health issues including depression, anxiety, panic attacks, self-esteem, weight-loss, addiction, and attachment insecurity, in addition to mental health disorders such as PTSD, OCD, eating disorders, and schizophrenia. Whatever the mental health goal, CBT tends to be an effective way of helping individuals to change the way they feel, by challenging their inaccurate negative thoughts and beliefs, and, by intentionally modifying their behaviours.

shona tritt clinician

By: Shona Tritt, Ph.D., C.Psych.
Shona Tritt is a registered Clinical Psychologist and Faculty Lecturer at the University of Toronto Scarborough who has worked at The Clinic on Dupont since 2016.

Posted June 25, 2019
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