Cognitive Behavioral Therapy for Anxiety and Depression
Cognitive Behavioral Therapy (CBT) is a general term for a category of psychotherapy that brings about recovery by exploring a person’s assumptions and beliefs (“cognitions”) as well as habits and actions (“behaviors”) that are unhelpful and self-defeating, and helping the person to change their thoughts and behaviors to reflect their actual values and goals.
One of the primary goals of CBT is to help people better understand how their thoughts, feelings and behaviors come together to create their overall emotional experience. This gives people greater situational and self-awareness with a chance to respond more carefully rather than with automatic responses. Here are examples of techniques I teach:
- Mood tracking - Learning to change your mindset regarding intense emotional experiences to change your reaction (e.g., viewing a crowded room as an opportunity to meet people rather than a place to embarrass yourself).
- Somatic sensation awareness - Carefully and thoughtfully entering a situation that makes you uncomfortable to put an end to avoidance of them and gradually work towards decreasing your anxiety (e.g., eating in a crowded restaurant).
A second important component of CBT is allowing the mind and body to come to the realization that it is strong enough to withstand the challenge at hand. Equally important is accepting that the most distressing emotions only go away when a person experiences and processes the pain. Ironically, trying to escape distressing emotions actually creates more suffering in the long run; suppressed emotions have a way of catching up to you. Instead, in CBT for depression and anxiety, I coach people to lean into discomfort and accept being uncomfortable, for example:
- Cognitive flexibility training - Rating your mood to track and observe patterns over the course of a day, week, and even month to understand your experiences (e.g., feeling more depressed during the weekends because there is less motivation to get out of bed and go to work)
- Exposure activities - “Provoking” physical sensations of anxiety and distress to learn how your physical sensations influence your thoughts and behaviors (e.g., the hyperawareness of anxiety might make you feel more self-conscious)
People naturally engage in all sorts of strategies to get away from emotional discomfort. A third critical piece of CBT for depression and anxiety involves figuring out what sorts of habits or coping strategies have developed and putting an end to the ones that are unhelpful while bolstering the healthy strategies. A part of this step is developing new ways of putting into action a person’s values and goals.
- Relaxation training - Learning breathing and imagery techniques to help you feel calmer when you feel overwhelmed and anxious.
- Motivation enhancement - Discussing the reasons you have decided on a course of action to help you feel engaged and enthusiastic about seeing it through (e.g., wanting to improve your relationships with loved ones).
- Behavioral activation - Discussing things in your life that you used to do or have wanted to try and begin to take actions towards those activities or interests.