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CBT EXPLAINED: HOW COGNITIONS, BEHAVIOURS, AND EMOTIONS INTERACT
- 2. “WE ARE WHAT WE THINK. ALL THAT WE ARE ARISES WITH OUR THOUGHTS. WITH OUR THOUGHTS WE MAKE THE WORLD” BUDDHA WE ARE MEANING-MAKING CREATURES!
- 4. COGNITIVE STRATEGIES “Logical Disputing” A: Activating Event B: Beliefs (thoughts, beliefs) C: Consequences D: Dispute Label the reasoning errors: For example: black and white, mind reading, jumping to conclusions, comparing, awfulising, hindsight vision, personalising, labelling, overgeneralising, etc. Cognitions BehavioursEmotions
- 5. EXAMPLE: A: Activating Event: Didn’t connect well at a social function C: Consequences: Feelings: anxious, despondent Behaviour: rumination, withdrawal
- 6. B: THOUGHTS AND BELIEFS Thoughts: I looked stupid . .. I’m a loser … they think I’m a misfit. Beliefs: I should always connect well, in every social situation People judge me harshly Negative events have permanent consequences.
- 7. D: DISPUTE Reasoning Errors: Labelling, Mind reading, Jumping to conclusions I prefer to connect well with people, but it’s unrealistic to expect this in every social situation I connect well in some situations and not in others Most people don’t notice and don’t care Most people have been in similar situations themselves Events like this do not have long-term consequences Problem Solve?
- 8. Addresses conscious and unconscious cognitions Rational and irrational cognitions Experiential learning. BEHAVIOURAL STRATEGIES Cognitions BehavioursEmotions
- 9. BEHAVIOURAL STRATEGIES … Behavioural Experiments For Example If I don’t do it perfectly, the consequences will be disastrous If I speak up in this group, I will make a fool of myself If I confront my fear, I will be overwhelmed and won’t be able to cope If I don’t give in to this craving, it will never go away If I stop being a ‘people pleaser’, no one will like me. Cognitions BehavioursEmotions
- 10. BEHAVIOURAL STRATEGIES … Graded Exposure For Example Panic attacks Phobias: elevators, driving, flying, spiders, tunnels Social Anxiety Exposure can be: In real life Writing Imagery Cognitions BehavioursEmotions
- 11. BEHAVIOURAL STRATEGIES … Activity Scheduling Direct effect on emotions: physical exercise social activity achievement activity pleasurable activity Indirect effect on emotions, via cognitions: “I have some control over my life”, “I can achieve things if I try” rumination Distraction. Cognitions BehavioursEmotions
- 13. DISTRACTION Walking Doing a puzzle (crossword, Sudoku, jigsaw) Shopping Writing (story, poem, diary) Singing Surfing the net / computer games Play with pet Cook a new recipe Dance with music Call a friend
- 14. BEHAVIOURAL STRATEGIES … ADDRESS PHYSICAL SYMPTOMS Tension, arousal, physical symptoms are AVERSIVE Trigger strong biological drives seeking relief Relaxation techniques (e.g. progressive muscle relaxation, imagery, breathing): arousal intensity of emotion and biological drives Physical exercise: arousal and endorphins intensity of emotion and improves mood.
- 15. MINDFULNESS Tension, arousal and aversive physical symptoms Build tolerance to unpleasant emotions and body sensations: observe without judgement. Drop the resistance. Use the breath for attention training and self- soothing Improved insight and awareness of current experience. Separate thoughts from reality.
- 16. COGNITIONS: FROM CONTENT TO PROCESS Observing thought processes e.g. rumination, worrying, threat monitoring Acknowledge the process as it occurs Understand what the mind is trying to do Step outside: “Just thoughts”. Cognitions BehavioursEmotions
- 17. METACOGNITIVE BELIEFS Unconscious beliefs about our own thoughts and emotions: My anger protects me from ‘them’ My worrying prepares me for the worst I need to suffer or I’ll make the same mistakes again If I feel hopeful I’ll be disappointed Identifying and challenging metacognitive beliefs improved outcomes.
- 18. GOAL FOCUSED THINKING: Does thinking or behaving this way help me to feel good or to achieve my goals?
- 19. IMAGERY Access Information from the past Change meanings Exposure using imagery (e.g. trauma) Imagery rescripting Using imagery as metaphors.
- 20. SELF-HELP: ON-LINE RESOURCES My compass: www.mycompass.org.au Mood Gym: moodgym.anu.edu.au CCI: www.cci.health.wa.gov.au E-couch: www.ecouch.anu.edu.au Anxiety Online: www.anxietyonline.org.au This way up: thiswayup.org.au
- 21. IN SUMMARY CBT: large collection of strategies Different strategies for different situations Living therapy: new methods keep evolving in response to research Emphasis is always on finding what works.