based on the idea that our negative or dysfunctional feelings (such as the physical sensations or fearfulness associated with anxiety ), or unwanted behaviors (such as avoiding social situations or the need to return home to make sure we turned the oven off for the 27th time), are the result of our negative or dysfunctional thinking.
By learning to first identify dysfunctional thoughts (cognitive distortions) and then challenge them with rationally based evidence that contradicts the original thought, we can change the thought and therefore change the feeling from a "bad" feeling to a good one.
The thoughts in question usually revolve around an old and strongly held belief, such as "I am not safe," upon which we have layered numbers of other supporting beliefs ("the world is a dangerous place," "people are untrustworthy"). CBT therapists often use workbooks or other pen and paper aids to teach the client how to recognize and keep track of their cognitive distortions, and there are many workbooks published to use as an adjunct to therapy or as self-help tools.
there are a couple of pitfalls with CBT that I have come across in my practice many times.
On the "pros" list, CBT is pretty effective, especially when combined with medication, and because it is considered a "brief" therapy, it tends to be favored by insurance companies. Heading the "cons" list is that many cognitive therapists discredit the importance of "feelings" completely, giving the impression that feelings are simply irrational, fleeting things that tend to get in the way. This can be frustrating to someone who has been suffering, worried, or confused by what they have been experiencing.
But even more important is that putting so much focus on a client's negative thoughts often creates so much anxiety that an individual might abandon therapy (or put down the workbook, cd's, etc.) prematurely and therefore never even get to the part where they begin to feel relief from their symptoms. I've often wondered if the studies touting the successes of CBT take into account the many individuals who never get further than the 2nd or 3rd exercise!
Finally, in my experience most people have a desire to understand or make connections that help them make sense of their experiences, positive and negative. While insight into one's problems may alone not be quite enough to create change, it is still often a necessary and integral part of healing.
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