CBT is considered an evidence-based therapy for a variety of mental health conditions. There’s been a lot of research done on CBT, and it’s very effective. It’s considered the “gold standard” psychological treatment for a number of different mental health conditions.
That’s not to say that it’s useful for everyone. It’s very present-focused, so it’s not going to help you work through things like early attachment issues. It’s also quite structured and focused on the key problems identified, so there’s not a lot of room for talking about anything and everything that might be going on in your life. Still, even for people that don’t think CBT is the right fit for them overall, there are likely to be some CBT tools that can be useful.
CBT identifies three levels of thought. The deepest is core beliefs, which are absolute beliefs we hold about ourselves, others, and the future (these three elements are sometimes referred to as the cognitive triad). Layered on top of those are underlying assumptions, which are beliefs that take the form of if… then… On top of those are automatic thoughts.
These pop up in response to a situation, and they have an immediate impact on both our mood and behaviour. Core beliefs tend to be ideas that we’ve held onto for a long time, and when we’re faced with new information that is discrepant from our core beliefs, cognitive distortions may develop in order to shield the core beliefs and maintain them as being true.
Since core beliefs are highly resistant to change, they can be hard to work on without guidance and objective feedback from a therapist. Core beliefs may be used as the basis for developing rigid, maladaptive rules/schemas of what we must/should do. These schemas in turn feed into negative automatic thoughts.
In a later section, we’ll take a closer look at these rules. Uncovering core beliefs involves peeling apart the layers of things that we experience to identify what is underpinning them. This can be done by asking questions such as:
• What does that mean?
• What is bad about that?
• If that were true/false, what would that say about me?
The Centre for Clinical Interventions has a core beliefs module that you can work through here: https://www.cci.health.wa.gov.au/~/media/CCI/Consumer%20Modules/ Back%20from%20The%20Bluez/Back%20from%20the%20Bluez%20-%2008%20- %20Core%20Beliefs.pdf
The diagram below of Beck’s cognitive triad (beliefs about self-world-future) shows how negative beliefs can feed into one another, keeping someone trapped in negativity.
Recognizing these patterns isn’t going to magically bring about change. CBT requires practice, and in particular, real-world practice, which is why therapists will typically give homework at the end of each session to be completed before the next session. I like to conceptualize familiar thought patterns as well-worn neural pathways through the forest of the brain.
Our brains like shortcuts, so that well-worn pathway is going to look pretty appealing, even if it’s not actually producing a good outcome. CBT is about building new neural pathways, and then practicing those pathways often enough that they become the new easy, automatic route. If you don’t put in the practice, you’re just trying to bushwhack your way through overgrown forest each time you try a new way of thinking.
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