In my private Psychotherapy practice, one of the first questions I’m often approached with is “do you specialize in CBT?”
After informing them that Cognitive Behavioral Therapy is a cornerstone of my treatment model, I’ll ask them: “What’s your understanding of CBT and why does it interest you?”
… crickets. A blank stare. An uncomfortable silence.
It seems that Cognitive Behavioral Therapy has become a trendy new clichè term to throw around a Psychotherapist’s office.
Most clients report having read about CBT in a magazine or overhearing something about it from their wealthy friend in the Hamptons.
The reality of Cognitive Behavioral Therapy, however, is very different from the trendy self-help reputation its acquired through being casually written about in glossy magazines and tongue-and-cheek Brooklynite blogs.
So, what is CBT? Let’s start by exploring a Clinical Explanation of the treatment model:
The term cognitive comes from the Latin “cognoscere”, meaning “to recognize.” The point of cognitive behavioral therapy is to form a clear idea of your own thoughts, attitudes and expectations. The goal is to reveal and change false and distressing beliefs. Often, it is not only the objects, subjects and situations in life that cause us a problem, but it is also the importance that we attach to those objects, subjects and situations. Robert Koch Institute (RKI). Psychotherapeutic healthcare. Berlin: RKI; 2008. (Federal Health Reporting, Booklet 41).
For me, as a Clinical Psychotherapist, I’ve always viewed the CBT model as closely correlated to an “Integer Number Line” in Mathematics.
Regardless of the specific diagnosis, when a client presents to treatment they are often experiencing emotions which could be best described as distressing or “negative” — even if their daily level of function is perceived as normal by themselves or others.
The goal, as a CBT practitioner, is to help the client recognize that they are living “in the emotional negative” — while making efforts to assist them in their ascension to the more neutral and positive numbers.
Case Example: A New client with Obsessive Compulsive Disorder presents to my office for Psychotherapy. Aside from the OCD-Specific treatment the client requires, it becomes evident that the client feels extremely sad and pessimistic about their future outlook, due to the toll OCD has taken on them. Once both the Clinician and Client establish that the client is currently functioning at, let’s say, -25 on the Emotional Scale — a primary focus of therapy becomes a gradual numeric climb into the neutral (0) and then into the Positive, once the client is ready for Constructive Living.
Two words we can also use, when discussing a Numeric Emotional Scale is “Deconstructive” and “Constructive”.
When someone is living “in the emotional negative” — their attitude toward life-events is often one of pessimism or discouragement — a reaction which causes the person to “disassemble” or even “destroy” any notion of a Positive Future.
When someone arrives “in the emotional neutral” — (something which is no small accomplishment) — they are functioning in a place where, although they aren’t feeling pessimistic anymore — they also aren’t constructing (or building) a more proactive reality.
Notably, attitudes within the neutral phase may even be described to a Clinician as “numb” — something which, although not preferable, is significantly better than a negative attitude.
When someone finally arrives “in the emotional positive” — they are finally able to “build” from whatever life event comes their way.
A great example of living in the emotional positive comes from Warren Buffett.
When he was asked what role “luck” has played in his life, he responded by saying “A major one — especially when I was rejected from Harvard.”
When Buffett elaborates, he explains “if I hadn’t been rejected from Harvard, I never would have met my partner and gone into business with him.”
The idea here, is that people who live in the emotional positive are able to “build” or “construct” something, from absolutely anything that happens to them — even if such is a seemingly “negative” event.
Again, CBT is always about the interaction between our Behaviors, Thoughts and Feelings — as well as the acquisition of both goals and problem-solving techniques.
Another important element of CBT is a focus on the Present Moment.
Many garden-variety psychological conditions, in some form or another, tend to be rooted in either Anxious Thinking or Depressive Thinking.
Although there is a major difference between the two — one organic commonality they share is a locked correlation to the notion of “time.”
Although many spiritual people will tell you that time is eternal — we (as egoic Human Beings) have a organized system of measuring of time.
Because of this organized system, depression has an intrinsic link to the past, while anxiety has an innate connection to the future.
Often times, the depressed individual is constantly reflecting upon events which have already happened — which continually results in feelings of sadness, guilt, dejection and so forth.
In contrast, the anxious person is constantly projecting into the future and worrying about things which haven’t happened yet. This, of course, results in feelings of nervousness, fear, panic and fright.
The thing is — when the past happened, it happened “here”, in the present moment.
And when the future happens — it will happen “here”, in the present moment.
The present moment is the only point in time where all events occur.
It is also the only place where our personal power lives.
From here, in this moment, we have the ability to transform the repercussions of the past and alter the course of our future.
Besides, based on our permanently locked position in the third dimensional present — the past is simply a memory and the future is just an idea.
Hence — the importance of working with clients to be more mindful and focused on the present moment.
Whether your goal is to: transcend the past — stop worrying about the future — or perhaps to climb the numeric emotional scale — Psychotherapy is an outstanding opportunity to explore yourself in pursuit of a healthier life.