CBT Certificate
My old CBT certificate had expired so I worked through a Udemy course to get a new one. Not the best course in my opinion, but it newed my certificate so I am pleased.
When I first approached Cognative Behavioural Therapy I was originally put in a group session to learn about it back in 2012. It was going to take some time before I could get 1-2-1 CBT and in the mean time I wanted to get a headstart on the process. I had really enjoyed working my way through many books “for dummies”, many “Complete idiot’s guide to” books and many “Teach Yourself” books so I looked through the options. Satisfied with Teach Yourself Cognitive Behavioural Therapy, I began to work through the exercises and had huge success. By the time I was in 1-2-1 CBT, I knew a vague outline of the process and could make the most out of the sessions focusing on the stuff that could not be dealt with by knowing a basic outline of CBT, the stuff that really needed a therapist. I saw other people who were annoyed that they were put into group therapy. They sadly became despondent and did not want to engage. By the time they were in a 1-2-1 session they had already declared that CBT didn’t work for them.
I never actually finished Teach Yourself Cognitive Behaviour Therapy and my 1-2-1 session led me to focus on more specific exercises to my needs. Trying to clear out my bookshelves, I thought after finishing my recent course, I will skim my way through the book as well to cement my knowledge and just enjoy the parts of the book which were helpful before. More than anything I hope this to be an exercise in celebrating how far I have come by engaging with the tool that Cognitive Behavioural Therapy has given me.
As I run through I’m going to leave a trail of notes here. THESE ARE NOT MEANT TO BE COMPLETE BY ANY STRETCH OF THE IMAGINATION.
What is Cognitive Behavioural Therapy?
- Often it is not the events in our lives that makes us happy or sad, but instead out reaction to them.
- Some of the happiest people on earth don’t necessarily have circumstances that reflect this.
- CBT is a combination of Behavioural therapy and Cognitive or learning approach.
- Sometimes the Behavioural approach is almost like fake it till you make it when it comes to the practice. Changing the behaviour which impacts the internal.
- Cognitive is more focused on learning.
- In CBT it is common to look at how Beliefs impact the consequences of our experiences. Frequently we go from an experience to an emotion, but the emotion is impacted by a belief. If through the cognitive approach we can change the belief our emotion can be impacted. For example, if a persons believes “many people ignore me because I have low value” when they experience a person blank them, they will likely fall into low mood. If however they regulate that thought by saying, “maybe they blanked me because they had headphones in and didn’t hear me.” “Maybe they were too focused on something so see me” “maybe they just didn’t see or hear me” then the belief is assuaged. Suddenly the emotional reaction is more realistic because it might not be that they were deliberately ignored due to a perceived low value, but it could be any number of situations. Now the belief is changed. This might be done in a diary session afterwards so the initial emotional event might not be avoided, but the process can teach the patient or coachee to use the new belief if they face a similar event in future.
As part of this book I covered SMART Goals, but this seemed worth putting down as a separate article since as it stands alone quite nicely. See SMART Goals.
The next chapter looks a little bit at cognitive distortions. Cognitive distortions are ways of thinking which are prone to errors. This is a unique area because sometimes thinking like this is actually helpful or accurate for us, but you know what they say about a broken clock, it too is accurate twice a day. It’s important to unlearn unhelpful habits otherwise our emotions will frequently reflect information that is inaccurate or prone to errors.
Normally examples of this are mind-reading (presuming the subject knows what someone else is thinking), catastrophizing, negative filter or negative automatic thoughts (NATs), Overgeneralization, Exaggeration, Misfortune telling (assuming you know the future and particularly making it negative), black-and-white thinking and more.
I noticed one which is really important, but I hadn’t noticed it as much before. It reads as follows “blaming other people for your feelings”. This is a special one for me. I often say to people “I blame myself for everything”. This can be terrible a lot of the time, but at least when I blame myself I look at what I could have done differently and I improve rather than not changing how I act and expecting the world to be different. I know other people who never change because they always blame the world. A lot of the time I get very upset with the council for the stuff I am dealing with where I live because I feel the council “should” act a certain way, and I continually surprise myself when it doesn’t. I let the council constantly affect my mood by setting unreasonable expectations of it. That’s my bad. Now the council is truly terrible and should be doing certain things, but I do not have the power to change them and well if we think about the serenity prayer… It should be acting with the wisdom to know that the council will not change unless it is forced to and so I need to have the serenity to accept the things I can’t change.
Serenity prayer – This is a prayer which is addressed to god, but it need not be a request to god only a recognise of health attitudes. It is said as follows: God grant me the serenity to accept the things I cannot change, the power to change the things I can change and the wisdom to know the difference Amen. This means not messing around trying to change broken systems which we are powerless to change and focusing on the things within our power.
The Importance of Our Own Judgements
An important chapter notes how the same thing happens to 3 people. While no two people’s experiences are identical it provides a clear example about how our reaction to things can give rise to our feelings. 3 people are “chewed out” by their boss about some recent work. The first person was deeply unset. They believe their boss never appreciates the effort that went into the work or how difficult the work was. He only looks at the final result which they admit wasn’t great. They feel unappreciated and like their own work is poor, so they feel unable and inadequate to improve the situation. It feels hopeless. The second person blames their boss. They believe their boss has bad mornings sometimes, he did not pay attention to the work and needed to chew someone out. He did not think he deserved it and he was angry at his boss. He thinks his work is perfect, but his boss is unable to admit that, so he squarely blames his boss and feels anger. Finally, the third person has a more balanced thought process. They recognise that this is not their best work, but also, that their boss can’t read their mind, so their boss doesn’t know the difficulties they faced. They also know that most of the time they have a good working relationship with their boss and it is possible that this situation is not their fault as they have seen their boss “chew someone out” when it wasn’t that person’s fault before, so they are trying not to take it personally. They are disappointed in the situation but think they could make it better. They know should make sure their boss is aware of the hurdles they have overcome. They also recognise that their boss would like to know those hurdles are not going to be an issue going forward, so they also came up with a plan as a good way to overcome similar hurdles in the future. They hope to give the boss a few hours to calm down, they will then present to their boss the difficulties they had, and what they plan to do in the future to improve the situation. They feel disappointed in themself, disappointed that their boss did not ask questions considering how good their work normally is, but they don’t feel hopeless, they have a plan to improve the situation.
You see these three people had very different feelings about the situation that reflected their thoughts. The first and second person had very strong feelings and felt helpless/hopeless. The third person still had negative feelings that reflected the situation, but their feelings were more accurate because they were more aware of all the possible angles. They also had a plan to sort it out.
If I were person 1 who entirely felt the failure was theirs, but that their boss did not consider effort only results, I would need to sit back and consider the possibility that their boss might consider effort if they knew what effort went into it. They also need to remember that although the work might not be their best, there was still some effort in there whether or not it was recognised. The failure to recognise the work does not mean the effort vanishes. They also need to consider the possibility their boss might be wrong and hadn’t considered the positives. Then they might have a more balanced fully considered mindset and their feelings might better reflect this. They also would benefit from having a plan to approach this matter going forward.
If I were person 2, who entirely felt this was my bosses fault, I would question whether my work needed improvement and perhaps my boss might be right about somethings even though he doesn’t always get it right. This means my feelings would be more balanced and because I recognised that at least some of the failure was in my court then I could finally think about what I could do about it.
The Flow of Effect
When experiencing an event which gives rise to emotion there’s a number of stages involved. Firstly, an event happens to this often gives rise to thoughts from existing beliefs held. The person then forms their own personal judgement of the situation and what it means about the things important to them. This judgement then gives rise to feelings and Bodily Sensations, for example sadness and feeling tired, happy and energised, guilty and heavy or something else.
By altering our judgements of situations and making sure we select judgements which are helpful which consider a whole situation we can control the feelings and sensations we experience. This sometimes means taking a second to think about things. Over time as we practice this, forming better judgements becomes easier. We also form beliefs that better guide our natural judgements of the situation.
Identifying Issues
Often this exercise works as a diary entering rows into this table at the end of each day. This enables you to identify the bigger and smaller issues in your life. It is often considered bad advice to go after the bigger issues first. It is better to increase your CBT skills working with smaller issues rather than the deep-set ones first. You need to learn how best to perform the technique before tackling the more difficult situations and often removing highly damaging beliefs is like trying to pull up a tree with deep roots. Those deep roots are going to be very difficult to pull up, but if you can loosen some of the soil around them first then you’re going to find it a lot easier. In fact, you might spend so long removing all the small issues that there is nothing holding those big heavy roots any more than the tree just falls on its own. This is like when you remove all the small events which confirm your deep-set negative beliefs and then you begin to realise that you no longer actually believe a very damaging things any more and suddenly loads of emotional issues vanish at once.
I have provided an example of the table here.
| Feeling | Situation | Automatic Thoughts | Strong? |
Graeme