My Personal Journey into CBT
A close friend recommended The Coddling of the American Mind. It is well worth reading. It gives interesting analysis regarding society and more specifically young/younger people who grew up with the internet and social media. Click here for my book review.
Coddling had a chapter on CBT. After that chapter, I noticed how negative and distorted my thoughts are. That lead me to the book Feeling Good which lead me to other CBT resources.
The shortish version, I took a depression test, Burns Depression Checklist, which Feeling Good referenced. I ranked mildly depressed. A few days ago, I retested and scored normal but unhappy (that's an improvement! haha). There are several variables that I cannot isolate to explain my improved mental health. For example, I went on vacation to Oregon and California; I spent lots time with family and friends; I enjoyed sunny 70 degree days; I reflected on the negative thinking I observed from myself and friends; and I learned about CBT. So it is impossible to say what caused what, but I consider the learning and thinking about CBT useful. Now I would like to formally follow the CBT guidelines and process to see if it can further help.
I'm creating a series of writing prompts and activities to act as a workbook. Then I plan to discuss the ideas I write about with a friend, who may or may not know my purpose. The writing and talking will be my pseudo therapist. I'll continue to monitor my depression and see how it goes. At the bottom I shared free resources I found. The references are the books I've read that taught me what I know about CBT.
Why CBT?
- It's scientific and empirical.
- Studies suggest CBT can be as effective or more effective than leading medications to treat many mental illnesses (along with conflicting evidence and criticism of results).
- It's training for your mind.
- Subjects/participants can be their own therapist.
- Self help helps.
- Anyone can benefit.
Assumptions in CBT
- People see reality subjectively.
- Thoughts, emotions, behavior, and autonomic responses are all interconnected.
- Brains can be trained.
- Cognitive distortions lead to negative mental health.
Disclaimer and Criticism
Every book or talk shares some version of this disclaimer. I doubt anyone expects a blog post from a blog with the word rant in it to solve all their problems in life, but just in case. This blog post and or any resources I share are not a substitutes or replacements for professional medical advice, diagnosis, or treatment of mental health conditions.
CBT is not a cure all treatment. CBT is a useful process that has helped many people treat many mental health conditions.
Although CBT has decades of research supporting it, there is conflicting evidence and plenty of criticisms against the findings of CBT. The wiki criticisms is a good place to start if you want to question CBT. There aren't double blind controlled studies of CBT, so it is difficult to identify why or how effective CBT is compared to other treatments. With that in mind, CBT can be useful if people accept the assumptions and follow the process, aka put in the work. Some people may put in the work and not benefit, and that's how treatments go.
Statistically speaking, CBT is way better than nothing. So if you're unhappy and not actively doing anything, keep reading. CBT could be a great starting point. It's also a great alternative to medications.
CBT The Basics
In one sentence, CBT is an intervention to improve mental health. It evolved from psychotherapy, behavioral psychology, and cognitive psychology. CBT is related to mindfulness and shares philosophical ideas with stoic philosophy. Over 2000 years ago, Epicteus said, "People are not disturbed by things, but by the view they take of them." For the last four hundred years, Hamlet (Shakespeare) has been telling audiences, “There is nothing either good or bad, but thinking makes it so." Those are also decent one sentence summaries of CBT. CBT's ideas are not new. Connecting the ideas of psychology and philosophy with the scientific method to measure a therapies effectiveness is what CBT brings to the stage. For decades CBT has been a leading practice in psychology and mental health.
"Cognitive behavioral therapy (CBT) has its own ideology—its own preferences. It’s grounded in Western empiricism, the value of rationality, [and] the power of the scientific method. It’s not saying that emotions or passions are bad or wrong. It’s really about striking a balance between rationality and passion or emotion." [4] CBT is "built on a solid foundation of neurological and behavioral research. CBT is an approach almost anyone can use for promoting greater mental health and improving one’s quality of life." [4] By focusing on thoughts and behavior, CBT "trains brains to improve motivation, management of emotions, and our interpersonal skills." [4]
The assumptions are people have subjective responses to reality and that thoughts, emotions, and behavior are all connected. The main idea is that thoughts, behavior, and feelings effect each other and by changing one you change the others. The two models below capture the relationships best. 
One critical aspect of thoughts are identifying cognitive distortions. Cognitive distortions are exaggerated or irrational thinking that lead to mental health issues. Everyone should learn the cognitive distortions and try to avoid them. (Cognitive distortions are my favorite concept in CBT)
During the therapy sessions, the CBT therapist provides and teaches multiple tools and skills for patients to use. The therapist tracks and measures the progress. CBT is an empirical study of what works and doesn't work. The therapist and patient work together to find what makes the patient feel better, good, or less bad. "One coping behavior is not necessarily better than the other. It depends on what needs to be done at the time, CBT data helps by allowing you to analyze your preferred coping styles and determine whether or not you’re selecting the most adaptive strategies." [4] "[The] emphasis [is] collaboration and active participation." [3] The end goal is for the patient to become their own therapist. "This is a form of self-help, because any form of self-improvement is a form of self-help. But there aren’t any shortcuts or magic. The CBT process can be quite difficult; it takes practice and commitment." [3]
The Plan
Over the past few years, I've had reoccurring bouts with mild
depression. I never saw anyone, so that is a self diagnoses. My learning
and preparation has been geared toward mild depression. For anyone
using this as a guide or starting point, what I made could easily be
adapted to treat other mental health issues. The Self Help Pamphlets I found are especially useful in providing quick and specific information for many of the most common mental health issues.
My plan is to focus on behavior. My plan and the preparation for my plan are actions/behaviors I take. The reading, writing, and discussing are all behaviors. These behaviors will affect my thoughts and emotions and hopefully improve my mental health. All this started from learning and identifying cognitive distortions, so part of my focus will be changing and improving my cognitive distortions.
I didn't make a final workbook, but here is my rough draft. As of now, I'm happy with my focus on talking to friends and family more often.
Writing is an activity I enjoy, and discussing my reflections with friends or family will add social interactions that I have ignored more since moving to the east coast. Both of these aspects could be beneficial in themselves. Those are behaviors I hope to take that will influence my emotions and thoughts. Hopefully all this starts and keeps a positive feedback loop with my thinking, emotions, and behavior.
Free Resources
Cognitive Behavioural Therapy (CBT) Skills Workbook (pdf)
Feeling Good Podcast (podcast)
Self Help Pamphlets for varying mental health issues
References
- Feeling Good (book)
- Retrain Your Brain: Cognitive Behavioral Therapy in 7 Weeks: A Workbook for Managing Depression and Anxiety (book)
- Cognitive Behavioral Therapy: Techniques for Retraining Your Brain (audio lectures, The Great Courses)
- Cognitive Behavior Therapy: Basics and Beyond (book)
