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Cognitive Behavioural Therapy

Cognitive-Behavioural Therapy (CBT) is an approach commonly used with individuals, couples and families, to address a multitude of issues. The underlying belief in this approach is that, when you bring awareness to automatic thoughts, maladaptive assumptions, and cognitive distortions that negatively affect the way that you feel about yourself or others, you can begin to question their accuracy and to change the way you feel about yourself and your relationships. CBT helps us to slow down and reflect on our ways of relating, so that you can begin to identify which parts are helpful and which parts are harmful.

For instance, many couples encounter difficulties as a result of unrealistic expectations and distortions which each partner may be bringing forward from their respective families growing up.

For example, a wife may express feeling “If Joe cared about me, he would do X. Since he did not do X, Joe doesn’t care enough about me.”

This is an unhealthy way of viewing the situation, since Joe may have valid reasons for not doing X that have nothing to do with his feelings and devotion for his wife.

Below are some of the most common cognitive errors that impact self-esteem or views of relationships . Take a moment and think about whether your thinking and feelings about a situation are affected by any of these distortions.

  1. All-or-Nothing Thinking You see things in only two categories and there is no middle ground (eg. Matters are either good or bad, safe or toxic,etc.)
  2. Labeling Labeling is a version of all-or-nothing thinking. Instead of saying “this didn’t go well. I misunderstood,” attach a global negative label to yourself: “I’m a failure”.
  3. Overgeneralization You interpret one isolated current situation as a sequence of bad events by using words like “always”, or “never” when you describe it or think about it.
  4. Mental filter You focus on an isolated negative detail and selectively attend to it, so that ultimately your interpretation of everything that’s happening becomes distorted.
  5. Discounting the positive You disqualify positive events and assume that they don’t matter. If you accomplish something you could be proud of, you tell yourself that it wasn’t that important, or that anyone could have done it.
  6. Mind reading You automatically assume that others are reacting negatively to you without having any evidence for it.
  7. Catastrophizing You automatically assume that things will turn out terribly before they even start and without having any evidence for this prediction.
  8. Magnification You blow out of proportion your shortcomings and problems.
  9. Emotional Reasoning You assume that your feelings reflect the way things really are. “I feel guilty, so I must have done something wrong. I feel anxious, therefore the situation must be dangerous.”
  10. “Should” and “must” statementsYou expect that things should be the way you want them to be. If they are not, you feel guilty. “I shouldn’t have made so many mistakes”.

Think about the reason you are seeking therapy, and about a particular situation that has arisen to bring you to this point. Cognitive Behavioural Therapy would prompt you to evaluate your thinking about this event by using the following types of questions:

  • What is the evidence for and against the specific interpretation?
  • Are my interpretations logical?
  • Have I confused a thought with a fact?
  • Are my interpretations of the situation realistic?
  • What would be a more rational way of looking at that?
  • Am I using all-or-none thinking?
  • Am I confusing certainties with possibilities?
  • Is my judgement based on the way I feel instead of facts?
  • What would I tell a friend who told me this?

This list and questions have been adapted from Cognitive Therapy: Basics and Beyond (p. 119), by J. Beck, 1995, New York: Guiford Press. Copyright 1995 b Guilford Press