The Way I Was

C is for CBT: living well, despite everything

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This series is an alphabetical exploration of 26 options for living well, despite everything. It answers the question–How can a person live well despite problems? 

Cognitive Behavioral Therapy (CBT) helps people think healthier. Healthy thinking sets us free to live a good life in all circumstances and situations, no matter what problems we’re facing.

If you desire to grow more competent, if you want your thoughts and behavior to reflect your increasing ability to deal positively, joyfully and gratefully with whatever comes your way, if you want your best, your most healthy and vibrant life–you might try CBT. It works.

What is CBT?

  • CBT is a proven therapy that is effective in addressing negative thinking.
  • CBT is not based on any religion, although its process might be familiar to those whose faith helps them manage their troubles.
  • CBT is a way to understand and think about problems from a hopeful perspective. CBT is based on the individual’s needs and beliefs, and neither teaches nor contradicts any religious practice. Anyone can practice it.
  • Research has shown that CBT is effective for treating anxiety, depression, chronic pain, disordered eating, anger, addiction and low self-esteem. 

CBT can be seen as a 3-step learning process. 

  1. You educate yourself about your particular problematic issues. When I decided to try CBT, my problematic issues were fibromyalgia, autoimmune disorder, multiple chemical sensitivities, and chronic pain.
  2. You learn to get through uncomfortable feelings such as fear and frustration. In my case, I chose to believe that even when I feel pain, I’m going to be all right. There’s no need to eliminate the problem (the pain, the anxiety or the frustration) during this stage. Techniques include deep breathing, muscle relaxation, distraction, listening to calming or mood-elevating music, and imagining calming scenes. All you’re doing at this point is consciously relaxing so that you can live through any difficult sensations and emotions until they pass.
  3. Over time you learn to notice when your thoughts become negative, unhelpful or destructive. Then you consciously replace unbalanced and unfair thoughts with more realistic, helpful ways of thinking about a problem. The goal is to be truthful and rational, without being overly optimistic. Optimism can be disastrous when it causes us to pretend there is no problem. We don’t want to evade the issue, or worse, recklessly plunge into deeper problems. Instead of being either negative or falsely positive, we want to deal with the truth of the situation in a helpful, rational manner.
    • An example of false positive thinking: My pain is all in my head. I can make the pain go away by ignoring it. If I Zumba with gusto, and if I keep pushing myself to participate in activities and events even when I feel awful, I’ll forget about my pain. But the reality is, whenever I stress my body by overdoing exercise or activity, I inevitably increase my pain–attaining the opposite result of what I had hoped for.
    • An example of negative thinking: I can’t take this pain! I’m miserable. I can’t do any of the things I like to do, or used to do. This pain is ruining my life.
    • An example of truthful, rational thinking: This pain is really intense right now. It’s true that I don’t feel up to going to the store at the moment, and maybe I won’t be able to get there today. But I’ve had pain like this before, and it will pass. If I do my stretching and breathing exercising, and take a hot bath, I’ll likely feel a whole lot better. Meanwhile, I can handle this. And my life is good–I’m surrounded by people who care about me (and there are people who will go to the store for me). I have many things to look forward to, including the curried chicken, basmati rice, and cucumber raita we’re going to have for dinner tonight. 

You can learn CBT:

How to find a CBT Therapist:

  • Ask questions–it’s your right to know how your therapist likes to work, which treatment methods she prefers to use. It’s your life and your health!
  • Look elsewhere if a therapist is guarded, withholds information or becomes angry when you ask questions about what treatments he or she uses.
  • When you find someone who appreciates the magnitude of your decision to hire a therapist, who validates your need to feel comfortable, and if this person is friendly, open, and knowledgeable, consider working with this person.
  • You will need to have supreme confidence in your therapist, especially since she/he may find it in your best interest to ask you to take risks, and might request that you do things you find uncomfortable. You need to be able to believe that your therapist really does care about you.
  • Interview a therapist over the phone before booking an appointment. The therapist should be willing to spend fifteen minutes answering your questions! If she’s too busy, or seems annoyed that you have questions, look elsewhere. To learn which questions to ask a potential CBT therapist, click here.
  • To search for a CBT therapist in your area, click here. 

CBT is a tool for achieving holistic health:

  • Any habitual unhealthy patterns can be changed only by one’s will to change. The decision to change then leads to a corresponding change in behavior. The very thing I long for–control over my life–is inherently, already mine. It’s up to me alone (and no one else) to learn to control my thoughts and my reactions, to live with wisdom, for good purpose, in holistic wellness.
  • The basic principles of living well do not change with changing times. To live wisely is to choose:
    • a nurturing and compassionate lifestyle;
    • to grow through adversity and trouble;
    • to become increasingly more loving, despite everything.
  • The brain is not a machine–it is a miraculous, mysterious, regenerative control center for life. Every time we use cognitive power to consciously change a habitual pattern of thought or behavior, we grow brain cells.

What are your tips or ideas for growing brain cells, or for developing healthier, wiser thinking?

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40 thoughts on “C is for CBT: living well, despite everything”

  1. I’m by no means an expert but everything I’ve read indicates that CBT is often a better alternative to the much-more-popular drug therapy. This is not, in any way, meant to cast drug therapy (DT) in a negative light–mountains of evidence exist to show that DT is effective and, moreover it can be seen to work in instances when CBT does not.
    That said, CBT, done skillfully and with perseverance, is often able to get at the root of issues and, in so-doing cause people to put their lives on fulfilling tracks that do not require the long-term usage of expensive and potentially harmful (through side-effects) substances.
    As you mentioned, though, it does require a long term commitment through a difficult and often expensive process. For my money, CBT should be seen as a first line of attack to issues.

    1. I’m in complete agreement with you. I’m absolutely no expert. But I’ve always been hesitant to use drugs. I’m not opposed to them, and I realize that there are times when they are the best treatment. But there are always side effects, often unforeseen, and sometimes worse than the original problem. When feasible, I believe it’s always best to begin with non-drug treatments and interventions.

      There does come a point, however, at which the pain becomes so excruciating, that I will take something to relieve the cycle. But the more skilled I become at using CBT and relaxation techniques, the higher that threshold gets.

  2. I think CBT is related in some ways with ACT. ACT is Acceptance, and Commitment Therapy; and the actions you take are also ACT 1. Accept your fears (thoughts or feelings) 2. Choose a valued response; and 3. Take Action. The idea behind the theory is that rather than trying to make your negatives thoughts (fears, feelings) disappear you simply accept that you will feel them. But then by focussing on a valued response and taking action, the negative feeling (fear, thought) begins to decrease in intensity. I have found this does work for me. Eg. Feel anger. 1. accept my anger will not go away. 2. Choose a valued response by doing something beneficial for myself (as opposed to acting on the anger) 3. take action by tidying kitchen out. Net result. (a) tidy kitchen (b) I feel empowered that I have acted on my values of self-composure and not become an angry person(c) Anger has lessened in intensity and even almost disappeared. (d) I feel calm
    I do not know whether this would work for pain.

    1. It sounds almost identical (and perhaps in Australia CBT has another name?)

      This technique definitely works in dealing with the fear and the anger that pain cause. These, when unrecognized and left to accelerate, cause more pain!

      And sometimes, by recognizing them, the pain becomes the secondary problem for a time. Then, dealing with the fear, anger, resentment (or whatever is happening), the pain can diminish.

      The very difficult thing about pain is that it isn’t actually measurable. The level of pain perceived has much (but not everything) to do with the mind. And, of course, it’s invisible. Pain cannot be seen or examined by others,

      When someone reports to another that his/her pain is mild or severe, the other has the option of believing or not believing the report. Which makes it all very, humanly complicated.

      1. I know what you mean. I have had a couple of times in my life when I have had severe pain (for several weeks or months) and both instances they were ‘unseen’. This contrasts with other types of pain such as broken limbs where people can see and sympathise with the pain.
        Whenever I hear of someone with either chronic pain or intermittent pain, my mind goes back and I can empathise.
        You are a very strong courageous lady to have daily pain and yet be so enthusiastic about each day.

  3. CBT is now offered by our National Health Service as a valuable aid to overcoming conditions such as anxiety and depression, and in some cases, more extreme conditions like Obsessive Compulsive disorder. We also call it the ‘talking therapy.’ It can work in tandem with drug therapy or be tried without – I would always take the without drug option first – I think Maurice’s comment reflects my own thoughts.

    1. I have a friend who very successfully treats OCD in children and adolescents with CBT. (Sounds like I’m talking alphabet soup–I just realized).

      I think it’s easier to grasp when it is begun very early–perhaps even when people feel quite mentally “healthy.” We all have moments of anxiety, fear, depression.anger… Perhaps if we taught our children to deal with difficult emotions this way, they would develop the habit and prevent a chronic onslaught of emotion that eventually turns into disordered thinking. Just an idea–I mean, what if something like this was part of a health class curriculum?

      1. That would be a brilliant idea Tracy. With more and more of our young people feeling overwhelmed with the pressures of our ridiculous curriculum* the type of health class you suggest may well hope the majority of them to cope.
        * I have to get a dig in whenever I can.

  4. What a great overview! Thank you, Tracy. I wonder if there are any books you recommend as well?

  5. What a wonderfully informative article Tracy. I’ve heard of CBT before but I’ve never been all that familiar with exactly what it entails. I like the idea of incorporating some of these methods into my own daily life. So often, I find that it’s easy to slip into a negative pattern of thinking, but I like the idea of using truthful and rational thinking.

    1. In my reply to Jenny, I mentioned that I think it’s a lot easier to develop these habits well before undue stress and trauma cause us to develop severely negative or disordered thinking. I think it’s preventative.

      I think that’s what I did. Once a person has a real problem with depression or anxiety or anger–so that it actually becomes a “diagnosis” the course of treatment with CBT is long and intense and a struggle. But I learned it rather quickly. I think you actually could teach yourself, by using that website.

      I kept a journal–and I really recommend doing that. It makes ones thoughts “visible.”

  6. I am lucky not to have been ill very often in my life. But when I was 6 I was hospitalised for a few months because I found it very painful to move my neck. As an adult looking back I think this was almost certainly to do with a fear of pain, brought about because of my mother’s anxiety and her reaction to me mentioning that I had a stiff neck. I was a very anxious child and I think that made any pain I had worse. Whereas as an adult I can deal with quite high levels of pain *so long as I know what it is*.

    I think my mother unwittingly discovered how to implement the complete opposite to CBT for pain.

    1. I think you’re right, Denise. Our minds often perceives that which we choose to believe. (And sometimes our choices are heavily influenced).

      I strongly believe that getting to the truth of the matter, or as you said, “as long as I know what it is” is liberating.

  7. I have so often heard of CBT but I actually knew very little about it so thanks for your comprehensive write up on it and your excellent advice on finding a therapist. I am sorry to hear about your health issues – i cannot imagine how difficult it is to deal with chronic pain. Take care. 😉

    1. Thank you for your kind concern, B. I’ve been living with this for so long now (17+ years of intense, almost daily pain; and off-and-on for a decade before that)– it’s not so terribly difficult any more. It certainly was very difficult until I learned how to cope with it, and that involves a lot of self-caretaking. The benefit is, I now have an excuse to take care of myself.
      🙂

  8. Thank you for introducing me to CBT; I wasn’t familiar with this before. It sounds like such an effective way to deal with negative issues. I’m glad to hear it’s helped you as it has. I like the focus on being realistically positive. I’m in a situation now where this will be very helpful – thank you!

    1. I’m glad to help, M. Do check out the links to the self-help pages. And since you’re a writer, consider keeping a journal as a way to find out what thoughts are hiding below your conscious level of thinking.

      1. Thanks Tracey. I notice the link you provided is Canadian; that always resonates with us Canucks! Although I like to write, I’ve always found it challenging to keep a journal, although I do give it a try from time to time.

        1. No need to “keep” one. There are no requirements about when or how often to write in one. Or whether or not to keep it in a journal or even all in one place. It’s the act of writing about feelings that is useful.

          I don’t keep a journal. Now and then I write to myself in a way I call “journaling.”

  9. Tracy, this is outstanding! I’m going to connect it to my blog tomorrow as a way of responding via a more hopeful perspective. This is very helpful.
    Another thing I need to thank your for is connecting me with Providence Perfume Co. My little spray vials for Ginger Lily arrived–for me, for Mom and for two friends–and also a sample of Samarinda! Wonderful!

    1. I’m so glad you like the perfume. I was going to make Ginger-Lily my signature scent, until Samarinda came out. Now I’ll have to have two! (Maybe one for spring/summer and the other for autumn/winter!)

      And thank you for the link. 🙂 I actually read your blog before I read this comment, and found that pleasant surprise. You’re a dear!

  10. This is most informative and very comprehensive, thank you so much for sharing this, Karen. I was living with pain as a constant load through so many of my “best years” due to heavy migraine and I tried about all there was. I can’t really say what was the best. A great help was therapy were I learned to interpret my dreams. I studied all the literature about dreams from Freud to Vollmar and took advanced courses and it was great fun. It helped my to change a lot in my life and I still use my dreams today for guidance and corrections in thinking and behaving. A change of life took place when the menopause came, the migraine was instantly gone and I now live the best years, feeling better and healthier than ever before.:-)
    Enjoy your weekend.
    Best wishes, Dina

    1. I’m so glad to hear that you’re migraine-free now, Dina. And I love that it’s becoming more and more known that life after menopause can encompass some of the best years of our lives.

      I have a good friend who is very involved in Dreamwork–goes to conferences and meets with a group, etc. I studied a few books about it and kept a journal in my 20’s. I think that I work with my dreams rather intuitively now. I don’t do all the “work” I used to (writing them down, journaling about them), and I tend to forget them upon waking. But when I do remember one, it’s usually because it’s important–and then I ponder on what it’s bringing to light. Always something is revealed, and usually the thing revealed is an answer to a problem, or a comfort of some kind.

  11. Excellent suggestions, Tracy. You’re right. CBT does have elements of other philosophies such as Zen. When you set the mind in a new direction, it might take time to change. But change is possible – whether it’s health related, or emotional (such as anger or stress management).

    1. I think it has the elements that are common to all religions–that of personal responsibility and personal empowerment to change, because of the hope of change.

      Thank you for helping me to see and articulate that, Judy. I’m going to incorporate that into my book. You’re a treasure!

  12. Thank you for sharing his common sense, non-pharmaceutical approach to achieving good mental health. I especially like your step by step instructions that make it seem doable. Very impressive post!

      1. Funny–I read it the way you meant it, not the way your wrote it! I guess that comes from doing bananagrams. 😉

        Thanks for stopping by–I’m heading over to your place now…

  13. Very informed and excellent post Tracy. As Jenny says here, we have this offered here in the UK along side drug therapy or sometimes just on its own for anxiety, depression and things like OCD and panic attacks. I went through a series of CBT sessions almost three years ago when I was suffering from quite bad depression. It did help me but I think I should have gone on for longer. As Denise says too, being able to know the ‘why’ does help tremendously with getting what’s happening into perspective and so not panicking and making things far worse. Thank you for this.

    1. It’s always a process, Sherri. Going on for longer, happens only when we’re ready for it. 🙂

      I trust that you know what I mean. I understand what you’re going through. Believe me. It’s not the same circumstances. But the emotions are the same….

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