
Last week I introduced Cognitive Behavioural Therapy (CBT). This week I wanted to explore in a bit more detail the thinking aspects of the CBT triangle. In short, one of the main take-aways from CBT is to not take your thoughts so seriously! A surprising amount of the time our thoughts are not accurate reflections of reality but are actually interpretations or “best guesses” of the situation based on our past experiences. The accuracy and helpfulness of these thoughts depends on how much the current situation is the same as the experiences from the past that we are unconsciously using to interpret it.
A lot of the time the past beliefs that we use to interpret our current situation were created in our brain when we were children and sometimes very young. This is because during our childhood we are essentially sponges trying quickly to figure out how the world works, who we are in it and how we can best get our needs met. This is not just for fun but for our survival! Childhood is where we develop our “core beliefs” or assumptions that we base our future understanding of ourselves, the world and other people.
One of the main ways our brain learns is through association. For example, if a pigeon gets an electric shock when it pushes a yellow button eventually after experiencing this enough times it will learn to avoid yellow things. In the same way our brain might say to us for example when I was in school I was bullied by other kids so now I’m going to continue to assume into adulthood that other people are going to bully me. The problem with this is that whilst it is true that there are still bullies in adulthood, adults are less likely to experience bullying than kids and as an adult we usually have more skills and power to defend against bullies. If we overestimate the likelihood of being bullied we are likely to be “on guard” with other people which can close us off from building meaningful connection with others.

One important thing to note here is that often the lessons we have learnt are not so explicit, so in that example we wouldn't actually think "other people are going to bully me because I was bullied as a child". Instead we may have learnt from the bullying experience "people don't like me" or "there is something wrong with me and that's why people will treat me badly".
As shown in this example, who we are in our childhood and the world we are living in when young is usually quite different to the world we are living in as adults. As adults we are usually bigger, stronger and have more autonomy and control over our lives than the dependency and vulnerability we experienced as young children. Although sometimes, if an experience is distressing enough such as a trauma it can lead us to develop rigid and unhelpful core beliefs even if it was experienced when we were older including as adults.
So how does CBT help us here? When we understand that our current interpretations of situations may not be accurate or helpful to our present experiences we can start to question these assumptions. A great way to do this is to look for the evidence to support or challenge our negative automatic thoughts about situations. We don’t want to ignore real threats so writing down the evidence for each side is a practical way to work out what part of our thinking is true and what might be coming from an unhelpful thinking pattern. In CBT there are ten common unhelpful thinking patterns that have been identified and I’m going to explore these in this blog next week.

A lot of people like this kind of CBT because it is present focused and doesn’t require us to dive much into childhood and past stuff. Research suggests that this type of CBT can be very effective in the short-term but there is a greater likelihood of symptoms returning after therapy is completed than if another therapy which also explores and targets the origins of these beliefs is incorporated, such as Schema Therapy. Schema Therapy is technically a type of CBT but I would say it is much broader and goes deeper in its conceptualisation and treatment of the issues.
As a therapist I like to integrate both the more present focused basic CBT therapy with therapies such as Schema Therapy and EMDR which can target the original experiences where we learnt the unhelpful beliefs and assumptions. However, I also consider the needs and the preferences of the client when tailoring treatment plans.
Next time you notice yourself having a negative thought that you think could be an assumption carrying over from the past check to see if you can notice the evidence for and against the belief. You might be surprised by what you find!
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