Cognitive Behavioural Theory (CBT) has become one of the predominant schools of thought in Clinical Psychology in recent years. One of the major reasons for this is that it is easy to understand – it makes sense quickly. This contrasts it with some schools of thought that are complex, difficult to understand, and sometimes greeted with disbelief by non-believers. The simplicity of CBT leads nicely into a “psycho-educational” approach to therapy. This is an approach that focuses on teaching clients to understand their psychological functioning and to learn skills to manage that functioning more effectively.
A simple CBT model that I use with clients is the following:
Situation ? Thoughts + Physical Feelings ? Behaviour
This is a model that can be used to explain how people experience any emotional state. Most commonly, clients will present for counselling with concerns such as depression, anxiety, anger, or grief, but positive emotions such as joy, pride, sexual arousal, or negative ones such as frustration, disappointment, guilt, can also be understood using this model.
The essential elements of the model are:
- Emotions can be thought of as a process, not a state. They are made up of different components and they fluctuate in terms of their presence, and the intensity with which they are experienced
- The process is triggered by “situations” or “stimuli”. These can be external to the person (events that occur, things they see or hear) or internal (memories, thoughts)
- These “stimuli” trigger thoughts that appraise, evaluate, or attempt in some way to “make sense of” the information coming in through our senses
- Associated with these thoughts are physical feelings or sensations. These sensations are neither negative nor positive, they are neutral. They are sensations that are associated with physical changes such as muscle tension, breathing rate, blood flow, secretion of bodily fluids. They are perceived by people as positive or negative on the basis of the other information available to the person. For example, anticipatory excitement (positive) and anticipatory anxiety (negative) are associated with the same physical changes in the body but are experienced differently because of the different stimuli and thoughts involved in each
- When people describe the unpleasantness associated with an emotion, they usually describe a combination of thoughts and physical sensations. The word “anger” for example, can be considered as a label for a particular combination of thoughts and physical feelings.
- The behaviours that are typically part of an emotional experience can be regarded as the means of coping with, or reacting to, the thoughts and physical feelings. In this way, for example, the avoidance that is typically associated with anxiety is the means of coping with (reducing) the distress associated with the unpleasant physical sensations.
One of the benefits of this model is that it provides four possible avenues to make change – triggering stimuli, thoughts, physical sensations, behaviour. Some of the other entries in my Blog will explore these areas.