How Cognitive Behavioural Therapy Can Help You Manage Your Anxiety
It’s not always easy to admit that you’re struggling. If you break an arm or develop an ear infection, you know where to go for help, but what if your problems are a little harder to pin down?
According to Beyond Blue, around 1 million Australians experience depression every year and over 2 million experience anxiety. By their estimates, 45% of Australians will deal with mental health issues in their lifetime. The good news is that help is available, even when the problems run deep.
One of the options for people who are dealing with emotional or psychological issues is Cognitive Behavioural Therapy (CBT). Unlike other forms of therapy, CBT doesn’t look for the root cause of a problem; it looks at what you think and how you behave, and how these things influence your mental health (cognitive refers to thought, behavioural refers to action). It works on the principle that if you can change your thought patterns and change your behaviour, you can change the way you feel.
It’s also the only non-physical form of therapy that affects neuroplasticity in the brain.
Is CBT for me?
According to Dr Jon Finch, a Melbourne-based psychologist specialising in CBT, the therapy is an effective treatment for a broad range of issues. “CBT is an umbrella term for a whole range of therapies that deal with thoughts and behaviours. It’s not a one-size-fits-all approach. It covers a diverse range of therapies which treat a whole range of problems, because there is no single theory that explains every problem,” Dr Finch says.
In addition to helping with depression and anxiety, CBT is used to treat post-traumatic stress disorder, insomnia, anger management and self-esteem issues, obsessive-compulsive disorder and eating disorders, as well as substance use problems and psychotic disorders. If your emotions or behaviour are not what you want them to be, CBT could help
So how does it work?
Traditional psychoanalysis assumes that if you can understand why you feel a certain way, the feelings will go away. In this model, you talk about your life and your experiences, digging around for subconscious triggers that cause unwanted mental health issues. When you identify the source, supposedly, the problems naturally evaporate.
CBT therapy is more pragmatic. Instead of trying to figure out how the problem started, it looks at how you view the problem, and how your perspective affects your emotions and actions. It tries to correct incorrect thoughts that can spiral into destructive and damaging beliefs.
“We can very easily think in ways that don’t sound extreme, but they make your feelings extreme,” says Dr Finch. “For example, if something bad happens to you and your response is to think, ‘This always happens to me,’ that’s actually quite serious. ‘Always’ is 100% of the time, which doesn’t give you much hope. So we might look at the whole of your life and think, is this really how life is? No – there are other times when bad things don’t happen. How can we look at those good things and start to build on those?”
Our thought processes hold power over our beliefs. Dr Finch explains, “If someone is sexually assaulted by someone they know and they’re trying to come to terms with it, they’re going through a thinking process to try and work out what happened. If that thinking process happens to go down a path where they start to believe that maybe they encouraged it, maybe they did this or that, then that thinking process will lead them to feel guilty, when in fact they never wanted it to happen.”
He continues, “In cognitive behavioural therapy, or cognitive processing therapy, we look at all the beliefs that support an idea that they encouraged something when in fact they didn’t want it to happen at all. It’s helps you to look at your beliefs and examine them, which takes away their power.”
Taking thought into action
In addition to talking to you about your thoughts, a CBT specialist will look at your behaviour and explore small changes that can dramatically affect your emotional wellbeing. “If someone is very depressed, for example, little things can be very hard to do. Simply going outside once a day might be the task, because we know light effects your mood,” Dr Finch says.
Small, consistent changes can have dramatic results. Your homework for CBT might be to devote some time every day to activities you find pleasurable, or to practice doing something that makes you uncomfortable.
CBT can also help you to regulate your physical body in times of extreme stress. A common CBT tool for people who are suffering from anxiety attacks is to take out a stopwatch and time their breathing. Using an external device to anchor you, trying to match each breath to an even 7-seconds-in-7-seconds-out pattern, can prevent the stress feedback loop of hyperventilation.
But is it actually effective?
Peter is a former journalist who began having anxiety attacks in his early 20s. He began feeling very awkward and self-conscious all the time, paranoid that everyone he met thought badly of him.
In a CBT session, Peter’s therapist asked him to describe every person he had encountered that day, before coming to their session. “Out of forty people, I only remembered one, for a positive reason. The point of the exercise was to show me that people weren’t judging me and no-one cared,” Peter remembers. Though the session was 10 years ago, he still finds it useful.
For Amy, a web and digital manager, CBT was a huge help in dealing with a stressful work environment. “My anxiety had become really bad at work, particularly when I had to provide feedback or say no to something,” she says. “I always anticipated a negative reaction and thought that people hated me. I avoided face-to-face conversation and hid behind email, but would become so paralysed by potential negative outcomes that it took forever to write the simplest sentence.”
Amy’s psychologist taught her to question her expectation that people would react negatively. He helped her to circumvent her fears about what might happen by imagining the worst-case scenario and imagining how she would deal with it. “Each time the anxiety came, I reminded myself that it was a new situation and that I couldn’t judge it based on the past. I found my communication became a lot less laboured and defensive, since I wasn’t conducting an argument. After a while, I even started seeking people out to talk through issues,” she explains.
Rebecca, a student, has suffered from severe depression since she was a teenager. She credits CBT with saving her life. “It taught me to disassociate from my thoughts,” she explains. “Thoughts are just thoughts and you don’t always have to act on them or take their emotional brunt. Just notice them pass by like clouds.”
Short term, practical and results-focused
If you want to get results from CBT, it’s important that you are committed to the process because it is a form of psychological and physical training. But CBT can be a relatively quick way to get on top of your problems compared to traditional psychotherapeutic models.
“With CBT, you’re not expected to be doing it for the rest of your life. If it’s a diagnosis of something like a personality disorder, you might be looking at a year or two years of therapy,” Dr Finch says. “With PTSD (post traumatic stress disorder), people often feel completely different after twelve weeks. For things like depression and anxiety, depending on the circumstances, it might be five or six sessions, once a week, just to give you some new tools for how to deal with things.”
And how do you know if CBT is the right therapy for you? “Simple,” says Dr Finch. “If CBT is working for you, you will start to feel better.”
Simone Ubaldi is a ghostwriter, music journalist, film critic and has co-authored four books, including memoirs of Bon Scott and Mark ‘Chopper’ Read.