Cognitive Behaviour Therapy. Joseph Avy

and knowledge, how we store it in our head, how we evaluate it and how we base some of our decisions on it.

      Behaviour means our action or reaction to something. It's the doing bit. Our behaviour can be conscious or unconscious (out of our conscious awareness). In CBT, the word ‘behaviour’ comes from a branch of psychology called ‘behaviourism’, which is concerned with what can be observed rather than what can be speculated or assumed. It is based on what you have learned and become accustomed to, how this affects your actions and feelings, and how you can unlearn what you have learned in order to change.

      Therapy means the treatment for a health problem after a diagnosis or an assessment has been made.

      CBT is a form of therapy that examines how our thinking, attitudes, beliefs, opinions and behaviour are formed, how they affect our success, our lives and feelings, and how changing them impacts on our performance. The ideas stem from both ancient and modern thinking in philosophy, science, psychology, common sense and humanity.

      Here are some of basic principles central to CBT. Many may be shared by other therapeutic approaches, but the combination of these principles goes some way towards understanding CBT.

The Emotional Responsibility Principle

      ‘People are not disturbed by events but by the view they hold about them.’

      This principle is at the heart of nearly all emotional and behavioural change. It can be challenging because you may believe that it's what has happened to you that ‘makes’ you feel how you feel and do what you do in the here and now.

      I hope that by questioning this you will learn that what you believe may be stopping you from empowering yourself to move forward with your life. This in turn may help you in the pursuit of your desired goals.

       Is it true that events, situations or people make us feel what we feel?

      First, let's look at the popular notion that your feelings are ‘caused’ by events, situations or other people.

      Think of a past event that you think ‘made’ you feel and do something. By this logic the only way you can change your feelings now is to wish the event had not happened in the first place.

      Maybe you think there's someone else who has ‘made’ you feel and act in a certain manner. In which case, the only way you can change your feelings now is to get that person from the past to undo what they did or said. And if that person is now deceased, how can this be done?

      Believing that the past, or a particular situation or person, causes our feelings today, means that no one would ever be able to move forward or to change. We would all be totally stuck without any possibility or hope of ever changing anything. We would be slaves to the things that had happened to us or the people we had been involved with.

      Can you imagine what it would be like if everyone felt hurt every time they experienced a rejection of some sort?

      Rejection = Hurt

      10 people rejected = 10 people feeling hurt

      100 people rejected = 100 people feeling hurt

      1000 people rejected = 1000 people feeling hurt

      As an example, when you experience rejection you might feel hurt. However, if you believe that your feelings are caused by others, you may then believe that being rejected by someone is the cause of your hurt feelings. But don't some of us experience different emotions if rejected by someone we like? Maybe anger, sadness, depression or relief?

      In fact, different people may feel different emotions when they experience the same event:

      Some people feel hurt

      Some people feel angry

      Some people feel depressed

      Some people couldn't care less

      Why do different people feel different things and what is at the heart of their feelings?

       Is it true that events or people make us do what we do?

      Let's think about what we do and assume that situations or people make us behave as we do.

      A colleague criticizes you = You start avoiding them

      If it is true that a colleague's criticism ‘made’ you avoid them, this means that every criticism made by your colleague would have the same effect on everyone. It means that avoidance is the only possibility whenever your colleague criticizes you, or anyone else for that matter.

      A colleague criticizes 10 people = 10 people avoid them

      A colleague criticizes 100 people = 100 people avoid them

      A colleague criticizes 1000 people = 1000 people avoid them

      Does this make sense?

      The problem is that people say, ‘he made me do it’ or ‘she made me lose my temper’. It is as if they have absolutely no control over their behaviour. Once again, if we do not have a part to play in how we behave then we would be completely stuck, unable to move forward, learn or do anything useful. Is this what you see happening to everyone around you?

      So what provokes your feelings and behaviour? Most of the time the simple answer is that you do. You provoke your feelings and actions by the way you think, the attitudes you've formed, the habits you no longer question and the beliefs you hold.

      This is the principle of emotional responsibility: you are largely responsible for the way you feel and act.

      The principle of emotional responsibility can be challenging, particularly if you are going through a difficult time or have experienced trauma or personal tragedy. It's natural to feel angry, sad, depressed or hurt in response to accidents, illness and other challenges in life, but if you get stuck in these feelings then you can change them.

      The thought manifests as the word; The word manifests as the deed; The deed develops into habit;

      And habit hardens into character;

      So watch the thought and its ways with care. (Buddha)

      The way you think about something affects how you feel and how you behave. Here are some examples:

      • If you think that your partner's late arrival for dinner proves that you are not lovable then you might feel hurt and sulk.

      • If you think that your partner was nasty and selfish because they arrived late for dinner then you might feel angry and shout.

      • If you think that your partner's late arrival for dinner is no big deal then you can feel calm about it and ask what happened.

      This shows that it is not the situation or what happens to us that provokes our feelings and behaviour. It is the way we think about the situation. The way we think about something can then influence how we behave.

The Behavioural Principle

      CBT considers behaviour as significant in maintaining or in changing psychological states. If, for example, you avoid some event, such as giving a presentation to your team, then you will deny yourself the opportunity to disconfirm your negative thoughts about yourself or capabilities. Furthermore, avoidance only sabotages what you want to achieve. Changing what you do is often a powerful way of helping you change thoughts and emotions and ultimately what you can achieve.

The ‘Here and Now’ Principle

      Traditional therapies take the view that looking at problems in the here and now is superficial. They consider successful treatment must uncover the childhood developmental issues, hidden motivations and unconscious conflicts that are supposed to lie at the root of the problem. These approaches argue that treating the current problem rather than the supposed hidden ‘root’ causes would result in symptom substitution, that is the problem would re-surface in another form later on. There is little evidence to support this idea. Behaviour therapy also showed that such an outcome, although possible, was very rare.

      CBT offers theories about how current problems are being maintained and kept alive and how they can be changed.

The Scientific Principle

      CBT