Cognitive Behavioral Therapy (CBT)

What is CBT?

Cognitive Behavioral Therapy (CBT) is based on the premise that our thoughts, actions, and feelings are all connected. Therefore, when we feel depressed, we are more likely to have depressed thoughts like, “I’m a loser” or “I’m a failure,” or “I am unlovable.” We are also more likely to engage in depressive behavior such as isolating. On the other hand, when we feel better we are more likely to have positive thoughts like, “I’m a good friend,” or “I’m a good person.” We are also more likely to be social and productive.

CBT has proven extremely effective in decreasing anxiety, depression, anger, and other negative emotional states. CBT also aims to increase positive emotion and self-esteem. With CBT, people learn to identify and challenge negative thoughts and come up with more realistic, positive ways of thinking. For example, CBT helps people see where they might be distorting thoughts by using “all-or-nothing thinking” or “catastrophizing.” These thought traps–common to everyone–are called Cognitive Distortions (click to see list (pdf)).

CBT is in a sense a design for living that is available to anyone who is willing to try it. It helps to retrain the mind to think more rationally and realistically, in time causing positive changes in mood and your behavior. You can think of CBT as the ultimate, all-purpose coping tool.

ABCD Thought Log

The Thought Log is the basic building block of CBT. Thought Logs are like a cognitive workout–the more you do them, the more results you are likely to see. There are several different approaches to Thought Logs in CBT. The ABCD Thought Log is one of the clearest and most straightforward.  Here’s what it asks:

Activating Event: What happened? What’s stressing me out?

Ex: “Had a bad date.”

Belief: What is my negative self-talk? What negative belief am I clinging to? What
interpretations am I making? Which Cognitive Distortions apply?

Ex: Thoughts/Beliefs: “I hate dating…I’m never going to meet anyone…There’s no
one out there for me…I’m such a loser!…No one could love me…I’ll be alone forever.”
Cognitive Distortions: Overgeneralizing…Labeling…Catastophizing…Fortune Telling…

Consequence: What am I feeling? What physical sensations am I having? What is my
behavior as a result of my beliefs? Note: It can be helpful to give a rating to each feeling (either
as a percentage or from one to ten).

Ex: Feelings — “Sad (8/10), Hopeless (8/10), Angry (6/10). Physical — Headache,
hunger, fatigue. Behaviors — Eat entire box of cookies, zone out in front of TV,
oversleep, ignore friends’ calls.”

Dispute: Counter-thought. What realistic and grounding statement can I use instead? Is there
an alternative way of thinking here?

Some additional questions to ask yourself when coming up with Disputes:

● What evidence do I have for thinking this way?
● Is this always true? Has this always been true in the past?
● Am I looking at the whole picture?
● What are the odds of this really happening or coming true?
● What would I tell a friend in this situation?
● What would someone I trust tell me about this?
● Consider getting a reality check from someone you trust.
● Focus on the things you can control rather than those you cannot.

Ex: “I’ve had fun on dates before (they’re not always terrible)…There are millions of
single people out there…I’ve had good relationships in the past…I have friends and
family who love me (I’m not unlovable)…I wish I could tell the future, but I can’t.”

Thought Logs won’t always flow naturally at first. Keep on trying.

To download a more complete description of Cognitive Behavioral Therapy, including the list of Cognitive Distortions and a blank Thought Log, click here (pdf).

Psychotherapy | Los Angeles