Cognitive Behavioral therapy (CBT) is a theory of treatment often used in counseling to treat depression and anxiety but can treat other mental health issues. It was founded by Aaron T. Beck and is a successful theory for reevaluating and redirecting thoughts. “CBT has been developing as a treatment for mental health problems for over the past 30-40 years” (Tredget, 2001, pg. 8). What is great about CBT is that it can be useful in teaching us how our thoughts, behaviors and feelings are all connected and how they affect each other. Have you ever noticed that when you think a certain thing, you feel angry and your behavior changes too or maybe put all of that in reverse? Have an insight into why you think the way you do can be helpful in know where you’re going to go with your thoughts, feelings and behaviors.
Tradget (2001) highlights that CBT posits that as Greek philosopher Epictetus states, “people are not disturbed by events but the view thy take of them” (pg. 9). It is a “here and now” form of treatment that does not dive so much into one’s past as it deals with the thoughts in the present and how they affect feelings and behaviors. It is a brief therapy that is often a desired form of therapy covered by insurance companies because of the amount of success clients can find in fewer sessions.
Another great thing about CBT are the depression and anxiety self-inventories, which can be used to measure success in therapy. This “inventories” as we call them, allow us to see your responses to questions that would measure your depression and anxiety and allow us to know if we are on the right track and helping to reduce your symptoms. In order to aid in reducing symptoms, homework and exercises are available that are specifically known as CBT exercises and homework. “For example, relaxation and graded exposure is used to eliminate avoiding-behaviors, distraction and control or hyper-ventilation to stop panic attacks and activity scheduling and cognitive restructuring is used to correct dysfunctional thinking in depression” (pg. 8). Even if you are taking medication, these exercises can be useful in restricting your thought processes and reduce symptoms further.
I like to use CBT in therapy as well, but in conjunction with other theories that I will cover at later dates. I like the idea of reworking thoughts so as to positively affect one’s feelings and behaviors. I believe that how we feel most certainly affects the way we work through our lives. How we feel in a situation will most likely be what we remember of a certain situation more than the details themselves. However, I believe that therapy is more than just one theory and while using certain theories, exercises and homework works well for one population, it may not with another. It may prove useful to delve deeper into one’s childhood in order to find healing and understanding. I don’t want to remain with only the context of the CBT triangle. There are evil people in the work, people who have done terrible things in their lives. I work with individuals whose lives have been negatively impacted by the choices that other people have made. Often times, clients feel the most betrayed by the ones who were supposed to care for them the most.
Although the exercises can be used far after therapy has ended, it is important to note that the guidance of a therapist is vital. Not only can a therapist teach you the proper way to use CBT exercises and techniques, but they can be there to help you when you stumble, to help you through the difficult times when you are still fighting your own cycle of maladaptive thinking.
Tradget, J. (2001). Introducing and explaining CBT. Mental Health Nursing. 21(6). 8-13.
How it happens
Post-traumatic stress disorder is a psychological reaction to trauma. Oftentimes we will see it in soldiers after they returned from a combat tour. However, it is common to see PTSD in victims of domestic violence, sexual and physical abuse, robberies and gun violence as well as auto accident victims. What happens is the human brain tries to make sense of what has happened in a traumatic situation. The brain seemingly gets stuck at a fixated point, unable to move forward, almost like there is a psychological brick wall. Everything that one remembers, the sights, sounds, smells are constantly replayed in the brain, almost like sounds vibrating off of a wall and bouncing back up at you.
What it Looks like
Often times individuals with PTSD will be easily agitated or overly agitated. Something that might have irritated them before now seems to make them aggressively angry. You will have someone who is overly alert. Someone who was in an auto accident might be overly vigilant behind the wheel like stopping when they see something from the corner of their eye. You’ll have someone who has constant flash backs of their traumatic event, whether it’s a rape or gun violence or time served in a combat zone. Individuals will avoid any triggers to their trauma like avoiding anything that is connected to the trauma. Again, an auto accident victim will avoid the road the accident took place. Below are more criteria for what PTSD looks like diagnostically.
The DSM 5 Criteria
Although the diagnostic criteria are listed below, it is vital to seek out the counsel of a mental health professional who can help properly diagnosis PTSD. A mental health professional can also aid in diagnosing any co-morbid disorders such as depression, anxiety or substance use disorders. Please do not self-medicated.
Criterion A: stressor (one required)
The person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):
The traumatic event is persistently re-experienced in the following way(s):
Avoidance of trauma-related stimuli after the trauma, in the following way(s):
Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):
Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):
Symptoms last for more than 1 month.
Criterion G: functional significance (required)
Symptoms create distress or functional impairment (e.g., social, occupational).
Criterion H: exclusion (required)
Symptoms are not due to medication, substance use, or other illness.
American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author.