Cognitive Behavioural Therapy (CBT) is effective in helping people to overcome panic disorders. I use CBT at my practice in Edinburgh and have found it very useful in treating agoraphobia, particularly when used in conjunction with Neuro Linguistic Programming (NLP). This article details some of the ways in which CBT and NLP are used during NLP Edinburgh to help clients achieve freedom from agoraphobia.

1. Cognitive Therapy – At NLP and CBT Edinburgh, people are supported to identify and challenge information processing errors that maintain anxiety. Panic attacks and anxiety are initiated by unhelpful thinking. Thoughts alone do not cause anxiety, but believing negative thoughts does lead to anxiety. During CBT and NLP sessions, clients are supported to question the evidence for and against their interpretations.

2. Behavioural Therapy – This is the doing part of cognitive behaviour therapy and in the case of agoraphobia, the therapist will support you in identifying a hierarchy of goals related to going out. The therapist will be aiming for you to become desensitized to going out activities that you currently fear. The therapist accompanies you into the community where appropriate.

3. Learning cognitive strategies to master panic – clients that come for NLP and CBT Edinburgh are taught techniques to practice during homework tasks. You are supported in becoming effective at using these techniques when you are feeling panicky.

4. Practising – You will get out of therapy what you put in and mastering your panic will involve you carrying out practice in between sessions. Typical practice assignments include keeping a ‘Beating Panic’ Journal’, carrying out practice related to your ‘going out and about’ goal and creating a routine that involves empowering ‘calm’ activities. You will also be required to practice any coping techniques taught to you by the therapist, such as using your anchors (see below).

5. NLP Communication Model – Clients are taught NLP clean language techniques. This means learning to think and communicate with your self in a way that supports being safe, confident, and relaxed.

6. NLP Change Techniques – NLP, which is an understanding of how we code experience in our brain, has a range of techniques, which can be used to reduce or eradicate the intensity of remembered experiences. Its possible to take an unpleasant memory, examine how it is coded and then make changes so that it is no longer unpleasant and the emotion can just drain away. If you suffer from unpleasant memories or fears, an NLP therapist can help you deal with this, via submodality work. These treatments are available from my therapy practice, where I use NLP Edinburgh. You can also learn to be aware of the impact of how you code experience yourself.

7. Anchoring For Emotional Balance – Anchors are naturally occurring associations between an external stimulus and a behavioural or emotional response. They occur because the human mind constantly seeks to make sense of the environment by looking for patterns and associations between things. People learn to make negative associations between things. In the case of agoraphobia this may be associating going for a walk to the corner shop with fear and panic. NLP deliberately makes use of anchors in order to empower people to have control over their emotional states. There are specific NLP techniques in which a stimulus is used to trigger and link an emotional state. The stimulus is usually external and may be a sound or touch. Through these techniques it is possible to for an individual to build up a resource of positive emotional states, which they can access in any situation in which they need them. It is also possible to completely collapse negative anchors so that external stimuli that cause you negative emotional states will no longer be a problem.

These are just some of the ways that NLP and CBT Edinburgh can be effective at empowering people to overcome agoraphobia and other panic disorders.

Cognitive Behavioural Therapy (or CBT) is an effective treatment for a wide range of psychological and emotional problems. The underlying theory of CBT is that our emotions are affected by our cognitions – put another way, “We feel what we think”. As a Psychiatrist and Therapist in Edinburgh I use CBT techniques extensively in the treatment of common problems such as depression, anxiety, and obsessive compulsive disorder (OCD).

CBT views emotional problems as the result of unhealthy and irrational thinking. It employs terms such as Negative Automatic Thoughts and Thinking Errors to describe the different ways in which unhealthy thinking can cause emotional problems. Having identified these unhealthy thinking habits, CBT also provides us with the tools to develop alternative, healthier ways of thinking about ourselves and the world around us. By thinking in a more balanced way we will feel better emotionally. Please see my articles on Negative Automatic Thoughts and Thinking Errors for a more detailed explanation of the above methods.

However, Negative Automatic Thoughts and Thinking Errors are not the whole picture. Many people will wonder why they have such ways of thinking when other people don’t. CBT uses the term Negative Core Belief to describe the fundamental root cause or causes of a person’s emotional difficulties.

A Negative Core Belief (or NCB) is a strongly held, intrinsic belief that a person holds about either themselves, others, or the world in general. Frequently people will have NCBs about all 3 categories. NCBs are usually an integral part of a person’s personality – so much so that they’re often blissfully unaware that they even have such a thing. One of my other articles on NCBs outlines ways that people can identify their NCBs – this article will focus on their causes.

Negative Core Beliefs arise most commonly during childhood and adolescence. This period would seem critical in the development of a person’s personality – it is the time when they first form opinions about themselves, others and the world around them. In lay terms, we are “impressionable” in our younger years.

If our experiences during these years are generally positive and empowering, then we are likely to develop healthy Core Beliefs. If we have loving parents, a pleasant and supportive schooling experience, and are lucky enough to have good friends when we are growing up etc, then we are very likely to see ourselves, others, and the world in general in a positive light. We may end up with Core Beliefs such as “I’m a generally nice person” or “People are usually OK”.

Unfortunately, this is not the case for everyone. Children grow up in violent or abusive households, children are bullied at school, children are ostracised by their peers – all these experiences can have a detrimental effect on a person’s core beliefs. Even seemingly minor experiences – perhaps having “pushy” parents or over-critical teachers – can influence our views of the world. Negative Core Beliefs are the result of such an environment, examples of such beliefs being “I’m bad” or “People are aggressive”.

It can seem reasonable (even logical) that a child forms these beliefs. After all, they’re young and have limited alternative experiences to compare. If your father is aggressive, or your teacher critical, then it can easily seem like every adult is aggressive or critical. Also, these people are powerful figures in your early life – role models – and you are likely to believe what they say. A father saying “You’re bad” or a teacher calling you “Useless” is, as far as you can see, the truth. You begin to believe that these are undeniable facts about yourself, facts that obvious to everyone.

These beliefs are the conclusions that are formed in a child’s mind based on his or her limited experience. You only have your parents judge how all parents are, and you only meet a certain number of teachers and schoolmates in your formative years. As a child, your view of the entire world is based on these few contacts and experiences.

The Core Beliefs we form as a child and adolescent tend to persist throughout our adult lives. This is not a problem if they are healthy, but Negative Core Beliefs predispose the individual to emotional difficulties. If you go through life believing, deep down, that you’re a bad person or a failure, then you’re prone to seeing much of your adult experiences in these terms. If a loved one is upset then you feel guilty even if it wasn’t your fault, or the passing comment by a boss can seem like the end of the world. Negative Core Beliefs are the cause of Negative Automatic Thoughts and Thinking Errors – and these are the causes of emotional difficulties.

Finding the cause of a clients Negative Core Beliefs is an important step in the treatment of their emotional problems. Please see my other articles on the Identification and Treatment of Negative Core beliefs.

Dr Steve Last is a Psychiatrist and Therapist in Edinburgh. He makes extensive use of CBT techniques to treat common problems such as depression, anxiety, and OCD. Please visit http://www.drstevelast.co.uk for further information about psychological problems and CBT.

Cognitive Behavioural Therapy, or CBT, is a an effective psychotherapy for a wide range of emotional problems. The theory underlying CBT is that our thoughts directly affect the way we feel – if we think in depressed ways then we will feel depressed. As such, a primary aim for a CBT therapist is to help a client recognise when they’re thinking in unhelpful ways. This article is a brief overview of one method of doing exactly this. I’ll use the example of someone suffering from social anxiety, a common problem amongst people I work with as a Psychiatrist and therapist in Edinburgh.

The first step for the client is to start “recording their thoughts” when they feel  anxious – that is, writing down (in brief sentences) what’s going through their head. This may sound a little strange at first, but it really is an essential part of the CBT method. Ideally the client should stop and write down what they’re thinking at the moment they’re thinking it, but writing it down at the end of the day is also acceptable. They should write down everything they were thinking of – this will usually produce quite a list of thoughts and statements and beliefs. In addition, the client should note both how they felt (physically and emotionally) and the situation in which these feelings occurred.

In my example, the client would record that the situation was a social gathering of work colleagues after work. His heart was racing, he felt hot and sweaty, and he was a  little light-headed (physical feelings). He described his emotional feeling as “very anxious”. Afterwards, when back at home, he wrote down the following thoughts that  he remembered having at the time: “I don’t know anyone very well”, “I’ve got body odour”, “They’re all friends”, “This place is too busy”, “I hate these things”, “I want to go home”, “I’m going to faint and make a fool of myself”, “I’ve got to get out of here”

This list of thoughts that he has recorded is a list of what a CBT therapist would call “Negative Automatic Thoughts”. They’re “Negative” in that they tend to hinder the person’s motivation and ability to engage with activities, and contribute to emotional problems. They’re “Automatic” in that they seem to occur “just like that”, popping into the person’s head as if from nowhere. Indeed, unless the person specifically focuses his attention on what he’s thinking – as in the thought-recording exercise – they may pass unnoticed. All that the person would then be aware of is a sudden feeling of anxiety and a desire to leave the situation.

These Negative Automatic Thoughts (or NATs) cause emotional problems (in this case, social anxiety). Thinking in this way triggers the “Fight or Flight” response to perceived threat, leading to the physical symptoms of anxiety such as a racing heart and nausea. If the person didn’t have these NATs (i.e. he didn’t think thoughts such as “I’m going to faint”) then the “Fight or Flight” response would not kick-in. No physical symptoms of anxiety would result, and he would be free to enjoy the social do.

Having identified the client’s NATs, the next step is to find alternative, more helpful ways of thinking about the situation. This is best done by examining the NATs for their rationality or “truthfulness”. A CBT therapist (along with the client) does this by conducting a “trial” for a particular NAT. In this example I will take the NAT “I’m going to faint and make a fool of myself” – this NAT was described by the client as the most distressing thought (in CBT parlance, this would be called the “Hot Thought”).

In a trial, evidence is presented “for” and “against” the party concerned. It’s the same in a trial for Negative Automatic Thoughts. So what evidence is there that the statement “I’m going to faint and make a fool of myself” is true? Very little – the client felt physically unpleasant and was anxious. And the evidence that says the thought is false? Much greater – he didn’t actually faint, he’s never actually fainted in all the times when he’s felt anxious, and it’s a well known fear of people experiencing anxiety that they will faint. And besides, there seems little evidence to suggest that even if he did faint, his colleagues would be anything other than concerned about him.

The verdict? That his NAT “I’m going to faint and make a fool of myself” is irrational and false.

Next, it’s time to identify an alternative thought that does actually fit with the evidence. How about “My heart is racing and I feel uncomfortable because I’m anxious, but I won’t faint and my anxiety will pass with time”? This seems a more accurate statement of the situation, and is clearly less likely to exacerbate his anxiety symptoms. Thinking in this way will reduce his anxiety and enable him to stay out longer with his colleagues, which in turn will help to reduce his anxiety.

Cognitive Behavioural Therapy (CBT) says that “we feel the way we think”. An important first step in the recovery from emotional problems is to learn to identify and challenge our irrational thoughts (or “NATs”). As a Psychiatrist and therapist in Edinburgh I have found this to be an effective (and surprisingly quick) way of relieving some of the burden of difficulties such as depression and anxiety. But it is just a first step, and most clients will benefit from a more in-depth CBT approach that addresses not just their Negative Automatic Thoughts but also their Negative Core Beliefs. Please see my other articles on this subject.

Dr Steve Last is a Psychiatrist and therapist based in Edinburgh. He uses CBT techniques to treat common problems such as depression, anxiety, and OCD.  Please visit http://www.drstevelast.co.uk for further information about emotional problems and CBT.

Please note that this is a “follow-on” article. It is best read after my articles “Cognitive Behavioural Therapy (CBT) and Negative Core Beliefs (NCBs) – Causes” and “Cognitive Behavioural Therapy (CBT) and Negative Core Beliefs (NCBs) – Identification”.

What can be done about Negative Core Beliefs? There are several options open to a CBT Therapist, but in my experience as a Psychiatrist and Therapist in Edinburgh I find that the following method is particularly effective.

Firstly, the method is to challenge these Negative Core Beliefs, in much the same way that a CBT Therapist would challenge a person’s Negative Automatic Thoughts. The CBT Therapist and the client can look for evidence that the Negative Core Belief is true, and then look for evidence that it is false. The client is then in a position to make a reasoned judgement as to whether it is rational and healthy to continue holding their Negative Core Belief. If they don’t think it’s rational, then they can begin to look for alternative beliefs that better explain the evidence.

An example of this method might be challenging a client’s Negative Core Belief that “People are dangerous”. Evidence in favour of this belief might be that they had unpleasant and frightening experiences growing up – perhaps their father was abusive, or they were severely bullied at school. Experiences as an adult may also play a role – the overbearing boss at work, or the “friend” who turns out to be rather two-faced etc. Evidence against the belief that “People are Dangerous” could include the fact that their mother and grandparents were kind and loving, and that she had a few friends at school who were supportive. Perhaps most of her work colleagues now are nice and trustworthy, and the boss is renowned for being unpleasant and cantankerous to everyone.

With evidence of this sort compiled both “for” and “against” the belief, the client can weigh it up and make a judgment. In this particular case, the evidence may seem roughly evenly balanced both “for” and “against”. In which case the client may decide not to totally reject their original belief, but modify it somewhat. They may decide that the statement: “Some people are dangerous, but some aren’t” is a better description of the evidence. Learning to live with this new modified belief will almost certainly lead to the client having less emotional problems.

However, this is easier said than done. After all, your Negative Core Beliefs have been with you a long time – they can seem like an integral part of who you are, and as such, you can’t just “turn them off” like that. They’re well-trodden paths that can feel very comfortable and familiar, even if (in the long run) they cause you a lot of problems.

What a CBT Therapist may suggest is that rather than trying to actively eliminate your Negative Core Belief, it can be more productive to focus your attention on actively cultivating your new, alternative Core Belief. In my experience as a therapist in Edinburgh, one of the most powerful ways that a client can employ in order to start thinking in newer, healthier ways is to start behaving as if they already truly believed the new Core Belief. That is, to make a conscious decision to act in accordance with their new belief. In the example given, the client will act as if they already believed the new core belief “Some people are dangerous but some aren’t”. They will (quite consciously and deliberately) assume that people are not always dangerous and act in accordance with this (e.g. smile, be friendly, trusting etc), and make a conscious note of the results of such behaviour. Ordinarily the results will be pleasant, positive, and re-inforcing of the new belief. By repeating this behaviour day-in and day-out it will become second-nature, and the client will, deep down, really start to believe their new Core Belief. No longer will they see all other people as inevitably dangerous, and their instinctive initial responses to others will reveal a mature and trusting attitude.

This CBT technique of acting “As-If” is a very powerful way of inculcating real sustainable changes in your Core Beliefs. As a Therapist in Edinburgh I always encourage my clients to use this method in their day to day lives, in addition to keeping a close eye on any Negative Automatic Thoughts or Thinking Errors they may be having. Emotional problems tend to be very resilient to change, so you need to be on their case at all times to prevent relapse.

Dr Steve Last is a Psychiatrist and Therapist in Edinburgh. He uses CBT techniques to treat common problems such as depression, anxiety, and OCD. Please visit http://www.drstevelast.co.uk for more information about psychological problems and CBT.

Cognitive Behavioural Therapy (CBT) is an effective psychotherapy for a wide range of emotional and psychological problems. The basic tenet of CBT is that our emotions are affected by our cognitions. To put it another way – the way we think affects the way we feel.

A CBT therapist aims to help people suffering from emotional problems by helping them to identify the ways in which their thinking may be causing their problem. A first step in CBT is therefore the identification of “Negative Automatic Thoughts” (or “NATs” for short) – these are the thoughts that accompany unpleasant or unhelpful emotions such as depression or anxiety.

A closely related aim of the CBT therapist is the identification of so-called “Thinking Errors”. These are habitual (and unhelpful) ways a person has of thinking about themselves, others, and the world around them. These thinking errors will often twist or distort experiences, acting to make the person seem a failure, others as hostile, and the world as dangerous or unpleasant.

The identification of NATs and related Thinking Errors is half the battle in CBT – once a person is aware of their unhelpful thoughts and mental habits they can then choose to think in more rational, healthy ways. A CBT therapist can guide them through this (fairly straightforward) process.

As a Psychiatrist and therapist working in Edinburgh I use CBT techniques extensively. Some of my clients are quite happy with the results they get from simply challenging their NATs and Thinking Errors – they feel much better and have no desire to delve further. However, the majority of clients are keen to “get to the bottom” of why they had their emotional problems in the first place. I tend to encourage this further work as it helps to reinforce the progress made to date and, in my opinion, helps to prevent the client from relapsing at some future date.

This further work involves a search for “Negative Core Beliefs” (or “NCBs”). These are the unhelpful beliefs that a person has had throughout their later childhood and adult life. They are core components of the person’s personality and they are the root cause of the person’s Thinking Errors and ultimately their NATs. If a CBT therapist can help a person to change their Negative Core Beliefs (or, more realistically, find more rational and healthier alternatives), then the person’s Thinking Errors and NATs will diminish, and their emotional problems will lessen (usually!).

A difficulty with NCBs is that a person is rarely aware of them. Even when someone is competent at identifying NATs and Thinking Errors, the cause of these problems may be hidden. But we can use NATs and Thinking Errors as clues.

In my experience as a Psychiatrist in Edinburgh I have found two techniques of most benefit in the search for the NCBs of my clients.

Firstly, there is the method of “Repeated Questioning”. I ask the client what a particular NAT he has identified means to him – he will give an answer, and I then ask him what that answer means to him. He will give a second answer, and I then ask him what that second answer means to him, and so on. Within a short space of time, the client ends up with a global statement that can’t be taken any further. This is a Negative Core Belief. It’s probably best demonstrated with an example:

Client:                                    “There’s loads of litter around Edinburgh” (He’s angry)

CBT Therapist:            “What does that mean?”

Client:                                    “That I’m the only one who cares about it”

CBT Therapist:            “What does it mean if you’re the only one who cares about it?”

Client:            “People don’t care about things that aren’t their personal property”

CBT Therapist:            “And what does it mean if people only care about their own stuff?”

Client:                                    “People are only out for themselves”

(“People are only out for themselves”. This is the client’s Negative Core Belief – a global statement that is uncompromising and will clearly influence the way he views and interacts with others in other areas of life, not simply littering!)

A second method of identifying Negative Core Beliefs is to look for the “themes” that run throughout a persons many NATs and Thinking Errors. Such themes may be “I’m a failure” or “There’s no point to life” (very common in depression), or perhaps “The world’s a dangerous place to live” (common in anxiety conditions).

Once a client’s Negative Core Beliefs have been identified, the CBT therapist will (along with the client) try and explore alternative and more rational ways of thinking about the self, others, and the world in general. This is where real, sustained recovery from emotional problems is made and I will discuss this in a follow-up article entitled “Cognitive Behavioural Therapy (CBT) and Negative Core Beliefs (NCBs) – Treatment”.

Dr Steve Last is a Psychiatrist and Therapist in Edinburgh. He makes extensive use of CBT techniques to treat problems such as depression, anxiety, and OCD. Please visit http://www.drstevelast.co.uk for further information about psychological problems and CBT.

Have you ever felt really depressed and stopped to think about why, and then realized that you experience these feelings on a regular basis? Depression is a pretty common affliction for people today, and it varies to different extremes. Some people might find that they become very depressed in very specific circumstances; that this feeling inevitably follows after certain events occur in your life. Many psychiatrists believe that the depression phase of the cycle can be avoided through various behavioural modification techniques, one of which is cognitive behavioural therapy. We will clarify and define this technique in this article.

An Example

In order to make the circumstances a little bit clearer, let’s take a look at a common example of a depression cycle. Let’s say a person in their job makes a mistake on an assignment, a mistake large enough to be noticed by superiors. Possibly this mistake will put the project behind schedule, thus backing everything else up. A superior informs the person of the mistake and the consequences. Now, instead of immediately getting to work on the corrections, the person focuses only on the mistake. He or she begins to feel that they can’t do anything right, and that will lead to depression. While in this state of depression, similar issues are avoided resulting in more problems and a reinforcement of the idea that one can’t do anything right; the cycle has now been created.

Cognitive behavioural therapy

What cognitive behavioural therapy seeks to do is change the initial reactions, or understanding, of the person in the above example. The process involves first identifying the negative reaction and then slowly replacing that with a reaction that is constructive and will not lead to the depression cycle.

In the above example, the catalyst which led to the depression was not the mistake; everyone makes those. Nor was it the fact that the mistake was addressed by a superior; that is the job of a person in charge of a project. Rather, the cycle started when the person who made the mistake felt that that mistake was ample evidence that they could do nothing right in their lives, it is this reaction and belief that the therapy will seek to change over time.

The problem with this type of reaction is that it is often rooted in “automatic thoughts” about themselves that have been formed in childhood. Cognitive therapy, therefore, can take quite a bit of time to be successful, and individuals using this form of treatment (and there are many different forms that it takes) must be prepared to work hard over a period of time for it to be successful. Nevertheless, the end results will be life changing.

The basic tenet of Cognitive Behavioural Therapy, or CBT, is that what you think affects the way you feel. That is to say, if you think depressive thoughts then you will feel depressed. Conversely, if you manage to stop yourself thinking these thoughts, then your depression will lift.

As a psychiatrist who uses CBT techniques, my first step is to look for unhelpful patterns of thinking with my clients. Depressed people often think in particular ways that are very different from non-depressed people. These ways of thinking are called – in CBT language – “thinking errors”. Thinking errors help to cause and then maintain depression.

Numerous different thinking errors have been identified by CBT therapists over the years, and particular kinds of errors seem to predispose to particular psychological problems. In my experience as a therapist, the most common errors found in depression are “All-or-Nothing” thinking, “Mental Filtering”, “Disqualifying the Positive”, and “Personalising”.

”All-or-Nothing” thinking (also known in CBT circles as “Black-or-White” thinking) emphasises extremes and ignores the fact that most things in life are shades of grey rather than absolutes. For example, a person thinking in this way may play one poor game of tennis and then decide that he’s totally useless and give up forever. Or she may miss one yoga class and tell herself that as she’s fallen behind, there’s no point in going back. “All-or-Nothing” thinking sets very rigid rules for a person to live by – rules that, if broken (as they almost inevitably are!) can lead to the abandonment of enjoyable and worthwhile activities, and predispose the person to depression.

”Mental Filtering” is the term applied to the thinking patterns of people who “see” the world in a depressive way. People with this thinking error are biased in what they take notice of, and what they later remember. They will tend to notice (or, in CBT parlance, “attend”) to objects, people, or events that “fit-in” or confirm their previously held beliefs. For example, a depressed person who thinks that the world is an unpleasant place to live is more likely to remember the sad news stories as compared to a non-depressed person. A depressed person who thinks that they’re unlikeable will take extra notice of possible sleights from others. CBT theory posits that such mental filtering reinforces a person’s depression.

A closely related thinking error is termed “Disqualifying the Positive”. As well as focusing on the negative features of the world (and themselves), depressed people will often actively ignore (or “disqualify”) evidence to the contrary. A depressed person may well recall the person at the party who ignored them, but he will forget or downplay the others who chatted to him for hours. If a CBT therapist asked them about this, he will often say things like “oh, they just felt sorry for me”, thereby turning a positive interaction into something very different.

”Personalising” is the term given to a type of thinking that places the person at the centre of events. Such a view of the universe places a huge burden on the persons shoulders – they can feel responsible for all the bad things that happen. You may be “Personalising” when you feel guilty about not being able to help an unemployed friend keep his house, or when reading about climate change due to our Western way of living. There are factors beyond your control and for which you should not take responsibility. If you do, then CBT hypothesises that you will experience feelings of guilt, shame, and ultimately depression.

The above is a brief review of the common thinking errors that I have come across during the course of my work as a therapist in Edinburgh. Identifying such errors with the client is a first step on the way to identifying other, healthier, ways of thinking.

The basic hypothesis of Cognitive Behavioural Therapy, or CBT, is that our emotions are greatly influenced by our cognitions. Or, put in plain English, “we feel what we think”.

Anger is, of course, a very common emotion and as such is not necessarily a problem. Getting angry occasionally can be entirely appropriate – I think we can all empathise with people who are angry because their car’s been stolen or someone’s spreading rumours about them. But anger can get out of hand – either through becoming too frequent or becoming too intense – and this certainly can be a problem.

And in today’s hectic lifestyles, anger can seem to be on the rise. Whether or not it is (in reality) increasing, there is certainly plenty anger-related crime reported in the media, perhaps the most obvious being the notion of “Road-Rage”. As a therapist in Edinburgh I see plenty of clients that have some difficulty in controlling their anger. Often the anger appears situational – often being related to a stressful working enviroment – but it can be more generalised as well. And yes, I have seen people with “road-rage”. Even a beautiful city like Edinburgh can’t avoid the rush-hour jams (especially not since the tram-works started…)

When anger is causing an individual problems (in their relationships, occupation, or with the police etc), CBT therapists will often call it “dysfunctional”. The causes of dysfunctional anger – like any other emotional problem such as depression or anxiety – can usually be traced back to the way a person thinks. In CBT parlance, a person exhibiting dysfunctional anger will often show particular “Thinking Errors” that predispose him to anger.

Most people that have anger problems show “Inflexible Thinking”. That is, they live by a varying number of rules that they’ve set for themselves and for others. These rules may not even be obvious to the person, but when they’re broken they will feel intensely angry. An example of a rule might include “People must always drive as well and as courteously as me”. Obviously it would be nice if everyone did drive like you, but they’re not going to, so you’re in for a lot of rule-breaking and hence a lot of anger! A CBT therapist would help the individual to identify this unhelpful rule, and help the person develop a more flexible way of thinking.

Having “Poor Frustration Tolerance” is another feature of dysfunctional anger. People can convince themselves that they can’t stand any discomfort and inconvenience at all, no matter what it is or what the possible benefits in the long run might be. You may really want to see Madonna in concert, but the queue for tickets is “too long” and you “can’t stand” queuing anyway. So you leave in a huff, and then kick yourself repeatedly over the next few weeks as your friends get more and more excited over the upcoming gig! A CBT therapist can help you learn to “frame” inconveniences and discomfort in a less emotive way, increasing your tolerance levels and lessening your self-defeating anger.

People with dysfunctional anger are often in the habit of “Labelling” others. That is, they are in the habit of describing (both to themselves and others) people or situations in just a few words – often just one! So a job is “irritating” and a work colleague “annoying”. Whilst such a way of thinking and talking scores points for brevity, it must surely be inaccurate – is every aspect of the job “irritating”? Is the work colleague always, 100% “annoying?” Probably not. By labelling situations and people in such a way you can predispose yourself to anger problems as these situations and people are always in your “bad books”, regardless of what they do. So a minor slip up here or there and you’re primed to jump down their throats. A CBT therapist will endeavour to help you regard other people and situations as more complex than this, allowing them (and you) room for error without causing anger.

The above thinking errors are those that I’ve most commonly encountered whilst working as a therapist in Edinburgh. CBT is an effective psychological treatment for a whole host of psychological and emotional problems, ranging from Anorexia to Trichotillomania.

The theory of Cognitive Behavioural Therapy, or CBT, is that emotions are closely linked to cognition. Put more simply, CBT says that “the way you think affects the way you feel”. People who think anxious thoughts will end up feeling anxious.

As a psychiatrist who uses CBT techniques, a significant proportion of my clients suffer from anxiety. Edinburgh is a beautiful city and a wonderful place to live, but as in any urban enviroment, individuals can start to feel stressed out and anxious. Thus it is important for me to help each client to become familiar with their own ways of thinking, and to help them to identify ways in which their thinking patterns may be contributing to their emotional problems.

A CBT therapist has a term for patterns of thinking that can lead to emotional problems – they are called “Thinking Errors”. Many different types of thinking error have been identified over the years, but what follows is a brief summary of those errors that I have seen as a therapist in Edinburgh when working with people suffering from anxiety.

”Catastrophising” is a thinking error frequently found in anxious people. In fact, I’m sure we’ve all done it ourselves at some point! When someone catastrophises they automatically “assume the worst”. A message to call back the boss is taken to mean that you’re going to be sacked, a clunking noise in your car means that the engine is about to fall to bits, and a pain in the chest is the beginnings of a heart attack. CBT hypothesises that habitually thinking like this will lead to long-term problems with anxiety.

Another common thinking error seen in people with anxiety is called “Mind-Reading”. As the name suggests, a person who’s exhibiting this thinking error will believe that they know (absolutely know) what people are thinking about them. This belief will often go contrary to what the other person says and does, and is almost always pessimistic in nature. For instance, if the CBT therapist yawns (heaven forbid!) during a session, the client will know that the CBT therapist is bored or fed up with them – even if the therapist apologises and explains that her young daughter is teething and kept her awake last night. Or if the person gets invited to a dinner party, they will know that they’re only invited along to make up the seating numbers. Thinking in this way can make life one long series of possible sleights and put-downs, leading to increased anxiety and excessive monitoring of those around you.

”Crystal-Ball Reading” is a third common thinking error in anxiety. People thinking in this way know what is going to happen in the future. And, lo and behold, it’s bad! The bus will definitely be running late, they will definitely fail the interview, and they will absolutely make a fool of themselves at the works party. Not a pleasant way to think. And certainly not a good way to prepare for an interview (or even a party!). CBT encourages people to “keep it real” – there’s enough strife out there without looking into the future for extra!

These three thinking errors are those that I’ve found most frequently in anxious people whilst working as a therapist in Edinburgh, although I doubt that they’re exclusive to East Coast Scots!

She is still insisting we do it. I don’t take it seriously. I’m depressed but I don’t think that this is going to help. I don’t want to do it but the court has mandated that I get therapy.

if succesful will this person be able to feel emotions and empathy again?

http://forums.wegohealth.com/forums/viewthread/283_32/

we were talking about how our insurance companies wouldn’t pay for needed Cognitive Behavioral Therapy.

I was wondering how much an average session cost, and whether people could just make online communities that went through a peer-reviewed book together, if individual members couldn’t afford the cost of a session.

Any thoughts on this?

Thank you.

Barbara

In the dictionary “cognitive” is simply defined as the way one thinks. “Behaviour” is simply defined as the way one behaves. Therefore the subject of “cognitive behaviour therapy” is looking at how one thinks in relation to how one behaves.

As discussed in previous arictles, counselling is the means of looking inwards to find one’s truth and in short, build a better life for one’s self.  

Needless to say as technology develops, likewise our understanding of the human mind. So we find better ways to help the individual locate those thoughts and feelings so the individual can undestand his or her thoughts.  

Only by truly understanding them can one hope to change them.

Cognitive behaviour therapy is one such route.

For example an indiviiduals may become agressive when or she is having a discussion about Money.

Now in every day life, for an individual to actually get agreesive is an extreme gradient.

Nevertheless with Cognitive behavious therapy, we are interested in the thoughts and feelings of that particular situation and how that effected the overall bevaviour pattern.

By looking and understanding those thoughts and feeling together with your counseller, can one begin to understand where those thoughts came from and what they mean ensuring that should the  situation arrise again. The mind does not look at the situation in the same way. In other words, he she does not get aggressive.

Cognitive behaviour therapy looks at the aspects of how one thinks about him or her self, what he or she thinks about the people and the world.
As the therapy continues, understanding how those thoughts and feeling create both the reality in which that person lives and how this in turn effects the individuals behaviour.

As one progresses with CBT otherwise known as Cognitive Behaviour therapy, (home work) may be issued, this is basically a case of keeping a journal or a diary up to date so as to monitor your thoughts, feelings and reactions.