Want to go deeper into Cognitive Behavioral Therapy (CBT) by learning common CBT techniques?
For this article I’m going to assume you’ve probably heard of Cognitive Behavioral Therapy before.
If you need more beginner info on CBT, check out my introductory article to CBT treatment here.
If you’ve already heard of CBT but need a quick refresher, here’s a brief CBT overview:
- Very simple and effective
- Based on studying your thoughts and changing your beliefs
- Treats many struggles including anxiety, depression and eating disorders
- Extremely well-researched
Now, are you ready to take your CBT game up a notch?
It’s time to learn about the common techniques used in CBT treatment!
I’m excited. Today we’ll be looking at the 6 most common techniques of CBT.
Let’s dive in……
What Are The Techniques Of CBT?
The heart of CBT treatment is three-fold:
- You become aware of your thoughts
- By studying your thoughts, you gain awareness of your beliefs
- By becoming aware of your beliefs, you change your beliefs
Why change your beliefs? The idea behind beliefs is simple.
Our beliefs are like computer programs running without our conscious awareness.
For example, when you start up your computer you probably don’t know all the background processes that are running.
Let’s say one of your computer’s background process malfunctions. Because of this malfunction, your computer runs 50% slower.
Your slow computer is really annoying! Unfortunately the situation is made worse because you’re no computer programmer. You have no clue how to fix your computer!
Your beliefs are similar. We all have unconscious beliefs which impact our behaviors.
In terms of binge eating, we know our behaviors are unhealthy and embarrassing.
However, just like we don’t know how to fix our computers, we also have no idea how to fix our beliefs!
Fortunately, with CBT techniques, we can learn to become aware of our broken beliefs.
We can then change our beliefs and our behavior can shift dramatically!
Let’s keep this analogy in mind as we examine Cognitive Behavioral Therapy (CBT) techniques.
1 – Self-Monitoring
Self monitoring is where you monitor yourself and your mental health.
This means you write down on paper, or electronically, various things related to mental health. For example when you monitor yourself you may record:
- Your thoughts
- Your emotions / moods
- Physical sensations in your body
- Food eaten
- Anxious situations
- Depressive thoughts
In self-monitoring you are usually asked to record before the situation.
For example, if you are struggling with social anxiety then you’ll be asked to record your anxious thoughts before getting into a social situation.
If you’re struggling with food then I’ll ask you to record your thoughts, emotions, etc., before you eat.
This self-monitoring practice is very important for improving your mental health.
Using the computer analogy, this is where you ‘troubleshoot’ the problem. This is where you spot the malware running on your computer.
Now, understand that the malware is still infecting your computer. You haven’t changed your beliefs yet.
But at least now you know where the malware is located and you can begin to take steps to remove those negative beliefs, thoughts and feelings.
2 – Cognitive Restructuring
Cognitive Restructuring is part of the removal process in Cognitive Behavioral Therapy.
This is where you change the computer code behind the malware.
For example, let’s say you practice self-monitoring. You keep track of your thoughts before you eat.
In a short time you have dozens of journal entries about what you’re thinking and feeling before you eat.
When you look back at your journal entries you notice a trend. For example, one trend might be that you seem to get very worried and anxious about ‘not eating perfectly’.
Not eating perfectly is an example of one of your negative thoughts.
Based on your journal entries, you get anxious around not eating perfectly very frequently. Nearly every meal you are fearfully thinking about the consequences of eating imperfectly!
This is where Cognitive Restructuring comes into play.
- You’ve gathered enough self-monitoring data to make an educated guess about your beliefs
- In this example, you could make a guess that your subconscious belief is related to perfectionism
So here is where you become educated about your beliefs. Based on your journal entries, what do you think is your belief around food and perfectionism?
Please note: our beliefs are typically formed in childhood. Beliefs oftentimes sound very silly or simplistic when you state your beliefs aloud to your therapist or write your beliefs out on paper.
But don’t worry if your beliefs sound too stupid or simple. This is why we restructure our beliefs!
Example Belief: I must get my food right or something horribly bad will happen.
Is this your belief? Does it make sense to you? Does it feel right to you?
Once you have a belief that feels right to you, you can begin the Cognitive Restructuring process.
Cognitive Restructuring is where you take how your belief is currently structured, and restructure it.
- For example, is it really likely something horribly bad will happen if you have an extra fry?
- What if you have an extra slice of cheesecake, what are the odds of something horribly bad happening then?
Obviously the odds are slim. Since you’ve examined your belief, you can now restructure your belief to be more accurate.
You might discover you have this belief based on the way your parents treated you at the dinner table when you were young!
New Restructured Belief Example: I feel anxious around food because my parents held me to very high standards around food as a kid. But these standards are stupid and not in alignment with my values. Most likely nothing bad will happen. While I still may have anxiety, I can see ‘through’ this anxiety and understand what’s really going on.
How does this restructured belief sound to you?
It sounds about right, congratulations, you’ve just had a taste of Cognitive Restructuring!
3 – Exposure
Exposure in Cognitive Behavioral Therapy is where you challenge your beliefs and negative thoughts in real-life situations.
To demonstrate how exposure works, let me ask you a simple question:
How would you teach your cat to swim?
Silly question, I know! But seriously, if you had to teach your cat to swim then how would you do this?
You can’t just throw your cat in the water because the cat will jump out, run away and never swim again.
But what if you got your cat to drink out of a water bowl first?
And then what if you moved the water bowl to the edge of the pool?
What if you then made a contraption so your cat had to dip one paw into the pool water in order to drink out of the water bowl?
You see where I am going with this, I hope. You challenge yourself, just a little bit. In due time your fear diminishes as you experience that what you fear isn’t so scary!
In terms of food and anxiety, what would challenge you?
Perhaps sitting still and breathing deep for 30 seconds before a meal would challenge you.
Or maybe it’s allowing yourself to not be perfect around food and noticing if anything bad happens.
Exposure is where ‘the rubber hits the road’. Exposure is how you ‘reprogram’ your mind and body to actually not be anxious around food!
4 – SMART Goals
SMART goals are where you think about your overall vision and intention.
Why are you writing down your thoughts around food? What do you hope to gain? What problems do you hope to alleviate?
SMART goals start with you exploring your long-term goal to be achieved with Cognitive Behavioral Therapy treatment.
If treatment goes successfully and all your eating problems go away, how would your life be different?
After you come up with a compelling long-term vision, then it’s time for you to break down your vision into Specific, Measurable, Achievable, Relevant, Time-Bound steps.
Specific, Measurable, Achievable, Relevant, and Time-Bound = SMART Goals.
SMART goals are extremely useful, and are definitely worthy of future study. For more info on SMART goals read here.
To put things more simply, you have your Big Vision.
- That’s the first part of SMART goals. You pick a vision.
- The second part of SMART goals is breaking your Big Vision into tiny pieces.
My piano teacher used to tell me ‘If you want to eat an elephant, be sure to cut the elephant into tiny bite-sized pieces!’.
It’s a strange quote, but I think you get the point.
You can’t achieve your Big Vision all at once, but if you break your vision into smaller pieces then you can move mountains, or eat elephants!
Let’s Say Your Big Vision Is To Stop Binge Eating
Now, how are you going to go about ending binge eating? What steps will you take?
In practical terms, this is where Exposure and SMART goals often overlap.
First, you’ll ‘expose’ yourself just a little bit to self-monitoring.
- Self-monitoring is Specific
- Did you record or not? Self-monitoring is Measurable.
- Just a little self-monitoring to make it Achievable
- Does self-monitoring tie into your Big Vision? Yes, it’s Relevant.
After you start self-monitoring, you then start to expose yourself to more anxiety by pausing for 1 minute or experimenting with not eating perfectly.
See how you’ve started from the beginning, started self-monitoring, and then are now challenging your anxiety?
Essentially, SMART goals are where you plan out your Exposure ahead of time and take small steps forward.
5 – Mindfulness
Mindfulness is incredibly important to Cognitive Behavioral Therapy.
There’s even a new branch of Cognitive Behavior Therapy called Mindfulness Based Cognitive Behavior Therapy that’s now becoming more popular!
Why the new Mindfulness Cognitive Behavior Therapy?
Mindfulness is the glue that makes exposure work.
With exposure, you start with something small and challenging. In our anxiety example, one way you may start to challenge anxiety is pausing for a minute and breathing.
But how do you stay calm while you breathe?
Mindfulness is how you learn to better tolerate uncomfortable feelings and thoughts.
Here are some easy ways you can practice mindfulness:
- Slowly exhale your breath
- Relax different muscle groups in your body
- Slow down, ‘mindfully’ eat
Ultimately speaking, mindfulness can include a deeper state of awareness where, as my Zen Teacher would say, ‘You become The Witness’.
Becoming The Witness is where you can ‘see’ your thoughts flowing by like clouds on a blue sky.
You simply ‘see’ your thoughts, instead of automatically believing or reacting to your thoughts.
But don’t worry, you do not need to become ‘The Witness’ or fully clear your mind of thoughts to benefit from mindfulness. You can be a mindfulness beginner and still receive benefits!
All you really need to do is slow down, let your breath be a little slower and fuller, and calmly notice how you feel.
By slowing down, doing some basic breathing meditation and letting yourself become aware of how you feel, you’ll really start to notice some powerful benefits:
- By being mindful you are more likely to find self-monitoring easier
- In learning how to calm yourself with mindfulness techniques, exposure to things you fear also becomes easier
- Taking time to pause and slow down will also assist in helping you keep your long-term vision in mind!
Overall, I love this topic of mindfulness! If you want to learn more about Mindfulness, be sure to check out my Mindfulness 101 article here.
6 – Role Playing
Role playing is another commonly used Cognitive Behavioral Therapy technique.
To explain role playing, let me give you another somewhat silly analogy.
You know how it’s easy to give other people great relationship advice, but then for some reason your relationships are cluttered and confusing?
Well, the same thing can be true of your thoughts and emotions.
Role playing is where you externalize situations so you don’t take your thoughts and emotions so seriously.
For example, what would you say to your friend if your friend was feeling anxious?
Would you tell your friend to relax? Or to not stress the small stuff?
By imagining yourself in a situation where you are advising your friend, you can shift your perspective and more easily tap into practical steps for yourself.
This is role playing! Now you take your imaginary responses to your friend and follow them yourself!
Role playing can also be used to address:
- Communication struggles
Is your computer stuck, stalled or infected with malware?
What about your brain, mind and subconscious beliefs? Are you stuck?
Cognitive Behavioral Therapy is a pretty simple approach that I recommend if you are stuck!
While there is some learning curve, I hope you can see the CBT techniques outlined above aren’t too difficult.
Remember, the overall approach is simply to bring awareness, and then magical great things happen when you become more aware.