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Cognitive behavioral therapy more commonly
referred to as CBT focuses on the way people
think and act in response to daily events.
It helps them overcome their emotional and
behavioral problems.
What Is Cognitive Behavior Therapy
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More and more physicians and psychiatrists refer their
patients for CBT to help them overcome a wide range
of problems as:
Addiction Anger problems
Anxiety
Chronic fatigue and pain
Depression
Eating disorders
What Does CBT Do?
Obsessive-compulsive disorder Panic disorder
Personality disorders
Phobias
Post-traumatic stress disorder
Relationship problems
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Cognitive means mental processes like thinking. The wordcognitive refers to everything that goes on in your mind includingdreams, memories, images, thoughts, and attention.
Behavior refers to everything that you do. This includes what yousay, how you try to solve problems, how you act, and avoidance.Behavior refers to both action and inaction, for example biting yourtongue instead of speaking your mind is still a behavior even thoughyou are trying not to do something.
Therapy is a word used to describe a systematic approach tocombating a problem, illness, or irregular condition.
CBT Components
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You can live more happily and productively if
you are thinking in healthy waysCBT = You Feel What You Think
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Think Feel Link
The THINK-FEEL LinkWhen she does
that, she makes
me angry
When she does
that, she makes
me behave
incorrectlyCBT Terms
1. Her Behavior leads to.2.Assumption that she does this
deliberately to upset me
3. This assumption makes me angry
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Think Feel Link
If your partner treats you inconsiderately, you may conclude that she makes you angry.
You may further deduce that her inconsiderate behavior makes you behave in a
particular manner, such as sulking or refusing to speak to her for a long time.
CBT encourages you to understand that your thinking or beliefs lie between the event
and your ultimate feelings and actions. Your thoughts, beliefs, and the meanings that
you give to an event, produce your emotional and behavioral responses.
So in CBT terms, your partner does not make you angry and sulky. Rather, your partner
behaves inconsiderately, and you assign a meaning to her behavior such as shes
doing this deliberately to upset me! thus making yourself angry and sulky.
The THINK-FEEL Link
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The meaning you attach to any sort of event influences the emotional responses you
have to that event. Positive events normally lead to positive feelings of happiness or
excitement, whereas negative events typically lead to negative feelings like sadness or
anxiety.
However, the meanings you attach to certain types of negative events may not be
wholly accurate, realistic, or helpful. Sometimes, your thinking may lead you to assign
extreme meanings to events, leaving you feeling disturbed.
CBT For Better Me
The THINK-FEEL Link
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CBT For Better Me
More THINK-FEEL Links
My partner
doesnt love me
and feels
depressed
My partner is about
to leave me for
someone else and
feels jealous
I dont deserve to be
treated poorly
because I always do
my best and feels hurt
This is a sign
that my partner
is losing interest
in me and feels
anxious
My partner has done
a bad thing by treating
me in this way, and Im
not prepared to put upwith it and feels
annoyed
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CBT For Better Me
More THINK-FEEL LinksAha! Now I have a
good enough reason
to break up with my
partner, which Ive
been wanting to do
for ages! and feelshappy
I really wish my partnerhad been more considerate
because were usually highly
considerate of each other
and feels disappointed
My partner must havefound out something
despicable about me to
treat me in this way and
feels ashamed
That idiot has no
right to treat me
badly and feels
angry
I must have done
something serious to
upset my partner and
feels guilty
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CBT ABC
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A: You imagine failing a job interview.
B: You believe: Ive got to make sure that I dont mess up this interview,
otherwise Ill prove that Im a failure.
C: You experience anxiety (emotion), butterflies in your stomach (physical
sensation), and drink alcohol to calm your nerves (behavior)
A: You fail a job interview.
B: You believe: Ishouldve done better. This means that Im a failure!
C: You experience depression (emotion), loss of appetite (physical sensation),
and stay in bed avoiding the outside world (behavior).
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CBT ABC Examples
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CBT ABC Getting Complicated
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1. Catastrophising
CBT For Better Me
IT IS taking a relatively minor negative event and imagining all sorts ofdisasters resulting from that one small event
Put your thoughts in perspective: Surely you arent the only person in the world to fall in public. Chancesare, people are far less interested in your embarrassing moment than you think, and if they notice, it will not a
cover page news
Consider less terrifying explanations: Isnt being late is common in adolescence? Perhaps the movie ranover or there was a traffic jam
Weigh up the evidence: Do you have any info proving he/she will leave? Probably you have info proving youhad good time together instead
Focus on what you can do to cope with the situation, and the people or resources that can come
to your aid: Engage in social activities, repair a damaged relationships, find another
Remediating Strategies (Turning Mountains To Hills)
Examples:You fall in public, conclude that everyone laughed at you
Your daughter is late, you conclude she is dead
Your spouse forgets something, you conclude she/he wants to leave
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2. All-or-Nothing Thinking
CBT For Better Me
IT IS like black-or-white thinking, it is extreme thinking that can lead toextreme emotions and behaviors. People either love you or hate you, right?
Somethings either perfect or a disaster. Youre either responsibility-free or
totally to blame?
Be Realistic: You cantpossibly get through life without making mistakes. One doughnutdoesnta diet ruin. Remind yourself of your goal, forgive yourself for the minor slip, and resume your diet
Develop bothand reasoning skills : You can both succeed in your overall educational goalsand fail a test or two - You can both assume thatyoure an OK person as you
are and strive to change in specific ways
Remediating Strategies (Finding A Place In Between)
Examples:You eat a doughnut while in diet, you conclude the whole diet is blown up
and you eat the rest of them
You fail one subject, you conclude the whole diploma is pointless and quit
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CBT For Better Me
3. Fortune TellingIT ISwhen you predict all the negative things about an approaching eventExamples:You reject a party invitation because the food will be bad, there will be
noise, traffic will be bad, it will be boring
You cancel a camping plan because the trip will be tiring and will not be
able to do the associated sports
Test out your predictions: You really never know how much fun you might have at a party untilyou get there
Be prepared to take risks: Isnt it worth possibly losing a bit of cash for the opportunity to try asportyouve always been interested in?
Understand that your past experiences dont determine your future experiences
Remediating Strategies (Step Away From The Crystal Ball)
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CBT For Better Me
4. Mind ReadingThe tendency is often to assume that others are thinking negative things
about you or have negative motives and intentions
You chat with someone who yawn, you conclude he think you are boring
Your boss asks you to hand over a project to someone else, and you
conclude he thinks your work is badGenerate some alternative reasons for what you see: The person you are chatting with can betired, your boss may want to give you different work
Consider that your guesses may be wrong:Are your fears really about yourbosss motives, or do
they concern your own insecurity about your abilities at work? Do you have enough information or hardevidence to conclude that your boss thinks your work is substandard?
Get more information (if appropriate): Simply confront and ask
Remediating Strategies (Pour salt to your guesses to shrink them)
Examples
IT IS
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CBT For Better MeCBT For Better Me
5. Emotional ReasoningRelying too heavily on your feelings as a guide which eventually leads you off
the reality pathHusband travels a lot, wife feels insecure he knows another one and is jealous
from his women colleagues
You feel guilty out of the blue. You conclude that you must have done
something wrong otherwise you wouldntbe feeling guiltyTake notice of your thoughts: Note thoughts such as Im feeling nervous, something must be wrongandIm soangry, and that really shows how badlyyouvebehaved, and recognize that feelings are not always the best measure
of reality, especially ifyoure not in the best emotional shape now
Ask yourself how youd view the situation if you were feeling calmer: Look to see if there is any concreteevidence to support your interpretation of your feelings. For example, is there really any hard evidence that something
bad is going to happen?
Give yourself time to allow your feelings to subside: When youre feeling calmer, review your conclusionsand remember that it is quite possible that your feelings are the consequence of your present emotional state (or even
just fatigue) rather than indicators of the state of reality
Remediating Strategies (Feelings are not facts)
Examples
IT IS
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6. Overgeneralizing
The error of drawing global conclusions from one or more events. When you find yourself
thinking always, never, people are . . ., or the worlds . . ., you may well be
overgeneralizingYou feel down. When you get into your car to go to work, itdoesntstart. You think to yourself, Things
like this are always happening to me. Nothing goes rightand makes you feel more gloomy
You become angry easily. Travelling to see a friend, youre delayed by a fellow passenger who cannot
find the money to pay her train fare. You think, This is typical! Other people are just so stupid, and you
become tense and angry
You tend to feel guilty easily. You yell at your child for not understanding his homework and then decide
thatyoure a thoroughly rotten parent
Get a little perspective: How true is the thought that nothing ever goes right for you? How many other people inthe world may be having car trouble at this precise moment?
Suspend judgement: When you judge all people as stupid, including the poor creature waiting in line for the train,you make yourself more outraged and are less able to deal effectively with a relatively minor hiccup
Be Specific: Would you be a totally rotten parent for losing patience with your child? Can you legitimately concludethat one incident of poor parenting cancels out all the good things you do for your little one? Perhaps your impatience
is simply an area you need to target for improvement
Remediating Strategies (Avoiding Part/Whole error)
Examples
IT IS
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CBT For Better Me
7. Labelling
The process of labelling people and eventsYou read a distressing article in the newspaper about a rise in crime in your
city. The article activates your belief that you live in a thoroughly dangerous
place, which contributes to you feeling anxious about going out
You receive a poor mark for an essay. You start to feel low and label yourself
as a failure
You become angry when someone cuts in front of you in a traffic queue. You
label the other driver as a total loser for his bad driving
Allow for varying degrees: Think about it: The world isnt a dangerous place but rather a placethat has many different aspects with varying degrees of safety
Celebrate complexities: All human beings yourself includedare unique, multifaceted, and ever-changing. To label yourself as a failure on the strength of one failing is so extreme. Likewise, other
people are just as complex and unique as you. One bad action doesntequal a bad person
Remediating Strategies (Giving up the rating game)
Examples
IT IS
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8. Making DemandsIT ISthe inflexibility of the demands you place on yourself, the world around you, andother people. It means you dont adapt to reality as well as you couldExamples:You believe that you must have the approval of your friends. You feel anxious in social
situations and drives you to try to win everyones approval
You think that because you try very hard to be kind to others, they ought to be as kind.
Because your demand is not realistic you feel frustrated
You believe that you should never let people down. So, you rarely put your own welfarefirst. You often end up feeling stressed and depressed
Pay attention to language: Replace words like must,need, andshouldwith prefer,wish, andwant
Limit approval seeking: Can you manage to have a satisfying life even if you dontget the approval of everyone you seek it from?Specifically, youllfeel more confident in social situations if you hold a preference for approval rather than viewing approval as a dire need
Understand that the world doesnt play to your rules: . If you can give others the right to not live up to your standards, youllfeel less hurt when they fail to do so
Retain your standards, ideals, and preferences, and ditch your rigid demands about how you, others, and the
world haveto be: keep acting consistently with how you would like things to be rather than becoming depressed or irate about thingsnot being the way you believe they must be
Remediating Strategies (Think Flexibly)
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CBT For Better Me
9. Mental FilteringIT IS a bias in the way you process information, in which you acknowledge onlyinformation that fits with a belief you hold. Information that doesnt fit tends to be
ignoredExamples:You believe youre a failure, so you tend to focus on your mistakes at work and
overlook successes and achievements
You believe youre unlikeable, and really notice each time your friend is late to call back
or seems too busy to see you. You tend to disregard the ways in which people actwarmly towards you
Examine your filters closely: For example, are you sifting your achievements through an Im a failure filter? Ifso, then only failure-related information gets through. If you look for a friends achievements over the same week
without a filter, youdbe likely to find far more successGather evidence: Imagine youre collecting evidence for a court case to prove that your negative thought isnttrue. What evidence do you cite?
Remediating Strategies (Keep an open mind)
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10. Disqualifying The Positive
CBT For Better Me
IT IS related to the biased waythat people can process
information. Disqualifying the
positive is a mental action that
transforms a positive event into a
neutral or negative event in your
mind
Examples:You believe that youre worthless
and unlovable. You respond to a
work promotion by thinking, This
doesnt count, because anyone
could get this sort of thing. The
result: Instead of feeling pleased,
you feel quite disappointed
You think youre pathetic and feellow. A friend tells you youre a very
good friend, but you disqualify this
in your mind by thinking, Shes
only saying that because she feels
sorry for me. I really am pathetic.
Remediating Strategis: Keep the baby when throwing a bathtubBecome aware of your responses to positive data: Practiceacknowledging and accepting positive feedback and acknowledging good
points about yourself, others, and the world. For example, you could
override your workplace disappointment by recognising that youre the one
who got the promotion. You can even consider that the promotion may well
have been a result of your hard work
Practice accepting a compliment graciously with a simple thank you:
Rejecting a sincerely delivered compliment is rather like turning down a gift.Steer your thinking towards taking in positive experiences. When others
point out attributes you have, start deliberately making a note of those
good points
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CBT For Better Me
11. Low Frustration ToleranceIT refers to the error of assumingthat when somethings difficult to
tolerate, its intolerable. Thisthinking error means magnifying
discomfort and not tolerating
temporary discomfort when its in
your interest to do so for longer-
term benefit
Examples:You often procrastinate on college
assignments, thinking, Its just toomuch hassle. Ill do it later when I
feel more in the mood. You tend
to wait until the assignments
nearly due
You want to overcome your
anxiety of travelling away fromhome by facing your fear directly.
And yet, each time you try to travel
farther on the train, you become
anxious, and think This is so
horrible, I cant stand it
Remediating Strategis: You can bear the unbearablePushing yourself to do things that are uncomfortable orunpleasant: For example, you can train yourself to work on
assignments even if you arent in the mood, because the end result
of finishing work in good time, and to a good standard, outweighs
the hassle of doing something you find tedious
Giving yourself messages that emphasise your ability to
withstand pain : To combat a fear of travel, you can remind yourselfthat feeling anxious is really unpleasant, but you can stand it. Ask
yourself whether, in the past, youve ever withstood the feelings
youre saying you presently cant stand
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CBT For Better Me
12. PersonalizingIT involves interpreting events asbeing related to you personally and
overlooking other factors. This canlead to emotional difficulties, such
as feeling hurt easily or feeling
unnecessarily guilty
Examples:You may tend to feel guilty if you
know a friend is upset and youcant make him feel better
You feel hurt when a friend you
meet in a shop leaves quickly after
saying only a hurried hello. You
think, He was obviously trying to
avoid talking to me. I must haveoffended him somehow.Remediating Strategis: You are not the center of universeImagine what else may have contributed to the outcome youreassuming personal responsibility for: Your friend may have lost his
job or be suffering from depression. Despite your best efforts to
cheer him up, these factors are outside your control
Consider why people may be responding to you in a certain way:
Dont jump to the conclusion that someones response relates
directly to you. For example, your friend may be having a difficultday or be in a big hurry he may even feel sorry for not stopping to
talk to you.
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Thinking Errors - Summary
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Remediation StrategyThinking ErrorTurning Mountains To Hills
Catastrophising
Finding A Place In BetweenAll-or-Nothing ThinkingStep Away From The Crystal BallFortune TellingPour salt to your guesses to shrink themMind ReadingFeelings are not factsEmotional ReasoningAvoiding Part/Whole errorOvergeneralizationGiving up the rating gameLabellingThink FlexiblyMaking DemandsKeep an open mindMental FilteringKeep the baby when throwing a bathtubDisqualifying All The PositiveYou can bear the unbearableLow Frustration LevelYou are not the center of universePersonalizing
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Mindfullness Meditation For Self Awareness
CBT For Better Me
DescriptionConceptMindfulness is the art of being present in the moment, without passing
judgement about your experience. Keep your attention focused onHERE AND NOW AND YOU. Suspend your judgement about what youre
feeling, thinking, and absorbing through your senses. Simply observe
whats going on around you, in your mind, and in your body without
doing anything.
Be present in the moment
You can develop your mindfulness skills and use them to help you deal
with unpleasant thoughts or physical symptoms. If you have socialanxiety for example, you can develop the ability to focus away from
your anxious thoughts (Watching a train carrying your anxiety passing
by or watching cars in a road)
Let your thoughts pass by
Given that many of the negative thoughts you experience when youre
emotionally distressed are distorted and unhelpful, youre much better
off letting some thoughts pass you by, recognising them as symptoms or
output of a given emotional state or psychological problem. Becoming
more familiar with the thoughts that tend to pop into your head when
you feel down, anxious, or guilty makes it easier for you to recognise
them as thoughts and let them come and go, rather than treating them
as Facts
Dont listen much to
yourself
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CBT In Practice
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CBT In Practice With Solutions
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CBT In Practice Example
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CBT For Better Me - Handout
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ActionBehaviorConsequencesDispute - Effect
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Activating events
Beliefs
Consequences
Dispute
Effect
AE D C B
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Activating events
-Beliefs-Behaviors
Consequences
Dispute
Effect
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AE D C B
25 4 1 3
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Activating events
-Beliefs-Behaviors
Consequences
Dispute
Effect
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AE D C B
5 4 1 3 2
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Activating events
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Beliefs-Behaviors
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AE D C B
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Activating events
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Consequences
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Effect
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Activating events
-Beliefs-Behaviors
Consequences
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Activating events
-Beliefs-Behaviors
Consequences
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Activating events
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Consequences
Dispute
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Activating events
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Dispute
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Activating events
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Activating events
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Activating events
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2012
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