What is Cognitive Behavioral Therapy?
If you’ve ever been in therapy for anxiety, or if you have been searching for a therapist for anxiety, you may have heard of Cognitive Behavioral Therapy (also known as CBT). Cognitive Behavioral Therapy is a type of counseling for anxiety that emphasizes the connection between our thoughts, feelings, and behaviors. While CBT is most often known as a treatment for anxiety, it is also highly effective for treating depression, grief, trauma, relationship distress, and more.
In this blog post, I’ll go over what Cognitive Behavioral Therapy is, provide insight to help you determine if CBT is the right treatment method for you, and give examples of how you can begin to incorporate some basic CBT practices in your everyday life to manage anxiety or other distressing emotions.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy is a type of talk therapy that is often practiced by therapists who specialize in anxiety treatment. CBT incorporates mindfulness as we start to bring conscious awareness to our thought patterns and understand how our thoughts impact our feelings and behaviors. Basically, our thoughts play a pretty significant role in how we feel and behave. Our thoughts, feelings, and behaviors are all connected. The idea is that if we gain control over our automatic thought patterns (which are usually unconscious), then we can change how we feel. When we feel better, we will likely behave differently (in ways that support our mental health), and when we change our behaviors, we feel better.
An example could be making a mistake at work. If you make a mistake and you have the thought “I’m such an idiot”, this thought will likely lead to you feeling ashamed, anxious, embarrassed, etc. If you begin to notice how this thought negatively impacts your feelings, you can change this thought to be more supportive and motivating, such as “I made a mistake, I’m human. I’ll learn from this”. The shift with this inner-dialogue can make a significant difference in how you feel. The second thought is self-compassionate, while the first thought is rooted in shame (and often times perfectionism).
How Does CBT Help With Anxiety?
The root cause of anxiety often stems from unhealthy and unhelpful thought patterns. When we catastrophize (imagine the absolute worse case scenario), ruminate, make assumptions, or overanalyze, this can cause a significant (and unnecessary) amount of distress and anxiety. When we become conscious of our thought patterns and how our thoughts negatively impact our mood, we can then begin to challenge those thoughts and create more helpful and positive thoughts to lessen anxiety (or better tolerate other emotions). When you are aware that your thoughts are heavily contributing to your anxiety, you can begin to consciously change your negative inner-dialogue to become more helpful and supportive. Helpful thought patterns will cause you to feel more at ease and/or peaceful.
While journaling has many benefits to reducing anxiety, it can also be helpful to start bringing awareness to your thoughts and implementing a CBT practice. A few journal prompts that are CBT-focused can be:
What thought am I having right now?
How is this thought making me feel?
How do I want to feel?
What thought is going to support the way I want to feel?
Is there another way to look at this situation, or a more helpful thought to have about this?
The idea is to first catch the thought (become aware of the negative or unhelpful thought), then check the thought (is this thought helpful, or is it unhelpful?), and if it is unhelpful, change the thought. You can remember this method by knowing it as the “Three C’s” - catch it, check it, change it.
This is also why stating affirmations and practicing gratitude is so effective. By consciously choosing to incorporate healthy and positive thought patterns, we can gain more control over how we feel.
This isn’t to say you can get rid of anxiety or other emotions. They will always be there because you are human, and some people are just more prone to anxiety than others. But CBT is one of the many tools that can help you feel more empowered in managing your anxiety in a healthy way.
How is CBT Used in Therapy Sessions?
Many thoughts are so engrained that we don’t even realize how unhealthy they are (or how much they impact our anxiety). A therapist who is trained in CBT can help you identify unhelpful thought patterns (when you are ruminating, thinking in black and white/extremes, catastrophizing, etc) and guide you towards a new perspective that challenges those unhelpful thoughts. Many thoughts that trigger anxiety are irrational, but it can be hard to distinguish irrational from rational thoughts when a certain “way of thinking” has been the norm for so long. A therapist can also help you identify where the unhealthy inner-dialogue stems from (it can often be internalized from parental figures, society, or elsewhere) to help you understand the origin of these thoughts and detach yourself from them.
A CBT therapist might provide homework assignments for you or simply ask that you be mindful of your thoughts outside of session, and practice challenging these negative thoughts (whether through journaling/writing them out, or just practicing shifting your thoughts in your mind).
How Long Does It Take For Cognitive Behavioral Therapy to Help Anxiety?
When it comes to CBT or any type of cognitive restructuring, you are creating new neural pathways in your brain that are not yet automatic. The automatic thoughts you currently have have likely existed for a while (many thought patterns go all the way back to childhood), and it takes time and repetition to form new neural pathways in your brain. As you make this a conscious and regular practice, the positive and helpful thoughts will become automatic. So while this is initially a conscious practice that times time and effort, it will eventually become your new way of thinking. Practicing cognitive-behavioral exercises (like the journal prompts above) can often provide immediate relief for anxiety by creating a shift in perspective, and therefor reducing the intensity of the anxiety in the short term. With a regular CBT practice, your baseline level of anxiety should be reduced in the long term. Changing your inner-dialogue isn’t something that happens over night, but CBT can definitely provide long term benefits for managing anxiety.
What Other Treatment Methods Help With Anxiety?
Anxiety should be treated with an eclectic approach — meaning we ideally want have a wide range of techniques available to us for anxiety management. Because emotions are stored in the body, anxiety treatment should also incorporate a somatic practice, which can include yoga, mindful walking, exercise, or any type of movement. Meditation is also excellent for managing anxiety because of it’s physical impact on the brain. With regular practice, meditation has been shown to reduce the size of the amygdala, which is the part of the brain where our emotions are activated. With the reduction of the amygdala, we are better able to access the part of the brain (pre-frontal cortex) that is in charge of logical thoughts and decision making. This is incredibly important for anxiety management because when we can easily access the pre-frontal cortex, we are less likely to go into a fight-or-flight state from our anxious thoughts and emotions.
Practices that soothe the nervous system should be incorporated on a regular basis. Deep breathing, mindfulness, spending time with loved ones, reading, laughter, play, etc. are all things that can bring joy and pleasure to our lives. Rest is not a luxury — it is a necessity! When you actively do things that bring you joy, you are giving your nervous system a break from the stress of life and allowing your mind to be in the present moment. This is why gratitude and mindfulness practices are so good for us — they reduce our anxiety symptoms and remind us of what’s truly important to us!
Other types of therapy that can be helpful for anxiety are Acceptance & Commitment Therapy (ACT), Mindfulness-Based Therapy, Humanistic Therapy, Existential Therapy, Psychodynamic Therapy, Experiential Therapy, and more.
How Do I Find a Cognitive Behavioral Therapist in Houston?
If CBT sounds like the type of approach you are looking for to manage your anxiety (or other distressing emotions), I recommend asking potential therapists if they specialize in anxiety and what treatment modalities they primarily use when treating anxiety. While CBT is a very effective approach for anxiety, there are a wide range of options when it comes to treating anxiety, and it can be targeted from many different angles. While there are many practices you can implement on your own to manage anxiety, a therapist can help you with identifying and implementing certain practices in a way that work best for you, and provide specific treatment recommendations for anxiety management based on your unique background and situation.
Online Therapy Services in Houston and throughout Texas
If you are looking for a Houston therapist for anxiety, feel free to explore my website to see if we might be a good fit to work together. My approach is trauma-informed, person-centered, and grounded in humanistic and existential philosophy. I work with young professional women navigating anxiety, relationship struggles, and life transitions.
Please note: this blog post is for practice updates and educational purposes only. This is not a replacement for mental health counseling or therapy.
