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 CBT Web Scraper.
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: