Cognitive therapy focuses on changing the thought patterns and behaviors contributing to depression. Unlike psychoanalysis, it deals much more with current distressing thoughts and beliefs.
Some examples of harmful thought patterns include over-generalization (drawing conclusions that are too broad) and catastrophizing (taking minor problems and making them huge). Behavioral therapy often includes learning methods to help you calm down.
Identifying Negative Thoughts
In CBT, a therapist will help you identify negative automatic thoughts and then work with you to examine those thoughts and develop healthier alternatives. For example, suppose you believe that others are judging or criticizing you. In that case, your therapist might ask you to list what evidence supports this belief and then encourage you to consider alternative ideas. Some therapists also employ behavioral experiments. In this approach, you and your therapist predict an anxiety-inducing event or behavior (like attending a networking event) and then test those predictions by participating in the activity or task.
CBT techniques like thought recording can help you learn to identify the irrational, negatively distorted beliefs that often trigger depression symptoms and self-sabotaging behaviors. Cognitive restructuring, activity scheduling, and mindful meditation are other techniques that help you reduce the power of negative automatic thoughts.
Negative self-talk and distorted beliefs can cause you to feel trapped. For instance, if you always think you’ll fail if you make any mistakes, this type of all-or-nothing thinking can lead to panic attacks and increased depression. Similarly, believing that you’re worthless or unlovable can have devastating consequences in your day-to-day life. CBT techniques like thought journaling and learning more realistic beliefs can help you feel more flexible in your thinking. This type of flexibility can reduce depression symptoms.
Identifying Negative Beliefs
Depression significantly impacts the lives of those suffering from it and their families and friends. It also imposes a financial burden on those who care for them, insurance providers, and employers. This is particularly true for individuals with severe cases of depression who are often unable to work or have difficulty keeping a job.
During cognitive behavioral therapy for depression, a therapist will help patients identify negative core beliefs and automatic thoughts contributing to their depressive symptoms. They will then teach them strategies for changing these negative beliefs and coping with the associated behaviors. The therapist may also assign homework, such as monitoring their thinking throughout the day and journaling about their experiences.
A cognitive behavioral therapy therapist will also educate patients about common cognitive distortions, such as all-or-nothing thinking, over-generalization, and “should” statements (ruminating about how things should be instead of how they are). These unhelpful patterns of thought can exacerbate depressive symptoms.
One challenge a therapist will face is ensuring they have a patient’s motivation to explore and change their thinking patterns. To increase a client’s motivation, it recommends helping them identify the distortions in their thinking, as this can make them feel less guilty about their unhelpful thoughts. This will also help them understand why they struggle with depression and anxiety.
Changing Negative Beliefs
Changing core beliefs is one of the most essential parts of cognitive behavioral therapy. Core beliefs are fixed thoughts that affect how you see the world and your decisions. Common negative core beliefs include overgeneralization – drawing far too broad conclusions based on a single event; all-or-nothing thinking – seeing events in extreme black or white terms; and unrealistically positive or negative self-talk. Changing these patterns is an essential part of overcoming depression and is one of the goals of CBT.
Your therapist will help you identify your negative automatic thoughts (thoughts that happen automatically and are often unnoticed) by asking you to pay attention to when they come up and how you feel afterward. They will then teach you to challenge those thoughts by looking for evidence that may not be accurate, such as noticing when your review is disproportionately negative or overgeneralized.
Your therapist will also help you develop more realistic and adaptive mood explanations. They may encourage you to engage in behavioral experiments, such as trying out a new behavior or activity you have been avoiding because of fear of how you react or what others might think. They will also help you learn to notice how your beliefs and actions relate to each other, as some of the simplest ways to overcome depression are to change one aspect of your life at a time.
Changing Negative Thinking
Cognitive behavioral therapy helps people unlearn negative thought patterns and behaviors. It is a highly structured treatment over a limited number of sessions and is usually used alongside other medicines, including medication.
During cognitive behavioral therapy, patients learn to recognize and challenge irrational thoughts that trigger or sustain depressive emotions or self-sabotaging behaviors. For example, one typical dysfunctional thinking pattern is called catastrophizing, which occurs when a person immediately draws negative conclusions from an event or situation and overstates them. Other distortions include all-or-nothing thinking, over-generalizing, and “should” statements (ruminating about how things should be or how they believe others expect them to be rather than as they are).
Clients also work on strategies for challenging negative automatic thoughts, such as identifying evidence that contradicts them. Eventually, therapists help clients replace them with more balanced thoughts that consider all the facts.
The goal is to reduce distressing thought patterns and behaviors, which can lead to improved mood and an overall better quality of life. The good news is that CBT has a high success rate and can have positive benefits long after treatment ends.