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Cognitive Behavioral Therapy
What You Think May Not Be What You Feel
Here’s what cognitive-behavioral therapy needs to pay greater attention to.
Posted October 24, 2018
One of the first things I do when meeting with clients who want to repair deficits in their self-image is to help them identify precisely what these deficits are. And to better assist them in their personal exploration, I hand them a sheet that pinpoints well over 100 negative beliefs common to individuals I’ve worked with over the past 40 years.
What’s pivotal for these clients is that they painstakingly read the instructions at the top of the page: namely, “Circle all the negative thoughts about self that feel at some level valid (i.e., may have gotten “programmed” into you)—whether or not you actually believe they’re true.” That is, although rationally, or objectively, they may not think an adverse self-referencing belief actually applies to them, their response needs to be based on whether in some way it subjectively feels true to them.
And the way clients react to this inventory can vary widely.
I once saw a man holding a prominent governmental position who, despite his willingness to share bothersome personal issues with me, balked when I suggested he fill out my Negative Beliefs form. After all, his career was one of outstanding accomplishment. I was still taken aback when he literally threw the sheet back at me in protest. All the same, a month into his therapy, sheepishly (and much more humbly) he requested I show him the form again. Immediately—and with surprising vigor—he proceeded to circle about 20 of the items listed.
In another case, a woman who’d been physically and emotionally abused by both her parents throughout childhood scanned the form and—with a half-smiling, wrinkling grimace—said that it would take a lot less time if she simply circled the items that didn’t characterize flaws or shortcomings in her self-image.
If there’s a “moral” to these examples (and I could provide many more), it’s that most of the time, unless we’re directly confronted with old, never-rectified negative beliefs about ourselves, we’re not all that aware of them (if we’re conscious of them at all). Only in particularly distressful moments are we forced to recognize the still-vibrating vestiges of burdensome self-doubts, misgivings or mistrusts we’ve been carrying much longer than we realized. And generally they relate—deep down—to not feeling good enough, attractive enough, smart enough, lovable enough, and so on.
Enumerating all these (mostly unconscious) negative self-beliefs goes beyond the parameters of this post. (A few of my earlier posts describe them in more detail: “I Feel Like a Child Syndrome"; “The Programming of Self-Sabotage"; “Gullibility: How Vulnerable Are You to Being Duped"; and “9 Ways Your Old Programming May Be Holding You Hostage.”
Quoted below is one of the more concise characterizations that I’ve seen (though perhaps slightly exaggerated) of what I’m describing:
Most of our thoughts and beliefs about the world are formed on a subconscious level, from the ages of 2 to 7, when learning is subconscious. It is at this time that a child’s perceptions of the world [and themselves] are downloaded and formed. (from Factinate)
The ramifications of this statement are, frankly, enormous. And abundant academic research has corroborated them. (See the pioneering Self-Esteem: Paradoxes and Innovations in Clinical Theory and Practice, 2nd ed., 1995, American Psychological Association.)
Lingering questions that secretly, or not so secretly, we harbor about ourselves show up in almost every area of our lives. It explains how people who’ve become rich and famous are still vulnerable to taking their lives. Regardless of the acclaim they’ve received, they still view themselves harshly—as an impostor or fraud; as undeserving.
Joel Rose, co-author of recently suicided Anthony Bourdain, wrote of his longtime friend: “He thought he was getting away with something.” And that mournful observation typifies how outward success may not translate into inner, enhanced self-esteem.
Another example here might be a former client of mine who’d distinguished himself at Stanford University by completing his M.A. and Ph.D. in a record two years—but still felt stupid (as circled on his Negative Beliefs sheet). For though, as the adult and eminent academic scholar he’d become, he knew intellectually that this wasn’t true of him at all, this regrettable aspect of his self-regard yet rang true for him. Why? Because that was the shaming message drummed into him by his parents because of his independent, strong-willed nature, which was extremely disturbing to them for it was totally beyond their ability to control.
One limitation of conventionally practiced cognitive-behavioral therapy is the central tenet that how we think, or what we believe, determines how we feel. That is, if you think you’re in danger, you’ll feel fear; treated rudely or unfairly, anger; estimate your prospects as hopeless, depression or despair. But if as a child you were traumatized, or otherwise seriously abused or neglected, and still haven’t been healed from such psychological wounds, your negatively sensitized child self will continue to believe that which, as an adult, you no longer regard as valid. So if, much earlier you concluded that you were weak or unworthy, then regardless of how many times you may later have demonstrated strength, courage, worth or value, you may still feel—in your gut, as it were—just as weak and worthless as you did long ago.
The modified cognitive-behavioral therapy required here is for your “outer adult” to gain access to your “inner child." Then what needs to happen is that the older part of you is able, step by step, to convince the younger part that the assumptions they made and the conclusions they came to about themselves—though definitely understandable, and quite possibly adaptive at the time—have been proven false. The child within you needs to learn that at that earlier age, with their limited cognitive development, they couldn’t help but take personally anything they interpreted as negatively directed toward them. Their sense of inherent worth, or even their very identity, was heavily influenced by the messages they got (or at least thought they were getting) from their family.
Put a little differently, the basic thesis that your feelings are caused by your thoughts is accurate enough—as far as it goes. But this premise must be qualified through better understanding that when such an assertion, however logical, doesn’t seem to fit, it’s because your adult thoughts don’t cohere with feelings still maintained by your child self. Or, to state it in a complementary way, it’s because your adult thoughts differ significantly from your child thoughts, which were never amended.
Such a mismatch can be understood and resolved only when you fully grasp the discord between thoughts that emerge from you today as not coalescing with thoughts still emanating from your (just below the surface) younger self. For this is what has led your current feelings to be so disturbingly out of sync with your much more reasonable present-day thoughts. In brief, your never having reprocessed, or rectified, earlier unfavorable thoughts about yourself are what has eventuated in your irrational, self-disparaging adult feelings.
How else, after all, could you know for absolute certain that you’re not stupid, yet nonetheless feel stupid?
In fact, a key aspect of therapy relates to updating your self-image to reflect the fact that as you aged you developed skills, resources, and competencies that may have been absent, or underdeveloped, much earlier in your life. So if there are significant discrepancies between what you’ve achieved, or how well you relate to others, with how you actually feel about yourself in these (and other) areas, it may be time to explore what from your past you’re subconsciously still holding onto. For your outdated self-image may be what’s preventing you from the unconditional self-acceptance that you—and, however covertly, everyone else—yearns for. And which, till now, has eluded you.
In a post like this, I’m limited in how adequately I can cover this crucial topic. But one of my earliest posts for Psychology Today—"The Path to Unconditional Self-Acceptance"—outlines how, with or without professional assistance, you can start resolving inner conflicts that have their roots in the past, perhaps going all the way back to early childhood. And there’s an abundance of articles and books well worth consulting on this topic as well (e.g., Reinventing Your Life by J. E. Young & J. S. Klosko or Self-Therapy by J. Earley). So there’s no good reason to abandon hope if you’re been struggling for what might seem an eternity to feel better about yourself—and the world you live in.
© 2018 Leon F. Seltzer, Ph.D. All Rights Reserved.
