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Cognitive Behavioral Therapy

Four Common Myths and Misconceptions About CBT

Forget the fiction and learn the facts about CBT.

Myth: CBT is mechanical and too technique-driven.

Fact: While it’s true that CBT has many tools in its toolbox and looks to scientific evidence when available, it is far from mechanical. Indeed, CBT, like all effective psychosocial therapies, prioritizes the therapeutic relationship, rapport, and a working connection. As Dr. Arnold A. Lazarus has been saying for decades, “The therapeutic relationship is the soil that enables the techniques to take root.” Thus, the cultivation and evolution of a trusting and honest therapeutic alliance is the essential foundation of CBT. What’s more, knowing precisely when and how to best use the specific methods in the CBT toolbox in a manner that is uniquely suited to a given client is far more “organic” than “mechanical.” In fact, a CBT expert understands the importance of a good fit between the client and therapist and will likely refer someone to a colleague when the fit doesn’t work.

Myth: CBT only treats symptoms, not the whole person.

Fact: When done properly, CBT, almost by definition, treats the whole person and is not just about symptom reduction. This is because CBT conceptualizes many of the problems that people have as “biopsychosocial” processes. This means that people have a physical body that can have physiological or metabolic problems (i.e., the “bio” in biopsychosocial). We also have a mind, emotions and sensations (i.e., the “psycho” or psychological aspect of biopsychosocial). And, very importantly, we are social beings whose relationships and interpersonal connections are vital parts of our lives (i.e., the “social” in biopsychosocial). So, while symptom reduction is certainly among its goals, CBT’s success comes from treating the whole person.

Myth: The past is unimportant.

Fact: Cognitive-behavioral therapists are very interested in their client’s history and past experiences. Obviously, our life experiences shape and influence us to be who we are in the present. But unlike traditional psychotherapy, which places tremendous emphasis on the past and tries to provide insight into it, CBT, by analogy, takes a good look in the rearview mirror but doesn’t drive while staring into it! Rather, a good CBT practitioner will endeavor to understand the social and psychological learning history of his or her clients so as to thoroughly assess past factors that might still be therapeutically relevant.

Myth: CBT is limited by available scientific evidence.

Fact: While it’s true that CBT tries to set its course with the compass of research findings, it is by no means limited by available scientific data. Indeed, as is the case with most psychotherapy approaches, CBT involves a high degree of creativity and artistry. Unlike most other psychological therapies, however, CBT tries to marry its artistic aspects to science as much as possible. Hence, in addition to understanding the empirical underpinnings of techniques and methods, a cognitive-behavioral therapist will often use some form of data to drive and gauge treatment (e.g., mood and thought records, assessment questionnaires, monitoring of specific behaviors or sensations, etc.). As noted above, the artistry in CBT often involves knowing how and when to best implement techniques and how to optimally help clients without over-challenging them (i.e., correctly determining where a person is on the readiness-for-change spectrum). To paraphrase Professor Gordon Paul, CBT requires a clinician to know what to do, when to do it, how to do it, and whether or not he or she is the right therapist to do it. All while helping to create and remain firmly planted in the soil of the therapeutic relationship.

Remember: Think well, act well, feel well, be well!

Copyright by Clifford N. Lazarus, Ph.D.

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