If you’re someone who struggles with anxiety, the process of finding a therapist can feel overwhelming. Since therapists often specialize in treatment methods, finding the right type of therapy for you is the best way to get started.
Cognitive behavioral therapy (CBT) is a popular and proven technique to treat anxiety disorders such as generalized anxiety and social anxiety. CBT is a short-term treatment aimed at developing skills to help you alter emotional responses that are harmful to your wellbeing. Your therapist will help you change the thoughts and behaviors that trigger or worsen your anxiety. Because thoughts come before feelings, and feelings lead to actions, changing your thoughts can reduce or eliminate your negative emotions and unhealthy behaviors. In other words: thought → feeling → behavior. If you can change your thinking, your feelings and actions will change, as well. CBT does this by using a three-step process.
For an example of how the CBT process works, let’s use a thought someone with social anxiety might have: “I feel so awkward at parties. Everyone must think I’m a loser.” This thought may lead to feelings of sadness, shame, and fear. You’re ashamed of how you act at parties, sad that people think you’re a loser, and feel anxious at the thought of attending a party. These feelings then lead to behaviors like isolation and avoidance, which make you feel worse.
In CBT, a thought like that is called emotional reasoning: “I feel it, so it must be true.” But feelings are not facts. Just because you feel awkward at parties doesn’t mean other people think you’re awkward.
Emotional reasoning is an example of a cognitive distortion. Cognitive distortions are irrational thought patterns that lead to an inaccurate perception of reality. It’s your mind convincing you that something is real when it isn’t. CBT is designed to treat the most commonly occurring cognitive distortions, including emotional reasoning.
A CBT-trained therapist will take you through three steps to reduce or eliminate the distortion:
Step 1: Identify the negative thought
In this case, the thought is, “I feel so awkward at parties. Everyone must think I’m a loser.” In a CBT session, it may take some time to uncover this thought. At first, you might talk to your therapist about your feelings toward going to parties, and how you feel when you attend one. Together, you’ll find the root thoughts behind your anxiety and tackle each one separately.
Step 2: Challenge the negative thought
Your therapist will help you question the evidence for your thought, analyze the belief behind it, and reality test it. For example, you might talk about the time in middle school someone called you a loser and how it has shaped your self-esteem. Then you’ll discuss why you feel awkward at parties. Finally, you’ll test your negative thought by separating your thoughts and feelings from reality. You may feel uncomfortable at parties and assume people dislike you, but they wouldn’t invite you if they thought you were a loser, and you get invites all the time! Your thoughts and feelings aren’t based on facts.
Step 3: Replace the negative thought with a realistic one
If you try to change your negative thought into its opposite extreme, the new thought won’t stick in your mind for long. “Everyone thinks I’m the coolest person in the world” also fails the reality test. It will quickly fall apart, which will send you hurtling back to the negative thought. Instead, you want to find a realistic thought that passes the reality test. For example: “Just because I feel awkward doesn’t mean other people see me that way.”
In CBT treatment, you’ll learn about more cognitive distortions and repeat this three-step exercise for other negative thoughts you have. When you practice challenging your negative thoughts and replacing them with realistic ones, it’ll become easier to identify distortions before they hurt you. With CBT, practice makes perfect and perfect is a life without debilitating anxiety. Finding a therapist who is familiar with CBT is a good place to start when looking for help with your anxiety.