As a psychotherapist, it is important to choose a theoretical orientation that fits with your personal viewpoints and beliefs. The better your theory fits your practice, the more congruence you will have in the clinical setting. I use cognitive behavioural therapy because, after studying neuroscience, I have come to the belief that the human mind has the ability to change and adapt to nearly any circumstance. I also believe in the power of strength and resiliency. Cognitive behavioural therapy gives the client’s strength back to them and encourages and enables thinking in a positive and healthy manner.
The philosophy behind cognitive behavioural therapy originated in Greek stoicism over two thousand years ago. The Stoics believed in logic and rationality, and the power of the human mind’s ability to help us comprehend the world around us. One of the keystones of Greek Stoicism was the belief that our rational actions are what separates us from animals, who only perform irrational actions. It also believed in treating others fairly and the importance of human cooperation. Funnily enough, one could trace my own initial draw to CBT back to Greek stoicism. I have always believed in the power of rationality when it comes to regulating your own emotions as well as improving healthy communication with others. In the 1950’s, behaviourism emerged as a key concept of modern psychology with a scientist named George Kelly created one of the first cognitive models using personal constructs. Kelly theorized that people’s beliefs affect changes in behaviour. During the 60’s, a talented psychologist by the name of Aaron Beck began researching depression, and came to see negative biases in people’s cognitive processing, which many would argue was the beginning of true cognitive behavioural therapy. Albert Ellis contributed to Beck’s work, conducting studies that showed that people can consciously adopt reason. In the 1970’s, cognitive behavioural therapy began getting more attention within the field of psychology, being especially notable for its simplicity and transparency and in the eighties, CBT more or less became defined how it is today.
Cognitive behavioural therapy is arguably the most evidence-based therapy. Coming from a background of psychological research, my views are cemented in empirical evidence and fact. My father is a scientist and I was raised to value the scientific process. Although I certainly see the worth in other forms of psychotherapy, I feel comfortable using a therapeutic technique that has been tested and proven effective. CBT is one of only two therapies (the other being interpersonal therapy) that psychiatric residents are trained in.
I believe that personality begins to develop from a very young age and that it is affected by a combination of both genetic and environmental factors. My belief is that individuals are born with a genetic code but that their environment has the potential to bring about an infinite number of outcomes from that initial information. In an ideal world, very few people would have mental health issues because their genetic potential for them wouldn’t be triggered. I believe that very few mental health issues would arise in an ideal developmental environment, however, there are certain chemical or genetic diseases that may be inevitable. That being said, I believe that the majority of psychological problems develop from environmental factors. I think that personality disorders are often a result of childhood or adolescent experiences – usually trauma, whereas mood disorders, such as depression and anxiety, often have a genetic potential but are activated by external factors. These external factors could be an infinite number of things that create a domino effect or a specific traumatizing event. One of the main components that affects the manifestation of mental health issues or illnesses is our interpretations of them and our cognitive processes.
Cognitive behavioural therapy works to empower the client. It sees the client as the expert, and helps guide discussion to allow the client to discover more about themselves. With this in mind, CBT emphasizes learning and psycho-education. I believe that personal growth is incredibly important and that all humans possess the ability to change. I also believe that each person is valuable and deserving of respect. This viewpoint fits well with CBT, which sees the relationship between client and therapist as an equal partnership, wherein both parties engage in active exploration together. I believe that putting the power in the hands of the client gives them autonomy and confidence. The act of giving the client knowledge and information puts more balance between client and therapist, and helps the client to understand his or herself without the help of another.
One way I believe change occurs is through the shift of unhealthy cognitive processes which we call cognitive distortions. Cognitive distortions are rationales or ideas that are inaccurate or untrue, often used to reinforce negative thoughts and emotions. For example, drawing a conclusion without any evidence or creating a general rule from one or a few isolated incidents and applying it to many other unrelated situations. Cognitive distortions cater to unhealthy or negative thought patterns and emotions and play a huge role in created or exacerbating problems. CBT targets cognitive distortions and unhealthy thinking.
While helping with reshaping cognitive distortions, the cognitive behavioural therapist also engages in active listening, unconditional positive regard, empathy, congruence, open-mindedness and flexibility. I am a firm believer in all the above, but especially empathy. The act of empathy assists in justifying the client’s emotions and helping them to feel less alone in their struggle. CBT also emphasizes the present, instead of looking in depth at the past. I genuinely believe that nearly everyone has the capacity to change. CBT often lasts 14 to 16 weeks, which means that it views the client as also being able to change – whereas other therapies may suggest treatment indefinitely. CBT aims to give the client the tools to continue growing and bettering themselves on their own.