The Most Important Thought Is The Next One – The Use of CBT in Therapy

At the heart of Cognitive Behavioural Therapy (CBT) is the concept of the Cycle of Behaviour. This simply states that every emotion stems from an initial thought. This, in turn, results in behaviour, as illustrated here:

Our emotions can feel so intense and immediate that we don’t often notice that we had a thought first. For example, when a car cuts across us in traffic we might get a fright and panic or we go into what feels like immediate rage, beeping the horn and waving a fist. Yet the first thing that happened was you noticed what was happening and you thought, “That car is cutting across lanes.” This has neither a positive or negative value – it is a neutral fact. Challenges arise for us, as individuals, when we feed these facts through the prism of our life experiences and habitual patterns and we put a negative spin on them. When using CBT in therapy, we are seeking to identify thoughts that result in unhelpful feelings. We then slow down the process to create the necessary space between the two to insert a new strategy.

This can feel impossible at first. During stressful moments and events, many of us tend to experience our heads as a chaotic swirl of thoughts and the various what ifs seem to overrun our mind like a baying mob pouring through a doorway. However, if we can slow the process down sufficiently, we realise that we can choose to control that doorway. In actuality, no matter how busy our heads might feel, we can only think one thought at a time. The feeling of chaos and overwhelm stems from the speed at which that flow of thoughts is allowed to move, unchecked, through our head.

The successful use of CBT can be imagined as teaching clients to put a bouncer on that door tasked with putting order on the queue. Each thought is stopped and subjected to what is known as the Three C’s:

Catch the thought – identity those that are troublesome or distressing .
Check the thought – ask yourself if it is accurate / helpful / important to act upon.
Change the thought – if it is not helpful or requiring action, it is turned away.
In much the same way that a bouncer might send someone home to put on a smarter pair of shoes, we ask these unhelpful thoughts to change into something that serves us in a more positive way before coming back and trying again. By changing the thoughts that move through the doorway, we change the resulting emotions and ultimately change our behaviour patterns to those that are positive and representative of our true values.

Colin Heffernan provides a range of psychotherapy and counselling methods for his clients, including CBT Ballintemple Cork