Cognitive behavioral therapy is one of the most widely accepted treatments for depression. It is a combination of cognitive therapy and behavioral therapy that are used to modify a person’s thought patterns. The idea behind CBT is that symptoms of depression are caused by a person’s distorted beliefs that lead to an inappropriate way of reacting to negative stimuli.
The word “cognitive” is derived from “cognition”, which means “the psychological result of learning and thinking perceptions”. The proponents of this idea stress that each person has a predominant way of thinking. A negative or dysfunctional thought process affects not only feelings and temper; it manifests itself in all aspects of a person’s life and character. The aim of the therapist is to help the individual recognize negative thoughts and learn to evaluate and modify the feelings arising from these ideas. The procedure, therefore, is meant to retrain an individual’s pattern of behavior in reaction to various stressors and suggest different coping mechanisms.
How does cognitive behavioral therapy (CBT) work?
In order to understand how the therapy is conducted, you need to understand what depression is according to CBT practitioners. It is normal to be sad or depressed for any loss or unpleasant events in our lives. However, in some cases or individuals, this feeling of sadness becomes so powerful that it starts interfering with their normal lives over prolonged periods of time. It is often accompanied by feelings of helplessness and worthlessness. The individual is sucked into the vortex of depression, unable to cope with routine tasks such as eating, sleeping, or maintaining general cleanliness.
We all face some negative stimuli or stressors in life, and our brains have developed various mechanisms in dealing with these stressors. What differs is the way individuals react to stress. While some people might choose to drink alcohol in response, some will become depressed. It is a form of retreat by the brain, like burying your head in the sand and hoping that the problem goes away. The individual loses motivation and the will to perform. However, as we already know, this strategy never works, but instead, only exacerbates the problem that started it all.
With CBT, cognitive therapy is important for the identification of a person’s thoughts and moods. This stage typically involves a professional’s keen listening to the individual’s perception of the world to pick out the key thoughts that may have led to depression. It can be a certain life event such as the loss of a job or a close friend. A person's thought process is then analyzed to establish the pattern he or she follows and the ways in which it determines his or her behavior. Once the pattern is recognized, the therapist trains the individual to actively interfere and resolve the course of his or her thinking.
The next stage is behavioral therapy where the findings in cognitive therapy are used to create new patterns of behavior. In the case of the loss of a job, the therapist may encourage the depressed individual to go out and look for a new job. It is the therapist’s role to effectively motivate the patient into retraining their mind. The individual is taught to choose positive action-oriented behavior over the negatives of fleeing the situation or mourning over the loss.
Some of the negative thought patterns that need to be effectively managed include:
- Disqualifying positive events – a depressed person is more likely to ignore a positive stimulus by stating it doesn’t count. This tendency is very common in individuals prone to depression, having an innate fear of being happy. Without realizing it, they push away a happy occasion, belittling its importance or entirely overriding it with some weak but negative stimuli. It falls upon the therapist to teach them to accept happiness and learn to enjoy it without giving way to anxiety.
- Overgeneralization – A few bad experiences can ruin the worldview of these individuals. They superimpose a previous course of events on current challenges, predicting failure. Statements such as, “I am a failure!” or “I can never do anything right!” predispose them to gear up for the debacle that they expect to follow. It is important to make people see more than just the big picture and to concentrate on every aspect of the problem. The therapist teaches them to overcome generalization of events and treat each task as a stand-alone opportunity, whose success or failure depends entirely on their reaction. Learning that it is completely under their control to take the necessary steps to succeed can help them overcome depression.
- Taking things personally – Another major issue with people who have depression is that they see the whole world as their enemy. Out of the insecurities stemming from childhood deprivation or failed relationships, they start believing that no one likes them. The therapist works to develop a positive self-image in the individual, along with the understanding that no one is actually out to get them or against them.
- Absolution – Depressive individuals are perfectionists in their right. They aim to achieve the absolute best, and anything less than that disappoints them leading to feelings of dissatisfaction. If they score a 90 percent, they will brood over the missing 10 percent. If an area of their life is falling short because of their unrealistic expectations, they are incapable of enjoying the success of others. The idea is to instill that a situation may be less than perfect, but totally enjoyable. Instead of thinking about the world in black and white, we ought to consider all the colors in between.
- Pessimism – concentrating only on the negative can demoralize people if they dwell on it for too long. Unfortunately, some of us learn to overemphasize on failures and develop a vision that magnifies disparities. This pattern of thinking eats away on the motivation and the will to make things better, pulling us further into depression. Over time, an individual can be trained to disregard the unpleasantness and emphasize on the good in any given situation.
How effective is it?
CBT is still a relatively new approach to managing depression, but the results by many psychologists who have used it are overwhelmingly positive. Not only is the process effective, but it also doesn’t take too much time either. A typical psychoanalysis treatment plan involves discussing deep-seated problems that go back years and may take numerous sessions to uncover. CBT, on the other hand, involves spotting the current negative behaviors and correcting them as quickly as possible. Therefore, CBT therapy can take about 10–20 sessions for the problem to be resolved.