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The C in CBT – why do we need to look at my cognitions (thoughts)?

One of the core components of Cognitive Behavioural Therapy is exploring cognitions, also known as your thoughts. CBT often comes under criticism for the way in which it focuses on this internal process, suggesting that in some way it lays too much responsibility within an individual and is critical of peoples thinking processes. And whilst this is a valid and useful argument, it does not reflect the full picture and CBT can in fact be a very compassionate and person centred therapy.

It is estimated that we have around 50-80,000 thoughts per day, which is a huge amount. Many we won’t even pay any attention to and they will float in and out of our consciousness without causing too much of a stir. However, some of these thoughts can become rather tricky. This may be because of their content, the frequency with which they pop into your mind, their intensity and what they may compel you to feel or in fact do in response to them.

The language that is often used in CBT around thoughts may be the thing that gives it a mixed reputation: ‘Negative Automatic Thoughts’ and ‘Thinking Errors can imply that there is something wrong with your thinking and that you are in some way responsible for this. However, what we are really looking to explore are the thoughts that are causing you distress and ones you would like to learn to respond differently to. For that reason, ‘unhelpful thoughts / thinking patterns’ may be a gentler compromise when referring to our thinking.

Depending on the type of difficulties you are facing and the types of thoughts you are struggling with, the focus in CBT will vary. However, it is often helpful to understand the types of thinking patterns that we may be vulnerable to falling into. These include:

  • Catastrophising
    Assuming, often with great certainty, that the worst is going to happen or over emphasising the negative outcomes of an event.
    ‘Well that was completely disastrous’.
  • Judgements
    Making judgements rather than noticing facts.
    ‘No one likes me’, ‘I’m pathetic’.
  • Black and white thinking
    Thoughts that are very all or nothing, good or bad and not being able to see the in-between.
    ‘Everything at work is bad’, ‘I never get anything right’.
  • Predicting the future
    Making assumptions that we know what is going to happen in the future on what a specific outcome is likely to be
    ‘I will definitely fail at this’.
  • Mental Filter
    Filtering what we notice and dismissing anything that goes against what we want to believe, normally focusing only on the evidence that supports the negative rather than noticing the positives, or dismissing them if they are noticed.
    ‘I’m absolutely terrible at this and never get it right’, ‘That time didn’t count, it was just a fluke’.
  • Mind-Reading
    Making assumptions about what someone else is thinking and what their intentions are.
    ‘They are doing this on purpose to wind me up’.
  • Compare and despair
    Viewing only the positive in others and only the negative in ourselves. Always comparing ourselves to others unfavourably.
    ‘They are so confident at public speaking; I am useless in comparison’.
  • Critical self
    Critical self-talk – berating, blaming and shaming ourselves and often taking too much responsibility for things that have happened.
    ‘You should be so embarrassed. Everyone thinks you’re a complete idiot’.
  • Should and must
    By using these words, we place a lot of pressure on ourselves, set high (often unrealistic) expectations and are likely to be critical if we do not meet them.
    ‘I should be able to get everything done perfectly all the time’.
  • Emotional Reasoning
    Confusing how we feel with fact.
    ‘I feel scared so therefore there is something scary about to happen’.
  • Memories
    Making judgements on a current situation based on a memory of a previous situation.
    ‘This is absolutely going to go wrong again’.

Although CBT does not suggest that thoughts are the root cause of all problems, because often the emotion or physical response may precede it. However, they are certainly seen as a key factor in maintaining emotional distress. If you find yourself falling into any of the traps above and they are having a detrimental impact on your emotional wellbeing or quality of life, CBT might be a helpful approach for you.