Cognitive Behavioral Therapy: 5 Things You Should Know About It

If you’re thinking of starting therapy, you’ve likely run into the term modality before. A modality is the approach a therapist takes when providing care for their patients. One of the modalities we utilize here is called Cognitive Behavioral Therapy (CBT). 

CBT is an approach that focuses on how our thinking patterns influence our behavioral patterns. The main idea behind CBT is that thoughts influence how we feel and act. Basically: how we act can in turn also affect how we think and feel in a given situation, and our unhelpful thoughts can then lead to unhealthy behaviors and feelings. CBT helps you to understand and break this cycle.

Here are five things you should know about Cognitive Behavioral Therapy: 

1). CBT has been shown to be effective for a wide range of presenting concerns: 

CBT is an active, goal-oriented psychotherapy treatment. As a treatment, it’s been studied and shown to be highly effective in treating a wide range of people (children, adolescents, and adults) with a wide range of presenting emotional and behavioral concerns such as: 

• Depression

• Anxiety

• bipolar disorder

• Perinatal mood and anxiety disorders (e.g., postpartum depression)

• Sleep

• Relationship problems

CBT has also been found to contribute to significant improvements in functioning and quality of life.

2). CBT has been studied extensively in both research and clinical practice. 

CBT is an evidence based treatment. What that means is that its efficacy has been proven to be safe and effective through extensive scientific and clinical research. This research involves thousands of patients and meticulous comparison of effects to alternative treatments. Evidence based treatments help increase the effectiveness of the treatment and helps reduce the risk of recurrence of damaging behavioral patterns. There’s heaps of scientific evidence out there showing that CBT is effective in producing meaningful change and improvements for clients.

3). One of the core principles of CBT is that problems with mood are related to unhelpful behaviors and thought patterns. 

These negative thinking patterns can influence our mood and exacerbate feelings of anxiety, depression, or other feelings of insecurity and self doubt. This can then contribute to a pattern of unhealthy behaviors–which in turn starts the cycle all over again. With CBT, these thought and behavior patterns are explored and new, healthy ways of coping are explored to effectively relieve symptoms and improve quality of life. 

4). Psychologists and clients work together collaboratively to develop goals and to actively target symptoms. 

Time is spent examining present-day issues, thoughts, and behaviors. For example: 

A teen who is depressed might think, "Everything is hopeless," or "There's no point to anything I do." 

Emotionally, these thoughts may occur with feelings of sadness, depression, apathy, and lack of motivation. Behaviorally, the depression may appear as increased isolation, withdrawal from usual activities, refusal to attend school, etc. However, these behaviors only reinforce the negative thinking patterns, and exacerbates the cycle of withdrawing from life due to a feeling that there’s no point in participating.  

For this, treatment would involve teaching the teen to identify and challenge negative thoughts, skills to cope with depressed mood (e.g., activity scheduling), and working with parents to develop a reinforcement system to encourage positive behaviors and use of coping strategies. CBT is highly collaborative, practical, and goal oriented. 

5). Because CBT is very goal oriented, there are many skills clients develop as part of the process. 

They are learning how to face fears, problem solving difficult situations, recognizing patterns of unhelpful thoughts and behaviors, and ways to calm the mind and body. Other skills taught as part of CBT include:

• Problem solving

• Communication training

• Cognitive restructuring aka learning to identify and dispute cognitive distortions. You can read more about cognitive distortions from these posts on our blog: 

• 8 Common Cognitive Distortions to Watch Out For

• 10 More Cognitive Distortions to Be Aware Of

• Managing Cognitive Distortions

• What is All or Nothing Thinking?

• Why “Should” Statements Make You Feel Worse

• Social skills training

• Relaxation training

• Behavioral activation aka intentionally practicing specific behaviors that promote a positive mental state, or avoid negative thinking traps. 

Are you interested in CBT? Our clinicians at Hope+Wellness offer CBT therapy in our office and online. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. If you would like to talk to one of our therapists, please contact info@hope-wellness.com.

5 Tips for Overcoming Perfectionism

Do you consider yourself a perfectionist? On its face, being perfect seems like kind of a great thing - you do everything right, there’s never a problem, and you’re happy as can be. In reality, though, the pressure to be perfect at everything you do can lead to an immense amount of pressure and distress. Perfectionism can be exhausting, but it’s possible to overcome it. 

It makes sense that we want things to be perfect. The world is a scary place for a lot of people, especially right now. On top of worrying about things like our job performance or our relationships, we’re also trying to deal with a multi-year global pandemic and facing a climate crisis. There is so much uncertainty in the world right now, and it can make you feel out of control. There’s not a lot you can do personally to end the pandemic (besides following local public health safety advice) or to fix the climate. You can’t control what the government does. You can’t control the weather, or the news, or institutional oppression, even though you may want to. So when it comes to things you can control, it’s easy to go a little overboard. You can control the way you perform your job. You control the way you keep your living space, what you eat, the media you consume. 

The problem is that perfect doesn’t exist. Everyone’s idea of what is perfect is different. There are always things at play that will get in the way of things being perfect. Focusing on perfectionism is actually a distraction. A really stressful, really high stakes distraction from the intense vulnerability or fear of not being in control. Even if you somehow manage to do everything in your life perfectly, you’d probably still find another reason to be disappointed in yourself, because the goalposts with perfectionism always change. Just when you think you’ve done it and become perfect, there’s something else to do. 

This cycle is so exhausting. If you’re struggling, know that there are some things you can do to let go of perfectionism. Here are 5 ways to shift your thinking and overcome perfectionism. 

Be curious about where it comes from 

There are other things that might play into perfectionism as well. If your caregivers demanded perfection from you in school and in your extracurricular activities growing up, it can be a hard habit to break. However, it can be helpful to interrogate where the urge to be perfect is coming from. What will happen if you aren’t perfect? Are you more concerned about letting others down, or yourself? Take some time to notice where the urge comes from. It might be helpful to journal about it or to take a walk and think things over. If the urge comes from something in your childhood, remind yourself that you’re an adult now and you get to make your own choices. It can be hard to feel like you’re letting others down, but it’s also painful to let yourself down. If it’s a need for control, try to see what happens when you let go of control for a few low-stakes things like tidying the house or responding to emails off-hours. 

Practice self-care

Over time, feeling intense pressure to be perfect can leave you feeling rotten. You might feel burned out, cynical, numb, exhausted, depleted, guilty, or even physically ill. Our bodies and minds need breaks regularly to function, so if you’re not making time to care for yourself, it will eventually catch up with you. Chronic stress can lead to all sorts of physical symptoms like gastrointestinal distress, heart problems, respiratory illness, fatigue, pain, and more. Taking some time to practice self-care can go a long way toward helping you feel better and preventing those physical ailments that come from stress. 

Notice the gray

Perfectionism can also be traced back to cognitive distortions like all or nothing thinking. Perfectionists tend to think in shades of black and white. You’re either perfect or you’re a failure. Instead of thinking in extremes, notice what’s in between. Instead of thinking in black and white, try to find the gray. Is it possible that more than one thing can be true at the same time? 

Focus on what’s going right

The thing about perfectionism is that nothing will ever be perfect, so being focused on perfection can leave you focused on what’s going wrong and keeping you from being perfect. Instead of letting yourself get swept up in negativity, focus on what’s going right for you. Taking some time to redirect your thoughts from negative to positive will help your brain learn how to do that on its own. With some practice, you will have to redirect your thoughts less and less because the full picture of positive and negative will be easier for you to see. 

Find joy in the process

Another aspect of perfectionism that’s tricky is focusing on the outcome. For perfectionists, it can be hard to see anything but the end result as meaningful. For example, let’s say you work hard for months on a project with the hopes of landing a promotion. When the project is over, you find out that you didn’t get the promotion. Perfectionists will see the lack of promotion as a failure, and decide that the whole process was a waste of time. People who aren’t perfectionists might have an easier time noticing all the good things that came from the project, like learning how to manage a team or expanding your skills. 

If that’s the case for you, try to notice the process of what you're doing and find positives in it, even if it seems silly at first. Most of life is a journey. There are very few points where we look around and feel that we’re at the peak. So make sure to learn how to find joy in the journey and the destination. 

If you're looking for more support overcoming perfectionism, our therapists are trained in modalities like Cognitive Behavioral Therapy (CBT) to help you move from feeling hopeless to feeling empowered.

8 Common Cognitive Distortions to Watch Out For

At Hope + Wellness, we used evidence-based practices to help people live happier, healthier lives where people can cope with what life throws their way. One of the treatment modalities we use is called Cognitive Behavioral Therapy, and we find it to be extremely helpful for challenging negative thought patterns and changing your way of thinking. Cognitive Behavioral Therapy, or CBT, is an active, goal-oriented psychotherapy treatment. CBT has been shown through research to be highly effective in treating children, adolescents, and adults with a wide range of emotional and behavioral concerns including depression, anxiety, bipolar disorder, perinatal mood + anxiety disorders, sleep challenges, and relationship problems.

One of the pillars of Cognitive Behavioral Therapy is identifying patterns in your thinking to get to the bottom of your negative thoughts. These patterns are called cognitive distortions. A cognitive distortion is a faulty way of thinking that we learn to believe is true. Cognitive Behavioral Therapy helps to identify cognitive distortions so you can challenge your negative thought patterns and not let them control your life.

The first step to challenging your cognitive distortions is to be able to spot them. Here are 8 common cognitive distortions to watch out for:

All or nothing thinking

This is sometimes called polarized thinking or black and white thinking, but the gist of it is that you tend to think in extremes. You don’t find a lot of middle ground - things are either good or bad. This kind of thinking can put a lot of pressure on you, which can be draining. 

The thing to remember, though, is that humans are complex. We all exist in the middle ground sometimes. We’re not all good or all bad, we’re something in between. When we get used to thinking in extremes, we lose the ability to let things be what they are.

Catastrophizing

If you catastrophize, you see the worst in every situation. Often this can come from a very real place - folks who grew up in traumatic environments often catastrophize. It’s important to remind yourself that just because you jump to the worst possible assumption doesn’t mean that it’s actually going to happen. It can be hard to break the habit of automatically assuming the worst. 

Personalization

One thing we tend to do as humans is assume everything is about us. It’s natural, right - we’re the main character in our story, after all. We feel like we’re responsible for events that are outside of our control, or that everything somehow relates back to us. However, it’s important to remember that not very many things are actually about you! The way someone acts probably has a lot more to do with them than with you. 

Jumping to Conclusions

When we decide something without evidence, we’ve jumped to conclusions. We might feel like we know what other people are thinking and feeling and what they’re going to do, but that’s not actually the truth. We aren’t mind readers. We only know what’s going on in our own minds. Jumping to conclusions can also overlap with Mind Reading, another cognitive distortion where we assume we can read the minds of the people around us, no communication needed. However, we need to let people do their own communicating. Thinking we know how everything is going to go can just lead to misunderstandings and frustration. 

Emotional Reasoning

Emotional reasoning leads us to believe that our feelings are the truth. Instead of letting our logical brains figure out what’s true, we let our emotions do the talking. You might feel like whatever you’re feeling is the truth, but take some time to investigate a little deeper. Are your feelings facts? What do the facts tell you about the situation? 

Discounting the Positive

This is a negative bias in thinking that makes us feel like anything good that happens to us is a fluke or good luck. We don’t believe that anything good could happen to us on purpose. When you start thinking that way though, it can lead you to feel like you have no control over anything good happening to you, so it can make you less likely to try things. Remember, good things can happen to you for all sorts of reasons - skill, good decision making, timing, your connections, etc. It doesn’t have to be about luck.

Filtering

Similar to discounting the positive, filtering happens when we filter out all the positive aspects of a situation and focus only on the negative. Viewing everything through a negative filter can be exhausting and depressing. Remember that there are positives and negatives to everything, and that just because you’re tempted to focus on the negative doesn’t mean there isn’t something positive you could also focus on. 

Overgeneralization 

Overgeneralization is when we make assumptions about something based on a very small amount of evidence. Something can happen to you once and you expect it to keep happening that way forever. You might see things as part of a negative pattern or expect your negative conclusion to apply to every situation. Remember to look for more evidence before making generalizations. 

To learn more about cognitive behavioral therapy and how it can help you challenge your negative thought patterns, get in touch with us today. Our clinicians are trained in CBT and can help you reframe your unhelpful thought patterns so you can cope more effectively. 

4 Tips for Coping with Depression

Everything feels harder when living with depression. You drag yourself out of bed and force yourself to get through the day. Friends invite you to go out, but you find yourself preferring to stay in. You try to participate in your usual activities, but they no longer spark joy. Around you, everyone seems to know where their life is heading, and what it all means. You feel empty, as if life is meaningless.

Depression can be tough to live with, but the good news is that there are ways to manage symptoms and improve your life.

Get active

Emotions and behaviors are related. For example, when you’re feeling depressed (i.e., emotion), you may prefer to isolate from friends and family (i.e., behavior). In this way, emotions can lead to behaviors. However, the opposite is also true. This means that engaging in behaviors and positive activities such as spending time with friends, can lead to improvements in mood. Try it out — create a list of positive activities to do when you’re feeling depressed, and get active.

Improve Sleep

Research demonstrates strong associations between sleep and mood. For instance, depression is linked to insomnia and sleep disruption, and individuals with insomnia are at higher risk for depression. Improvements in sleep hygiene can thus help, including having a regular sleep routine, turning off electronics an hour before bed, and implementing regular sleep and wake times.

Increase Social Support

Depression can make you want to isolate from others, but the opposite — spending time with friends and family — is what can actually help. Spend time developing stronger connections with others and get help and support.

Challenge Negative Thinking

Negative thinking is a hallmark feature of depression. Oftentimes depression can cause you to believe these thoughts and over identify with them. It is thus important to begin identify negative thoughts, to challenge and replace them with more balanced or positive thoughts. This can be tough to do since depression can color your thoughts and mood. However, treatments such as Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT) can help either manage negative thoughts or form new perspectives on them.

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Therapist in mclean, tysons corner, merrifield, falls church, arlington and vienna

Victoria Chialy Smith, PhD is a licensed clinical psychologist serving the Falls Church, McLean, Great Falls, Vienna, Arlington, Alexandria, and the greater Washington DC region. She provides individual therapy to children, teens, and adults with stress, anxiety, and depression. Our practice provides Cognitive Behavioral Therapy (CBT), mindfulness and acceptance based therapies, and other top, premier evidence-based treatments. Call, email, or schedule an appointment with us online today. We’re happy to help!