Living with anxiety and OCD can be hugely disruptive and distressing. But there is hope that comes from Cognitive Behavioral Therapy (CBT). CBT helps individuals to challenge the cycle of negative thoughts, beliefs and reactions, ultimately empowering the sufferer to establish greater balance in their lives. As medical professionals and society increasingly prioritize mental health, learning about and applying CBT can be a significant source of comfort and understanding.
Reclaim Control with CBT – Understanding the Basics
At its core, CBT is an established problem-focused approach to psychotherapy with the main goal of naturalizing, alleviating and preventing distress. Practitioners of CBT, such as certified psychologists and social workers, equip individuals with the tools to help create positive change. This change comes in the form of recognizing and addressing negative thought patterns and reactions, in order to initiate healthy functioning rather than continually “living in the loops” of chronic conditions.
CBT includes six major components: psychoeducation, cognitive restructuring, cognitive-behavioral techniques, exposure and response prevention, internalization and mastery, and intervention targeting environmental influences. Within these essential components exist powerful techniques that allow for meaningful understanding and management.
Through psychoeducation, CBT practitioners strive to educate clients about symptoms and common experiences. This deeply grounded base of understanding allows for the process of treatment to be more constructive and manageable. Such education is the cornerstone of restoring control and awareness of anxious triggers.
The “cognitive” portion of CBT seeks to recognize, analyze and reframe irrational thoughts that trigger anxious and/or obsessive behaviors. Negative thinking is identified and challenged using evidenced-based questions and interventions.
- As an example, during cognitive restructuring, individuals are encouraged to reflect on their self-talk and ask themselves questions such as:
- Does this thought help me stay calm and make better decisions?
- Is this thought based in reality or fear?
- Is this something I would tell a friend if they were going through this situation?
Cognitive-behavioral techniques use a combination of cognitive restructuring (as noted above) and activation or modification of behavior in response to a particular situation. A client’s therapeutic responses are tracked and adjusted consciously and deliberately, such as a client abstaining from activities or habits that are known to agitate or perpetuate the symptoms of anxiety and OCD. This may include avoiding activities that increase physical and emotional stress, such as drinking alcohol or spending time in crowds.
Exposure and Response Prevention:
The objective of Exposure and Response Prevention (ERP) is to desensitize the person to their target stimulus and to interrupt the repetitive behaviors that characterize OCD. Clients broaden their perspectives and more insightfully address their fears, such as facing one’s fear of contamination and allowing their mind to realize that the fear isn’t going to be realized.
Internalization and Mastery:
Once clients understand and accept the skills of CBT, it is essential for them to practice them in daily life. Clinicians often assign “homework” such as journaling, creating visual aides, relaxation exercises, and other coping skills that can be used to regulate emotions and navigate negative thinking patterns.
Intervention Targeting Environmental Influences:
CBT interventions extend beyond individual exploration and into the client’s environment. A skillful CBT therapist can provide proactive guidance to the client and their family on how to constructively respond to alarming triggers, as well as constructive ways of communicating with loved ones to create a meaningful and collaborative environment.
Practicing the Power of Cognitive Reframing
Cognitive reframing involves challenging automatic, ingrained thought patterns by redirecting our reactions to them, ultimately transforming them from negative to positive. By breaking the automatic cycle of negative thought patterns, clients can become aware and in control of their thoughts.
Practicing cognitive reframing can be done in a protected therapeutic setting, or away from the therapist by utilizing the techniques discussed in previous sections. To challenge the automatic thought process, clients can start by repeating positive statements or affirming statements to themselves.
- Rather than letting their mind believe “I will never be normal,” they can instead reframe it to “I accept who I am and I am learning new ways to cope with my struggles every day.”
- Rather than dwelling in fear of being contaminated, they can instead reframe it to “I don’t have to be scared if I turn my focus on the positive thoughts and behaviors that support my wellbeing.”
Finding Balance in the Reframing Process:
Finding a healthy balance in the reframing process is essential. It’s important to be aware that information can sometimes overwhelm and distress the individual, so it’s essential to keep their reframing balanced and achievable. If a client is having difficulty with a step, it’s important to recognize what that step is and provide guidance on how to make each step more manageable.
Cultivating a Positive Mindset: Overcoming Negative Thinking
Cultivating a positive mindset is paramount in managing symptoms of anxiety and OCD. Positive thinking is defined as according attention to, and believing in, positive thoughts and feelings. The power of positive thinking can be especially helpful in challenging feelings of worthlessness, self-degradation, and depressive rumination.
- A powerful positive thinking technique involves using prompts or affirmations to focus on positive habits, behaviors and thoughts.
- Acknowledging and expressing gratitude can have an immense impact on one’s overall mental well-being.
- In order to combat negative thoughts, clients can learn their triggers and how to effectively reframe unhelpful thoughts, as noted previously.
- Making changes to physical environment such as adding or removing plants and artwork, as well as arranging the furniture to generate a sense of balance, can also improve mental calibration.
Challenging Unhelpful Beliefs at the Core of Anxiety & OCD
The traditional CBT approach does not simply focus on eliminating symptoms or behaviors. Instead, it encourages individuals to confront and challenge the unhelpful beliefs at the core of distress, such as the fear of being judged or ridiculed, feelings of guilt or shame, feeling vulnerable, or the need of perfection. This can be quite difficult, but with the help of a care provider, clients have the opportunity to face their underlying challenges through guided discussions and activities.
Seeing Unhelpful Thoughts as Thoughts Only:
An important step in conquering and managing anxiety and OCD is to view persistent, unhelpful thoughts as just thoughts and not necessarily truths. This is a key CBT skill that empowers clients to separate themselves from their thoughts and reaction to those thoughts. Through this process clients can gain clarity and perspective on their thoughts, rather than to get lost in them
- Clients can start this process by identifying beliefs and fears that are fueling their anxious and obsessive behavior.
- Provided insight and understanding of why these thoughts or behaviors may be occurring, and how it is impacting their daily lives.
- Develop alternative responses to cope with these issues in a healthier way.
Embracing Acceptance: Moving Beyond Resistance
Life can sometimes throw curveballs, and it can be difficult to accept when these winds of change arise. With the help of CBT, it is possible to push boundaries and break away from familiar, unhelpful patterns of behavior, ultimately facilitating personal growth and rerouting behaviors. Embracing acceptance is an integral part of this process.
Acceptance involves recognizing and acknowledging the problematic situation at hand and finding ways to move forward despite discomfort. To practice real acceptance it is important to remember the following:
- Set realistic goals and expectations for yourself, rather than expecting yourself to be perfect or flawless.
- When faced with obstacle, view it as an opportunity for growth, rather than something to dread or fear.
- Be open to evaluating the situation objectively, instead of ruminating in negative thoughts.
- Be mindful of the present, instead of dwelling in the past.
Finding Balance: Applying CBT in Different Situations
It is common for individuals to kick off their CBT sessions feeling overwhelmed and intimidated by the prospect of change. Over time, however, participants learn to become more comfortable and confident in their skills and gain the trust to approach new situations. With practice, clients pave the path to finding balance in even the most anxiety provoking situations.
Measuring the Impact of Anxiety:
Measuring the impact of anxiety helps to recognize the progress of CBT sessions. Symptoms are tracked in order to assess the patterns, causes, and outcomes of the anxieties experienced. This helps clients to understand their triggers and personal routines in order to adjust and apply their skills to different scenarios. For example, if a client is struggling with anxiety in social situations, they can look back in their measurements to monitor their behaviors and any changes that have taken place.
Navigating Everyday Stressors with Mental Agility
Once CBT has been established, it is important to maintain mental agility and use the attained confidence to take control of individual situations. Navigating everyday stressors requires understanding and reflecting on one’s own emotional states and what triggered them. This allows for an effective response to be initiated and allows for the individual to manage daily life with greater ease.
- The essential skill of problem solving becomes an instrumental tool in managing both stress and situations.
- Rather than ruminating in worry, focus on practical solutions and use the skills developed from the CBT process.
- Remind yourself of the progress made and reflect on the resources used. This insight develops confidence to take control of individual situations.
Situational Awareness: Applying CBT to Common Challenges
CBT can be applied in stage-specific tools. These tools can support individuals facing situations such as work promotion, job interview, parenting challenges, and so forth. By utilizing the skills of CBT, these tasks can be seen as opportunities to set and reach goals, build resilience, and build upon the acquired skills to tackle more demanding and complex circumstances.
Setting achievable goals empowers individuals to identify the potential and acquire the confidence to progress further. Utilizing the previously discussed CBT components, clients can articulate their goals, breaking them down and evaluating their progress along the way.
Learning from Challenges:
Learning from challenges allows clients to stay mindful of how their experiences and achievements build strength and resilience. Reflecting on challenging experiences can help in recognizing, understanding, and appreciating how much progress has been achieved, and how far the individual has come. Reframing the experience, again utilizing CBT components, allows for understanding, insight, and a sense of control.
CBT is an established, powerful approach in managing the symptoms of anxiety and OCD. By developing the tools and techniques offered, individuals can optimize and manage their mental health in meaningful and lasting ways. CBT is not a silver bullet, however – it is a process that takes dedication and commitment to see desirable outcomes. With the right support, resources and determination, CBT empowers individuals to lead more balanced, fulfilled and meaningful lives.