• Henk Nagel

What is CBT?

Cognitive Behavioral Therapy was first developed in the 60s by Aaron Beck and rapidly became the most widely used psychotherapy in the West.


In CBT, you break down your experiences into thoughts, feelings and behaviors. You explore the links between the three. Sometimes our struggles feel like an overwhelming, tangled web. CBT helps you gain clarity. Your problems become easier to understand, and therefore easier to change.


Unhelpful thoughts and behaviors fuel painful emotions, which in turn drive even more destructive thoughts and behaviors. It’s a vicious cycle. But, when you understand these links, you see how making a small change in one area, for example taking a different perspective, or implementing a small behavior change, can alter the whole cycle. With the support of Embrace Sober House’s experienced CBT therapists, you can transform the vicious cycle into a virtuous cycle of sustained improvement and well-being.


CBT is an evidence-based psychotherapy. This means it has been extensively researched, and has proved to be highly effective for helping people with a range of problems, from addiction to depression and anxiety. At Embrace, we stay up to date with the latest research to provide world class, evidence-based care. As such, our CBT therapists are not just throwing out ideas and going with gut instincts. They are working with a sound scientific evidence base to give you the best chance of recovery.



How can CBT help?


The first step is awareness. You can’t change what you’re not aware of. So initially you will work with your therapist to explore your thoughts, feelings and behaviors. You will start to understand what has been causing your painful emotions and destructive behaviours.


In CBT we say it’s not outside events that cause our feelings, but rather our interpretation of those events. Often our interpretations are negative and distorted, like we’re seeing everything through dark glasses. CBT helps you take those glasses off and see the world as it really is.


For example:


I arrive at work and say hello to my boss as he walks past. He does not reply. I think to myself- “He ignored me because he doesn’t like me, he thinks I’m bad at my job and he’s probably going to fire me.” As a result, I feel down, anxious and stressed, and have a terrible day at work.


However, when I examine those negative thoughts, I see that I have no evidence for them. He has never suggested I’m bad at my job. In fact he has often praised me and he’s usually friendly to me. I think to myself instead- “He’s probably having a bad day or is thinking about other things.” Instead of feeling down, anxious and stressed, I feel calm and perhaps compassionate towards him. Instead of a terrible day, I have a good day, all by changing my perspective.


Through CBT, you learn tools to examine and challenge your negative thoughts, altering them to more helpful, realistic perspectives. At first it takes a lot of work, but over time the new helpful perspectives start to become more ingrained as you develop new neural pathways. It’s a bit like reprogramming your brain.



CBT and addiction


Addiction is usually an unhelpful strategy for dealing with difficult emotions. These are often caused by irrational thought patterns.


By learning how to identify and challenge these negative thoughts, you can change the emotions that led you to start using in the first place. Rather than simply focusing on the addiction, you will tackle the underlying causes of your addiction. CBT helps you remove those causes, clearing the way for a happy, healthy life.


Irrational thoughts are a common obstacle in recovery that lead people back to old behaviors. Here are a few examples of the types of thoughts people experience in sober living houses, and how you might challenge them through CBT.


“I’m a chronic relapser and I’ll never change.” → “I have learned something from each of my relapses that I can build on to do things differently this time. I know many people who are clean and happy after multiple relapses, so it is definitely possible.”


“I can’t cope with social situations without drinking.” → “Recovery is a gradual process of rebuilding my confidence. Although it feels difficult now, I am learning new strategies to help me cope with anxiety. If I keep working at recovery, in time I will feel more confident than I ever did during my drinking days when I was just papering over the cracks with alcohol.”


CBT gives you strategies to keep growing and flourishing independently long after you leave treatment. You will have the tools to confront all the challenges of life with confidence. It can help you maintain your sobriety, and an all round sense of well-being and happiness.


A sober house like Embrace is a perfect place for CBT work. You have freedom to get out and explore the vibrant city of Chiang Mai, confronting challenges that give you an opportunity to put the techniques into practice.



CBT and other disorders


Dual-diagnosis is common in addiction. This means you are experiencing another problem alongside addiction, such as depression and anxiety. It might feel like this makes recovery even more challenging, but with CBT you can tackle several problems at once. The same CBT strategies that help with your addiction also help with various other challenges too, including depression, anxiety, social anxiety, stress, self-esteem problems and OCD. CBT helps with much more than just staying sober. It can also heal the underlying problems that led you to drink and drugs in the first place. It can boost your self-esteem, giving you the confidence to move forwards and build the life you want to live.



Other Examples of CBT Strategies


Beyond identifying and changing unhelpful thought patterns, there are many other CBT techniques that can help you overcome struggles and live a happy life.



Core Belief Work


Although CBT focuses on making changes in the present, sometimes it is useful to understand the deeper layers of your thinking. During childhood, we develop core beliefs. These are deeply held beliefs about ourselves, others and the world. Sometimes they can be helpful, but other times they are quite negative and problematic. Understanding how they developed, and how they are playing out in your life today even though they are no longer relevant, can have a powerful impact in changing long term patterns of thoughts, feelings and behaviors. You can nurture new core beliefs, coming to see yourself, others and the world in a fundamentally different, brighter way.



Behavioral Experiments


CBT is not just about changing the way you think. Sometimes you might have worked on building new perspectives that you believe in your head, but don’t quite believe in your heart. This is where behavioural experiments come in. You can try out new ways of doing things, to test those new beliefs in action. Experiencing these new beliefs in reality deepens the therapeutic change. It opens up exciting new possibilities for engaging with the world.


For example, you previously believed that people won’t like you if they see the real you. Through thought challenging, you have developed a new perspective that people are actually quite accepting of others, although you do not yet fully believe it in your heart. To test this out, you might go to one of the many welcoming recovery meetings we have around Chiang Mai, share honestly about your struggles, and see how people respond.



Exposure


Exposure is a powerful CBT technique that helps people gradually confront situations that make them anxious.


It’s only natural that human beings tend to avoid things that make us anxious or fearful. However, over time, this avoidance amplifies the fear by repeatedly giving our minds the message- “I can’t handle that”.


By gradually exposing yourself to the things you’re afraid of, such as speaking in front of others, or painful memories, your mind starts to learn you can handle things much better than you feared. You start to break the fear association. The more you confront those anxious situations, the more your anxiety goes down. As your confidence grows, with the support of your therapist, you can gradually confront increasingly challenging situations. People are often amazed how far they can come in a short space of time through exposure work.



How is CBT different?


CBT focuses primarily on finding solutions and helping you move forward in the present, rather than spending extensive time trawling through the past. It is also action-oriented. Instead of just talking about things with your therapist, you will focus on actively changing thoughts and behaviors. This solution-focused approach means you can make rapid progress at Embrace towards the life you want to live.


As such, the relationship between the therapist and client is quite different in CBT. In some branches of psychotherapy, the therapist is passive, simply giving you a space to process things. In others, the therapist sits on an expert pedestal, handing down interpretations of your experiences. On the other hand, CBT is based on collaborative teamwork between the therapist and client. Both play an active role. You are the expert on your own experience, and your therapist is an expert on CBT and psychology. Together, you combine your expertise in a joint-effort to help you move forwards.


In contrast to some other psychotherapies where the focus is on the therapist’s expert opinion, the aim of CBT is to help you become your own therapist. In a short space of time, you will be empowered with knowledge, tools and techniques to maintain your progress independently.


At Embrace Sober House we have experienced therapists trained in CBT. They can help you overcome the root causes of your addiction and equip you with all the tools you need to flourish in recovery.



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