Cognitive Behavioural Therapy and Approaches

Cognitive behavioural therapy is a common practice used to help people suffering from a variety of problems from depression to anxiety, fear and impulsive disorders.

This type of therapy is carried out by professionals such as psychiatrists and psychologists and involves talking through problems and problem solving.

The professionally trained psychiatrist or psychologist will spend a number of sessions with the patient talking to them to find the root cause of their problem. This involves how they think and behave, how they think about themselves and how they deal with various situations. They then work on coping techniques, which is a type of problem solving to assist them in dealing with situations moving forward.

Cognitive behavioural therapy is also often used in couples counselling, to help couples air their concerns and feelings and then learn coping mechanisms to deal with those feeling. This teaches them to communicate effectively, find ways to deal with problems within the relationship and determine if they want to move forward together or apart.

Through regular talks and being open and honest, patients are able to identify key issues and then learn how to deal with them, finding solutions that can help them in the future. The patient moves at their own pace, each session is up to an hour long and this type of practice can last anywhere from six weeks to twenty weeks, or it can be ongoing, depending on what the patient is most comfortable with.

The psychologist or psychiatrist will speak to the patient to determine their routines and habits and then give them the tool they need to manage their day effectively. This type of treatment can improve self-esteem, social skills and so much more.

There are a number of approaches that are used for cognitive behavioural therapy and these approaches are based on the problem and the patient. Not all patients will respond to the same treatment solution, which is why each patient is treated as unique as the profession determines the best way to move forward.

One of the most common cognitive behavioural approaches includes desensitisation. Desensitisation is carried out over a number of sessions and requires the patient to list everything they fear from the item that isn’t too bad to the most frightening.

The therapist will work on relaxation techniques with the patient, which is designed to help them face their fears head on. Over a few sessions the patient will work on relaxation and then think of the least fearful item on their list. They need to imagine themselves there and calm themselves in the situation. Then they work up the list until they are faced with their most feared thing.

Relaxation techniques is another very popular approach in cognitive behavioural therapy and can include relaxation and breathing exercises to help calm the patient when faced with a difficult situation which they can’t normally deal with.

Social skills is another approach that is used, especially for those who are afraid of other people or members of the opposite sex. It is often found that those that have been bullied throughout their lives don’t have the best social skills in their adult’s lives and this type of therapy can help them overcome this to lead a normal and happy life.

It is very important when choosing cognitive behavioural therapy that you choose a therapist you feel most comfortable with. If you are a woman and are nervous around men, then make sure you choose a woman therapist for the best results. Remember you will need to be open and honest and it’s easier to do this if you feel at ease during your sessions.

How to Prevent Panic Attacks At Work or Out Socially

The anticipation of what might go wrong is so familiar. You anticipate how bad you will feel, how “everyone” will know something is wrong and you cannot face the shame or embarrassment of people seeing you like this. The dry mouth, the palpitations, feeling fuzzy. You tell yourself to stop blushing, to stop shaking but it only seems to get worse. You can hear your heart pounding inside your chest, it must look like a cartoon, thumping in and out. Where is the escape, where can you go?

Unfortunately, many people suffer without anyone noticing. They can maintain a calm exterior but on the inside they are quivering. The thoughts drive the feelings and the feelings drive the thoughts.

What is happening is that your mind has interpreted this event, minor or major, as life threatening. When this happens, the fight or flight alarm is activated. This is a self-preservation tool.

Unnecessary actions such as digestion are slowed as the blood supply needs to go to where action is required i.e. the arms (to fight) and legs (to run away).

Saliva disappears as this is part of the digestive process. Some people experience the need to urinate or evacuate the bowels (all part of releasing unnecessary cargo). Blood drains from the brain so the brain is now in a primal state, not enough oxygen and blood to function logically.

It is about survival, looking for the escape, with no time to weigh up pros and cons. It is a primal response.

How can you interrupt this cycle? By understanding that where your mind perceives a life or death threat, the actuality is that you are afraid of being judged in someway or have to “perform” i.e. focus will be on you and you are afraid of the “judgement”. This is a throw back to being at school and speaking in front of the class and perhaps making a mistake, others laughed and your mind interpreted this as something never to be done again. Each time you had to repeat the scenario, feelings and thoughts went into overdrive, your mind doing its best to free you by wanting you to avoid it. But this is not how to live your life. So therefore, you have to begin reframing the event before you get to it:


1. Think about how you will feel at the end of night when you have succeeded or coped well (whatever the situation). What would that mean to you – to have this sense of achievement that something you thought would be difficult was actually okay.
2. How do you need to be different for this to work? See your successful self and rewind to earlier in the evening and notice how different you were to the usual fearful self. What is different? Hints: notice body language, facial expression, hear your voice – everything is more at ease.
3. Rewind further to the start of the event, hear your self talk – words need to be “I’m okay”, “I feel calm” or even shorter “calm”, “relaxed”. Not what you don’t want but what you want to be and feel.
4. Starting from this point, how to make yourself even more relaxed – play some music that eases your mind and body. Tell yourself that are surrounded by people who care about you and should something panicky happen, anyone who would be amused by this speaks volumes for their personality type as the majority of people would want to help and ease your discomfort. Remember those that mind, don’t matter, and those that matter, don’t mind.

These thoughts take great pressure off you and once the fear is being dampened, you are beginning to take control.

Tips for during an event:

1. Keep words like “calm” and “relaxed” at the front of your mind. These words need no thinking about as the mind instinctively knows what they mean.
2. Keep sipping water. This keeps the mouth moist and mimics saliva.
3. Roll your shoulders to relax this (this can be done in the restroom) as this eases tension in the body and produces a physiological response of relaxing the muscles.
4. Keep your favorite song playing inside your head as when you focus on it, it will whisk you away to a more relaxed time.
5. Don’t forget to breathe.
6. When in conversation, instead of thinking of something incredibly intelligent to say, listen to others, observe something about them, earrings, tie and this helps to focus your mind outwardly rather than inwardly.

The post-mortem:

1. Focus on what was good about the night. We are ingrained to focus on the negative but this needs to change.
2. Think about what could be better next time and how you would make that happen.
3. Thank your mind for helping you. All it ever wants to do is to help you but sometimes its interpretation is not correct. You have to tell your mind what you want, not what you don’t want.

Every night as you settle down to sleep, think about three positive things that happened during the day. Think about how you want to be tomorrow and you will begin to notice that each day you are feeling a little bit better within yourself.

We can spend a lot of time worrying unnecessarily about how people view us and how we will cope in situations that make us feel uncomfortable. It can feel overwhelming at times but it is your mind and your body and you are in control. You just need to know how to do this. Panic and anxiety are conditioned responses and if you experience these, you can also be calm but you have to want this. You are stronger than you think.