Cognitive Behavioral Therapy and the Power of Thoughts

There is a great deal of research on the effectiveness of Cognitive Behavioral Therapy (CBT) in the treatment of various mental health disorders including anxiety, depression and addiction. CBT places an emphasis on the power of thoughts and beliefs. There are many constructs to grasp in CBT. I will focus on three fundamental ones: core beliefs, underlying assumptions, and automatic thoughts.

What is a core belief? It is how we come to see ourselves and our future. It is our unique lens that we see the world through. These beliefs are responsible for producing automatic thoughts. An automatic thought is a thought that happens instantaneously. It’s our internal impressions that are triggered by certain situations. It’s a good idea to keep track of automatic thoughts. Often, we don’t even notice all the negative self-talk that we do on a daily basis. Journaling can be helpful in stopping, reflecting, and processing what is going on in our minds. Questions to ask yourself when journaling: “What emotion was experienced? What thought triggered this unpleasant emotion? What was going on during that time?”

Identifying these automatic thoughts and then digging deeper can uncover the underlying assumptions and core beliefs. Discovering the core belief is like peeling off layers of an onion. To elaborate on this metaphor, Automatic thoughts are the first few layers, underlying assumptions form the middle layers, and finally core beliefs are the heart of the onion. In Cognitive Behavioral Therapy, the uncovering of core beliefs is referred to as the “downward arrow technique.” I find that my clients gain a great deal of self-awareness through this process.

A core belief could be “I’m not good enough, or I’m not lovable.” So how does an individual come to believe this? The underlying assumption influences this belief or “schema.” An underlying assumption is typically in the form of an “if… then” statement. They are usually not questioned by the individual and are taken as facts, rather than subjective opinion.

Here is an example of an underlying assumption:

“If everyone would just love me then that would mean I’m a worthwhile person and I would feel good about myself.”

But it’s impossible to be loved by all of the people all of the time! This distorted underlying assumption can set the person up in such a way that he or she starts feeling like a failure. For instance, one bad review by a critic could be interpreted as “I’m not accepted, so that must mean something is wrong with me… I must not be a worthwhile person.”

Anyone who is depressed will overlook or discount the positive aspects or interactions in their lives, and zero in on only the negative “evidence” that confirms the core belief (i.e. “being inadequate”). And it can take many positive thoughts or affirmations repeated on a daily basis to debunk a deeply rooted negative belief.

As you can imagine, it is difficult to live with these negative core beliefs, or schemas (such as “I’m not lovable”). Some turn to substances from time to time for a temporary refuge from this unpleasant state of mind. And for some, this maladaptive coping strategy can turn into a full blown addiction. Core beliefs can influence day to day behaviors and major life decisions. Learning to identify negative core beliefs and then challenging the assumptions that maintain them I believe is a vital aspect of the recovery process.