Recent events in my life have lead to me to take an interest in psychology and psychiatry, more out of curiosity than anything else. I know almost nothing about these fields other than that they attempt to treat disorders of the brain and mind. I’ve heard of some of the disorders, like schizophrenia, ADD and manic-depression, but I know very little about them. So I decided to take a closer look at what this field has shown us about the least understood aspect of ourselves: our own mind.
There are two main types of psychological treatment: psychotherapy, treatment through interaction with a trained professional, and pharmacotherapy, treatment through medication. The two are often used in conjunction to treat patients.
In this article, I wanted to explore Cognitive Behavioral Therapy, a category of psychotherapy. It seems to me that cognitive behavioral therapy is one of the main psychotherapeutic tools in treating psychological issues, though I haven’t exactly found an authoritative source for that opinion. There are a ton of types of psychotherapy, all of which derive from different schools of thought on psychology. Most people have heard of psychoanalysis, as developed by Sigmund Freud, one of the earliest forms of psychotherapy. Cognitive Behavioral Therapy (CBT) is different from that and seems to have grown out of frustration with the limitations of psychoanalysis.
CBT is not just one specific therapy. There are different models of it depending on what particular condition you are attempting to treat, but all these models share central themes. As the name suggests, CBT combines both cognitive psychology and behavioral psychology to treat a problem on two fronts. The cognitive aspect looks at how the person perceives and interprets everything around them. The behavioral aspect is exactly what it sounds like: the observable behavior of the person. One paper describes the similarities between CBT models as follows: “Despite differences among specific CBT protocols, a major similarity across protocols is the assumption that maladaptive cognitions are causally linked to emotional distress, and therefore, by modifying cognitions emotional distress and maladaptive behaviors will decrease.” Or, in plain English, bad perceptions cause bad emotions. So you need to change the person’s perceptions to make them positive, or at least not negative, which in turn will decrease bad emotions and behaviors. You change those perceptions with both cognitive and behavioral approaches.
Depending on the disorder and the therapist’s opinion, there are many specific types of therapies that can be used under the overarching rubric of CBT, such as exposure therapy (exposing the patient to the object or situation that causes stress or fear), cognitive process therapy (a structured format for treating post-traumatic stress disorder), relaxation training (training to reduce stress, i.e. deep breathing), and so on.
What is interesting to me is the effectiveness of the CBT approach to psychotherapy. I found a 2006 review of CBT’s effectiveness compared to other forms of therapy for a wide range of disorders. Basically, it’s really good for depression, anxiety, panic attacks, social phobia, and PTSD. It’s also pretty good for bulimia and works well along with drugs for schizophrenia. For marriage counseling, anger, sleep issues and chronic pain, it does decently. It does ok for sex offenders, but the combination of CBT and hormone treatment is the best for reducing repeat offenses for sex offenders. That’s a pretty solid track record, in my opinion.