Therapy is just like everything else. It’s based upon simple principles that people can use in their everyday lives as well. That doesn’t mean everyone can ‘do therapy’. It does mean that everyone can use at least some of the skills and techniques of therapy to help themselves to feel better.
The Cognitive Model is the basic idea behind Cognitive Behaviour Therapy (CBT). It might sound complicated but really it’s just a form of ‘cause and effect’ where thoughts lead to feelings and feelings lead to behaviours. Once we understand these links, anyone can use them. It’s not complicated. Let me show you what I mean…
Imagine that you’re a passenger in my car. The weather is clear and there aren’t too many other vehicles on the road. It’s a good road. It’s a motorway and there’s ample room for overtaking. There’s nothing wrong with the car and I’m driving just within the national speed limit of 70mph.
The chances are that you are feeling quite relaxed as we speed along having an enjoyable conversation about nothing in particular.
Just as I manoeuvre the car into the outside lane to overtake a large lorry I happen to mention how surprisingly easy driving is. Even though I have no licence and have never had a driving lesson in my life I’m really enjoying myself.
An uncomfortable thought pops into your head… You’re in a fast-moving car on a major motorway, being driven by an untutored, unlicensed novice and you can’t get to the brakes.
How do you feel now?
What effect will this new feeling have upon your body, your physical reactions?
What will you do?
Different people react in different ways but this might be fairly typical….
Thought: This is not safe
Physiology: ‘Freeze, flight or fight’ symptoms (heart rate and breathing changes, muscular tension, churning stomach, shaking, sweating etc)
Behaviour: Demand that I (the driver) pull over and stop the car as soon as possible.
I begin to laugh. I ask you to look in the glove compartment in front of you. Inside you find my clean driving licence, my insurance documents with many years ‘no claims bonus’ and I explain that I drive hundreds of miles every week without a problem.
You may feel aggrieved at my little joke but you probably don’t feel frightened any more. Your physical symptoms will subside (unless you turn them to anger instead) and you will probably stop demanding that I pull over.
There’s nothing surprising in any of that, is there? It’s a normal set of reactions to a genuinely scary practical joke. You don’t need to be a therapist to understand that people react to what happens to them.
We can ‘plot’ these events as follows:
This next bit is really important though. It’s the key to understanding the cognitive model. This is why therapists say that our emotions aren’t caused by what happens to us after all. Our emotions and behaviours are caused by our interpretations of what happens to us…
Nothing has changed in the outside world at all. The road is still clear, the weather is still fine and I’ve been driving perfectly well all along. The only thing that has changed is your perception, your beliefs and your expectations. Your thoughts. Your thoughts triggered your physical, emotional and behavioural reactions. That’s what the cognitive model is all about.
When you thought you weren’t safe you got scared and tried to get me to pull over.
When you realised I was joking you stopped being frightened and settled down for the journey ahead. Cause and effect. And it all happened inside your head. Nothing changed in the real world at all.
By controlling not only our thoughts but also our expectations and assumptions we can decide whether the emotional/behavioural ‘cycle’ we’re in is helpful to us or unhelpful. We can make changes starting at any point in the cycle to alter the outcome.
Let’s look at another example…
It’s easy for people to misinterpret each other’s behaviours or intentions. That can lead to major problems. This is what Professor Robert Bramsom calls the ‘negative interaction cycle’.
Imagine you’re at a party where you see a good friend. Your friend smiles and says hello to you but then spends the rest of the evening talking and laughing with others without even bothering to introduce you.
There are many possible thoughts you might have. We’ll consider only two:
- My friend is ashamed of me;
- My friend is really popular.
The first thought won’t help your mood at all. Let’s look at what happens…
The second possible thought changes everything…
Can you see how the different thoughts produce different feelings and behaviours?
Can you see how one leads to an unhappy cycle and the other leads to you having a great time? That’s why it’s important to understand where our thoughts might lead and make it a habit to choose helpful thoughts instead of unhelpful ones
The real trick at this level is being able to tell the difference between a feeling and a thought. That might sound easy but it’s surprising how many people can’t tell the difference. A very general rule (not always accurate but not bad either) is this
- Feelings can be described in a single word (happy, sad, angry, frightened etc.)
- Thoughts tend to take up a sentence or more.
One of the basic skills in developing emotional control is understanding the links between thoughts and feelings. You don’t need to be a therapist to do that. You just need to understand cause and effect.