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Cognitive Behavioral Therapy: Techniques for Retraining Your Brain
Why is it so hard to lose weight, stop smoking, or establish healthy habits? Why do couples argue about the same issues over and over? Why do so many people lie awake at night, stricken with worry and anxiety? Why is it so difficult to come to terms with a loved one's death, even if it's after a long illness?
The answers to these questions - and the path to lasting change in your life - lie in cognitive behavioral therapy (CBT), a well-tested collection of practical techniques for managing moods and modifying undesirable behaviors through self-awareness, critical analysis, and goal-oriented change. CBT illuminates the links between thoughts, emotions, behaviors, and physical health and uses those connections to develop concrete plans for self-improvement. Built on a solid foundation of neurological and behavioral research, CBT is an approach almost anyone can use for promoting greater mental health and improving quality of life.
In 24 engaging half-hour lectures, you'll build a robust and effective self-improvement toolkit with the expert guidance of Professor Satterfield of the University of California, San Francisco. You will explore CBT's roots in Socratic and stoic philosophy, build a toolkit of CBT techniques, and hear about the latest research about its outcomes. Additionally this intriguing and practical course allows you to take on the role of medical student, physician, psychologist, and patient.
Throughout the course you'll explore issues that cause people to seek out therapy. In some cases you'll get to hear Dr. Satterfield working with a patient, and in others you'll be delving into research to find what causes issues and how CBT helps to resolve them.
Everyone has something about their life that they would like to improve. With the tools in CBT and the desire to make your situation better, you can create lasting change in your life.
The answers to these questions - and the path to lasting change in your life - lie in cognitive behavioral therapy (CBT), a well-tested collection of practical techniques for managing moods and modifying undesirable behaviors through self-awareness, critical analysis, and goal-oriented change. CBT illuminates the links between thoughts, emotions, behaviors, and physical health and uses those connections to develop concrete plans for self-improvement. Built on a solid foundation of neurological and behavioral research, CBT is an approach almost anyone can use for promoting greater mental health and improving quality of life.
In 24 engaging half-hour lectures, you'll build a robust and effective self-improvement toolkit with the expert guidance of Professor Satterfield of the University of California, San Francisco. You will explore CBT's roots in Socratic and stoic philosophy, build a toolkit of CBT techniques, and hear about the latest research about its outcomes. Additionally this intriguing and practical course allows you to take on the role of medical student, physician, psychologist, and patient.
Throughout the course you'll explore issues that cause people to seek out therapy. In some cases you'll get to hear Dr. Satterfield working with a patient, and in others you'll be delving into research to find what causes issues and how CBT helps to resolve them.
Everyone has something about their life that they would like to improve. With the tools in CBT and the desire to make your situation better, you can create lasting change in your life.
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First published June 26, 2015
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September 2, 2015
Cognitive Behavioral Therapy (CBT) is the current "gold standard" of psychotherapy treatments and serves as the foundation for many of the new "cutting edge" mindfulness based therapy modalities such as Dialectical Behavioral Therapy (DBT) and Acceptance and Commitment Therapy (ACT).
Because CBT is so common, it has become kind of unglamorous. It's like the workaday, "la-di-sensible", "cargo shorts and flip flops" of the psychotherapy world.
To say you're a CBT therapist is like saying that your hobby is watching television, or that your favorite author is John Grisham, or that you're a New York Yankees fan.
Not that there's anything wrong with all that, but it's just not considered very, how you say, ummmm..... interesting?
So I'm actually saying a whole lot when I tell you that professor Jason M. Satterfield is so fucking good, that he makes CBT into about the most fascinating subject since Dan Blizariean* and the cataclysmic pole shift hypothesis** combined.
* considered by many/some/at least one person (citation needed) to be the most interesting man on Instagram.
**listed (by a web sight) as one of the most interesting subjects on the Internet (and it's actually is pretty interesting - Google it for yourself if you don't believe me).
Anyway.
Professor Satterfield makes CBT phenomenally interesting.
How does he do it?
He pretty much just does a really good job of explaining and demonstrating it.
As it turns out, CBT is actually really fuckin' neat and we're all just sort of jaded or under informed or something.
If you really take a close look. CBT is an amazingly developed, incredibly broad and actually quite deep psychotherapeutic modality.
Plus there's tons of experimental data to back it up.
Unlike its Freudian psychoanalytic predecessors, CBT is light on theory and heavy on evidence i.e. it's been found to be effective (significantly better than placebo) in hundreds of randomly assigned, double blind, placebo controlled trials (RCT's).
In other words, CBT is essentially the thing that makes psychotherapy not just another homeopathy or (insert other quasi medical practice that is pretty much 100% placebo effect).
Again, not that there's anything wrong with placebo effects. A lot of evidence demonstrates that all therapeutic, psychopharmacological, medical and even surgical interventions rely on the placebo effect (to some extent).
Placebo effects are powerful and rad and we'd be fucked without them. But I think we'd all agree that we would like our (expensive and time consuming) therapy to be more effective than a sugar pill (or being on a wait list as it were), and according to the data, CBT achieves this bench mark, distinguishing it from many other psychotherapy modalities that quite simply don't.
Good to know right?
Anyway.
That's a really unnecessarily long way of saying that this is an absolutely top shelf primer on Cognitive Behavioral Therapy.
I think it will be useful for clinician and client alike. But even if you're neither, I believe almost everyone could benefit from this program.
However, it is over 12 hours long, and it's like 25.00 or something. So if you're interested, please allow me to give you some of the highlights so that you can make a maximally informed purchase.
What exactly is Cognitive Behavioral Therapy?
CBT is a short-term, goal-oriented psychotherapy treatment that takes a practical approach to problem-solving and symptom reduction.
CBT assumes that people suffer from unpleasant feelings and moods (e.g. anxiety and depression) because they have inaccurate or unhelpful ways of thinking (cognitive distortions) and maladaptive (negative, harmful etc.) behaviors.
CBT focuses on identifying and restructuring distorted cognitions as well as activating adaptive behaviors, all with the intention of reducing psychopathological symptoms and (dare we say) increasing positive affect.
In other words. CBT is about changing the crazy shit you do and think so you quit feeling like shit and maybe even start feeling nice.
That seems reasonable, right?
Forgive the horrendous cliché but, it ain't rocket science.
It's actually one of the big strengths of CBT. It's theoretical foundations are very simple and commonsensical.
CBT emerged form the Behaviorist tradition that began with Ivan Pavlov and John Watson and later B.F. Skinner.
As (psychology 101) legend has it, Pavlov rang a bell as a signal just before feeding an experimental subject dog (oh fuck, better call PETA right? Don't bother, it was like 150 years ago when he did all this shit. Dogs are almost never use as test subjects now a days).
After months of this dinner bell stimulus, the dog became conditioned to salivate at the mere sound of the bell instead of only in the presence of the food. The bell tone stimulus had been associated (paired) with the food stimulus.
If this sounds analogous to how your pet freaks out when you jiggle the food bag or leash, you're right. It's also the action behind your own shopping behavior when you pass by the ice cream section at whole foods.
I'm sure many of you are not exactly wowed by the insight that environmental stimuli can become associated with and elicit basic physiological and behavioral responses. But at the time it was a HUGE discovery, and it lead to a whole theory of learning called Classical Conditioning.
Classical Conditioning:
Asserts that if an neutral stimuli is paired with an unconditioned stimuli, over time, the neutral stimuli becomes "conditioned" to elicit the same response as the unconditioned stimuli.
Of course Classical Conditioning is not limited to Food and Sound stimuli. It's literally happening all the time, in all sorts of contexts, with all sorts of (internet porn*) stimuli.
* Rapidly becoming the cheapest joke in western culture. Just as all (on line and many off line) arguments lead to an inevitable use of Hitler as an example of bad behavior. All humor (on and off line) is increasingly (and will soon inevitably) include a reference to internet porn.
Later on, Behaviorists under the leadership of B.F. Skinner began experimenting with how behaviors are "shaped" via punishment and reward. They referred to this type of learning as Operant Conditioning.
Operant Conditioning:
The theory asserts that the animals behavior "operates" on the environment (i.e. causes shit to happen).
If the consequences of the behavior are favorable, the animal (including us) will be more likely to repeat the behavior. If the consequences are aversive, than the animal will be less likely to repeat the behavior.
Another way of saying this is:
Desirable consequences increases the likelihood that the behavior will be repeated in the future.
Undesirable consequences decrease the likelihood that the behavior will be repeated in the future.
This "behavioral shaping" process can happen all at once (with big rewards or punishment) or a little bit at a time (with tiny little treats or lil baby electrical shocks).
Behavioral Therapy:
The clinical implications of Classical and Operant Conditioning are relevant to behavioral issues such as addiction and eating disorders where learned associations trigger deeply unconscious (implicit) motivational processes and highly automatic behavior.
Behavioral Therapy was (and still is) wildly effective.
To this day, most psychotherapeutic interventions for eating disorders, addiction, and even anxiety and depression primarily employ Behaviorist principals in order to "retrain" the maladaptive (problem) behavior.
The Behaviorists assumed that:
(A) antecedent events cause (B) behaviors, which have (C) consequences.
If you wrote it out it would look something like this:
A=>B=>C
Behavioral Therapy intends to analyze and modify behaviors via the principals of Behaviorists learning theory i.e. Classical and Operant Conditioning.
In a nutshell, Behavior Therapy assumes that if you don't like the (C) consequences, than change the (B) behavior by either removing the (A) antecedent stimuli, or by rewarding the desired behavior and punishing the undesirable behavior.
For example:
If someone is addicted to drugs:
Than remove the triggering (A) antecedents and engineer a system of (C) consequences that reward (increase likelihood of) desired (B) behavior and punish (decrease likelihood of) undesirable behavior.
This is the logic behind most drug treatment to this day.
You get them away from using friends and remove triggering stimuli like drug paraphernalia by shipping them to Utah or Hawaii or some shit. Than reward sobriety by giving them more freedom or what ever. And you punish relapse by restricting freedom.
Behavioral Therapy assumed that if you changed a persons behavior, than you're done. Problem solved. It also has the added benefit of not necessitating subjects to talk about their feelings or childhood (or really anything for that matter).
But what about memories, beliefs, thoughts and feelings?
How do they factor in to human behavior?
The tacit assumption of Behavioral therapy was that thoughts don't really matter too much. Additionally it was assumed that if you change the behavior that's causing the undesirable consequences, than the person will probably feel better. But the Behaviorists weren't necessarily all that interested in feelings per se.
In fact it's kind of hard to tell if the Behaviorists gave a rats ass about how people feel.
A lot of evidence suggests that they didn't.
But most people sure do seem to care about how they feel and in fact most people report to therapy because they feel like shit and want to feel better.
Furthermore, as in the example of addiction treatment, if a person is self medicating for depression or anxiety (the problem) and you remove the drugs (the dysfunctional solution) than you still have the original problem, and you run the risk of probable relapse.
So Behaviorism and Behavioral Therapy had some serious short comings. And In the early to mid 1960's, strict (radical) behaviorism and Behavioral Therapy got a massive facelift after psychologists, linguists and computer engineers started developing information theory and cognitive science.
The Cognitive Revolution:
Cognitive Theory asserts that, in the case of language adapted animals (people) culturally and linguistically informed core beliefs, procedural (if/than) scripts and internal dialog (self talk) all play a significant role an individual's emotions and behavior.
Beck's Cognitive Theory:
CBT founder Aaron "Tim" Beck posited that it's not the events in our lives that trouble us, it's the view we take on these events that dictate our reaction.
In Beck's model, we have an activating (anticedent) event, followed by automatic thoughts (and feelings), which are proceeded by emotional and behavioral consequences.
A (antecedents) B (beliefs) C (consequences)
ABC
WARNING: This is another (totally different but related) ABC Thing. There are a lot of these ABC things in CBT, so it can get confusing, but the idea for this one is:
(A) antecedent events, trigger
(B) automatic thoughts and beliefs, which trigger (C) consequences, which become the
(A) antecedent event for the next
(B) automatic thoughts and beliefs,
(C) consequences, which become the......
- ad infinitum.
This psychotic merry-go-round of thinking, feeling and doing chugs along, on and on, and the ultimate output is the miracle/mystery we call human behavior.
In this model Human Behavior looks like this:
(A) antecedent events
(B) automatic thoughts and beliefs
(C) consequences, which become the
- repeat
Or:
A=>B=>C=>A=>B=>C= (on and on till you die)
Beck postulated that specific kinds of (B) automatic thoughts and beliefs are linked to certain kinds of emotional and behavioral reactions.
For instance:
Anger is typically preceded by thoughts and beliefs that some injustice or unfairness has been committed, or some type of violation has occurred.
Depression is often preceded by thoughts about loss and/or about powerlessness (hopelessness and helplessness as we say in the biz).
These beliefs and thoughts may be absolutely reasonable, but it's important to note that two different people in the same situation may have two totally different beliefs and automatic thoughts, with really different emotional and behavioral consequences.
Beck asserted that if a person has certain unhelpful or inaccurate beliefs (CBT calls these "Cognitive Distortions") that are making them feel anxious and/or depressed, than if we strategically changed their way of thinking, they will feel less depressed and anxious (CBT calls this Cognitive Restructuring).
In other words, if you can teach an anxious and depressed person to think like a not anxious and depressed person, than they won't be anxious and depressed anymore.
That seems reasonable right?
Like I said earlier, it ain't rocket science.
But (as you may have noticed) changing the way a person thinks is hard.
In order to do it in a meaningful way, we may have to deconstruct thinking into its component parts.
Core Beliefs:
Core Beliefs are basic, implicit assumptions about the (S) self, (O) others and your (F) future.
These Basic Core Beliefs about Self, Others and the Future all effect each other "tri-directionally"
In other words. Your Core Beliefs about Self, Others and your Future are in a three way love triangle, each one being interdependent upon and effecting the other.
It looks sort of like this:
Core Beliefs Triangle:
(S)
/ \
(O) __ (F)
S: self
O: others
F: future
Maladaptive Core Beliefs:
We all have core beliefs about our selves i.e. who we are and what we're capable of. How we stack up in comparison to others. What's fair and what isn't fair. How the world works, what we have to do in order to survive and what our future in it will be like.
Ideas and Beliefs have value based on their:
1. Functionality
2. Accuracy
Hopefully our core beliefs are functional and at least somewhat accurate. But sometimes they are neither. Sometimes they are dysfunctional and inaccurate.
We all acquired our core beliefs at some point, and ideally these are changing and growing as we change and grow.
But sometimes they don't. Sometimes we learn something in one context (i.e. in childhood) and we maintain these core beliefs into other different contexts (i.e. adulthood), even when they are dysfunctional (maladaptive) and inaccurate (distorted).
Maladaptive Core Beliefs:
Having very strong maladaptive or distorted core beliefs can lead to some really bad problems like:
- I'm unlovable => low self-esteem
- Everyone leaves me => intimacy problems
- I always choke under pressure => anxiety
- The future is hopeless => depression
When a young person is subjected to abuse or neglect it's difficult (if not impossible) for them to understand that their abuser is at fault.
The abused or neglected child often internalizes the core belief that they are somehow at fault.
In these circumstances, he/she often adopts the implicit (unconscious/automatic) belief that:
- I'm unworthy of love
- My loved ones and care givers won't be there for me when I need them.
These core beliefs may become the foundation of low self esteem or insecure attachment in adult relationships.
When a young person is subjected to a chaotic environment he/she often adopts the implicit (unconscious/automatic) belief that:
- I am incompetent
- The world is dangerous and overwhelming
These core beliefs can become the foundation for depression and anxiety in adult life.
They can also be the foundation for a multitude of other Cognitive Distortions.
Cognitive Distortions:
Cognitive Distortions are unhelpful and inaccurate ways of thinking that unnecessarily increase distressing feelings and maladaptive behaviors.
Here is a few of the more common ones (Google Cognitive Distortions for a complete list):
1. All or nothing thinking:
Seeing things in black or white as opposed to shade of grey.
Example: thinking "either your with me or your against me"
2. Overgeneralization:
Making hasty generalizations from insufficient experiences and evidence.
Example: thinking "everyone from Dallas is a drugged out train wreck" because a few (or a lot of) people you know from Dallas fit that description (to a tee).
3. Filtering:
Focusing entirely on negative elements of a situation, to the exclusion of the positive.
Example: thinking "this salmon is a little over cooked" at a free lunch.
4. Mind reading:
Assuming that you know what another person is thinking or what they will think.
Example: thinking "if I say hi to her she will think I'm a creep".
5. Catastrophizing:
Giving greater weight to the worst possible outcome, however unlikely.
Example: thinking "if I don't get my car back by Thursday I will die and my life will explode".
What to do about Cognitive Distortions:
Most people recognize that hey engage in at least some of these ways of thinking at least some of the time.
But some people engage in a lot of this types of maladaptive thinking a lot of the time.
Either way It can be a huge problem.
Cognitive Restructuring:
As mentioned earlier. CBT assumes that if you identify and change these Maladaptive Core Beliefs and Cognitive Distortions (referred to as Cognitive Restructuring) than the person is going to feel a bunch better.
But it's not all about Cognitive Restructuring. Beck still views behavioral change as important.
WARNING: one more ABC thing.
In Beck's view (A) affects, (B) behaviors and (C) cognitions all "tri-directionally" effected each other.
Remember the Core Beliefs "love triangle"?
It's another one of those smashed up with another ABC thing.
It looks like this:
The Cognitive Behavioral Triangle
(A)
/ \
(B) __ (C)
A: affect i.e. feelings, emotions etc.
B: behaviors
C: cognition, thoughts, mental images, beliefs (see core beliefs)
The idea is:
Feelings and Thoughts effect Behaviors
But more importantly to CBT
Behaviors and Thoughts effect Feelings
So if you really want to change how you feel, you have to change what you think and what you do.
Bringing it Back to Behavior:
Remember. CBT didn't replace Behavioral Therapy, it just sort of added (integrated) the cognitive component.
Here is the part of CBT that retained and refined all of the behavioral interventions.
Behavioral Activation:
Refers to any behavioral modification based on the Skinnerian (Operant Conditioning) model of behavior change.
The idea is to systematically increase the frequency of adaptive behaviors through reinforcement and reduce the frequency of maladaptive behavior through extinction.
In other words:
Behavioral Activation for depression entails getting the depressed person to do more shit they like that makes them less depressed (like exercise) and do less shit that makes them depressed (like laying in bed all day long).
You get the general idea.
Again, not exactly rocket science.
Easy to understand.
But surprisingly difficult to implement.
Particularly with anxious and depressed people.
Anyway. I could (clearly) go on and on.
This review was actually about four times as long.
I had to edit a bunch of it out in order to post it to Goodreads.
But at least you now have a general outline of what CBT is.
If you're curious as to how (exactly) it works, and what you actually do in session, than by all means GET THIS COURSE.
I can't say enough good stuff about it. Again, the instructor is absolutely top shelf. The material is excellent, and the presentation is spectacular.
You literally can't go wrong.
Five stars!!!!!
Because CBT is so common, it has become kind of unglamorous. It's like the workaday, "la-di-sensible", "cargo shorts and flip flops" of the psychotherapy world.
To say you're a CBT therapist is like saying that your hobby is watching television, or that your favorite author is John Grisham, or that you're a New York Yankees fan.
Not that there's anything wrong with all that, but it's just not considered very, how you say, ummmm..... interesting?
So I'm actually saying a whole lot when I tell you that professor Jason M. Satterfield is so fucking good, that he makes CBT into about the most fascinating subject since Dan Blizariean* and the cataclysmic pole shift hypothesis** combined.
* considered by many/some/at least one person (citation needed) to be the most interesting man on Instagram.
**listed (by a web sight) as one of the most interesting subjects on the Internet (and it's actually is pretty interesting - Google it for yourself if you don't believe me).
Anyway.
Professor Satterfield makes CBT phenomenally interesting.
How does he do it?
He pretty much just does a really good job of explaining and demonstrating it.
As it turns out, CBT is actually really fuckin' neat and we're all just sort of jaded or under informed or something.
If you really take a close look. CBT is an amazingly developed, incredibly broad and actually quite deep psychotherapeutic modality.
Plus there's tons of experimental data to back it up.
Unlike its Freudian psychoanalytic predecessors, CBT is light on theory and heavy on evidence i.e. it's been found to be effective (significantly better than placebo) in hundreds of randomly assigned, double blind, placebo controlled trials (RCT's).
In other words, CBT is essentially the thing that makes psychotherapy not just another homeopathy or (insert other quasi medical practice that is pretty much 100% placebo effect).
Again, not that there's anything wrong with placebo effects. A lot of evidence demonstrates that all therapeutic, psychopharmacological, medical and even surgical interventions rely on the placebo effect (to some extent).
Placebo effects are powerful and rad and we'd be fucked without them. But I think we'd all agree that we would like our (expensive and time consuming) therapy to be more effective than a sugar pill (or being on a wait list as it were), and according to the data, CBT achieves this bench mark, distinguishing it from many other psychotherapy modalities that quite simply don't.
Good to know right?
Anyway.
That's a really unnecessarily long way of saying that this is an absolutely top shelf primer on Cognitive Behavioral Therapy.
I think it will be useful for clinician and client alike. But even if you're neither, I believe almost everyone could benefit from this program.
However, it is over 12 hours long, and it's like 25.00 or something. So if you're interested, please allow me to give you some of the highlights so that you can make a maximally informed purchase.
What exactly is Cognitive Behavioral Therapy?
CBT is a short-term, goal-oriented psychotherapy treatment that takes a practical approach to problem-solving and symptom reduction.
CBT assumes that people suffer from unpleasant feelings and moods (e.g. anxiety and depression) because they have inaccurate or unhelpful ways of thinking (cognitive distortions) and maladaptive (negative, harmful etc.) behaviors.
CBT focuses on identifying and restructuring distorted cognitions as well as activating adaptive behaviors, all with the intention of reducing psychopathological symptoms and (dare we say) increasing positive affect.
In other words. CBT is about changing the crazy shit you do and think so you quit feeling like shit and maybe even start feeling nice.
That seems reasonable, right?
Forgive the horrendous cliché but, it ain't rocket science.
It's actually one of the big strengths of CBT. It's theoretical foundations are very simple and commonsensical.
CBT emerged form the Behaviorist tradition that began with Ivan Pavlov and John Watson and later B.F. Skinner.
As (psychology 101) legend has it, Pavlov rang a bell as a signal just before feeding an experimental subject dog (oh fuck, better call PETA right? Don't bother, it was like 150 years ago when he did all this shit. Dogs are almost never use as test subjects now a days).
After months of this dinner bell stimulus, the dog became conditioned to salivate at the mere sound of the bell instead of only in the presence of the food. The bell tone stimulus had been associated (paired) with the food stimulus.
If this sounds analogous to how your pet freaks out when you jiggle the food bag or leash, you're right. It's also the action behind your own shopping behavior when you pass by the ice cream section at whole foods.
I'm sure many of you are not exactly wowed by the insight that environmental stimuli can become associated with and elicit basic physiological and behavioral responses. But at the time it was a HUGE discovery, and it lead to a whole theory of learning called Classical Conditioning.
Classical Conditioning:
Asserts that if an neutral stimuli is paired with an unconditioned stimuli, over time, the neutral stimuli becomes "conditioned" to elicit the same response as the unconditioned stimuli.
Of course Classical Conditioning is not limited to Food and Sound stimuli. It's literally happening all the time, in all sorts of contexts, with all sorts of (internet porn*) stimuli.
* Rapidly becoming the cheapest joke in western culture. Just as all (on line and many off line) arguments lead to an inevitable use of Hitler as an example of bad behavior. All humor (on and off line) is increasingly (and will soon inevitably) include a reference to internet porn.
Later on, Behaviorists under the leadership of B.F. Skinner began experimenting with how behaviors are "shaped" via punishment and reward. They referred to this type of learning as Operant Conditioning.
Operant Conditioning:
The theory asserts that the animals behavior "operates" on the environment (i.e. causes shit to happen).
If the consequences of the behavior are favorable, the animal (including us) will be more likely to repeat the behavior. If the consequences are aversive, than the animal will be less likely to repeat the behavior.
Another way of saying this is:
Desirable consequences increases the likelihood that the behavior will be repeated in the future.
Undesirable consequences decrease the likelihood that the behavior will be repeated in the future.
This "behavioral shaping" process can happen all at once (with big rewards or punishment) or a little bit at a time (with tiny little treats or lil baby electrical shocks).
Behavioral Therapy:
The clinical implications of Classical and Operant Conditioning are relevant to behavioral issues such as addiction and eating disorders where learned associations trigger deeply unconscious (implicit) motivational processes and highly automatic behavior.
Behavioral Therapy was (and still is) wildly effective.
To this day, most psychotherapeutic interventions for eating disorders, addiction, and even anxiety and depression primarily employ Behaviorist principals in order to "retrain" the maladaptive (problem) behavior.
The Behaviorists assumed that:
(A) antecedent events cause (B) behaviors, which have (C) consequences.
If you wrote it out it would look something like this:
A=>B=>C
Behavioral Therapy intends to analyze and modify behaviors via the principals of Behaviorists learning theory i.e. Classical and Operant Conditioning.
In a nutshell, Behavior Therapy assumes that if you don't like the (C) consequences, than change the (B) behavior by either removing the (A) antecedent stimuli, or by rewarding the desired behavior and punishing the undesirable behavior.
For example:
If someone is addicted to drugs:
Than remove the triggering (A) antecedents and engineer a system of (C) consequences that reward (increase likelihood of) desired (B) behavior and punish (decrease likelihood of) undesirable behavior.
This is the logic behind most drug treatment to this day.
You get them away from using friends and remove triggering stimuli like drug paraphernalia by shipping them to Utah or Hawaii or some shit. Than reward sobriety by giving them more freedom or what ever. And you punish relapse by restricting freedom.
Behavioral Therapy assumed that if you changed a persons behavior, than you're done. Problem solved. It also has the added benefit of not necessitating subjects to talk about their feelings or childhood (or really anything for that matter).
But what about memories, beliefs, thoughts and feelings?
How do they factor in to human behavior?
The tacit assumption of Behavioral therapy was that thoughts don't really matter too much. Additionally it was assumed that if you change the behavior that's causing the undesirable consequences, than the person will probably feel better. But the Behaviorists weren't necessarily all that interested in feelings per se.
In fact it's kind of hard to tell if the Behaviorists gave a rats ass about how people feel.
A lot of evidence suggests that they didn't.
But most people sure do seem to care about how they feel and in fact most people report to therapy because they feel like shit and want to feel better.
Furthermore, as in the example of addiction treatment, if a person is self medicating for depression or anxiety (the problem) and you remove the drugs (the dysfunctional solution) than you still have the original problem, and you run the risk of probable relapse.
So Behaviorism and Behavioral Therapy had some serious short comings. And In the early to mid 1960's, strict (radical) behaviorism and Behavioral Therapy got a massive facelift after psychologists, linguists and computer engineers started developing information theory and cognitive science.
The Cognitive Revolution:
Cognitive Theory asserts that, in the case of language adapted animals (people) culturally and linguistically informed core beliefs, procedural (if/than) scripts and internal dialog (self talk) all play a significant role an individual's emotions and behavior.
Beck's Cognitive Theory:
CBT founder Aaron "Tim" Beck posited that it's not the events in our lives that trouble us, it's the view we take on these events that dictate our reaction.
In Beck's model, we have an activating (anticedent) event, followed by automatic thoughts (and feelings), which are proceeded by emotional and behavioral consequences.
A (antecedents) B (beliefs) C (consequences)
ABC
WARNING: This is another (totally different but related) ABC Thing. There are a lot of these ABC things in CBT, so it can get confusing, but the idea for this one is:
(A) antecedent events, trigger
(B) automatic thoughts and beliefs, which trigger (C) consequences, which become the
(A) antecedent event for the next
(B) automatic thoughts and beliefs,
(C) consequences, which become the......
- ad infinitum.
This psychotic merry-go-round of thinking, feeling and doing chugs along, on and on, and the ultimate output is the miracle/mystery we call human behavior.
In this model Human Behavior looks like this:
(A) antecedent events
(B) automatic thoughts and beliefs
(C) consequences, which become the
- repeat
Or:
A=>B=>C=>A=>B=>C= (on and on till you die)
Beck postulated that specific kinds of (B) automatic thoughts and beliefs are linked to certain kinds of emotional and behavioral reactions.
For instance:
Anger is typically preceded by thoughts and beliefs that some injustice or unfairness has been committed, or some type of violation has occurred.
Depression is often preceded by thoughts about loss and/or about powerlessness (hopelessness and helplessness as we say in the biz).
These beliefs and thoughts may be absolutely reasonable, but it's important to note that two different people in the same situation may have two totally different beliefs and automatic thoughts, with really different emotional and behavioral consequences.
Beck asserted that if a person has certain unhelpful or inaccurate beliefs (CBT calls these "Cognitive Distortions") that are making them feel anxious and/or depressed, than if we strategically changed their way of thinking, they will feel less depressed and anxious (CBT calls this Cognitive Restructuring).
In other words, if you can teach an anxious and depressed person to think like a not anxious and depressed person, than they won't be anxious and depressed anymore.
That seems reasonable right?
Like I said earlier, it ain't rocket science.
But (as you may have noticed) changing the way a person thinks is hard.
In order to do it in a meaningful way, we may have to deconstruct thinking into its component parts.
Core Beliefs:
Core Beliefs are basic, implicit assumptions about the (S) self, (O) others and your (F) future.
These Basic Core Beliefs about Self, Others and the Future all effect each other "tri-directionally"
In other words. Your Core Beliefs about Self, Others and your Future are in a three way love triangle, each one being interdependent upon and effecting the other.
It looks sort of like this:
Core Beliefs Triangle:
(S)
/ \
(O) __ (F)
S: self
O: others
F: future
Maladaptive Core Beliefs:
We all have core beliefs about our selves i.e. who we are and what we're capable of. How we stack up in comparison to others. What's fair and what isn't fair. How the world works, what we have to do in order to survive and what our future in it will be like.
Ideas and Beliefs have value based on their:
1. Functionality
2. Accuracy
Hopefully our core beliefs are functional and at least somewhat accurate. But sometimes they are neither. Sometimes they are dysfunctional and inaccurate.
We all acquired our core beliefs at some point, and ideally these are changing and growing as we change and grow.
But sometimes they don't. Sometimes we learn something in one context (i.e. in childhood) and we maintain these core beliefs into other different contexts (i.e. adulthood), even when they are dysfunctional (maladaptive) and inaccurate (distorted).
Maladaptive Core Beliefs:
Having very strong maladaptive or distorted core beliefs can lead to some really bad problems like:
- I'm unlovable => low self-esteem
- Everyone leaves me => intimacy problems
- I always choke under pressure => anxiety
- The future is hopeless => depression
When a young person is subjected to abuse or neglect it's difficult (if not impossible) for them to understand that their abuser is at fault.
The abused or neglected child often internalizes the core belief that they are somehow at fault.
In these circumstances, he/she often adopts the implicit (unconscious/automatic) belief that:
- I'm unworthy of love
- My loved ones and care givers won't be there for me when I need them.
These core beliefs may become the foundation of low self esteem or insecure attachment in adult relationships.
When a young person is subjected to a chaotic environment he/she often adopts the implicit (unconscious/automatic) belief that:
- I am incompetent
- The world is dangerous and overwhelming
These core beliefs can become the foundation for depression and anxiety in adult life.
They can also be the foundation for a multitude of other Cognitive Distortions.
Cognitive Distortions:
Cognitive Distortions are unhelpful and inaccurate ways of thinking that unnecessarily increase distressing feelings and maladaptive behaviors.
Here is a few of the more common ones (Google Cognitive Distortions for a complete list):
1. All or nothing thinking:
Seeing things in black or white as opposed to shade of grey.
Example: thinking "either your with me or your against me"
2. Overgeneralization:
Making hasty generalizations from insufficient experiences and evidence.
Example: thinking "everyone from Dallas is a drugged out train wreck" because a few (or a lot of) people you know from Dallas fit that description (to a tee).
3. Filtering:
Focusing entirely on negative elements of a situation, to the exclusion of the positive.
Example: thinking "this salmon is a little over cooked" at a free lunch.
4. Mind reading:
Assuming that you know what another person is thinking or what they will think.
Example: thinking "if I say hi to her she will think I'm a creep".
5. Catastrophizing:
Giving greater weight to the worst possible outcome, however unlikely.
Example: thinking "if I don't get my car back by Thursday I will die and my life will explode".
What to do about Cognitive Distortions:
Most people recognize that hey engage in at least some of these ways of thinking at least some of the time.
But some people engage in a lot of this types of maladaptive thinking a lot of the time.
Either way It can be a huge problem.
Cognitive Restructuring:
As mentioned earlier. CBT assumes that if you identify and change these Maladaptive Core Beliefs and Cognitive Distortions (referred to as Cognitive Restructuring) than the person is going to feel a bunch better.
But it's not all about Cognitive Restructuring. Beck still views behavioral change as important.
WARNING: one more ABC thing.
In Beck's view (A) affects, (B) behaviors and (C) cognitions all "tri-directionally" effected each other.
Remember the Core Beliefs "love triangle"?
It's another one of those smashed up with another ABC thing.
It looks like this:
The Cognitive Behavioral Triangle
(A)
/ \
(B) __ (C)
A: affect i.e. feelings, emotions etc.
B: behaviors
C: cognition, thoughts, mental images, beliefs (see core beliefs)
The idea is:
Feelings and Thoughts effect Behaviors
But more importantly to CBT
Behaviors and Thoughts effect Feelings
So if you really want to change how you feel, you have to change what you think and what you do.
Bringing it Back to Behavior:
Remember. CBT didn't replace Behavioral Therapy, it just sort of added (integrated) the cognitive component.
Here is the part of CBT that retained and refined all of the behavioral interventions.
Behavioral Activation:
Refers to any behavioral modification based on the Skinnerian (Operant Conditioning) model of behavior change.
The idea is to systematically increase the frequency of adaptive behaviors through reinforcement and reduce the frequency of maladaptive behavior through extinction.
In other words:
Behavioral Activation for depression entails getting the depressed person to do more shit they like that makes them less depressed (like exercise) and do less shit that makes them depressed (like laying in bed all day long).
You get the general idea.
Again, not exactly rocket science.
Easy to understand.
But surprisingly difficult to implement.
Particularly with anxious and depressed people.
Anyway. I could (clearly) go on and on.
This review was actually about four times as long.
I had to edit a bunch of it out in order to post it to Goodreads.
But at least you now have a general outline of what CBT is.
If you're curious as to how (exactly) it works, and what you actually do in session, than by all means GET THIS COURSE.
I can't say enough good stuff about it. Again, the instructor is absolutely top shelf. The material is excellent, and the presentation is spectacular.
You literally can't go wrong.
Five stars!!!!!
July 6, 2020
This is a valuable set of lectures that, I fear, suffers from some bad marketing. The subtitle—“Techniques for Retraining Your Brain”—suggests that this is a source of self-help. But for the most part, Satterfield refrains from the sort of exercises or advice that one might expect from a self-help title. Instead, these lectures serve as a kind of overview of Cognitive Behavioral Therapy itself—its theory and practice. Whether to listen thus depends on what you are looking for.
For my part, these lectures were quite enjoyable and compelling. Satterfield takes care to introduce the listener to the basic concepts and to the range of techniques. But the highlights of these lectures are the examples. Satterfield incorporates recordings from several therapy sessions, showing how he helps patients suffering from depression, anxiety, relationship issues, and anger problems. These excepts were generally illuminating and at times even moving, and it certainly deepened my understanding of the therapy.
Many things attract me to CBT—its emphasis on rationality, its connection to Stoicism and mindfulness, and its insistence on goal-oriented treatment. The techniques themselves seem quite plausibly effective, and Satterfield is careful to cite studies of the therapy’s efficacy. It is cheering to think that serious psychological afflictions can be mitigated through the diligent applications of fairly simple tools. Indeed, there were times I even found myself wanting to become a therapist! Well, on second thought…
For my part, these lectures were quite enjoyable and compelling. Satterfield takes care to introduce the listener to the basic concepts and to the range of techniques. But the highlights of these lectures are the examples. Satterfield incorporates recordings from several therapy sessions, showing how he helps patients suffering from depression, anxiety, relationship issues, and anger problems. These excepts were generally illuminating and at times even moving, and it certainly deepened my understanding of the therapy.
Many things attract me to CBT—its emphasis on rationality, its connection to Stoicism and mindfulness, and its insistence on goal-oriented treatment. The techniques themselves seem quite plausibly effective, and Satterfield is careful to cite studies of the therapy’s efficacy. It is cheering to think that serious psychological afflictions can be mitigated through the diligent applications of fairly simple tools. Indeed, there were times I even found myself wanting to become a therapist! Well, on second thought…
March 31, 2016
This author got his PhD under Beck, the father of CBT. I went to the same institution and learned a lot of the info in this book during my undergrad years and loved it! I remember being blown away that when I was taking class, our prof pointed down the hall and told us that right at that moment, they were treating people with schizophrenia with CBT instead of medication. We were all in disbelief that it was even possible. That study exceeded all expectations for this therapeutic method. Considering this author knows a lot more than I do, I was excited to deepen my understanding.
The information in the book was great, but I listened to this on Audible and I felt frustrated with the therapy sessions. I would rather have spent that time being lectured to. I could not wait until each session was over so lectures could resume. (Good thing I never decided to be a therapist:)
If you don't mind listening to him model the CBT with patients in real time (to me each patient session seemed like a long time), then this book will be an excellent fit. CBT is the most successful treatment for an incredible variety of issues and learning directly from Beck sets this author apart. Despite the 3 stars, I would recommend this book for people who are interested in understanding CBT techniques and the myriad studies that support its efficacy.
The information in the book was great, but I listened to this on Audible and I felt frustrated with the therapy sessions. I would rather have spent that time being lectured to. I could not wait until each session was over so lectures could resume. (Good thing I never decided to be a therapist:)
If you don't mind listening to him model the CBT with patients in real time (to me each patient session seemed like a long time), then this book will be an excellent fit. CBT is the most successful treatment for an incredible variety of issues and learning directly from Beck sets this author apart. Despite the 3 stars, I would recommend this book for people who are interested in understanding CBT techniques and the myriad studies that support its efficacy.
September 17, 2018
I started this series at the beginning of the year with the mindset that it would be trash and I would only end up listening to a couple lectures. BOY WAS I WRONG. This course was so surprisingly practical and beneficial. It's helped me with my personal issues, relationships, and broadening my view of the psychotherapeutic field. While the sessions can be gut-wrenching to listen to, they're so helpful for getting to see the treatments in action. The lectures cover a wide range of topics and the last one is how to find a therapist, what questions to ask, and how to set up a good working relationship, which is just the icing on the cake of this course. HIGHLY RECOMMEND.
January 6, 2020
Wow, I am surprised at how much enjoyment I extracted from this course. If you’re interested in learning more about CBT, this is a great primer to start your learning curve. I really admire the lecturer as well, very poised, guided patients through what seemed like extremely harsh life circumstances to deal with (in the case of Maria)
I thought including the conversations with patients was helpful, as you can see the flaws in people’s thought patterns and how these flaws can slowly begin to shape your whole outlook. You can see how divisive thought patterns create a feedback loop of isolation and desolation from society. If these thoughts are accepted without disassociating yourself from the thought by not engaging, it can dramatically fracture your life.
To me that was extremely valuable, now if you’re an avid reader of topics regarding mindfulness and positive psychology. This course might not be for you, this will be regurgitating Information you already know and can begin to feel like there is no novelty involved which dampens the learning experience.
If you need a refresher course, this will be a great starting point I would recommend. I think this course is from 4-5 stars in that range. I think it delivered on what it set out to do.
5 stars.
I thought including the conversations with patients was helpful, as you can see the flaws in people’s thought patterns and how these flaws can slowly begin to shape your whole outlook. You can see how divisive thought patterns create a feedback loop of isolation and desolation from society. If these thoughts are accepted without disassociating yourself from the thought by not engaging, it can dramatically fracture your life.
To me that was extremely valuable, now if you’re an avid reader of topics regarding mindfulness and positive psychology. This course might not be for you, this will be regurgitating Information you already know and can begin to feel like there is no novelty involved which dampens the learning experience.
If you need a refresher course, this will be a great starting point I would recommend. I think this course is from 4-5 stars in that range. I think it delivered on what it set out to do.
5 stars.
November 7, 2018
I loved this book.
Not only it explained how a few very simple tools can help people, but also showed proof for this. I honestly loved both the "theory" part and the part where we listened to sessions (and progress) with people who had come to work on themselves. It was an amazing journey and although I have always been quite interested in pshychology and learned in uni about the Cognitive Behaviour Therapy, listening to this book and seeing living proof for the efectiveness was just so good.
I think that while I listened to this book, I became more positive without even noticing it, I saw so many options to improve my happiness levels, my confidence, and my life in general. And had the ancient realisation that if I am feeling unhappy or sad, it is me who makes me and no one else. And I have the power to change it.
I listened to this book on Audible narrated by the author and I think I might re-listen to it at some point in the future. The reason it didn't get five stars was that some topics or parts of few chapters just didn't interest me as much as everything else in this book.
Not only it explained how a few very simple tools can help people, but also showed proof for this. I honestly loved both the "theory" part and the part where we listened to sessions (and progress) with people who had come to work on themselves. It was an amazing journey and although I have always been quite interested in pshychology and learned in uni about the Cognitive Behaviour Therapy, listening to this book and seeing living proof for the efectiveness was just so good.
I think that while I listened to this book, I became more positive without even noticing it, I saw so many options to improve my happiness levels, my confidence, and my life in general. And had the ancient realisation that if I am feeling unhappy or sad, it is me who makes me and no one else. And I have the power to change it.
I listened to this book on Audible narrated by the author and I think I might re-listen to it at some point in the future. The reason it didn't get five stars was that some topics or parts of few chapters just didn't interest me as much as everything else in this book.
January 13, 2021
A very well structured course that will give you great overall understanding of CBT. The interviews are very helpful.
April 28, 2022
Excellent course complete with snippets of CBT sessions the lecturer did with actual patients. This stayed largely in the foundations of CBT, but I still found helpful info throughout. Satterfield covers a wide range of application from substance use and weight loss to trauma and depression/anxiety.
This would be helpful for someone looking to apply CBT themselves, or perhaps caregivers looking to learn more about CBT. I think most people who have a foundational knowledge of CBT will know much of the concepts presented. That said the course is masterfully taught, and even more masterfully applied which is a delight to listen to in the recorded therapy sessions.
My only complaint? Dude can't stop saying "grist for the mill" to save his life. Oh well.
I would recommend the listen, especially since it was free on Audible (although not for much longer).
I'd rate this a PG.
This would be helpful for someone looking to apply CBT themselves, or perhaps caregivers looking to learn more about CBT. I think most people who have a foundational knowledge of CBT will know much of the concepts presented. That said the course is masterfully taught, and even more masterfully applied which is a delight to listen to in the recorded therapy sessions.
My only complaint? Dude can't stop saying "grist for the mill" to save his life. Oh well.
I would recommend the listen, especially since it was free on Audible (although not for much longer).
I'd rate this a PG.
October 21, 2022
Super interesting and well spoken audiobook. It also comes with a PDF as well. The case studies really help put CBT into context and even shows how one person was helped by it. The others had deeper issues, so it’s understandable that they needed longer than a woman struggling with her husband’s dementia.
February 28, 2019
We spend a bajillion dollars annually on self-improvement, therapy, dieting, financial management courses, relationship coaching, and other efforts to change and improve. And yet...we change so little! I’m super interested in CBT as currently one of the most effective tools for change (though I’m sure something soon will replace it). I loved this course and will be revisiting it in the future. Definitely recommend it!
October 19, 2019
Pragmatism is a healthy American attitude. Surprisingly, the pragmatic efficacy that so often characterizes the American attitude to problem solving in other spheres of life did not prevent the meandering Old World malady of psychoanalytic talk therapy from becoming the norm and infesting the salons of New York and Hollywood. Thankfully, Cognitive Behavioral Therapy, together with various other outcome oriented therapies, has partially turned the tide in the past couple of decades and turned the scientific management of psychic pains and discomforts into a practical skill.
This course is a good introduction to the subject. I enjoyed listening to Satterfield's clear explanations of the theory behind the work, but I also enjoyed listening to the recordings of the therapy sessions that illuminate the practical procedures that CBT utilizes in the treatment of various maladies. The human element of hearing the doctor patient relationship helps to contextualize the struggle. The lecture series is not overtly technical, and this reflects the spirit of CBT itself. The pragmatic theory behind the CBT approach serves only one purpose: to produce empirically testable and skill enhancing improvements in the patient's capacity to manage their own lives. This is what makes CBT a pragmatic school of psychotherapy.
One weakness of CBT might be that it is often content with producing "superficial" improvements or the mere treatment of "symptoms." But this supposed lack of analytic depth or interest in the root causes of ailments (virtues which Freudian psychoanalysts supposedly excel at) is precisely what has allowed CBT to outperform several others forms of psychotherapy. In the terse spirit of the pragmatic path, CBT prefers to get to the point (quickly) in order to deliver the goods.
Towards the end, the lecture series plateaus off into a cavalcade of case studies. These touch various human problems, from relationship issues to substance abuse and self-confidence issues. While I enjoyed them as interesting examples of applied CBT, I felt that, towards the end, the pedagogical value of the course as a learning experience was somewhat diluted or dissipated as a result. I was left wanting more in terms of analytical synthesis or self-criticism. But I guess that would be kind of self-defeating, since CBT is genetically averse to such grand theorizing or philosophizing.
For anybody who has problems, CBT has something to offer. We all have some problems, so we could all use some CBT techniques in our lives. Putting our problems into helpful perspective and finding practical means of alleviating unnecessary suffering is at the heart of the CBT approach. This course explains that lesson very well, but it is not a bitter pill to swallow at all! It feels more like a pleasant and educational stroll on bittersweet pastures. The course works reasonable well as a self-help course thanks to the convincing tone of the speaker as well as the empirical strength, quick applicability, and ease of self-administration of many of the techniques discussed. I would recommend it to you. Yes, you.
This course is a good introduction to the subject. I enjoyed listening to Satterfield's clear explanations of the theory behind the work, but I also enjoyed listening to the recordings of the therapy sessions that illuminate the practical procedures that CBT utilizes in the treatment of various maladies. The human element of hearing the doctor patient relationship helps to contextualize the struggle. The lecture series is not overtly technical, and this reflects the spirit of CBT itself. The pragmatic theory behind the CBT approach serves only one purpose: to produce empirically testable and skill enhancing improvements in the patient's capacity to manage their own lives. This is what makes CBT a pragmatic school of psychotherapy.
One weakness of CBT might be that it is often content with producing "superficial" improvements or the mere treatment of "symptoms." But this supposed lack of analytic depth or interest in the root causes of ailments (virtues which Freudian psychoanalysts supposedly excel at) is precisely what has allowed CBT to outperform several others forms of psychotherapy. In the terse spirit of the pragmatic path, CBT prefers to get to the point (quickly) in order to deliver the goods.
Towards the end, the lecture series plateaus off into a cavalcade of case studies. These touch various human problems, from relationship issues to substance abuse and self-confidence issues. While I enjoyed them as interesting examples of applied CBT, I felt that, towards the end, the pedagogical value of the course as a learning experience was somewhat diluted or dissipated as a result. I was left wanting more in terms of analytical synthesis or self-criticism. But I guess that would be kind of self-defeating, since CBT is genetically averse to such grand theorizing or philosophizing.
For anybody who has problems, CBT has something to offer. We all have some problems, so we could all use some CBT techniques in our lives. Putting our problems into helpful perspective and finding practical means of alleviating unnecessary suffering is at the heart of the CBT approach. This course explains that lesson very well, but it is not a bitter pill to swallow at all! It feels more like a pleasant and educational stroll on bittersweet pastures. The course works reasonable well as a self-help course thanks to the convincing tone of the speaker as well as the empirical strength, quick applicability, and ease of self-administration of many of the techniques discussed. I would recommend it to you. Yes, you.
October 5, 2015
Wasn't sure how much I would get out of this, as my interest in psychology has tended away from the therapeutic/treatment side of things, but this was a very well-presented set of lectures that was greatly enhanced by the presence of recordings of actual therapy sessions. It interested me more than I thought, and Dr. Satterfield is a good lecturer and is very passionate about this field. I learned a lot about CBT and I can see why it is one of the more promising areas of treatment in our current era. I recommend this to anyone with an interest in the topic or who enjoys psychology but isn't sure if delving into therapeutic matters is for them: this will give you a taste of that domain and an excellent understanding of the principles involved.
December 5, 2018
This is a great overview of CBT for those interested in what it's all about. I personally enjoyed the glimpses into actual sessions. Though it does get a bit repetitive and dry toward the later chapters, I do recommend it for those who have an interest in this particular style of therapy.
November 10, 2019
I absolutely liked this book. It is very fluid, easy to follow and with great case studies throughout the book. I will definitely go back to this one and work on myself with the tools provided in the book. Great toolbox to have.
July 23, 2021
This course was interesting and helpful. I feel many people could benefit from the tools discussed in the course.
September 23, 2018
I came in with only a very basic understanding of CBD, yet somehow I didn't learn very much. I liked the lecturer and the sample therapy sessions, and there were some interesting statistics scattered within, and I generally like the CBT approach, but it all seems so basic to me. Maybe that's the strength of CBT, I just thought there might be some deeper insights. Still, worth a listen. I guess if you're not particularly self-reflective or into betterment stuff there might be some very helpful info here.
April 18, 2016
Most of the Great Courses are surveys of topics, but this is like training for doing CBT. The professor is not just lecturing, he is playing tapes of real interviews with clients and then discussing them.
October 4, 2020
Wow Satterfield said at the start of the book that his goal was to "give CBT away" and this book is the GREATEST intro to CBT ever. Everyone should read it.
Here are a few of the awesome techniques in CBT that I scribbled down:
Behavioural activation: Noticing what you do & don't like doing, finding out WHY you do/don't like these things (AKA asking what your values/goals are), then restructuring your life so that it aligns more closely with your values & long-term goals.
Pleasure predicting: Depression distorts perception of the future. As a result, people who are struggling often think things will be less enjoyable than they are. To rewire this assumption, literally just write down how much pleasure you think you'll get from doing something (from 1-10) then after you do it, write the actual level of pleasure you received from it.
Behavioural experiment: If you have a thought like "nobody wants to talk to me" you can create a testable hypothesis based off this thought (a prediction about what will happen) e.g. "if I
Thought record: keep a record of notable thoughts you had and the situation that elicited them, and the emotions and behaviours they caused. Then you can start to see how you could have thought differently given the same situations, and how much that new thought would have changed for you. Super useful to see your mind work in action and how malleable this stuff is.
What else was relaly awesome was the inclusion of strategies to temper emotions that started in anxient Greek philosophy:
Stoic problem solving & acceptance: Identify all the ways to solve a problem you can think of. Rank them. Then map out how you can act on the best ones & rate how likely it is you think you will actually follow through on this action. Then act. Delineate what's in your control and what's not so that you can accept the latter rather than pushing against it.
Decatastrophizing (called negative visualisation in stoicism): Take what you're freaking out about and don't shy away from it, play out the worst possible consequences and you'll realise they're often not even worse than how you're feeling about it right now. ESPECIALLY when you adjust for the likelihood of the worst possible consequences happening (usually very unlikely).
Socratic questioning: What's the evidence for/against a certain thought? Is it a simplified view of reality? Could there be other interpretations of the same events? Is this thought just here out of habit? Is my thought describing something likely to happen or just the worst possible thing that could happen?
Then there's the more obvious stress reducing stuff like incompatible responses (relaxation training for anxiety) and mindfulness. Overall so so so so cool, CBT is something I think I'll take a formal course in because of this book.
Here are a few of the awesome techniques in CBT that I scribbled down:
Behavioural activation: Noticing what you do & don't like doing, finding out WHY you do/don't like these things (AKA asking what your values/goals are), then restructuring your life so that it aligns more closely with your values & long-term goals.
Pleasure predicting: Depression distorts perception of the future. As a result, people who are struggling often think things will be less enjoyable than they are. To rewire this assumption, literally just write down how much pleasure you think you'll get from doing something (from 1-10) then after you do it, write the actual level of pleasure you received from it.
Behavioural experiment: If you have a thought like "nobody wants to talk to me" you can create a testable hypothesis based off this thought (a prediction about what will happen) e.g. "if I
Thought record: keep a record of notable thoughts you had and the situation that elicited them, and the emotions and behaviours they caused. Then you can start to see how you could have thought differently given the same situations, and how much that new thought would have changed for you. Super useful to see your mind work in action and how malleable this stuff is.
What else was relaly awesome was the inclusion of strategies to temper emotions that started in anxient Greek philosophy:
Stoic problem solving & acceptance: Identify all the ways to solve a problem you can think of. Rank them. Then map out how you can act on the best ones & rate how likely it is you think you will actually follow through on this action. Then act. Delineate what's in your control and what's not so that you can accept the latter rather than pushing against it.
Decatastrophizing (called negative visualisation in stoicism): Take what you're freaking out about and don't shy away from it, play out the worst possible consequences and you'll realise they're often not even worse than how you're feeling about it right now. ESPECIALLY when you adjust for the likelihood of the worst possible consequences happening (usually very unlikely).
Socratic questioning: What's the evidence for/against a certain thought? Is it a simplified view of reality? Could there be other interpretations of the same events? Is this thought just here out of habit? Is my thought describing something likely to happen or just the worst possible thing that could happen?
Then there's the more obvious stress reducing stuff like incompatible responses (relaxation training for anxiety) and mindfulness. Overall so so so so cool, CBT is something I think I'll take a formal course in because of this book.
Read
November 4, 2020Cognitive Behavioral Therapy is evidence-based psychology that revolves mainly on three variables called the CBT triangle: thoughts, behaviours, and emotions; all of which are interconnected. (This explains why sometimes actions precede the motivation, unlike what is generally believed that it is only one way road: motivation-->action. Actually, it is motivation<-->action).
However, the characteristic thing I like about CBT is its flexible practicality. There is no digging in your subconscious mind nor childhood memories (you know, psychoanalysis) which makes me utterly uncomfortable. The CBT approach focuses on the present, it begins by self-monitoring to collect data on, say, a behaviour one needs to change, then formulates the case by generating a contextual-individual hypothesis on that particular behaviour, and testing it out in reality by targeting the CBT variables.... all is found in the lectures.
Now, I'd like to drift away to the realm of philosophy and focus on an implication of CBT that supports what I call the non-self or outward-gaze view. What I mean by this, I think, is something akin to Confucius' rituals, Kantian duty, and islamic ethics.
In Chinese philosophy, which focuses mainly on morality, the individual has no inherently intrinsic nor developmental characteristics that essentially should determine one's behaviour. And here comes the significance of rituals: in every day life, we are confronted with many possible choices to react in different situations, the one that is best is what results in the best outcome and not what represents oneself or what is claimed as authenticity nowadays.
Kantian rational imperatives are commonly known. One should do what is not only of interest to oneself but what one ought to do. My favourite consequence to this is that we start to view others disinterestedly, as things in-themselves.
Islam stresses strongly on behavioural management regardless of internal conflicts. That one should always do what is good and right is a recurrent theme in the Quran. This entails suppressing hurtful impulses and venting passions in order to manifest the most appropriate behaviours and creating friendly environment.
So, to react in the best way in each situation and not in the same pattern you used to before, to view people disinterestedly and as an end in-themselves, and do what is right despite your contrasting inner desires — is not considered moral in our age of selfish individualism. Our current culture plagues us with spontaneity and authenticity (as opposed to hypocrisy: having feelings not parallel to your actions), giving reigns to passions disregarding consequences in the name of living the moment, and, worst of all, is the notion of patterned-self as the normal. Now, CBT hints that our thoughts, actions, and emotions are not us: there is a self beyond all of that. This is a great catalyst to the aforementioned rituals, duty, and Islamic morality.
Finally, it is worth mentioning that that is not hypocrisy nor superficiality. Because CBT makes clear that behaviours and emotions are deeply connected to core beliefs, the former are just the manifestation of the later. So, CBT intelligently employs a top-bottom approach, which I think is liberating in that it greatly allows for change and development and beautifully widens the probabilities for forgiveness and acceptance. What else could make our lives together more enriching?
However, the characteristic thing I like about CBT is its flexible practicality. There is no digging in your subconscious mind nor childhood memories (you know, psychoanalysis) which makes me utterly uncomfortable. The CBT approach focuses on the present, it begins by self-monitoring to collect data on, say, a behaviour one needs to change, then formulates the case by generating a contextual-individual hypothesis on that particular behaviour, and testing it out in reality by targeting the CBT variables.... all is found in the lectures.
Now, I'd like to drift away to the realm of philosophy and focus on an implication of CBT that supports what I call the non-self or outward-gaze view. What I mean by this, I think, is something akin to Confucius' rituals, Kantian duty, and islamic ethics.
In Chinese philosophy, which focuses mainly on morality, the individual has no inherently intrinsic nor developmental characteristics that essentially should determine one's behaviour. And here comes the significance of rituals: in every day life, we are confronted with many possible choices to react in different situations, the one that is best is what results in the best outcome and not what represents oneself or what is claimed as authenticity nowadays.
Kantian rational imperatives are commonly known. One should do what is not only of interest to oneself but what one ought to do. My favourite consequence to this is that we start to view others disinterestedly, as things in-themselves.
Islam stresses strongly on behavioural management regardless of internal conflicts. That one should always do what is good and right is a recurrent theme in the Quran. This entails suppressing hurtful impulses and venting passions in order to manifest the most appropriate behaviours and creating friendly environment.
So, to react in the best way in each situation and not in the same pattern you used to before, to view people disinterestedly and as an end in-themselves, and do what is right despite your contrasting inner desires — is not considered moral in our age of selfish individualism. Our current culture plagues us with spontaneity and authenticity (as opposed to hypocrisy: having feelings not parallel to your actions), giving reigns to passions disregarding consequences in the name of living the moment, and, worst of all, is the notion of patterned-self as the normal. Now, CBT hints that our thoughts, actions, and emotions are not us: there is a self beyond all of that. This is a great catalyst to the aforementioned rituals, duty, and Islamic morality.
Finally, it is worth mentioning that that is not hypocrisy nor superficiality. Because CBT makes clear that behaviours and emotions are deeply connected to core beliefs, the former are just the manifestation of the later. So, CBT intelligently employs a top-bottom approach, which I think is liberating in that it greatly allows for change and development and beautifully widens the probabilities for forgiveness and acceptance. What else could make our lives together more enriching?
October 20, 2017
Very slow going (meaning has low density of information) to the point I have book-reading-induced ADHD returned. When listening also doing other things or reading other texts. The advice so far is pure common sense, but will see how that goes to the end.
One of my oldest statements: "what you believe is what you get" in my (also evidence based) framework seems has similarities with CBT, which also derives its roots in philosophy. "Stoic philosophers, particularly Epictetus, believed logic could be used to identify and discard false beliefs that lead to destructive emotions, which has influenced the way modern cognitive-behavioral therapists identify cognitive distortions that contribute to depression and anxiety." Source
Desensitization from behaviorism seems also gave birth not only to CBT, but also Scientology. Same principle and same period of time in development.
Doesn't address core problems/ beliefs? For example, the common sense way to not be grieving about "the mortgage payments" or "kids" is simply not to have mortgage payments or kids. OK, this can't be reversed, so basically CBT here deals with symptoms that will be recurring (ensuring business continuance for "therapists" of any kind).
For the core beliefs - a lot of suffering comes from anthropocentrism (or egocentrism). "Oh, why god doesn't help me", "why life is so hard for me", etc. Seems CBT is like a yoga compared to jnana yoga (wisdom yoga done in the mind). For example, instead of dealing with lots of symptomatic problems, they can be erased just changing core beliefs (usually acquired through childhood conditioning).
People tend not to tolerate ambiguities or non-predictability, or confuse maps with the territory (Science and Sanity: An Introduction to Non-Aristotelian Systems and General Semantics). By changing culture induced paradigm to more realistic one (accepting reality as-is: unpredictable, without absolute truths or absolute morals, and that words as maps aren't reality too) probably can do more for longer time.
(P.S. OK, It addresses core beliefs in PDF.)
Quitting smoking. Slow, quitting with "realistic" goal setting didn't worked for me. Tried three times. Even if you quit for some time, you're still are addicted - any stimulus can encourage to start again. What worked is cold turkey, final decision. If you can decide "it is enough", then it works immediately and no stimulus would work against you. So, 7 years of smoking and now 12 years nicotine free, without all this B.S. playing with half-decisions.
Interesting to note, there are legends of "smokers going cold turkey are more likely to cheat or relapse on their quit smoking plan than those who use nicotine replacement therapy", that are also represented in this book. I don't know what the real is here (though there are some anecdotal stats without references), but brain has ability to immediately respond to your orders and quitting cold turkey had no relapses at even thoughts level for me after he final decision ("strong order not to send me any impulses requesting nicotine").
(P.S. found some data that contradict statements in this book.
Another: "...cited by 76%, 85%, or 88% of long-term successful quitters. In a large British study of ex-smokers in the 1980s, before the advent of pharmacotherapy, 53% of the ex-smokers said that it was "not at all difficult" to stop, 27% said it was "fairly difficult", and the remaining 20% found it very difficult."
That nowhere near compare to 7% mentioned in this course (chapter 15, 2:20), and this will remove one star from the course.)
Even more, brain has ability to learn things automatically, but people too much confuse everything with years of useless "studying" or "innate abilities".
Likewise in order to gain weight, you first need to give order to eat more.
That's on the thoughts level, which I consider the most important. For behavioral level - common sense.
Pain. Distractions, prayers (haha), etc. in my opinion work only temporarily. If you can change the pain processing with some techniques, then probably it's just an imaginary pain. It's like believing cancer can be "treated" with homeopathy. Of course, I'm not talking about pan that is induced by behavioral (happens with migraines). Sometimes there is pain that even morphine doesn't help (mentioned here as hyperalgesia, probably).
The best help if friend feels some pain is to give him (her) a pill and find the solution to eliminate cause if known. There is no need to try too hard (but Americans probably don't have money for their 100-fold higher drug prices). One of my friends in U.S. suffers from some problems with leg constantly. How she treats it? Suffers with prayers and doesn't look or tries to solve the causes. Wtf, people, it's dangerous idea to treat physicals with mind-stuff. I until very recently was constantly getting crazy proposals how to recover some organs with mind "powers".
So, if you feel the back pain, go to pool, not the psychiatrist, CBT here goes into realm of "self help" idiocies and contradicts with its own chapter of taking medications on time. Behavior, feelings and thoughts can only influence symptoms for the most time, not the causes.
Social support from dog, haha. OK ok, good chapter, but this was funny. If I will die not young as I hope, probably I would be left only with some dog then, haha.
That's just only comments when listening. Overall, not bad, don't know if it will be useful in the long term as I prefer somewhat very easy things. And as I recall what really changed my life for the better, it was just some pretty simple information in the form of realization that I didn't knew at the time. That realization then led to some behavior changes. But it's, probably - not, we don't change, everything is pretty random and progress is somewhat an illusion. Or a dream, whatever we call it. We can only create, experience some shots of ecstasy at the moments.
January 26, 2019
Though I was already aware of CBT (Cognitive Behavioral Theory) and its origins from reading the works of Daniel Kahneman and Marty Seligman, I wanted a deeper drive into what was involved in practice. This book/"course" provided excellent coverage of the topic. It begins with the origin of the method and its relationship to traditional psychotherapy, then goes into the theory and nature of its practice before diving into a wide variety of problems and life situations in which it has shown to be helpful.
Not only does the author provide data on the effectiveness of CBT in these scenarios as well as relevant citations from leaders in the field, there are live recordings of sessions with a handful of patients that are followed from their first visit to through a significant stage of treatment. These real-life glimpses into patient's raw challenges in their own words, as well as the therapist's application and adaptation of the described techniques to these individual cases are what took my rating from four to five stars.
The author also attempts to present the techniques in a "self-help" context, i.e., how the reader could use them on their own, but the live sessions make it quite clear that the adaptive creativity and empathy of a skilled therapist are a critical factor in the application of CBT.
Not only does the author provide data on the effectiveness of CBT in these scenarios as well as relevant citations from leaders in the field, there are live recordings of sessions with a handful of patients that are followed from their first visit to through a significant stage of treatment. These real-life glimpses into patient's raw challenges in their own words, as well as the therapist's application and adaptation of the described techniques to these individual cases are what took my rating from four to five stars.
The author also attempts to present the techniques in a "self-help" context, i.e., how the reader could use them on their own, but the live sessions make it quite clear that the adaptive creativity and empathy of a skilled therapist are a critical factor in the application of CBT.
September 18, 2020
I got this for a discounted price on Audible, out of only a mild interest. But man, was this good value. The lectures and recorded interviews between Satterfield and many of his patients are wonderfully insightful, engaging and, in certain cases, surprisingly entertaining. Rather than a dry and overly scientific program, Satterfield delivers an excellent, warm and refreshingly thoughtful exposition on a whole range of cognitive maladies we might find ourselves or our loved ones dealing with at some point in our lives, and how we might prep ourselves to deal with them. Some of the stories are sad - I especially felt for Maria, who was looking after her dying husband who also had Alzheimer's.
All round, this is a great listening experience.
All round, this is a great listening experience.
July 19, 2018
I listened to this non fiction book, and am so glad I did.
It's a heavy topic, and this book breaks it into chapter/ lectures that make it much easier to understand what could be hard going.
If you're a coach, or anyone who works or cares for anyone, or indeed are someone, with addictions stress, anger etc etc. you can really learn some great survival techniques.
I'm no therapist but I've learned so much about how to handle day to day issues, as well as how to help others take a step back and look at things differently.
Recommended, unless you are a really interested reader I'd suggest the audio. It's quite a few hours too, so a bargain for the monthly 'freebie' if you're on Audible.
My You Tube review is out now!
https://youtu.be/aDUf-Q3worU
It's a heavy topic, and this book breaks it into chapter/ lectures that make it much easier to understand what could be hard going.
If you're a coach, or anyone who works or cares for anyone, or indeed are someone, with addictions stress, anger etc etc. you can really learn some great survival techniques.
I'm no therapist but I've learned so much about how to handle day to day issues, as well as how to help others take a step back and look at things differently.
Recommended, unless you are a really interested reader I'd suggest the audio. It's quite a few hours too, so a bargain for the monthly 'freebie' if you're on Audible.
My You Tube review is out now!
https://youtu.be/aDUf-Q3worU
September 6, 2018
Its hard to rate this books as I am not very familiar with its subject. However, the author essentially uses a descriptive form of writing probably to let people treat this as a self help book. I'm missing out on rigour in doing so, especially on the underpinnings of various tools and techniques and their scientific or even anectodal establishment. There is a lot of material taken from other popular books, perhaps on purpose, to let the readers tread in familiar territory. There are several interviews that provide real context to the material. Overall, I didn't get as much out of it as I had expected.
December 9, 2017
3.5 stars. The early lectures are strong and provide clear examples which the reader can implement in their lives. The last set of lectures looks at a bunch of different topics on a surface level and provide little useable information. In fact, sometimes there isn't much a reader takes away from the lecture outside something generic like, resilient people fair better under adversity. Um, okay. Full review to come
October 3, 2018
This is one of the more uniquely structured of the Great Courses presentations I've come across. Dr. Satterfield presents the psychiatric branch of Cognitive Behavioral Therapy (CBT) as not only easy to understand, but with very practical examples through integration of recorded sessions with some of his patients. He works with a woman with severe social anxiety, a man with anger management issues, and a woman with depression. The course offers links to further help with dealing with these and sleep deprivation, stress management, and overcoming addictions. If you're like me in that you are skeptical of any branch of treatment that is "meds first, ask questions later" approach, then you'll be refreshed to know that this is a hands-on DIY approach to psychology that uses medicine only as a last resort.
January 10, 2020
Experiencing the book in audio format is recommended. It contains in-session dialogue and a lot more can be understood from the tone and dynamic about the empathic side of CBT. Simply reading can be a bit limiting.
Overall a very good book, especially if you never had experience with/as a counsellor because of the dialogues.
Overall a very good book, especially if you never had experience with/as a counsellor because of the dialogues.
March 6, 2021
I liked it.
The course has a lot of therapy sessions included in the lectures. I enjoyed the therapy recordings, but they weren't very practical to my situation.
The wide range of mental illnesses addressed were also interesting but not practical for me.
This course would be best for people considering a profession in CBT. People looking for self help would be better off getting a more specific workbook or
The course has a lot of therapy sessions included in the lectures. I enjoyed the therapy recordings, but they weren't very practical to my situation.
The wide range of mental illnesses addressed were also interesting but not practical for me.
This course would be best for people considering a profession in CBT. People looking for self help would be better off getting a more specific workbook or
May 21, 2018
Such a great introduction.
May 12, 2020
Having the pdf of each of the chapters/lessons was very helpful. It was also nice that the author didn’t just read the pdf, but gave a lot of different explanations in his lecture than what is in the text. I learned listening to the counseling sessions that were shared as well.
I think that for this book to have an impact on your life, though, you would have to actually employ the tools, do the work, … And, most of us won’t, though if we are paying a counselor with set sessions then we probably will.
I think that for this book to have an impact on your life, though, you would have to actually employ the tools, do the work, … And, most of us won’t, though if we are paying a counselor with set sessions then we probably will.
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