Cognitive behavioral therapy (CBT) is a modality of mental health therapy that hinges upon the interconnected relationship between thoughts, emotions, and behaviors. Aaron Beck is credited with the origin of CBT in the 1960’s, and was born out of a desire to treat common patterns of clients’ thinking. (Beck & Fleming, 2021)
Practically, when using CBT-informed therapy, I like to start by teaching clients the cognitive triangle.
You can think of the cognitive triangle as a series of roads that travel both ways. A thought may lead to an emotion(feeling) and a behavior. For example, the thought “I am smart” leads to a feeling of “happiness,” or perhaps a more complex emotion like “competence,” or “empowered.” It might also lead to an associated behavior like raising a hand in a class or speaking up in a meeting.
The same thing happens if you start at either of the other two points. A behavior like playing a game, which could cause the emotions of happiness and enjoyment, and perhaps complementary thoughts of “This is fun,” or “I am good at this.”
When explaining the triangle to clients, I point out that emotions are hard to change. It is hard to move from sadness into happiness using will alone, but if the client targets either the thought or the behavior, we should be able to change the other two points.
With anxiety, I like to start by targeting the thought. Consider the thought “I am going to lose my job if I am late again.” A client might have this thought, and when asked about the emotion, will tie it to the feeling of fear or sadness, and an unhelpful behavior like being short with a partner, friend, or coworker. If we can change the thought to something more helpful, then we should be able to change the emotion and the behavior to something more helpful.
Consider what happens if the client reframes “I am going to lose my job if I am late again,” to “There is a corrective plan the company puts in place before firing someone, so if I am late again, I am more likely to get a warning rather than get fired.” With that simple reframe to a less severe consequence, the emotion might change to relief, feeling safe, or content. The behavior might also change, to something more helpful, like getting a good night’s sleep or slowing down to eat breakfast.
Beck, J. S., & Fleming, S. (2021). A Brief History of Aaron T. Beck, MD, and Cognitive Behavior Therapy. Clinical psychology in Europe, 3(2), e6701. https://doi.org/10.32872/cpe.6701