What is CBT and why would hypnotherapists use it?

Cognitive behavioural therapy (CBT)?is a combination of behaviour therapy and cognitive therapy. Because it combines an interest in the client's thoughts and behaviour it can work where cognitive therapy or behaviour therapy alone might not.

Behaviour therapy?is an action-oriented therapy that is concerned with people's behaviour rather than cognitions (in its purest form). It draws on behaviourism e.g.?classical and operant conditioning, punishment?and, more often these days,?reward systems. In 1961 Ayllon and Azrin designed a hospital ward environment in which reinforcers were applied to change the behaviour of patients with psychosis. The patients were given tokens for appropriate behaviour which they could then exchange for certain privileges. This was known as a?token economy?and helped to modify their behaviours into more productive ones.

A lot of research has been conducted that shows?CBT?to be very effective with many issues including anxiety, depression, anger, body dysmorphic disorder, chronic pain, eating disorders, OCD, PTSD, panic, phobia and relationship problems. It is therefore an?evidence-based?approach. CBT has been recommended by?NICE?(National Institute for Health and Care Excellence) as a treatment of choice for post-traumatic stress disorder, OCD, bulimia nervosa and clinical depression in the?National Health Service?(UK).

At its simplest,?CBT?asserts that?we feel the way we think. Much of?CBT?comes from?cognitive therapy. In sum,?CBT?encourages us to tackle inflexible, extreme, self-deprecating beliefs and develop flexible, moderate, kind ones. There is an appreciation of the client's?environment?which includes people around them. Emphasis is placed on?behaviours?- both mental and physical - that are maintaining the problem and on finding new behaviours that could lead to solutions. For example, worrying with anxiety is replaced by a more carefree attitude, and the lethargy experienced by someone with depression is gradually replaced with energy and exercise.?CBT?is?focussed and goal-oriented.?Like?cognitive therapy, it is assumed that beliefs mediate between the real world and our thoughts and behaviours.

CBT?is concerned with?how problems are maintained?in the present rather than searching for root causes, say, in childhood, or hidden, deeper problems. There is a recognition that emotional problems may stack on top of one another e.g. feeling embarrassed about feeling depressed. The aim is to empower the client to take control of their problem and ultimately become their own therapist with the tools they have learnt. A simple?ABC approach?is used where the client is encouraged to identify?A = Activating event, B = Belief, and C = Consequences.?'D' and 'E' are sometimes added, where D = Dispute the belief and E = Effect of alternative beliefs on feelings and actions.?For example, a client with depression might find:

A = not getting a promotion at work

B = I'm not good enough

C = not applying for future promotions, becoming dissatisfied with work, feeling depressed, not progressing financially, and feeling left behind and disempowered, loss of appetite.

D = I am good enough - lots of people were overlooked for that promotion, other opportunities will arise, I may be good enough but I need more experience in current post first.

E = Effect of alternative beliefs on feelings and actions

An important aspect of?CBT?is that?it is not reality but our perceptions of reality that makes us the way we are.?The reality might be that someone pulled out in front of us on the road but whether we get angry or not is for us to decide. The world, or another person, didn't make someone angry, they make themselves angry.

CBT?dovetails well with?hypnotherapy?and is a relatively easy therapy to understand. In combination, hypnotherapy and CBT can create a very effective and brief therapy for most psychological issues. Not all hypnotherapists are trained to use it, but those that are may or may not inform their clients?they are using it as it is integrated amongst a number of other useful tools to facilitate changes within the client on many levels e.g., to process thoughts and images, to challenge and manage core beliefs and automatic thoughts and feelings, and facilitate behavioural changes.

Want to find out more about how CBT and hypnotherapy could help you or attend training to integrate them into your practice? Let's chat or see the website for more details.

Resilience is Contagious! Catch it if you can ??

Further reading

Alladin, A. (2008)?Cognitive hypnotherapy: an integrated approach to the treatment of emotional disorders. Chichester, England: John Wiley & Sons, Ltd.

Ayllon, T., & Azrin, N.H??The measurement and reinforcement of behavior of psychotics.?J Exp Anal Behav. Nov 1965; 8(6): 357–383.?https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1338117/