Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 3/8/2021
Have you ever caught yourself telling lies to yourself about... yourself?
“You’re a failure.” “You’re unattractive and no one could possibly love you.” “Your friends don’t really care about you.”
For people suffering from depression, anxiety or any other number of mental health issues, thoughts like these can be so common they go unnoticed. They’re a type of negative self-talk constantly playing in the background of the mind.
Think about what this constant stream of insults would do to someone — how it would affect their emotions, their behavior and their ability to thrive in their daily lives. The effects could be disastrous.
Whether you suffer from anxiety, depression or are just mean to yourself on a daily basis, learning to manage and change these dysfunctional thoughts can be game-changing.
And that’s what cognitive behavioral therapy is about.
Cognitive behavioral therapy (CBT) is a form of psychotherapy useful in the treatment of stress, anxiety, depression, eating disorders, serious mental disorders, substance abuse and more.
CBT built upon existing therapies in the 1950s through the 1970s and added an emphasis on cognition or thoughts as a root of emotional and behavioral problems.
CBT seeks to help people identify the unhealthy and disordered thoughts that fuel negative emotions and behaviors.
These unhealthy thoughts can largely go unnoticed until you learn to identify and correct them.
CBT is generally done with a supportive mental health therapist.
CBT is a well-researched form of psychotherapy and there are numerous studies demonstrating its effectiveness.
Cognitive behavioral therapy stemmed from what already existed in behavioral therapy, but brought about a new emphasis on cognition — or the role of thought — in our behaviors and emotions.
The earliest form of therapy that could be called CBT came from Albert Ellis in the 1950s and was called Rational Emotive Behavior Therapy. REBT focused on changing irrational beliefs about life and the world such as, “I should be good at everything” or, “I have no control over my happiness.”
According to Ellis, these types of ideas set people up for emotional distress and could be corrected to rational thoughts.
Following Ellis came Aaron Beck and Cognitive Therapy in 1967. Beck’s version was based on a strong relationship between therapist and patient, whereby the therapist helps the patient confront negative thoughts.
Beck believed there were three forms of negative thinking that appear as automatic in depressed people and that interfere with regular, healthy cognition, memory and perception. Those three aspects of cognition were: automatic thoughts, cognitive distortions, and underlying beliefs or schemas.
These early approaches were new for their unique focus on cognition. The idea that human thought could be responsible for maladaptive human emotion — like depression or anxiety — was further developed in the decades to come.
Psychotherapy became not only concerned with changing behaviors and emotions, but modifying people’s ways of thinking, their beliefs about themselves and the world around them, and their expectations.
The premise of CBT is that psychological and emotional problems are caused by dysfunctional or unhelpful ways of thinking or behaviors. These problems feed into the negative thoughts, which feed back into the destructive emotions and behaviors. It’s one big, ugly psychological cycle.
CBT aims to interrupt that cycle. First, by learning to recognize dysfunctional thoughts and behaviors. Second, by learning to correct them.
You learn healthy problem-solving skills and ways of speaking to yourself that can start to turn the ship of emotional dysfunction. Then, you repeat this again and again.
Those unhelpful thoughts — “Today’s going to be a shit day,” “No one at work really even likes you,” “Oh look, you woke up fat again” — often begin the minute you open your eyes in the morning.
You may not even “hear” them, but you woke up again with that sense of dread and mix of sadness and worry. CBT begins when you are first able to intercept or “hear” those thoughts.
Generally, a therapist assists with the CBT journey. They’re there to help you identify the negative self-talk and irrational thoughts that feed into your day. And they’re there to teach you the skills to relearn a healthy way of thinking.
It generally involves taking an introspective look at the questions bothering you and coming up with rational answers that help address them.
CBT is a process. It takes time. You can’t unlearn destructive behaviors in a day. You’ll work with your therapist regularly to confront your thoughts, fears and emotions.
You may use role-playing, practice journaling or learn meditation techniques to help you gain control. More than anything, you’ll practice what you’re learning until it becomes a new way of life.
CBT helps patients regain control of their emotions, thoughts and behaviors.
CBT is a widely researched form of therapy. It has been repeatedly shown to be a superior form of therapy when compared with other types, according to a paper published in the journal Frontiers In Psychiatry. It is generally considered the “gold standard,” or the best currently available in the field.
One thing that makes CBT superior is the volume of research behind it. It is the first type of therapy that could be considered evidence based, as it was the first to be studied in scientifically stringent conditions such as randomized trials, similar to the testing of pharmaceutical drugs.
A 2012 meta-analysis looked at the effectiveness of CBT in treating a wide range of problems. For each disorder, the researchers looked at a comprehensive representative sample of the available scientific literature on CBT.
Problems such as anxiety, stress management, personality disorders, depression, substance abuse and bulimia all showed varying levels of success with CBT, leading the authors to conclude: “... It is clear that the evidence-base of CBT is enormous.”
Cognitive behavioral therapy is used for a wide range of mental health problems and help people cope with other emotional issues, including:
Eating, sleep and sexual disorders
Obsessive-compulsive disorder (OCD)
Manage symptoms of or preventing relapses of mental illnesses
Identify better ways to manage emotions and expectations
Treat a mental illness when medications aren’t effective or not an ideal treatment option
Learn techniques for coping with stressful life situations
Cope with loss or grief
Resolve relationship conflicts and learn better ways to communicate
Overcome emotional trauma related to violence or abuse
But it’s also used in things like marital counseling, insomnia, and substance abuse counseling.
If flawed or destructive thoughts could be at the root of your problem, or you’re just having a hard time coping with things properly, CBT is a potential solution.
The short answer? As long as it takes.
But the long answer is that there’s no real definitive time period for how long CBT takes to work. Because CBT is used to help treat a very wide array of issues and disorders, there’s no real telling how long your individual treatment will take.
For some people, feeling better can take just a few weeks of visits (typically an hour per day, one day per week), but others can take months to start feeling any kind of relief or measurable progress.
It’s important to remember as you enter CBT that every person’s case is different, as will be their response to treatment.
If you’re interested in learning more about CBT and putting it into practice in your own life, here are some worthwhile resources to check out:
Happify: This mobile phone app gamifies mental health, making better moods the goal of scientifically-backed activities and games. (iPhone/Android)
CBT of Los Angeles: This L.A. practice provides a page full of exercises to help patients practice CBT approaches.
Positive Psychology Project: Here you’ll find 25 exercises including worksheets to practice CBT at home and in your daily life.
Psychology Today: Psychology Today’s therapist database will help you find a psychotherapist specializing in CBT in your area.