Cognitive Therapy

Anxiety takes many forms. Treatment for anxiety also takes many forms, including cognitive therapy and cognitive techniques. Here you'll learn the basics of the cognitive school of therapy and many cognitive exercises you can begin implementing into your daily life to reduce anxiety.

Remember that help is available to you in person and online. Trained cognitive therapists can further help you develop a cognitive restructuring program from the essentials presented in this section.

What is Cognitive Therapy?

Cognitive therapy is a school of therapy concerned with how people's thinking affects their behavior and sense of self. At its core, cognitive therapy holds that a person's thinking—especially ongoing negative thoughts and self-talk—plays a major role in how they self-identify, the ways they approach and avoid conflicts, and ultimately the ways they act in response to negativity.

Cognitive therapists teach their clients that much of their thinking is counter-productive, untrue, and exaggerated. Everyone is prone to looping negative thoughts, and cognitive therapy gives people specific terms and techniques to help them label and experiment with these patterns. Once such thoughts are seen for what they are—mental representations, not stone-cold facts—people in cognitive therapy work with a therapist to apply their new knowledge to their daily lives.

Cognitive theory also says that many of the most common psychological disorders, including those on the anxiety spectrum, are exacerbated and given legs as a result of a person's ingrained patterns of thinking and feeling. You also learn that your thinking affects the severity of your anxiety symptoms.

Even if you feel that cognitive therapy is not the right fit for you, many of its ideas and exercises can be implemented individually outside of a therapeutic setting.

What does Cognitive Therapy Teach?

People in cognitive therapy for anxiety (and curious learners like yourself) learn many new ways to strengthen and correct their own thinking. Here is a short list of the concepts a cognitive therapist may help you understand:

• Self-evaluation – Every minute of every day, people evaluate how they feel about who they are, what they've done, and what they want to do. They ask themselves if they are competent enough, handsome enough, successful enough, and so on. People with anxiety evaluate themselves as incapable of coping with the symptoms and stressors of life. These evaluations are constant and have a cumulative effect on an anxious person's thought process.

• Self-talk – Are you more likely to give yourself the benefit of the doubt or to blame yourself for shortcomings? The ways you speak to and think about yourself and your abilities greatly influences how you approach problems and solutions. This running commentary provides you a ceaseless play-by-play of how you think and feel about yourself and your abilities. A person adapted to negative self-talk ("I'm an anxious mess, I'll never recover, I'm too dense to be helped") only reinforces further negative self-talk.

• Automatic/Negative Thoughts – Over time, the ways a person self-evaluates and self-talks can become automatic habits. People with anxiety disorders may come to believe that their situation is hopeless as a result of weeks, months, even years of unflattering and exaggerated negativity. Cognitive therapy gives people the space to realize their current feelings are the product of long-standing patterns of thinking and feeling, not a direct reflection of reality. A large part of cognitive therapy is working on bringing these automatic, unconscious patterns into conscious focus to be manipulated and tweaked for the better.

• Irrational Beliefs – Just because you think and feel a certain way does not mean you or your life truly are that way. A thought is irrational if it is always believed to be true ("I am an anxious person and always will be") and if it is based on a false assumption ("I feel anxious and don't deserve better"). Irrational thinking can take on many specific forms called cognitive distortions.

What are Some Common Cognitive Distortions?

Cognitive distortions are specific ways of thinking, feeling, and evaluating your character, worth, or situation. They are often negative, always exaggerated, and are easy to slip into, especially if your anxious mind is already working overtime.

Here is a handful of common cognitive distortions—do you recognize any in your own mental life?

1. Filtering – Focusing on the negative (or positive) of a situation only. For negative thinking, this is often called the negativity bias

2. Polarized (Black and White) Thinking – Believing that there are only two options for any situation—a good option and a bad option. This limits nuanced and creative problem-solving

3. Overgeneralization – Believing a specific example of your behavior ("I embarrassed myself at a party") will always happen in future situations ("I will always embarrass myself at parties")

4. Catastrophizing – Always expecting or imagining the absolute worst-case scenario; never considering a neutral or positive outcome

5. Personalization – Believing that the actions of others around you, or the situations that arise, are always related to something you did/didn't do. You make yourself responsible for everyone and everything

6. Global Labelling – Calling yourself a loser, a coward, a hopeless case. Any unexamined term you define yourself as colors and confines how you come to think and evaluate yourself in the future.

Some of these cognitive distortions likely hit close to home--but don't get discouraged! After you identify these and other distorted thought patterns, there are many ways you can retrain yourself to think of them differently and better. Here are a few:

1. Demand Evidence – Can you prove these distortions are true? Can you prove them wrong with positive examples?

2. Double-Standard Method – Talk to yourself and address your situation as you would to a close friend or loved one. Give yourself the same self-compassion you reserve for helping others

3. Re-attribution – Regardless of how personally responsible you feel for a situation, think up external factors that were likely at work

4. Survey Others – Feeling anxious about an event coming up? Ask other people if your feelings are justified; get outside guidance and opinions

5. Cost-Benefit Analysis – List out the pros and cons of thinking, feeling, or behaving the way you do. Are your anxious tendencies really worth it? Do they produce results?