CBT Skills for a Good Life
Disclaimer: The contents of this blog post may be entirely true, entirely false, or somewhere in between. Reader discretion is advised. If in doubt, consult a medical or mental health professional.
I picked up a random CBT book a while ago, titled Confidence and Success with CBT by Avy Joseph and Maggie Chapman. At the time, my mental health issues weren't too serious. The book was very repetitive and I could not read through it.
Recently, I picked up the book again. This time, I needed something to help dig myself up from my own rut. The repetitiveness of the CBT book is actually to help form the habit of doing CBT in real life.
CBT stands for Cognitive Behavioral Therapy. As the name implies, it is something you would do with the help of a therapist (counselor or clinical psychologist). However, seeing a therapist is very much a hit and miss process, because every therapist is different. The younger (and cheaper) ones are often too inexperienced to help, and as the client I could sense their inexperience. On the other hand the senior ones are expensive enough to cause me to not want to commit to 8 or more weeks of CBT sessions (e.g. RM300 per session), whereby the eventual outcome isn't even guaranteed. So much for real therapists.
I believe that (and I say this without qualification) CBT is the most effective and important non-medicative tool to pull one out of anxiety and depression. Antidepressants only bring you to a better place so that you can start exercising some CBT skills on yourself and regain your life back. No, this is not medical advice; I am not a doctor or mental health expert. On the contrary, I work in IT!
The ABC Model
CBT theory espouses the ABC Model. An Event / Trigger (A), leads to some Belief (B), which causes some Consequences (C). This is why while the same events or triggers (A) may occur to different people, the individuals emerge from it with different consequences (C), because different people form different beliefs (B) about the events (A).
Beliefs (B) come in two categories, Healthy Beliefs, and Unhealthy Beliefs. CBT is the tool to address Unhealthy Beliefs, i.e. beliefs that lead to unhealthy Emotions, negative Thoughts, unhelpful Behaviors, and Symptoms.
For example, if you failed to find a job after numerous tries (A), you may come to believe that you are no longer employable (B), and thus you refuse to even apply for jobs anymore (C). On the flip side, another person may come to the belief that since there are many jobs out there they just need to do something differently (B), and thus retrain, reskill, find jobs in a different career track, loosen a hard requirement, get a recruiter's help, or put out a white flag on LinkedIn (C), thus setting themselves up for success.
Why is it important to address these unhealthy beliefs? As the example above, you can easily see why such an unhealthy belief leads to joblessness, which leads to the self-damning and global "I'm a loser" belief, which may end up throwing you into depression. These unhealthy beliefs are not based on reality. Do you want to live a life based on fantasy or reality?
This is where CBT comes in.
Three Major Disturbances
In 1955, Albert Ellis first articulated the principles of REBT (Rational Emotive Behavior Therapy), a particular CBT psychotherapeutic model that is fundamental to the aforementioned book. He identified three major themes of disturbances, into which we can classify most if not all of our unhealthy beliefs:
- I must perform well or outstandingly at all times
- Others must treat me nicely, considerately, or fairly at all times
- Life must be comfortable or hassle-free
Can all unhealthy beliefs really be classified into three major themes? So far, it seems to hold up pretty well, e.g.
- "I need to be able to do things perfectly, otherwise it is not worth doing" (Theme 1: I must perform well at all times)
- "I worry that I will fail" (Theme 1: I must perform well at all times)
- "I worry that people will disapprove of my endeavor" (Theme 2: Others must treat me nicely at all times)
- "I am disappointed that people keep misunderstanding me" (Theme 2: Others must treat me nicely at all times)
- "Working towards a goal brings me discomfort. I can't stand it" (Theme 3: Life must be comfortable or hassle-free)
- "I must not be bored when I'm working. I can't stand boredom" (Theme 3: Life must be comfortable or hassle-free)
Three Irrational Derivative Beliefs
For each unhealthy belief, there are three irrational derivative beliefs that can stem from the unhealthy belief:
- Awfulising – A belief that a bad event is not just "bad" but 100% ABSOLUTELY BAD: "It is a disaster/catastrophe", "It is awful/horrible/terrible".
- Low Frustration Tolerance – A belief which underestimates your ability to cope: "It is intolerable", "I can't cope", "I can't stand it", "It is too hard".
- Self-Damning – A belief where you judge yourself in a totally and globally negative way: "I am a loser", "I am a failure", "I am weak", "I am stupid", "I am worthless", "I am useless", "I am an idiot".
Step 1: CBT on Unhealthy Belief
For an exercise, let's take the belief (B), "I must not be bored when I'm working. I can't stand boredom". The trigger (A) for this belief is likely to be repetitive work, or no work at all (which for some reason is very common for me lately, i.e. employed to do seemingly nothing). The consequence (C) in my case was well, to put it mildly, I basically held like 10 jobs in the past 10 years, including 3-4 self-employment stints.
CBT (according to this book, at least) dictates that we examine the belief with the following three checks:
- Reality check
- Common sense
So let's have a CBT session:
Reality check The reality is that every job will eventually become repetitive and some of the same. And there will be some jobs that are not so demanding and do not reach 100% utilization. In the case of consulting companies, there would also be bench time.
Common sense tells me that doing the same things again and again to produce different results is the definition of insanity. Jumping from job to job in order to "be less bored" will end up with the same result, as each job will have its own element of boredom.
Helpfulness It is not very helpful to beat myself down with the thought that "I must not be bored when I'm working. I can't stand boredom", only to end up wasting time hopping from job to job, doing and redoing training, wasting HR time and resources, and doing myself a disfavor with recruiters. It is more helpful to offer my help to colleagues that need help, take the initiative to start a self-driven project, offer my services to another part of the company, or inform my line manager of my desire to be more useful.
Step 2: CBT on Irrational Derivative Belief(s)
Often it is not the unhealthy belief that is debilitating, but the derivative belief. It is easy to see how the example belief in Step 1 can be subject to all three: Awfulising, Low Frustration Tolerance (LFT), and Self-Damning.
As an example, let's address the awfulising derivative belief, e.g. "Being bored at work is very very bad, 100% end-of-the-world bad".
Reality check The reality is that the company still sees me as valuable because they are paying me a salary each month. The fact is that I am fortunate to be able to have a job as there are many who do not.
Common sense tells me that being bored at work is not the worst thing in the world. There are many worser things than having a boring job. In fact, having a job is a privilege.
Helpfulness The debilitating effect of thinking that a boring job is 100% end-of-the-world bad is not helpful to me in order to perform at work. It is numbing and unhelpful. It causes me to look for another job, which when repeated makes the situation even worse.
And we can repeat the above as such for low frustration tolerance (e.g. "I cannot stand being bored") and self-damning (e.g. "I am useless").
CBT is an important skill to have in your toolbox in order to combat unhealthy beliefs. Yes, a dose of realistic thinking is necessary in life, but often the mind automatically short-circuits to the most damning and unhelpful of beliefs without us realizing it. The brain is somehow very susceptible to unhealthy beliefs, and by itself does not actively perform reality checks on these beliefs. We thus need to help our brain out.
Once you have gained an awareness of the beliefs underlying your thoughts, feelings, or symptoms (not easy and may take time), you may then be able to apply CBT on the belief for a better quality of life. You ought to start today, don't wait for anxiety and depression to debilitate you and your loved ones.