3 Phases of Cognitive Behavioral Therapy (CBT)


The continuous negative feedback loop caused by post-traumatic stress disorder, obsessive-compulsive disorder, depression and generalized anxiety disorder often requires direct intervention to stop the cycle. Without proper intervention, bothersome beliefs and fears will continue to dominate your mind and threaten to rule your life. Since people are wired to pay close attention when fears come to fruition, the relatively rare poor outcomes or other negative occurrences reinforce these anxious thought patterns. Thankfully, the development of cognitive behavioral therapy, or CBT, has provided psychologists with a way to interrupt this cycle and restore healthy thought patterns. Since mental health care typically worsens symptoms at first, it is important to understand the process of obtaining CBT. This guide will help you learn what to expect before you sign up for this effective therapy option.

Phases of Cognitive Behavioral Therapy

Breathing Exercises

Your CBT sessions will start with the development of healthy coping skills, so you can naturally calm yourself down. This is an important aspect of the therapy since you will continually challenge your beliefs and naturally calm down to rewire your system. One of the most effective self-calming rituals is breathing exercises. Since you do not need any special equipment to perform this coping technique, it can be used anywhere and in any situation.

Many people attempt to calm themselves by slowly inhaling, and then immediately exhaling with force, which does little to calm your mind and body. Since anxiety actually causes you to hyperventilate, a more effective way to self-calm with breathing is to take a long deep breath in and hold for 10 seconds. After the ten count, exhale for as long as possible and hold again for three to five seconds. Repeat until you feel the anxiety subside. Your psychologist will introduce this method and have you practice it under controlled conditions before starting the next phase.

Mindfulness Practice

The second phase of CBT teaches you to become mindful of your inner thought patterns and feelings. Negative thought patterns frequently invade your subconscious in trying situations. Approaching your challenges with a negative mindset can actually become a self-fulfilling prophecy and contribute to the situation ending in a bad outcome. Negativity also exacerbates anxiety, which can cause it to trigger full-blown panic attacks. Furthermore, if a negative outcome does occur, it reinforces your worries and strengthens the unhealthy thought patterns and feelings.

Recognizing the swell of anxiety and negative thought patterns can help you avoid inadvertently making the situation worse. When you address your current state of mind, you are able to challenge the negativity by turning toward positive statements. You must first achieve total mindfulness, however. You will likely accomplish this feat by jotting down every thought and feeling in a journal for about two weeks.

Trigger Exposure

The third phase of CBT focuses on identifying and exposing yourself to your personal triggers. Triggers can be sights, smells, noises, locations and experiences that ignite your mental health symptoms, including anxiety. You will make a full list of specific triggers with help from your psychologist. Your psychologist will then create a guide for exposing yourself to the triggers. Repeated exposure to your triggers will allow you to address the thoughts and feelings that arise, and then calm yourself using the breathing exercises.

Sitting through anxiety and waiting for the feeling to subside is another important part of this process. You will record your anxiety rate on a scale from 1 to 100 before exposing yourself to the trigger. You will sit through the experience until you notice your anxiety or other distressing symptoms start to fade. Over time, you will notice that your anxiety rating, both before and after the exposure exercises, steadily decreases.

Seeking Cognitive Behavioral Therapy

You can speak with a psychologist to see if you would be a good candidate for cognitive behavioral therapy techniques or exercises. Your underlying mental health disorders and life experiences, especially trauma, will help your psychologist determine if this type of therapy will work best for you. You can also elect to simply try out CBT techniques for anxiety or depression and gauge its ability to reduce your anxiety and other mental health symptoms to a manageable level.


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