Unraveling Negative Thought Patterns: Using CBT to Alleviate Chronic Anxiety

CBT can have tremendous benefits for your personal health, both emotional and physical. This modality has been in practice for over 50 years and was founded by a world-renowned psychologist named Aaron Beck. First and foremost, CBT is a solution-focused therapy. From day one, the work helps you understand the interactions of your thoughts, beliefs, and actions with your day-to-day life. Within the CBT relationship, you are never alone in the process; you and your therapist work together as a team towards a solution. This team approach provides a sense of comfort, support, and empowerment. From your very first session, you are working towards identifying and implementing a solution for the anxiety that has been bothering you for so long. This approach helps you gain awareness of the maladaptive thinking processes that are feeding the anxiety below the surface. CBT focuses on identifying these thoughts and helping you learn new ways to think and attribute meaning to the world around you.

Two common examples of maladaptive thinking patterns that CBT can help to transform are defense mechanisms and “should” thinking. Defense mechanisms form in your unconscious mind as responses to anxiety-provoking situations. They are your brain’s attempt to maintain a steady state in times of chaos and stress. “Should” thinking is a way of communicating with yourself that implies a right or better way of doing things based on learned beliefs and expectations. This pervasive voice is critical by nature, and it tends to lead with expectations that are out of touch with reality.

Defense Mechanisms

• Denial is when your mind blocks external events from your consciousness by refusing to acknowledge their existence. For example, a smoker may have all of the information pointing to the dangers of smoking and the reasons to quit but still may refuse to see the truth. Facing the truth would mean facing the fears and the difficult responsibility to quit. Denial can present itself as a barrier to anxiety treatment because your mind is afraid that dealing with the anxiety will be too difficult or painful, so you refuse to acknowledge it as a problem in the first place. Because each CBT session is guided by a trained therapist, it allows people to approach their most difficult truths in a protective, supported environment.
• Repression is how your mind hides away too-intense memories and information from your consciousness. For example, a man has an intense fear of riding in elevators, and this fear is significantly affecting his life because he works in a high-rise building. He knows he is absolutely terrified of elevators, but he cannot remember when the fear started or why. His mind has repressed, or hidden away, the sentinel fearful event because it was too traumatic. CBT helps you work through repression to understand the basis of your fear, and then helps you reformat your thinking and the way you attribute meaning to those anxiety-provoking situations in order to diminish or eliminate that fear.
• Rationalization is when you try to explain a behavior away, telling yourself that something is okay even when you know it’s not. “My anxiety is normal; my life is just really stressful right now because of X, Y, Z.” We do this because it’s easier to blame someone or something else for our emotions instead of taking responsibility and facing the anxiety head on. This can keep people from entering or progressing in treatment because they try to normalize their inner pain. Life is stressful, yes. But that doesn’t mean you have to suffer with anxiety. CBT empowers you to look clearly at your anxiety, acknowledge that it’s something you need and want to work on, and move forward with doing so even when it’s difficult.
• Sublimation is a defense mechanism that can be either productive or destructive. Sublimation is the transformation of an unwanted impulse or feeling in order to channel it into something else. Sublimation can be negative when you are substituting one negative behavior for another, such as transferring the urge to smoke into the urge to overeat. CBT helps you learn to engage this defense mechanism in a positive, helpful, and therapeutic way, by teaching you how to identify your anxious feelings and redirect them (or sublimate them) into something productive and acceptable. It involves retraining your mind and emotions to transform your habits from something unhelpful, such as anxiety, into something productive, such as work, exercise, diet, or creativity.

“Should” Thinking

“Should” thinking is comprised of preconceived notions that have come to rest in your mind as what “should be.” This “should” factor is a container of unhappiness and unmet expectations that can cause your anxiety to build and your treatment to halt when left unchecked. “I should have done that differently!” “I should be able to handle this!” “This isn’t the way it’s supposed to be!” The critical “should” takes away your power and leaves you feeling disappointed and helpless. When you hold yourself and others up on a pedestal, the results will always fall short. When you are trying to compare what is to what you wish it would be, it can lead to tremendous anxiety. CBT helps you deconstruct these “should” beliefs and replace them with an understanding and appreciation of what is. It teaches you to replace those unrealistic expectations with a realistic view of yourself, your family, your job, and the world.