The ABCs of Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a rigorously tested theoretical approach and has proven to be effective at relieving feelings of depression and anxiety, among others, in a much shorter time period. CBT is a core focus of my work and when introducing this to my clients, I often rely on the ABCD model first proposed by Albert Ellis. This simple, yet incredibly powerful, way of viewing our thoughts is a great way to begin with CBT. 

A - The Activating Event

In this model, the "A" represents the things that happen to us throughout our days. In CBT we focus on the events which create negative feelings and behaviors. This could be when someone cuts us off in traffic, we lose our keys, or a friend cancels a meet-up. The important thing to remember is that an event, any event, is a simple occurrence in the universe but, as we will see with the "B", we define what these things mean to us and our decisions. 

B - Our Beliefs About the Event

What we believe about the things that happen to us is a crucial component of this concept. Since events are just things that happen, our belief about those things gives them weight and significance. The "B" is the crucial bridge from occurrence to feeling and even resulting behavior. 

C - Emotional Consequences

Emotional consequences are felt because of our beliefs about an event. Returning to when we were cut off in traffic, we feel angry because we believe our safety has been threatened. Acknowledging this allows us to view our emotions in an entirely different way. 

D - Dispute

Since our beliefs often determine how we feel about an event we must dispute these beliefs in order to feel differently. Will we feel as angry if we try to empathize with the other driver, or think of a time when we made a simple mistake? 

There is much more that can be done with the ABCD model, but trying to implement this in daily living can have an immediate effect on troublesome interactions and experiences. Ultimately, this model will lead to a new awareness and mindfulness of self allowing space for reflection and change. 

To read more about this model and other information about CBT, visit my resources page for my favorite books about these powerful concepts. 

Source: Ellis, A., & Harper, R. A. (1961). A guide to rational living. Englewood Cliffs, NJ: Prentice-Hall.

Expectations

In the last few years of my life I have come to appreciate the power of expectation and how it can literally define much of my waking experience. Expectations are a big focus of my work with clients, particularly when working with cognitive behavioral therapy principles. We are all familiar with the concept of an expectation, but it is not until I have stopped to really consider how my expectations could contribute to my discontent that I began taking things seriously. 

Expectations create a narrow set of circumstances for happiness and satisfaction

An expectation is not hard to understand. We expect something to happen or use it to define the way someone should behave. It seems simple enough, an expectation being a situation we define as satisfactory which will lead to at the very least contentment, and at the most genuine happiness and ease. However, by setting an expectation we have unwittingly defined a very narrow window in which we will be satisfied, and limitless others which are now outside the bounds of satisfaction.

Expectations are a part of life, but we must determine when they are reasonable

As an example, if I expect that every time I go into a restaurant I will be served with a smile and an urgency that communicates the server is interested in my happiness, I will be satisfied. But, at the same time, this expectation also means I will not be happy if my experience is anything else. With this scenario, it seems I will likely be more unhappy with my restaurant experiences given how the world actually works. 

When our expectations take over our experience, we lose control of our thoughts, feelings, and actions

To put this in different terms, I like to think about the expectation as a literal chunk of my happiness. Whenever I place an expectation on a person, place, thing, etc. I essentially give over a chunk of my happiness and expect that that person/place/thing will nurture and maintain it to my liking. This illustrates the biggest issue with expectation, which is that an expectation is ultimately the loss of power over our own emotions. Someone, or something, else is in control.

Engaging in thoughtful monitoring and evaluation of our expectations can lead to more positive and meaningful experiences

Letting go of certain expectations frees us to experience things for what they truly are.  Simple things like driving in traffic or waiting in line become an accepted reality of life rather than another daily obstacle. It isn't easy to challenge our long held expectations, but doing something so simple can have great impact ourselves and those around us. 

For further reading about other cognitive behavioral therapy principles, see my resources page here. 

Two-Choice Dilemmas

The venerable David Schnarch, Ph.D. (author of Intimacy and Desire) applied the phrase "two-choice dilemma" in the context of intimate relationships as a way of conceptualizing a primary area of concern for couples who are experiencing "issues" in their relationship, particularly around sex. As an example, many of us can imagine the two-choice dilemma inherent in the spouse who is cheating, but also wishes to stay in their relationship. The spouse wants two things at once: to have an affair and to maintain a marriage (or avoid the pain inherent in ending it). As Schnarch highlights in The Passionate Marriage, the spouse is saying "I want this other person AND I want you". The problem is the spouse cannot have both, or cannot have both for very long and will ultimately need to account for engaging in the affair (possibly leading to another two-choice dilemma: I want to fix my marriage but I don't want to change!). 

the two choice dilemma gives us a good way to view many of life's "Problems"

While the two-choice dilemma has obvious footing in the context of couples and marriages, I feel the two-choice dilemma gives us a good way to view many of life's "problems" and how they contribute to our daily trials. For those struggling with substance use, the dilemma may be: "I don't want to use, but I also don't want to feel so terrible". For someone in the depths of depression: "I want to push myself socially, but I also want to feel safe". In these examples we see what is ultimately a choice between the lesser of two evils. The problem, particularly with these common dilemmas, is the greater evil (the higher anxiety choice) is often the one which will ultimately benefit us the most and the lesser evil is the more familiar, unthreatening choice. 

Two-choice dilemmas highlight the area in which we can make the most growth

Why bring this up? I have found in my life and in my work with others that the two-choice dilemma, and the inherent confrontation with anxiety it entails, often highlights the area in which we can make the most growth. If you find yourself in the midst of a decision which feels challenging, take it as an opportunity to ask an important question: "Which choice will ULTIMATELY benefit me the most?" 

The most difficult decisions often Bring great benefit

Of course, the more difficult decisions in life are the ones which take more time, and are not quickly rewarded. It would be convenient if every time we challenged ourselves we were quickly given the positive benefits, and motivation along with, in order to be propelled forward in a burst of productivity and progress. With this in mind, it may be best to remind ourselves to take comfort in the struggle of the storm because, when it passes, we will be rewarded with clear skies, smooth seas, and bolstered capability and confidence. 

For further reading about David Schnarch and the two-choice dilemma, check out my resources page.