What Is CBT/DBT ?

What Is Cognitive

Behavioural

Therapy ?

Everyone goes through times in their lives when things seem to be going wrong -- it may be that a relationship has broken up, work is difficult when relations with managers are difficult, family members have problems or maybe you have been involved in an accident. It is easy to think that the fault lies with someone in particular, or even with yourself. It is so easy to get pulled into a spiral of negative or automatic thoughts about yourself, others, or the world in general. This way of thinking does not produce solutions but only drags you further into a black hole. You can end up feeling depressed, hopeless and physically and mentally exhausted. Worse, you can find yourself dwelling on situations, feeling pity for yourself and eventually you isolate yourself from others. This is not unusual -- it happens to all of us sometimes. 

Solutions to these problems can come from CBT, "Cognitive Behavioural Therapy". This kind of therapy does not dwell on the problems in your past which you cannot change, but rather focuses on your present problems and difficulties to enable you to work around them and think about them differently. This turns problems into opportunities. You can feel pleasure at having overcome them successfully, giving you a real sense of achievement.

CBT begins with the core idea that our thought processes affect the way we feel and the way we respond to situations. Often you can change the way you think by looking at the evidence and challenging your unhelpful ways of thinking. This is a challenge but it's worth it because you come out feeling accomplished and positive.

 

In order to feel better it is important to change your thinking but also to change your behaviour -- for example, instead of avoiding frightening situations, you face them. The more you do this, the better equipped you are to face new challenges. You develop confidence and resilience, learning new skills.  

In CBT, the fundamental concept is the idea of core beliefs -- the beliefs that are fundamental to the ways we perceive ourselves, others, and the world.  They are often irrational and may originate in early childhood. They do not necessarily need to have origins in trauma or in invalidating environments, but simply as children, we tend to develop rather fixed impressions that can last throughout life if they are not challenged.

Uses for CBT

CBT has been shown to be an effective way of treating a number of different mental health conditions.

In addition to depression or anxiety disorders, CBT can also help people with:

  • bipolar disorder

  • borderline personality disorder

  • eating disorders – such as anorexia and bulimia

  • obsessive compulsive disorder (OCD)

  • panic disorder

  • phobias

  • post-traumatic stress disorder (PTSD)

  • psychosis

  • schizophrenia

  • sleep problems – such as insomnia

  • problems related to alcohol misuse

What Is Dialectical

Behavioural

Therapy ?

Dialectical behaviour therapy (DBT) is one type of cognitive-behavioural therapy. It was developed in late 1980 by Marsha M. Linehan and is used to treat individuals who have chronic suicidal thoughts, suicidal ideation and urges to harm themselves. The condition is sometimes referred to as Borderline Personality Disorder (BPD).

DBT is a highly structured therapeutic approach, It aims to develop acceptance and change-orientated strategies. For instance, in DBT a therapist accepts clients as they are, but at the same time acknowledges that they need to make changes in order to achieve their life-worth-living goals. These help highly suicidal individuals to find a synthesis that enables them to achieve a "life worth living". This concept is fundamental in DBT. Therapy aims to reduce self-destructiveness and therapy-interfering behaviours.

DBT consists of four main modules that teach clients a set of skills to help them manage their intensive emotions. One assumption is that the clients' life is unbearable because their emotions are dysregulated and they lack the self management strategies that can help them to bring their emotional intensity under control. The modules are: Distress Tolerance Skills (crisis skills used to reduce emotional intensity and keep the client safe), Mindfulness (to teach clients to stay in the present moment rather than engage with past experiences or future worries), Interpersonal Effectiveness (that teaches clients to use their communicative skills more effectively) and Emotional Regulation  (teaching the management of emotions in a more constructive and effective way).​

DBT is well supported by much academic research. It has been demonstrated to be effective in reducing suicidal behaviour, self-harm, substance misuse, eating disorders, Post-Traumatic Stress Disorder (PTSD) and chronic depression.

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