Move over, Freud: There’s a new, popular kind of therapy in town, and it doesn’t involve lying on a couch or talking about your mom.
It’s called cognitive behavioral therapy (CBT), and it’s actually not that new, having been around in one form or another since at least the 1960s. CBT is a form of talk therapy where you interact with a trained therapist, but it isn’t about dredging up your past. Instead, it focuses on the present and teaches you to recognize how you respond to stressors in your life and how you might change your responses in order to ease your distress.
“The therapist and client work together, with the understanding that each person has expertise. The therapist has expertise about how to change behavior and the client has expertise on their life experiences and what matters most to them,” says Kristen Lindgren, Ph.D., a psychologist and CBT expert who practices at University of Washington Medical Center-Roosevelt.
CBT is based on the idea that our thoughts, emotions and behaviors are interconnected and that changing one can change the others. This may sound trendy, but it’s also effective and has been rigorously studied. There are variations of CBT for all kinds of mental health problems, from anxiety to depression to schizophrenia to substance use disorders.
The goal is to learn skills you can use outside the therapist’s office to address real-life problems, Lindgren says. The more you practice, the more of a habit CBT skills will become.
“If you’re someone who has good intentions but need someone to be accountable to, I would make an appointment with a therapist,” Lindgren says. “But if you know you’re a person who is good at being self-taught, it’s reasonable to think about doing it on your own.”
Here are her tips for practicing the techniques at home (or wherever you happen to be).
Change your perspective
Using a technique called cognitive restructuring can help you modify problematic thoughts, which in turn can help you change your behavior. The next time you notice yourself feeling anxious or depressed, ask yourself: What am I thinking about or what emotions am I struggling with that might be causing me to feel this way? Notice if any particular thoughts or memories give rise to distressing physical symptoms; you can even make a list. Doing this will help you begin to understand how your emotions and thoughts are connected and what triggers you.
Balance your thoughts
Many mental health struggles involve distressing, but inherently flawed, thoughts or predictions that influence behavior. For example, if you get anxious when you’re in crowds and thus actively avoid them, you might tell yourself that if you tried to go to a crowded place—like a sports game or concert—you’d panic, do something to embarrass yourself, and wouldn’t enjoy it. That belief then reinforces your avoidance.
Notice how your brain rationalizes decisions you make based on fear or avoidance and then ask yourself: What’s the evidence for that thought? Are there any cold, hard facts that things will go poorly, or am I just speculating? Consider if there are other thoughts you could have that would be more balanced or helpful. If you changed your thought process a little to be less fearful or negative, what new emotions might crop up? If you work to make your thoughts more balanced, your emotions and behaviors are likely to follow.
Be patient with yourself
Change won’t happen overnight, so don’t expect that if you try CBT on your own (or even with a therapist to guide you). Instead, your goal should be to build your skills so you feel more equipped to handle whatever challenges your mental health wants to throw your way.
Focus on setting yourself up for small victories, then slowly build up your goals over time. Be proud of any positive change you make, no matter how small it may seem. Recognize that progress isn’t linear; some weeks will be easier, others will be harder, and that’s normal.
Be kind to yourself
It’s easy to get caught up in negative self-talk without even realizing it. But constantly getting down on yourself isn’t going to inspire the confidence needed to help yourself feel better.
When you notice negative thoughts creeping in—things like “Why can’t I just get it together?” or “Other people don’t have this problem”—replace them with something kinder. Ask yourself if your friends would ever say the things to you that you say to yourself. No? Then don’t allow yourself to say them, either.
This doesn’t mean you should make excuses for yourself when you’ve actually made a mistake or done something wrong, but instead should encourage you to cut yourself the slack that you usually reserve for others.
Do what you love
Anxiety, depression and other mental health struggles have a way of stripping away the activities that matter to you in life, either because you become fearful of them or lack the motivation you once had to pursue them. Maybe you loved to read but now feel tired all the time. Or maybe you used to like going out with your friends but now fear being away from home at night.
Make a point of taking time to do one or two things on a regular basis that always used to bring you joy and do your very best to be present instead of distracted about the past or worried about the future. Afterwards, ask yourself how you feel now that you did the thing. Did it make you feel better?
Maybe you’re ruminating about work problems when you’re trying fall asleep or beating yourself up over something you said to a friend when you should be finishing an important work project; either way, you aren’t focused on the present moment.
Instead, try to switch your thoughts whenever they aren’t aligned with what’s happening right now. Ask yourself: Do my emotions reflect what’s going on in this moment? If not, focus on your senses. What do you see and hear? What’s going on in the world around you? Try to be mindful about what’s right in front of you instead of what happened in the past or what you’re afraid will happen in the future.
A bright future
Ultimately, one of the most powerful things about CBT is that it can give you hope.
“It is inherently optimistic. It teaches you to believe that change is possible and that you have the power to effect change in your life,” she says.