Day in, day out your mind is working, engaged in interpreting external events and internal responses, comparing experiences, ruminating on memories, and making calculations about the future. Your thoughts are your constant companions.
A cognition is what you are thinking about at any given moment. Whether you can put your cognitions into verbalized words or not, your thoughts are the self-talk or dialogue of your mind. Your thoughts have a significant impact on how you feel, which in turn has a significant impact on your behavioral and emotional responses. But thoughts are not always accurate. Many of the thoughts that go through your mind are not actually true, rational, or helpful for progressing toward your goals.
How can you know if your thought is accurate or not?
Cognitive behavioral therapy (CBT) is a psychotherapy that can be used to reshape thoughts, enhance positive emotions, change behaviors, and re-form rational beliefs. CBT can also help you improve your emotional intelligence. It is an effective treatment for numerous mental health conditions, such as depression, anxiety disorders, eating disorders, personality disorders, marital issues, addictions, and substance use disorders. While CBT is not a fix-all solution for every mental health disorder, it is considered the current gold-standard psychotherapy intervention.[i] Brain neuroplasticity means that people of all ages can create new neural pathways as old thinking patterns are challenged and re-routed using CBT. You are not stuck with your current feelings or thoughts, and, although this process requires effort, it is well worth the investment.
“Our unique patterns of thinking, feeling, and behaving are significant factors in our experiences, both good and bad. Since these patterns have such a significant impact on our experiences, it follows that altering these patterns can change our experiences."(Martin, 2016)
CBT focuses on current life rather than the past, and helps develop awareness of triggers, self-talk, automatic thoughts, emotions, and behaviors, and how to reframe irrational beliefs. To begin using CBT, you will follow structured steps to change your thoughts. If you change your thoughts, you will naturally change your emotions and behaviors.
The Steps of Cognitive Behavioral Therapy
- Hear your internal dialogue: listen to your thoughts
- Analyze your thoughts: look for possible distortions in your thoughts and label those distortions
- Reconstruct your thinking
Remember the acronym HARP – and that you need to HARP on your thinking so you won’t harp on those around you, or yourself!
Even if you don’t consciously think a thought, a cognition can trigger you to feel a certain way; we call those thoughts automatic thoughts. Many thoughts are negative and highly repetitive, and most people have NATs (negative automatic thoughts). Negative self-talk can lead to unhealthy, unpleasant feelings.[ii] With CBT, thoughts are evaluated in the context of being helpful or harmful, positive or negative.
Cognitive distortions are inaccurate thoughts that reinforce negative thought patterns or emotions. Learning the ABCs of cognitive behavioral therapy can help us effectively combat these common irrational thinking errors. Learn how to recognize the 10 irrational cognitive distortions here. The ABC model originates from rational emotive behavioral therapy.
Many of us naturally experience what we call “crooked thinking.”
Activating event → Emotional or behavioral consequence
Your neighbor doesn’t return your wave when you get home. “She’s so unfriendly. Why even try, we’ll never be friends,” you dejectedly tell yourself.
This is also called A-to-C Thinking. A-to-C Thinking is believing that you have little or no ability to influence your feelings and that events and situations directly cause your emotions and behavior. Crooked thinking has the tendency to make you a victim – because you think the causes result from something beyond your control.
But we can use the simple ABC model to break down practicing CBT so that we aren’t skipping over our ability to actually control how we respond to activating events. A→ B→ C Thinking allows us to avoid the consequences of thinking errors.
ABCs of CBT
A = Activating event
B = Belief
C = Consequence
D = Dispute
E = Effective outcome
Based on what you choose to think and believe about activating events, you will have a behavioral or emotional consequence. You may not always think you are choosing. And this is where you have the opportunity of learning how to identify your thoughts and feelings so that you can choose a rational thought and thus your corresponding behavioral and emotional consequence/outcome.
Download the Nedley Health CBT Worksheet to begin practicing the steps of CBT. With the worksheet in hand, let’s look more closely at the ABCs.
A – Activating event
Activating events can be whatever you are externally experiencing, what people are saying or doing, how circumstances are playing out, or what your own internal thoughts and feelings are (depression, anxiety, self-deprecating thoughts, oppression, etc.).
Example: Activating event - Your neighbor doesn’t return your wave when you get home.
B – Belief
A belief is your brain’s way of placing a value on something. Often your core beliefs are your fundamental ideas about yourself, others, and the world. For example, you believe that when someone does something nice for you that you should say “thank you.” You may also believe that you are a bad person or that you cannot trust people. These beliefs are examples of values you make about things – whether right, wrong, or neutral.
Thoughts and beliefs are similar, but beliefs tend to be deeper seated than thoughts. Thoughts are the commentary running through your mind. A thought can be a verbal or non-verbal cognitive response to something, such as, “Mark is only offering to take me to dinner because he wants my support for his fundraiser.” Your thoughts are rooted in values and beliefs that you hold, which may not actually be helpful or accurate. You must evaluate your thoughts and beliefs for cognitive distortions.
Example: Belief - I need to be friends with my neighbors
Thought - “She didn’t wave because she doesn’t like me. We’ll never be friends”
C – Consequence
You respond to your beliefs with both emotional and behavioral consequences. Of themselves, your feelings or emotions are not wrong. It is what you do with your emotions that has consequences. Your emotions are often good clues to assess what kind of thoughts you are having. The goal of CBT is to achieve emotions that will help your brain be calmer and be in a better position for using emotional intelligence. Learn more about emotions here.
Behaviors are the things that you do, or the things that you don’t do. Often your behaviors come as the result of the emotion that you are experiencing.
Example: Emotional consequence - Dejected, sad, grumpy
Behavioral consequence - Isolate, cease friendly gestures
D – Dispute
This is the way in which you reframe your irrational, distorted beliefs. A reframed, restructured belief or thought is one that is based on what is true, accurate, helpful, rational, and positive, when possible. It is important to test your thoughts against truth (truth is accurate and not distorted - it takes the whole picture into account). We recommend the Filter for Accurate Thinking from therapist Krystin Henley for specific ways to dispute irrational beliefs.
Example: Dispute - “While I’d enjoy being friends with all of my neighbors, my happiness does not depend on it.”
“She may have not seen me, but even if she had, she has still been kind to me in other interactions.”
E – Effective Outcome
Once you’ve disputed your irrational belief, you will experience effective changes in both your behaviors and emotions. Often disputed beliefs result in lessened emotions and calmed behaviors, and should leave you in better control of your response to an activating event.
Example: Emotional outcome – Peace, calmness
Behavioral outcome – Smile and wave, kindness
The ABCs need the 4 steps of CBT
The four steps of CBT help you better understand what is taking place with your internal dialogue (Beliefs) and emotional and behavioral responses (Consequences). If you’ve just experienced A→ C Thinking it’s time to HARP on your thoughts. Ask yourself what you are thinking (Hear) about the Activating event, Analyze your thoughts for distortions, and then work for a more helpful, rational way of thinking (Reconstruct). Reconstructing your thinking is how you Practice Disputing irrational beliefs and will lead to an Effective change in emotions and behaviors.
In our fast-paced world, the average person doesn’t even try to listen to their thoughts, let alone analyze them! Whether you practice CBT habitually on your own or with a CBT therapist, you will experience a change in how you think. As you change the way you think about things, you will often experience lasting changes in your mood, outlook, relationships, productivity, and life in general.
Check out these resources as you practice the ABCs of CBT:
Nedley Depression & Anxiety Recovery Program Online
Telling Yourself the Truth
SOS: Help for Emotions
Lost Art of Thinking
Telling Each Other the Truth
[i] David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in psychiatry, 9, 4.
[ii] Clark, L., & Robb, J. (2020). Sos Help For Emotions: Managing anxiety, anger, and depression. SOS Programs & Parents Press.