Therapists use various tools and techniques to help you identify and change negative thought patterns and behaviors.
Here are some common therapeutic tools and techniques used in CBT:
Cognitive Restructuring
Behavioral activation
Activity Monitoring
Journaling
Psychoeducation
Graded Exposure
Mindfulness and relaxation techniques
Role-playing and behavioral rehersal
Behavioral experiments
Success Stories
List of problems/symptoms:
- worry, restlessness, tachycardia, constant agitation, fatigue, insomnia (difficulty falling asleep and staying asleep during the night), swating, difficulty relaxing, gastric disorders, low appetite, the feeling that something bad is about to happen, tingling in the hands.
Automatic negative thoughts:
- thoughts of devaluation: “I`m good for nothing” “I`m ugly and unattractive”, “I don`t have anything intelligent to say”, “I`m going to die alone”, “no one will want to know me better”.
The main emotions:
- worry, irritability, fear of post-operative recovery, restlessness, feeling alone.
Unwanted behaviors:
- insomnia, social withdrawal, difficulty in socializing, difficulty in creating and maintaining social relationships.
From Andrew`s accounts, the clinical picture so far highlights:
- generalized anxiety disorder with a slight depressive component.
Later, however, after discussions about his life history and his family of origin, the traits of an avoidant personality disorder began to be highlighted.
Working Hypotheses were:
(1) the childhood interaction with both dysfunctional parents who did not know how to satisfy his basic needs facilitated the development of early cognitive schemas (abandonment schema)
(2) the childhood interaction with a mother who was always busy and a father who was always absent – both physically and emotionally, gave him a dysfunctional model of relationship as a couple.
(3) the childhood interaction with the grandmother who always forbade him to do things that a child would normally do, gave him a dysfunctional model of relating to those around him, the client always going on the premise that he should not bother anyone.
The Therapeutic Objectives were:
- Reducing anxiety,
- Developing communication skills to be able to initiate and maintain a long-term relationship,
- Developing communication skills to interact more easily with friends,
- Developing the ability for communication and assertiveness, to be able to impose healthy limits in relationships with others.
The Emphasis was placed on:
- the psychoeducational component, which helped the client to understand better where the anxiety comes from and all the symptoms he feels.
- Decatastrophization, to adress the cognitive distorstions commonly seen in anxiety disorders. This techique it`s a cognitive restructuring technique used to treat cognitive distortions. In anxiety disorders it is common for people to tend to obsess on catastrophes out of fearful thinking. This technique aims to help the client overcome their irratinal thinking with a question worksheet that helps him become aware of how unlikely such an event would take place. Then the client sees that his unreasonably fearful thoughts are blown out of proportion and how to cope with them when they are triggered.
- The techniques used: cognitive restructuring, Socratic questioning, behavioral activation, activity monitoring, journaling, mindfulness and relaxation techiques, homework assignments.
Working with the dysfunctional cognitive schemas that the client acquired during childhood (mainly the schema of abandonment and rejection), proved to be a key element that helped him to start having successful interactions and social relationships.
By the end of the therapeutic process, Andrew not only got rid of generalized anxiety, but he started to live a life that before these therapy sessions, he was afraid to live. He allowed himself to be himself, to be authentic, and to let others know him for who he really is, without fearing that he will be rejected or abandoned when the others really get to know him.