Cognitive Behavioral Therapy (CBT) and Negative Core Beliefs (NCB) – Identification
Cognitive Behavioral Therapy (CBT) is an effective psychotherapy for a wide range of emotional and psychological problems. The basic tenet of CBT is that our emotions are affected by our cognitions. To put it another way, the way we think affects the way we feel.
A CBT therapist aims to help people who are experiencing emotional problems by helping them identify the ways that their way of thinking may be causing their problem. Therefore, a first step in CBT is the identification of “Negative Automatic Thoughts” (or “NAT” for short): these are the thoughts that accompany unpleasant or unhelpful emotions, such as depression or anxiety.
A closely related goal of the CBT therapist is the identification of so-called “thinking errors.” These are common (and unhelpful) ways a person thinks about himself, others, and the world around him. These thinking errors often twist or distort experiences, making the person seem like a failure, others seem hostile, and the world seem dangerous or unpleasant.
Identifying NAT and related thinking errors is half the battle in CBT: once a person is aware of their unhelpful thoughts and mental habits, they can choose to think more rationally and healthily. A CBT therapist can guide you through this (fairly straightforward) process.
As a psychiatrist and therapist working in Edinburgh, I use CBT techniques extensively. Some of my clients are very happy with the results they get simply by challenging their NAT and Thinking Errors; they feel much better and don’t feel like digging any deeper. However, most clients are willing to “get to the bottom” of why they had their emotional problems in the first place. I tend to encourage this additional work as it helps reinforce the progress made to date and, in my opinion, helps prevent the client from relapse at a future date.
This additional work involves a search for “Negative Core Beliefs” (or “NCBs”). These are the unhelpful beliefs that a person has had throughout their childhood and adult life. They are core components of the person’s personality and are the root cause of the person’s thinking errors and ultimately their NATs. If a CBT therapist can help a person change their Negative Core Beliefs (or, more realistically, find more rational and healthy alternatives), then the person’s Thought Errors and NATs will decrease, and their emotional problems will decrease. (usually!).
One difficulty with NCBs is that a person is rarely aware of them. Even when someone is proficient at identifying NAT and thinking errors, the cause of these problems may be hidden. But we can use NAT and Thinking Errors as clues.
In my experience as a Psychiatrist in Edinburgh I have found two techniques to be most beneficial in the search for the BCN of my clients.
First of all, there is the “Repeated Questions” method. I ask the client what a particular NAT that they have identified means to them; He gives me an answer and then I ask him what that answer means to him. He’ll give a second answer, and then I’ll ask him what that second answer means to him, and so on. In a short space of time, the client ends up with a global statement that cannot continue. This is a Negative Core Belief. Probably best demonstrated with an example:
Client: “There are heaps of rubbish in Edinburgh” (he is angry)
CBT Therapist: “What does that mean?”
Client: “That I’m the only one who cares”
CBT Therapist: “What does it mean if you’re the only one who cares?”
Client: “People don’t care about things that aren’t their personal property”
CBT Therapist: “And what does it mean when people only care about their own stuff?”
Client: “People only care about themselves”
(“People only care about themselves.” This is the client’s negative core belief: an overarching statement that is uncompromising and will clearly influence the way you view and interact with others in other areas of life,! not just littering!)
A second method of identifying Negative Core Beliefs is to look for the “themes” found in a person’s many NATs and Thinking Errors. Such themes may be “I am a failure” or “Life is meaningless” (very common in depression), or perhaps “The world is a dangerous place to live” (common in anxiety conditions).
Once a client’s negative core beliefs have been identified, the CBT therapist (along with the client) will attempt to explore alternative, more rational ways of thinking about oneself, others, and the world in general. This is where real and sustained recovery from emotional problems takes place and I will discuss this in a follow-up article titled “Cognitive Behavioral Therapy (CBT) and Negative Core Beliefs (NCB) – Treatment.”
