Cognitive therapy helps you identify automatic unrealistic thoughts and modify the interpretations and the meaning of the thoughts, resulting in a decrease of anxiety. I utilize several Cognitive Behavioral Therapy approaches including Rational Emotive Behavior Therapy, Cognitive Therapy, and Dialectic Behavior Therapy depending upon the nature of the issues we are working on and your needs.

In the first stage of Cognitive Therapy, you are taught to be aware of your worries and self talk by keeping a daily diary or journal, called a thought record. In the thought record, you will write down your thoughts, feelings, beliefs and the interpretations associated with them. Important details to record, if we would be working on anxiety issues, may include:

  • what were you doing when the anxiety began?
  • the content of the anxious thoughts,
  • the meanings attributed to them, and
  • what  did you do in response to the feeling(s) and thoughts?

We will review the thought record and identify how the thoughts were interpreted. Using gentle reasoning and Socratic questioning, we will verbally challenge an unrealistic belief. This helps you to identify the cognitive distortion, typically a faulty assessment of danger, an exaggerated sense of responsibility, or fears that thinking something negative will make it come true.

Once you are able to more easily identify your self-talk, we may initiate a few behavioral experiments to identify and possibly restructure thinking about cause and effect. For example, if someone with Obsessive Compulsive Disorder, a form of anxiety, believes that smoking four cigarettes will prevent their family from being harmed in an auto accident, they may be asked to smoke only three cigarettes and then wait to see if family members are actually harmed that day in an auto accident. This experiment’s results can be used as a springboard for further discussion about other types of magical thinking. Over time, people learn to identify and re-evaluate beliefs about the possible consequences of engaging in or refraining from self-defeating behaviors and subsequently begin to decrease their anxious responses.

Salkovskis PM. Psychological approaches to the understanding of obsessional problems. In: Swinson RP, Antony MM, Rachman S, Richter MA, eds. Obsessive-Compulsive Disorder: Theory, Research, and Treatment. New York, NY: Guilford Press; 1998:33–50.

Here is a link to National Association of Cognitive-Behavioral Therapists Website which provides a brief overview of CBT: