Cognitive behavioral therapy was invented by psychiatrist Aaron Beck in the 1960s. He was doing psychoanalysis at the time and observed that during his analytical sessions, patients tended to have an internal dialogue going on in their minds—almost as if they were talking to themselves—but they would only report a fraction of this kind of thinking to him.
For example, in a therapy session the client might be thinking to herself: “He (the therapist) hasn’t said much today. I wonder if he’s annoyed with me.” These thoughts may provoke slightly anxious or perhaps annoyed emotions in the client, who might then respond with a further thought: “He’s probably tired, or maybe I haven’t been talking about the most important things.” What Beck noticed is how this train of seemingly inconsequential thoughts could have a significant impact on how a patient was feeling.
Beck realized that the link between thoughts and feelings is very important and began investigating further. He invented the term “automatic thoughts” to describe emotion-filled thoughts that might pop up in the mind and observed that people weren’t always fully aware of such thoughts but could learn to identify and report them. If a person was feeling upset in some way, the thoughts were usually negative and neither realistic nor helpful. Beck found that identifying these thoughts was the key to the client understanding and overcoming his or her difficulties.
The Importance of Negative Thoughts
The model or theory CBT is based on posits that it’s not events themselves that upset us but the meanings we give them. Thoughts that are too negative can block us from seeing things or doing things that don’t fit or disconfirm what we believe is true. In other words, we continue to hold onto the same old thoughts and fail to learn anything new.
For example, a depressed woman may think, “I can’t face going to work today: I can’t do it. Nothing will go right. I’ll feel awful.” As a result of having these thoughts – and of believing them – she may well ring in sick. By behaving like this, she won’t have the chance to find out that her prediction was wrong. She might have found some things she could do and at least some things that were okay. But, instead, she stays at home, brooding about her failure to go in and ends up thinking: “I’ve let everyone down. They will be angry with me. Why can’t I do what everyone else does? I’m so weak and useless.” She probably ends up feeling worse and has even more difficulty going into work the next day. Thinking, behaving, and feeling like this may start a downward spiral. This vicious circle can apply to many different kinds of problems.
One example of my own negative thoughts occurred in a difficult work situation where I began to think that I was incompetent, ineffective, and ultimately a failure (I’ve written more about this here). It’s important to understand how these negative thoughts, regardless of their original cause, can become unmoored from reality and resistant to correction. Even with numerous examples and feedback to the contrary, I failed to update my assessment that I was a failure. The thoughts took on an emotional life of their own that gave them great power and deep roots.
Negative emotions started triggering negative thoughts no matter how illogical and disconnected the thoughts were from a rational perspective. Ultimately negative thought patterns like this were consumed into a meta-narrative pattern that usually ended in the seemingly automatic thought, “I should probably just kill myself.” The true danger of these thoughts was how long I disregarded them as irrelevant. But disregarding thoughts without opposing them with truth allows them to fester interminably and gain subtle influence over time.
I hope it is obvious that I am talking about something quite different from general negative feedback. If I am lazy one morning or dishonest in a conversation, I want to have negative thoughts and assessments about those occurrences. In fact, I would go so far as to say I try to train myself to have negative reactions following instances where I am shown to lack virtue. The difference is when my negative thoughts defy truth and logic and become emotional parasites feeding on negative emotion and leading to a cycle of depressive tendencies.
Where Do These Negative Thoughts Come From?
Beck suggested that these thinking patterns are set up in childhood and become automatic and relatively fixed. So, a child who doesn’t get much open affection from their parents but is praised for school work might come to think, “I have to do well all the time. If I don’t, people will reject me.” Such a rule for living (known as a dysfunctional assumption) may do well for the person a lot of the time and help them work hard.
But if something happens that’s beyond their control, and they experience failure, then the dysfunctional thought pattern may be triggered. The person may then begin to have automatic thoughts like, “I’ve completely failed. No one will like me. I can’t face them.”
Instinctually, I believe negative thought patterns are often deeply ingrained for a long time before they become a noticeable problem. Most likely, we all have negative thought patterns floating around unaddressed and unnoticed until one of them finds the right set of circumstances to “go viral.” However, I am far more reluctant than many psychologists to blame all my maladies on childhood traumas.
Passions at War Within Us
The biblical author James identifies “passions at war” inside of a person as the cause of interpersonal quarrels.
What causes quarrels and what causes fights among you? Is it not this, that your passions are at war within you? You desire and do not have, so you murder. You covet and cannot obtain, so you fight and quarrel. You do not have, because you do not ask. You ask and do not receive, because you ask wrongly, to spend it on your passions. – James 4:1-3
Lest we miss the fundamental point, James is saying that at the core, every person is at war within themselves. Biblical authors describe this inward war in many terms: idolatry, as opposed to worship of the one true God; sin nature perverting the image of God in us; the flesh against the spirit; and so forth. But it is this war within us, which I will refer to henceforth simply as sin, that in some way is the cause of what CBT describes as negative thoughts.
Fighting Negative Thoughts
Cognitive-behavioral therapy acts to help the person understand the pattern of negative thoughts. It helps him or her to step outside automatic thoughts and test them out. CBT would encourage the depressed woman mentioned earlier to examine real-life experiences to see whether her dire predictions have ever been true in the past or are likely to be true in the future. Then, in light of a more realistic perspective, she may benefit from revealing something of her difficulties to friends or family and allowing them to expose the irrationality of her fears.
Clearly, negative things can and do happen. But a disturbed state of mind more easily prompts us to base our predictions and interpretations on a biased view of the situation, making the difficulty we face seem much worse.
Approaches like CBT, while certainly limited, can help people begin to correct these misinterpretations. CBT is not a solution all by itself, but certainly it is an excellent tool to have at your disposal. However, if you do not have a true and hopeful meta-narrative of the world and your place in it, you simply will not have the ammunition to defeat hopelessly negative thoughts.
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