What is Cognitive Behavioural Therapy and how can it help?

By Prof. Paul Aveyard, Behavioural Scientist

Cognitive Behavioural Therapy (CBT) is a form of talking treatment used to help us manage our problems. It helps change the way we feel, think and behave. Although commonly CBT takes place with a therapist it is also something that you can practise by yourself. There are many self-help treatments that teach how to use CBT techniques. One technique we taught our Emotional Eaters is called 'Catch it, Check it, Change it'.

Catch it, Check it, Change it

We recommended CBT to help our Emotional Eaters because they had developed unhelpful patterns of eating that led to putting on weight and feeling bad about themselves. Cognitive is the C in CBT and addresses the thoughts that lie at the heart of unhelpful behaviour. Often thoughts are not necessarily explicit as though a person is saying them inside their head. These thoughts are often automatic and the first task in doing CBT for yourself is to catch the thoughts. A person who eats when they are stressed could think, "Nothing else matters right now. I feel so stressed I just need a moment to myself. I know that eating biscuits will make me feel better". The next task in CBT is to check the rationale behind these thoughts.

Checking means asking yourself whether the thoughts are really true. In this case, you might question some of the statements. Is it really true that "nothing else matters"? It may well be correct that you "need a moment to yourself". But is it really true that "eating biscuits will make you feel better"? You know that you would enjoy the taste but afterwards you will feel bad because eating the biscuits will not help you lose weight and also the very thought of gorging yourself on biscuits is not really the image you want of yourself.

Having checked your thoughts and found some of them are wrong, your final task is to change them. The aim here is to think through the thoughts you would like to have run through your brain when one of those moments strike. In our example, our Emotional Eater might say instead, "I am stressed and I definitely need a moment to relax. But I know that sticking to my promises to myself is important and I am going to relax by watching TV".

Practise the Practice

If you use CBT it is important to remember that this kind of response takes practice. You have to practise thinking this way so that when trouble strikes you are ready to put the routine into practice. Your old thoughts are often so automatic that they will take over unless you try. The more you practise, the more likely you will find your new routine takes over.

The B in CBT stands for Behaviour and it does not just mean changing behaviour by practising thought control. You can do things to change your behaviour as well as think differently. If your weakness is eating biscuits when you are stressed or upset then can you get rid of the biscuits? If you can't get rid of them altogether, can you package the biscuits into one biscuit packages using cling film? This way you might not munch your way through an entire package.

If you want to try to modify your behaviour with CBT you need to try it when you are feeling good. What might be going on when your eating feels out of control? What automatic thoughts are going through your head? Are these correct? If not, what might you try to replace these thoughts with? What can you do to stop the behaviour?

Paul Aveyard is professor of behavioural medicine and fellow of Wolfson College, Oxford.