Telling someone who is depressed, “Just think positive thoughts,” is about as helpful as telling an angry person to, “Calm down.” As well intentioned and wise as the advice may seem, it’ll come off as condescending and won’t help the person hearing it.
But isn’t that basically what Cognitive Behavioral Therapy is?
So why is it so highly regarded as a treatment modality?
While CBT can be boiled down to “think positive thoughts,” it doesn’t capture the whole picture. Sure, part of it is finding things we can tell ourselves to control our emotions–developing positive self-talk–but that’s only part of the process.
A core part of CBT is looking not only at the thoughts we are aware of, but also trying to bring into awareness the thoughts we aren’t aware of. People learn things about the world or themselves, internalizing a way of thinking about things. These internalized beliefs steer the meaning people take from events, influencing thoughts, which in turn influences how they feel.
For example, someone who experiences trauma may “learn” on some level that they don’t deserve to be happy. This isn’t something they actively believe, but is something their minds have internalized, a belief that they’ve internalized. They may not even be aware that they believe it, but it will become a filter that affects their thoughts and experiences.
If you were to tell that person, “Just think that you are happy,” they’d be unable to believe it. Their internalized belief would make them simply reject the reality of the thought as soon as they had it–they’d feel like they were lying to themselves, or that the thought was so obviously not true that it would be meaningless. No amount of “think happy thoughts” will move the needle much until they reckon with the internalized belief.
That’s where the meat of CBT is–it’s exploring the internalized beliefs that a person may not even be aware that they have. It’s taking that belief and making it explicit, putting into words the lesson their brain had learned. Once it’s understood it can be challenged, modified, countered, or resisted.
Then, when they say to themselves, “I can be happy,” and it feels like they are lying to themselves, they can think, “This feels like lying because part of me has learned that I don’t deserve happiness. That doesn’t mean it’s true.” That lets them start to believe “I can be happy” and slowly, over time, this thinking will come to compete with the negative belief, and ideally replace it.
Thoughts, beliefs, emotions, and behaviors are all part of CBT. Understanding how each part develops, how it influences the others, and which parts can be controlled becomes the focus of treatment. We help people understand how their brains work so that they can step into the driver’s seat. When we tell them “Think positive thoughts,” we’re not offering a condescending solution; we’re reminding them of a well discussed and understood coping skill, both of us knowing it’s more complex than that, not as easy as it sounds, and that it’s also fundamentally the path out.
Compassionately understand your thoughts. Challenge negative beliefs. Think positive thoughts. Believe positive things, even when your mind is telling you not to.
It’s the simplest and hardest thing in the world.