What a Cognitive Behavioral Therapy (CBT) Session Looks LikeJun 14, 2021
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therapydr judy and i sit down to discuss the ins and outs of how does that
therapywork and how can it be used to change your thoughts, your emotions and ultimately your behaviors and then we decided we would do a mock therapy
sessionwith myself role playing someone who has a
whatis it, yeah, some kind of core belief. belief core belief yes and it will walk me through that belief and show viewers how CBT can move them closer to the truth and closer to a healthier way of thinking, reacting and behaving when it comes to our emotions and thoughts so my My main belief in this mock therapy
sessionwill be that I feel like I'm unpleasant to everyone, right that's my main belief, I feel like I'm pretty lovable to most people, yes I'm sure not everyone's real core belief rybody kyle, exactly, you're playing a patient where um has that core belief and I think it's a common core belief for people, whether they want to admit it or not, that's right um and it makes sense because it's one of our core What drives it is to be loved by people, I mean it's just a basic human drive and it's not just about the emotional well-being of you feeling loved, it's actually about the super physical survival if you are not loved and nurtured then you could die, you know your physical being will. actually die well if you're not well nourished if you're not well cared for so I think this is a good one for us to role play great well it'll be great for viewers to see
whata therapy session could be .
I like it and also how CBT is used so I'll let you take it ok so Kyle what's up for you today? I recently broke up with a long term partner and it's been one of the many breakups I've had in my life and at this point I'm getting older I have gray hair I feel like the clock is ticking and I don't feel like I'll ever find someone who loves me love me I don't feel like I've found it already I feel like I've dated enough people to make that happen and it's not happening and I don't see anything changing and my depression is through the roof because of it ok so I'm sorry about your breakup and I'm sorry that that has led to a cascade of thoughts in your head about what this really means about your future for relationships and ultimately you so we're going to do a practice technique right now and this technique is called scaling and what What this will help us with is having some of those automatic negative thoughts, I mean you said a lot right now, really just in your description we're going to work with one of those and it helps us sort them out.
Here's a way for you to see what that automatic thought leads to if you think automatic thoughts are like an iceberg rg and automatic thoughts are the tip of the iceberg you can see on the water it's conscious but you have to tune your consciousness to it , but the deepest thoughts are actually submerged, you can't see them, they're below the water level and that's what we have to get to because that's the crux of the matter. These core beliefs drive how you feel, how you think, and even the rules you have in life about how you should behave to be secure in many ways.
Start with an automatic thought. I heard you say that you were thinking based on this breakup and others that I may never find someone to love me. Yeah, so let's work with that automatic thought. There were others, but I think this one is good. one to work with so if your automatic thought is i'm not going to find someone to love me what could that mean what does that thought mean to you well i look around at my friends and family who are in a relationship and having children who are posting pictures who are sending christmas cards with their loved ones and i dont feel like i will have that i feel like while everyone else will have love in their life and meaning and purpose i wont have anything i will be alone and i am alone and i feel it too Alone, right and that's devastating, so what could it mean if you were alone?
Let's take that part so you know you broke it as well I don't think I'm going to find it. someone who loves me or who i love or will have this relationship with and to me that means i'll be alone so what would it mean if you were alone? what if that happened? what would that mean to you? on the one hand it means no one me on the one hand it means people wouldn't be alone it means people don't want to be with me which is horrible it's a horrible thought um and it also means I won't I won't be able to enjoy life like I could I i'll miss the dinners and the vacations and the weekend trips and the kids and the legacy and the memories there's a long list of consequences of being alone right and you just said that one of the things being alone means would be that maybe that it means that nobody wants to be with you and so what would that thought mean if it were true, if nobody wanted to be with you, if that were a real fact, like, what would that mean that there is something wrong with me and if there is something wrong with you If that thought were true, then what would it mean that I haven't done a good job in my life it could be I haven't done a good job becoming someone people want to be okay with who people want to be with.
I want to be in a good relationship and what would that mean to you if people didn't I don't want to be in a relationship with you that you didn't do a good job and people didn't want to be around you that I hope I'm worthless and that I'm a waste of time yeah well that's the core belief the core belief is i'm worthless or sometimes people will let's just say i'm nasty sometimes they're interchangeable but that's how we got to the core belief we keep doing this escalation technique where any negative thought you have i ask you what does that mean if that thought were true what would that mean about you are ok well if that thought were true that would mean i would be alone ok what would that mean if that was it true?
If you were alone, that would mean that no one would want to be around me. got down to a deeper and deeper level until he got to this idea that that would mean that I was worthless that maybe I'm just not capable of being loved that I'm not deserving of love and that's what we mean by a core belief which It's a horrible thing to think about and I want to make it clear that core beliefs aren't necessarily what you truly believe about yourself, but core beliefs are your biggest fear, which means if it were true, it would be devastating if you really were. . is it worth it ess or if you really weren't lovable that would be devastating I don't think if you would have asked me three minutes ago or four minutes ago do you think you are do you think you are a worthless person I would have said no, quite right, yes, and I think when people first encounter what might be their core belief they have that kind of reaction, but I really don't think it's true, at least not intellectually, but it's really about the fear of man. but what if it were true?
What would that mean for my life and what could it become and what kind of legacy would I leave behind if that were true and everyone has different fears for different reasons? I'm incapable, you know, and that to them is crippling like man, if I wasn't capable, that could ruin my life, you know, and it's not that they really think they're incapable, but it's like, oh my gosh, if that was TRUE. The consequences to my life would be devastating and I wouldn't even be able to tolerate it, so this is what we're working with and I always say when we come to our core belief, it doesn't necessarily have to be your core belief, but let's work with it. let's see if you know that part of this is kind of hypothesis testing like let's work with that and see if that might be true for you okay when people have core beliefs they usually have rule conditionals and assumptions about how the world will work . and how they should act within that world, so what I mean by this is that when you have such a core belief that I'm worthless or unlovable, there will be certain things that you believe are scripts that you have to keep going in order to have some semblance of emotional security or to prevent that core belief from coming true so we're going to talk about some of those things that might be for you when someone has a worthless core belief what might that do in terms of your expression of your needs and desires to other people such as what kind of rule could you have if you truly believe you might not be worth anything or if you fear that might be true what kind of rule would you give yourself in terms of how you might communicate your needs and desires to others Well, uh, I would probably only do it in terms of a romantic relationship. just in that um because if I really was worthless, then I would need to be with someone else who couldn't see that, who would never know that I was worthless, right?
So I would have to go out with you accordingly, right? I would. I would not go after people I really wanted to date because they are too smart to realize that, at least that would be as a possible thought there, yeah, and I would also try to prove myself even though I thought I wouldn't. I was worth nothing, I'd try to show it off I look at the big house I have and I look at how happy I'm being and I look at how funny my friends are and I look at my great work and I look look look look look I'm worthless I'm worthless I'm worthless, right , yeah, no, those are great, examples of the kinds of rules you could have when that's your core belief and you could also have a kind of rule where you felt like in certain situations you had to contribute something. that it would be worth it even in friendships like how are you like always about them instead of oh now we can talk about me for 20 minutes right?
Do you sometimes find yourself doing that with your friends? forever since i can remember constantly making sure the other person was happy with our interaction first professionally friendship romantic family are you happy with our interaction constantly? h I'm glad about this because I don't want you to have an interaction with me where you're not happy ok ok ok again another great example of a possible assumption or rule you could put on yourself when this is the core belief , etc. as you can imagine there's a long list of these if we sit here for two hours we could probably come up with 20 other rules that probably play some role in your life but I want to move on to the problem solving phase because that's what CBT is all about. , it's like we solved the problem so yeah I love that part so we've identified the problem and there have been many different ways that you can work with your core beliefs but you have to remember that these beliefs have been there for a long time and they're kind of pervasive like this idea that I'm worthless, as you just demonstrated, it's not just about your romantic relationships, it's about how you interact with friends, professionals, colleagues, you name it.
There's kind of insight here into almost every domain of your life, so what we're going to do now is one of my favorite ways to work with core beliefs and assumptions once we've identified them and that's to create a
behavioralexperiment. individualized. It's okay to try to see if your core beliefs and the assumptions that follow them really apply to each situation, as I mentioned the core beliefs feel omnipresent and we want to make them more conditional. situations and with certain people can make me feel this way and maybe that even stems from childhood but it doesn't apply to every thing well and the way we shake it off is to get evidence that CBT is a science program and this it's kind of like our mini science experiment that we're going to do together so there's just a couple of rules to this experiment we're going to design an experiment around one of your rules or assumptions and the one that I don't want to use what I think which is good because you want to start with a fruit at hand that isn't too active, but we shouldn't start with the rule that you date people who might be a different level than you because that one is a bit deeper, but we start with something that
lookslike you can tackle and there's a little bit of risk, it makes you feel a little bit uncomfortable, but it's not the worst that could happen and I think that would apply to the rule.
I always have to take care of other people's needs first because there are so many people that apply to this, it can apply to your intimate relationships, but it can also apply to friends, colleagues, anyone else you know, so let's take that rule and try . to test it out with a person in your life and I would also say again this person should not be the most active person but it should be a person where there is some skin in there is some skin in the game but this is not a person in which if this experiment failed,it means you tried to challenge this assumption and failed in some way and actually made your core belief feel more meaningful to you that you would feel bad about it but it wouldn't be so bad that you'd be torn to pieces so is there such a person which are you?
Hey? I have always taken care of this person's needs first, as I usually do, and I could probably try something with them and if so. If it works, I'd be a little sad about it, but like I'm not devastated. um hmm, well I have a friend in mind. years oh wow ok so ten years yes um but we are not like everyday friends right yes but you guys have been family and like most of the time you are probably taking care of this friend how are you? oh let me give your advice how can i bring you are you sick like that kind of relationship ok this experiment will be very limited in duration it will be very specific so i need you to set a specific date and time that you will do this in the next few seven days. be very specific because we need to get that data and it's going to be something that's contained, which means it should be something where it's not like free-for-all from now on I'll just be you know I'm vomitous and they always tell them I'll list all my problems first, but it's more about this particular conversation.
I'm going to go to him with the problem and once I talk about the problem, I'll get the advice from him. I will be like this it was very helpful thank you bye and don't do that about him at all because that's the other thing where with your kind of belief and poor assumptions sometimes you'll be like and how you are and then you spend another 45 minutes dealing with it absolutely like that we don't go to do that, this is going to be literally you go to him to express a need of yours to express a problem that this person give you the advice and then say thank you that was very helpful to talk to you later so that's the experiment and I have to go do that and you have to go do that and then what do you expect me to report to you?
So first we're going to predict how you think that's going to go based on your beliefs or maybe your assumptions and rules, like how do you think that might go? In terms of maybe how you might feel or how they might feel or how they'd do well, I mean, I think it's going to be okay, okay? Do you think he'll have some sort of internal judgment on you like Kyle? um, I mean, maybe I don't know, yeah, well, let's be specific and you think that's a possibility, yeah, okay, yeah, and obviously you don't want that to be anyone's thoughts about you. "You're going to keep that heartbreak to yourself for a bit and then you said it" It's probably going to work out okay, I mean, you think you can pull it off, but it might make you feel a little uncomfortable, yes, and I hope I don't slip up and start saying and how are you and say, well, I'm sorry. that you went through something you know you like and then you just turn around yeah yeah exactly right so we've set a couple of expectations one is okay I'm sure he'll be okay giving me the advice but maybe in his mind he'll be like whoa kyle is being selfish today like he's not even asking how i'm doing and then you might as well feel a little gross and then you're afraid you might like to break up and just start wanting to take care of him so you'll feel better about yourself same again exactly so those are the expectations ok so you're going to do this experiment so when do you think you can do something like this give me a day okay tomorrow and then what problem do you think you're going to bring it um i'll bring it uh uh a i'm just so stressed I'm so busy and it's okay which is true that's great so you'll just talk about it and oh my gosh I need help with this yeah that's right it's on a level I've never experienced before. keep it time limited, how long do you think the conversation will last?
Just give us 15 minutes, perfect, okay, and remember we're not going to do it for another 20 minutes, okay, great, then we'll do this and we've already talked. about expectations and after you do I want you to do two things, one is I want you to really ask him at the end of that conversation is it okay that we just talked about me today? I'm really stressed. You literally ask him that very specific question because you want to get some level of feedback, of course he can still lie to you, but at least it gives you an idea of what he might be thinking and I don't think he's expecting that kind of question from you, no, so he would say, hey, i have to go because i'm busy, but just to see if it was okay that i called you just for advice today and we couldn't talk about how you're doing.
I can do that. he'll give you some feedback on it, you'll write it down and write just your feelings leading up to it, like it's so awkward and then once you get those feedback from him, how did you feel then? and i will say that what I'm hoping is this guy has been your friend for 10 years and he's probably as a friend that's great that's what friends are for something like that and then using that experience now let's go back to your assumptions again and Tell me if that assumption really holds, I mean do you always have to take care of people or are there at least certain people in your life that you can have it back and forth with and this is the first step, then we do another experiment with a different person and a different kind of experiment so that we can loosen these assumptions, make them more conditional and that will feed back into that core belief, like it really is as universal as you think it is and that's really going to be the process, so it's going to take us a few weeks run it. all the way, but this is the first step and I think if you can do this first step it will start to shake up that assumption enough for the rest of our work. i'm like morphing into kyle kittleson yeah that's what i need i need to be patient no ok that's great because i was really committed to the role of patient you know yeah and i was like where is it going her with this?
I'm just talking about how I feel like I'll never find love and she wants me to go complain to a friend yeah you know so I thought this has to work out somehow but it definitely did yeah yeah and is it really I mean again it's a process so the core belief was that it was a process to develop that core belief yes but the more you can design these behavioral experiments to challenge the specific assumptions and realize that those assumptions don't hold up yeah then core beliefs are shaken because it's like waiting if this assumption doesn't hold up and there are people who like to seem to love me for me even if I'm being a little negative today or a little selfish today , whatever, I'm labeling this as in my head, yeah, what does that mean about me actually being nasty? really disgusting yeah or is it just that i just have to find the right people to like yeah yeah yeah and it's such a nice thing to notice or realize that a core belief doesn't necessarily mean it's true it's just you belief hidden very deep down in the iceberg and it's more like your fear friend if this was true that was good i love our youtube viewers i want you to leave a comment if you watched the whole session because it was a little longer than normal so i want know who is watching d to act throughout the session and then if you feel comfortable enough I want you to share one of your core beliefs or something that you think is a core belief because we all have them as Dr.
Judy said, we all we have them, but they are living there unnoticed and affecting every part of our life, yes, and through CBT therapy we can discover something that is very, very, very deep within us and bring light on Be aware of it and become aware of it, and simply that awareness changes everything. absolutely all of that is what starts all of that is what starts you on the right track yeah if you got motivated by watching this go to medcircle.com and see the complete series on cognitive behavioral therapy dr judy amazing thank you thank you thank you thank you that's it great i I'm Kyle Kiddleson remember whatever you're going through you got this.
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