Here’s some excerpts from a paper Glen has written on Cognitive Behavioural Therapy:
What is CBT?
Cognitive Behavioural Therapy (CBT) is a
- short-term,
- practical,
- client-based,
- collaborative,
- problem-solving,
- life-skill learning
‘talking therapy’ which has had excellent and well documented success in alleviating certain emotional problems.
…
The underlying assumption is that faulty emotions and behaviours flow from faulty thinking.
Thoughts => Feelings => Behaviours
These thoughts are themselves the result of faulty beliefs which underlie them and need to be confronted and changed.
…
How does this help the church?
Christians have always known that beliefs and thought-patterns are life-altering, but three or four decades of clinical practice at ‘digging down’ into the beliefs of counselees has produced very useful tools which can also be used by the Christian.
For example:
Identifying Negative Automatic Thoughts (NATs)
- Ask directly – What are you telling yourself when you feel X…?
- Guided discovery (ask around the issues, get them to unearth)
- Note emotional change as they speak – these are ‘hot cognitions’
- Worst consequence scenarios – What would be so bad if…?
- Imagery (some NATs are images) – Do you have a picture of yourself or of your environment when this is happening?
- Exposure exercises – go to uncomfortable situations either physically or in your mind. How are you now thinking?
- Offer multiple suggestions of what the NATs may be
- Offer suggestions opposite to client’s expected response. They will usually say ‘No, no, I’m telling myself X’
Question the assumptions underlying the NATs:
- What would be so terrible about X?
- What would it be like for you not to do or feel X?
- What does it say about you that you have done or felt X?
- Are there verdicts being passed on you from God, the world and yourself associated with X? What are they? Could you put them in words?
- On what basis are these verdicts being passed?
- On what basis are you believing them?
At this stage, CBT identifies certain kinds of faulty thinking:
- Arbitrary inference: e.g. ‘I was much happier when I happened to be X, therefore I must regain X’
- Selective abstraction: e.g. ‘X (and nothing else) is what makes me special.’
- Over-generalisation: e.g. ‘Everyone who has X is happier and more successful.’
- Magnification (of the bad) and minimisation (of the good): e.g. ‘I may have Y and Z, but that’s nothing. X is everything.’
- Personalisation: e.g. ‘My performance of X wasn’t bad, I was bad. Everyone must hate me.’
- Absolutist, dichotomous thinking: e.g. ‘It’s black and white, all or nothing. Either I’m X or I’m nothing.’
- Mind reading: e.g. ‘I know what they’re all thinking…’
- Crystal ball: e.g. ‘I know what’s going to happen now…’
- Catastrophizing: e.g. ‘It’s all over now. X is out of the bag, all hell will break loose.’
- Emotional reasoning: e.g. ‘I feel X so strongly, therefore it must be a fact.’
- Self-labelling / blame: e.g. ‘X makes me an idiot!’ ‘X makes me ugly!’
To identify core beliefs, look for…
- ‘If…, then…’ statements: ‘If I’m X, then I’m a failure.’
- ‘Shoulds’ and ‘Musts’
- Themes in the NATs
- Family sayings, mottoes, memories
The CBT practitioner should then get the counsellee to put this core belief into words. Make them identify it as a rule: e.g. “I need everyone in my environment to be ok with me or else I will be destroyed.” Simply the process of articulating this rule – exposing it as the dominating force in a person’s every decision, act and feeling – is incredibly powerful. In Christian contexts it should lead to heart-felt and deep confession.
…
The Good:
Through loving Christian community, the tools listed above can be a means of the Spirit uncovering those false faiths.
A key verse in Christian counselling is Proverbs 20:5: “The purposes of the heart are deep waters but a person of understanding draws them out.” When I encounter a Spirit-filled ‘person of understanding’ in these circumstances I am exposed for my sinful beliefs and purposes – not simply my behaviours – and therefore may be brought to a broken and contrite heart.
…
But
Perhaps the chief criticism that could be levelled at CBT from a Christian perspective is this: It is not wise and persuasive words that are required but a demonstration of the Spirit’s power.
At the core of CBT is the challenging of irrational beliefs with logical standards. However the deceitful and unfathomable heart will take more than good reasoning to shake it from its madness. The truth of God’s gospel must be driven home to the counsellee with living power by the Spirit. ..
It is not our intellects that need changing but our hearts. The heart is the centre of a person according to Jesus and the source of our thoughts and actions. Our true hope is in the change of hearts. This means:
a) we will not look for non-rational means (the heart is not an anti-intellectual concept in the Bible)
b) we will employ emotional, artistic, sensory means also
c) true change is ultimately the work of God
…
The whole article, including a potted history of the development of CBT, can be found here.
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I have found that there is a difference between thinking a negative thought and living in a negative reality. I have found that the only ministry that has actually has shifted my reality and increased my intimacy with The Father, Son and The Holy Spirit is as you say when the spirit has come to minister to the root of my belief and take the pain away of the initial entry of the emotional wounding. Theophostic Prayer, Sozo, Healing Prayer. As a Christian I would encourage people to look into getting at the root of the lie that you believe. Blessings
Thank you Tim. Yes ‘getting to the root’ of the lies we believe is so important. Ephesians 4 puts this right at the heart of our life together in Christ.
So true that we need “a demonstration of the Spirit’s power” not just words – but what do you do when that doesn’t seem to come?
Hi Lucy, I chose the phrase deliberately because in 1 Corinthians 1 and 2, Paul links it to the simple preaching of Christ and Him crucified. The Spirit’s power is at work in a people who are gathered around the Word of the Gospel and around the Lord’s Table. It’s not necessarily a flashy thing. It’s actually a very ordinary thing – a weak looking thing to the eyes of the Greeks and Jews who demand wise words and miracles. Yet when the Lord’s people get together around the message of the cross the Spirit can work something more powerful than CBT ever could (even though it’s useful!).
Glen
Thank you Glen – that’s really helpful
I have found it useful to apply (ie read, remember, pray) God’s truth to my negative thoughts. I.e. bible verses, in the context of the gospel & not taken out of context. I feel worthless, but “how great is the love that the Father has lavished on us, that we should be called children of God. And that is what we are!” (1 john 3:1?). I am upset by someone/feel angry/belittled, but if I remember that “all have sinned & fallen short of the glory of God” (romans) AND “God so loved the WORLD…that he gave his one & only Son, that whoever believes in him shall not die but hv eternal life” (john 3:16) ie God loves me & them equally, & I am as much a sinner as them (no more, no less). I have been helped by church family-wise & loving ppl who point me back to Jesus. Reading more of the bible has helped, as has listening to verses to music (i hv little kids & I benefit more than them from learning bible verse based songs!). So I think the Spirit works through his word, it don’t need to be an “experience”. And thru praying. I hv found snippet prayers during the day good. “Lord help me remember this” “God help me to know you as the loving God you are” etc.
Helpful article Glen, thanks. Thinking about the draw-backs of CBT in a Christian context (really helpful analysis in your full-length article, thanks), the work of CCEF addresses these: you might already know about it but there’s a launch conference for CCEF’s work in the UK on 23rd Feb – http://www.ccef.org/uk
I’ve certainly found the biblical counselling approach developed by CCEF (How People Change) really helpful in heart-change, through the gospel, in addressing my ED and the underlying idols of my heart (though it’s very much a work-in-progress!)
Hi Emma/Glen,
For a Christian struggling with depression or other emotional/mental issues how do you think the use of CBT can work out practically. I’ve often wondered if seeing a ‘secular’ psychiatrist or therapist could do more harm than good because it points inwards rather than to God and you would get a conflict in advice from church and advice from your treatment?
Hi Caitlin,
I guess we’re always getting a conflict of advice between the church and the world but as long as people are prayerfully thinking things through and listening through gospel filters, there’s nothing fatally “toxic” about CBT I don’t think. I would be much more uncertain about ongoing counselling done from a Freudian or Jungian perspective, but CBT is both relatively short-term and not particularly wedded to deeper philosophies of life and meaning. Literally it’s about examining your beliefs and seeing if they match up to reality. To me that’s almost the definition of repentance (Romans 12:2). It would be much better if “transformation by the renewing of our minds” happened in the context of a worshipping community, explicitly under the word, and I would love Christians to take much more responsibility for pastoring each other with the gospel rather than going down the road to “the professionals”, but if your GP offers you 6 sessions with an NHS counsellor I don’t think it’d be the worst thing in the world. If such sessions were surrounded by prayer and talked through with trusted Christian friends, they might be quite useful.
Again, there’s longer term counselling out there with much more anti-gospel rationales and I’m not recommending them. But CBT doesn’t seem like such a bad idea to me. But perhaps others here have different experiences/opinions?
Hi Caitlin
I’ve got a few Christian friends who’ve had CBT (with non-Christians) and they’ve found it very helpful. Most of the work you do yourself, so the time with the counsellor isn’t necessarily the biggest part.
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