Phaedra Caruso-Radin, Psy.D. 
Clinical Psychologist, Berkeley, CA

Cognitive Behavioral Therapy (CBT):  Think Well.  Be Well.  Live Well.

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*What is CBT and is it right for you?

Cognitive Behavioral Therapy (CBT) is a pragmatic, present-focused, results oriented and evidence-based approach to treatment.  CBT focuses on the interplay between thoughts, emotions, behaviors, and the environment.  CBT theory posits negative and/or distorted thoughts and beliefs interfere with day to day functioning.  

Thus, the focus of treatment involves learning techniques to challenge and restructure unhelpful thoughts and behaviors to overcome symptoms and improve functioning. make practical, observable changes in their lives on a daily basis.  In CBT, the client and the therapist work collaboratively to set clear, measurable goals for therapy and to monitor progress.  As a team, we also set an agenda each week for the session, plan home practice to be done between sessions and also decide on the length of therapy.

CBT is an empirically based approach which has proven to be effective for many issues.  Together we will create a treatment plan that will be tailored to the issues with which you'd like to make change.    See my Treatment Philosophy for further information about my particular approach. 

An Example

When Allison's (not her real name) relationship of two years ended, she was devastated, bewildered, angry, and most of all grieving the loss of her constant companion.  She had invested time in the relationship, of course, but had also brought in her other friends and her family to share her newfound love.  Now, she was embarrassed, distressed by a false perception that she was to blame and therefore unworthy and she felt incapable of cultivating intimacy and creating a family of her own.  She became paralyzed by the collective weight of so much heartache and began to withdraw from the people and activities that normally made her happy.  Her negative thoughts and painful emotions were jumbled together, seemingly inseparable.  

My first goal was to help her identify the thoughts, feelings, and behaviors that were contributing to her suffering.  Her thoughts included, "I just don’t know how to maintain a good and healthy relationship,” “I must be unworthy," "I'll never find another relationship," and "I'm just not good enough."  Our objective was to develop more adaptive thoughts about her value to herself and others.  We helped her to see that her thought distortions were producing her shame and embarrassment and resulting in behaviors such as isolating herself from family and friends.  She was elated to learn that as painful as her separation had been, she had succeeded at leaving behind an unproductive primary relationship and could begin to see what made it so difficult.  She learned to grieve the losses of companionship, misplaced esteem, and romance, and she was then able to cultivate more realistic expectations of future intimacy and the very thoughts that will support her future success.  Where she had once thought of herself as unlovable and immature, she came to see that she was an independent woman who could be both vulnerable and strong.

About CBT for Weight Management

Judith Beck conducted a study of CBT and weight loss:  When using CBT patients lost 18 lbs over 10 weeks compared to the waiting list of folks who lost NO weight over the same 10 weeks. 
Furthermore, 1.5 years later they were continuing to lose weight compared to waitlist folks who gained weight.

Compare this to research completed by Tufts University who found that between 50-70% who start 1 of 4 widely used diets - these clients were unable to stay on their diets and lose weight for 1 year.  Other studies have shown that those who lose weight on these popular diets regain some within 1 year.

To lose weight you must reinvent yourself, and to reinvent yourself you must think differently.

Everyone comes to the weight loss process with a bag of beliefs which are getting in the way.  Consider this analogy: take 2 evenly matched speed runners and put them on a race track.  Who will win?  Hard to tell.  Now, have one of them jump hurdles.  Now, who is going to win?  These beliefs, or sabotaging thoughts, are getting in the way of meeting your goals. 

CBT is based on the concept that the way people think affects how they feel and what they do.  For example, when one has the thought “I’m hungry” – if it is then followed by “sabotaging thoughts’ such as “This is terrible, I can’t stand it, I have to eat” the result is a feeling of panic and the resultant behavior is to grab some food.  But if one has thoughtful responses such as “But it’s alright, I’m going to eat in a couple more hours, I can wait” then the result is feeling more in control and the behavior might be to get involved in a productive activity rather than a food sabotage.

Change begins in language.  Speak as if what you say is true.  Change your story and you change your life.  

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