What a Cognitive Behavioral Therapy (CBT) Session Looks Like

[Music] watch this full series at the links in the description below and subscribe to our youtube channel to watch new mental health videos every week in our med circle series on cognitive behavioral therapy dr judy and i sat down to discuss the ins and outs of how that therapy works and how it can be used to change your thoughts your emotions and ultimately your behaviors and then we decided that we would do a mock therapy session with myself portraying somebody who has a a cognitive belief or what is it yeah a certain kind of core belief core belief core belief yes and you're going to walk me through that belief and show the viewers how cbt can actually bring them closer to the truth and closer to a more healthy way to think and react and behave when it comes to our emotions and thoughts so my core belief in this mock therapy session is going to be that i feel like i'm unlovable right by everybody right that's my core belief i feel like i'm pretty lovable by most people yeah i'm sure not everybody kyle's actual core belief right exactly you are playing a patient in which 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 basic drives is to be loved by people i mean that's just a basic human drive and it's not just about emotional wellness that you feel loved it's actually about physical survival if you're not loved and nurtured then you might die right you know your physical being will actually perish right if you're not nurtured well if you're not taken care of well and so i think this is a good one for us to role play cool well this will be great for the viewers to see what a therapy session could be like and also how cbt is used so i'll let you take it away okay great so kyle what brings you in today i uh recently broke up with a long long-term partner and it's been one of 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 will ever find somebody who loves me i don't feel like i feel like i would have found him 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 okay so i'm sorry about your breakup and i'm sorry that kind of led to a cascade of thoughts in your head about what this really means about your future for relationships and about you ultimately so we're going to do a practice technique right now and this technique is called laddering and what this is going to help us with is getting some of those negative automatic thoughts i mean you said many right now actually just in your description we're going to work with one of those and it helps us to get them organized in a way so that you can actually see what that automatic thought leads to sort of like if you think about automatic thoughts being kind of like an iceberg and the automatic thoughts is the tip of the iceberg that you can see above the water it's conscious but you have to kind of attune your awareness to it but deeper thoughts are actually submerged you can't see them they're below the water level and that's what we need to get to because that's the crux of the issue these core beliefs drive how you feel how you think and even the rules that you have in life about how you should behave in order to have safety in many ways and so let's start with an automatic thought i heard you say that you were thinking based on this breakup and other ones that i might never find somebody who will love me yeah so let's work with that automatic thought there were other ones but i think this one is a good one to work with so if your automatic thought is i'm not going to find somebody who loves me what might that mean what does that thought mean to you well i look around at my friends and my family who are in relationships who are having kids who are posting pictures who are sending out christmas cards with their significant others and i don't feel like i will have that i feel like while everyone else will have love in their life and meaning and purpose i will have nothing i will be alone and i am alone and i am also lonely right and that is devastating so what might it mean if you were alone like let's take that part of it so you know you kind of broke it down like well i don't think that i'm going to find anybody to love me or who i love or who will have this relationship with and and to me that means that i'll be alone so what would it mean if you were alone like what if that did happen what would that mean about you well on one hand it means that nobody i on one hand it means that people wouldn't i'm alone it means that people don't want to be with me which is right awful it's an awful thought um and it also means that i won't be able to enjoy life how i could i will miss out on dinners and holidays and weekend trips and children and legacy and memories there are there's a laundry list of consequences from being alone right and you had just said that one of the things that being alone means would be that maybe that means nobody wants to be with you and so what would that thought mean if it was true what if nobody wanted to be with you what if that was an actual fact like what would that mean that there's something wrong with me and if there is something wrong with you if that thought was true then what would that mean that i haven't done a good job in my life could be becoming i haven't done a good job becoming somebody that people want to be around right that people want to be in a relationship with right and what would that mean about you if people didn't want to be in a relationship with you that you haven't done a good job and people didn't want to be around you that i'm hope that i'm worthless and i'm a waste of time yeah well that's the core belief the core belief is i'm worthless or sometimes people will say i'm unlovable sometimes they're interchangeable but like that's how we got to the core belief is we keep doing this laddering technique where any negative thought you have i ask you what does that mean if that thought was true what would that mean about you okay well if that thought was true that would mean that i would be alone okay well what would that mean if that was true if you were alone well that would mean that nobody would want to be around me you know and you kind of kept breaking it down to like the deeper and deeper level until you got to this idea of that would mean that i was worthless that maybe i'm just not capable of being loved that i'm undeserving of love and that's what we mean by a core belief which is like a horrible thing to have to think about and i want to be clear that core beliefs are not necessarily what you actually believe about yourself but core beliefs are your biggest fear meaning that if it was true it would be devastating if you truly were worthless or if you truly were unlovable that would be devastating i don't feel if you would have asked me three minutes ago or four minutes ago do you do you think you're do you think you're a worthless person i would have said no not at all right yeah and i think that when people first encounter what could be their uh core belief they they have that kind of reaction of but i don't really believe it's true at least not intellectually but it's really about the fear of man but what if it was true like what would that mean about my life and what i could even amount to and what kind of legacy would i leave behind if that was true and everybody has different fears for different reasons some people's core belief is you know i'm incapable you know and that to them is paralyzing like man if i wasn't capable like that could ruin my life you know and it's not that they actually believe they're incapable but it's just 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 and so this is sort of what we're working with and i always say when we get to our core belief it doesn't necessarily have to be your core belief but let's let's work with it let's see if it is you know part of this is sort of like hypothesis testing like let's work with that and see if that could be true for you okay when people have core beliefs they usually then have conditional rules and assumptions about how the world will work and how they should act within that world so what i mean by this is when you have such a core belief like i'm worthless or i'm unlovable there will be certain things that you believe are scripts that you have to follow in order to have any semblance of emotional safety or to prevent yourself from having that core belief come true and so we're going to talk about what some of those things could be for you when somebody has a um worthless core belief what might that do in terms of your expression of your needs and wants to other people like what rule might you have if you actually believe that you might be worthless or that you fear that that might be true what kind of rule would you put on yourself in terms of how you could communicate your needs and wants to others well i would uh i would probably only in terms of a romantic relationship i would probably only date someone who i felt uh was like below my league i guess yeah that's a rude thing to say but um it's honest and i think you're not um alone in that um because if i if if i truly was worthless then i would need to be with somebody else who couldn't see that who would never know that i was worthless right and so i would need to date um accordingly right um i i wouldn't go after the people that i actually wanted to date because they're too smart to figure it out right that's at least that would be like a possible thinking there yeah and and i would also uh try to show my worth a lot even though i believed i'm worthless i would try to show well look at the great house i have and look at how happy i'm being and look how fun my friends are and look at my cool job and look at look at look at look at see i'm not worthless i'm not worthless i'm not worthless right yeah no those are um excellent um examples of the types of rules you might have when that is your core belief and might you also have a type of rule where you felt like in certain situations you had to contribute something so that there would be worth so like even in friendships for example like how are you like always about them as opposed to oh now we can talk about me for 20 minutes right do you find yourself sometimes doing that with your friends yes okay i'm always forever for as long as i can remember constantly making sure that the other person was happy with our interaction first professionally friendship romantic familial are you happy with our interaction constantly i i constantly remember thinking are you happy about this because i want to make sure you're happy about this because i don't want you to have an interaction with me where you're not happy right right okay so again another great example of a possible assumption or rule that you might put on yourself when this is the core belief and so as you might imagine there's a long list of these if we sat here for two hours we could probably come up with like 20 other rules that probably play some role in your life but i want to move on to the problem-solving phase you know because that's what cbt is all about it's like let's solve the problem so yeah i love that part wow so we've identified the issue and there's been very many different ways in which you can work with your core beliefs but you have to remember that these core beliefs have been there for a long time and they're kind of pervasive like this idea of i'm worthless as you just demonstrated it's not just about your romantic relationships it's about how you interact with friends with professional people with colleagues whatever there's permeating of sorts in almost all the domains of your life and 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 is to create an individualized behavioral experiment okay to try to see if your core beliefs and the assumptions that follow them actually apply to every single situation as i mentioned core beliefs feel pervasive and we want to make them more conditional you know we want to make it so that well you know in certain situations and with certain people they may make me feel this way and maybe that even comes from childhood but it doesn't apply to every single thing right and the way that we shake that is to actually get evidence cbt is a scientific program and this is kind of like our mini science experiment that we're going to do together so there's only a couple of rules for this experiment we're going to design an experiment around one of your rules or assumptions and the one that i want to use which i think is a good one to do because you want to start with a lower hanging fruit that's not too activating but we shouldn't start with the rule of you dating people who might be of a different level than you because that one is a little bit deeper but we start with something that feels like you can approach it and there's a little bit of risk it makes you a little uncomfortable but not like the worst thing that could happen and i think that that would apply to the rule of i always have to take care of other people's needs first because there's a lot of people that applies to it it can apply to your intimate relationships but it can also apply to friends colleagues anybody else that you meet so let's take that rule and let's try to test it with a person in your life and i would also say that again this person should not be the most activating person but this should be a person who there's some stakes in it there's some skin in the game but this is not a person in which if this experiment failed meaning that like you tried to challenge this assumption and they failed it in some way and actually made your core belief feel more um significant to you that you would feel bad about it but you wouldn't be so bad that you would be in pieces so is there a person like that who you're like huh like i've always taken care of this person's needs first like as i usually do and i could probably test something out with them and if it didn't work out i'd be kind of sad about it but like i wouldn't be devastated um hmm well i i have a friend in mind okay great okay and so this is somebody that how long have you known this friend ten ten more than ten years oh wow okay so ten years yeah um but we're not like every day friends right yeah but you guys have been familiar and like most of the times you're probably taking care of this friend right how are you like oh let me give you advice like what can i bring you you're sick like that kind of relationship all right so this experiment is going to be very time limited it's going to be very specific so i need you to set like a specific date and time that you're going to do this in the next seven days oh okay yeah it was going to be real specific because we need to get that data and it's going to be something that's kind of uh contained meaning it should be something where it's not like a free-for-all like from now on i'm just going to be you know we're vomit and always tell them all about my problems first but it's more about okay in this particular conversation i'm going to go with him with the problem and once i talk about the problem get his advice i'm going to be like that was so helpful thank you goodbye and not make that about him at all because that's the other thing where with your type of poor belief and assumptions sometimes you'll be like and how are you and then you spend another 45 minutes dealing with that absolutely so we're not going to do that this is literally going to be you going to him to express a need of yours to express a problem have this person give you the advice and then be like thank you that was super helpful 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 are you expecting me to report back with so first we're going to predict how you think that's going to go so based on your beliefs or maybe your assumptions and rules like how do you think that might go like in terms of maybe how you might feel or what they might feel or do well i mean i think it will go fine okay do you think that he's gonna have some kind of inner judgment of you like kyle selfish he didn't even ask about me today um i mean maybe i don't know yeah well let's get specific and do you think that that's a possibility yes okay yes and you obviously don't want that to be anybody's thoughts about you no okay all right so you're gonna hold you're gonna hold that distress a little bit for yourself and then you said it's gonna probably go fine meaning like you think you can carry it through but it might make you a little uncomfortable yeah and i'm hoping i don't slip up and start being like and how are you and go oh well i'm sorry that you went through something you know like and then just complete turn around yeah yeah exactly okay so we've laid out a couple of expectations one is well i'm sure he'll be fine with giving me the advice but maybe in his mind he'll be like whoa kyle's being selfish today like didn't even ask about how i am and then also you might just feel kind of like icky and then you're afraid that you might like break and just start to like take care of him so you feel better about yourself again exactly so those are the expectations all right so then 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 him um i'll bring him uh uh a just i'm so stressed out i'm so busy okay which is true that's great so you'll just talk about that and oh my gosh i need help with this yeah like it's it's it's on a level that i've never experienced before okay great that's perfect and then we'll kind of keep it time limited so how long do you think the conversation will be just give us 15 minutes perfect okay and remember we're not gonna make it another 20 minutes okay awesome so then we're going to do this and we've already talked about the expectations and after you do it i wanna i want you to do two things one is i want you to actually ask him at the end of that conversation was this okay with you that today we just talked about me i'm just 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 it at least gives you some semblance of what he might be thinking and i don't think he's expecting that kind of question from you no so he'd be like hey i gotta run because i'm busy but just so just so i know like was this okay that i called you just to get your advice today and we didn't get to talk about how you're doing i can do that okay cool i can totally do that awesome so then he'll give you some feedback about that you will write that down and you will write down just your feelings leading up to it like was it that discomforting and then once you get that feedback from him how did you feel then and i will say that what i'm expecting is this guy's been your friend for 10 years that he's probably gonna be like dude it's cool like that's what friends are for something like that and then using that experience we're going to now go back to your assumptions again and say did that assumption really hold i mean do you always have to take care of people or are there at least certain people in your life who 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 to that core belief like is it truly as universal as you think it is and that's really going to be the process so it'll take a few weeks for us to execute it all the way through but this is the first step and i think if you can do this first step it's going to start to shake that assumption enough for the rest of our work wow cool right it's really good it's going to be fun now now i'm like morphing into kyle kittleson yeah that do i do i need to be patient anymore no okay that is um really good because i was really committed to the patient role you know yeah and i was like where is she going with this like i'm just talking about how i don't feel like i'll ever find love and she wants me to go complain to a friend yeah you know and so i was like this has got to come together somehow but it definitely did yeah yeah and it's really i mean again it's a process so the core belief was it was a process to develop that core belief yeah but the more that you can design these behavioral experiments to challenge the specific assumptions and to realize that those assumptions don't hold yes then the core beliefs get shaken because it's like wait if this assumption doesn't hold and there are people who like seem to love me for me even if i'm being a little negative today or a little selfish today whatever it is that i'm labeling this as in my head yeah what does that mean about me truly being unlovable am i really unlovable yeah or is it that i just have to find the right people to like yeah yeah yeah and it's such a good thing to note or realize that a core belief does not mean necessarily that it is true it is just your belief hidden way deep down on the iceberg and it's more like your fear like dude if this was true that was nice i want our youtube viewers i want you to leave a comment if you watched the entire session because it was a little longer than normal so i want to know who watched that act that whole session and then if you feel comfortable enough i want you to share one of your core beliefs or or something that you believe is a core belief um because we all have them like dr judy said we all have them but they're they're living down there unnoticed and they're affecting every part of our life yeah and through cbt therapy we can uncover something that's deep deep deep within us and bring light on it right and bring awareness to it and just that awareness changes everything absolutely everything that's what starts everything that's what starts you on the right path yes if you got motivated watching this go to medcircle.com and check out the entire series on cognitive behavioral therapy dr judy amazing thank you thank you thank you thank you that's great i'm kyle kiddleson remember whatever you're going through you got this thanks for watching if you liked what you just saw then why not subscribe click right here for new episodes and new series every week and to access exclusive mental health videos that we only release at medcircle.com check out the links below [Music] you

Channel: MedCircle

Views: 1,327,967

Keywords: therapy, cognitive behavioral therapy, cbt, depression, anxiety, mental health, psychology, psychotherapy, health, cognitive, behavioral, therapist, stress, behavior, psychotherapy techniques, counseling, what is cbt, cognitive distortions, chronic pain, core beliefs, cbt therapy, mental illness, emotions, childhood, dealing with anxiety, dealing with depression, thoughts, behaviors, medcircle, kyle kittleson

Id: 8-2WQF3SWwo

Length: 23min 9sec (1389 seconds)

Published: Fri Dec 13 2019