Cognitive Behavioral Therapy (CBT) and Negative Core Beliefs (NCBs) – Identification

Cognitive Behavioral Therapy (CBT) and Negative Core Beliefs (NCBs) – Identification

Cognitive behavioral therapy (CBT) is an effective psychotherapy for a wide range of emotional and psychological problems. The basic idea of ​​CBT is that our emotions are influenced by our cognitions. In other words, the way we think affects how we feel.

A CBT therapist wants to help people suffering from emotional problems by helping them identify the ways in which their thinking may be causing their problem. A first step in CBT is therefore to identify “Negative Automatic Thoughts” (or “NATs” for short) – these are the thoughts that accompany unpleasant or unhelpful emotions such as depression or anxiety.

A closely related goal of the CBT therapist is to identify so-called “thinking errors.” These are habitual (and unhelpful) ways a person thinks about themselves, others, and the world around them. These thinking errors will often twist or distort experiences, making the person appear as a failure, others as hostile, and the world as dangerous or unpleasant.

Identifying NATs and associated thinking errors is half the battle in CBT – once a person is aware of their unhelpful thoughts and mental habits, they can choose to think more rationally and healthily. A CBT therapist can guide you through this (fairly straightforward) process.

As a psychiatrist and therapist working in Edinburgh, I use CBT techniques extensively. Some of my clients are very happy with the results they get when they simply challenge their NATs and thinking errors - they feel much better and don't feel like delving further. However, the majority of clients want to “get to the bottom” of why they had their emotional problems in the first place. I am inclined to encourage this further work as it helps to consolidate the progress made so far and, in my opinion, helps prevent the client from relapsing at a later date.

This further work includes a search for “Negative Core Beliefs” (or “NCBs”). These are the unhelpful beliefs that a person held throughout their later childhood and adult life. They are core components of the person's personality and they are the root cause of the person's thinking errors and ultimately their NATs. If a CBT therapist can help a person change their negative core beliefs (or, more realistically, find more rational and healthy alternatives), the person's reasoning errors and NATs will decrease and their emotional problems will (usually!) decrease.

One difficulty with NCBs is that a person rarely notices them. Even if someone is able to identify NATs and reasoning errors, the cause of these problems may be hidden. But we can use NATs and reasoning errors as clues.

In my experience as a psychiatrist in Edinburgh, I have found two techniques to be most useful in finding my clients' NCBs.

On the one hand, there is the method of “repeated questioning”. I ask the client what a particular NAT they have identified means to them - they will give an answer, and then I ask them what that answer means to them. He'll give a second answer, and then I'll ask him what that second answer means to him, and so on. Within a very short time, the client receives an overall statement that cannot be further elaborated. This is a negative core belief. It's probably best demonstrated with an example:

Customer: “There’s a lot of rubbish in Edinburgh” (He’s angry)

CBT Therapist: “What does that mean?”

Client: “That I’m the only one who cares.”

CBT Therapist: “What does it mean when you’re the only one who cares?”

Client: “People are not interested in things that are not their personal property”

CBT Therapist: “So what does it mean when people only mind their own business?”

Customer: “People are only out for themselves”

("People are only out for themselves. This is the client's core negative belief - a global statement that is uncompromising and will clearly influence the way he sees and interacts with others in other areas of life, not just littering!)

A second method for identifying negative core beliefs is to look for the “themes” that run through many of a person's NATs and reasoning errors. Such themes may include "I'm a failure" or "Life has no meaning" (very common in depression) or perhaps "The world is a dangerous place to live" (common in anxiety).

Once a client's negative core beliefs have been identified, the CBT therapist (along with the client) will attempt to explore alternative and more rational ways of thinking about themselves, others, and the world in general. This is where real, sustained recovery from emotional problems occurs, and I will discuss this in a follow-up article entitled “Cognitive Behavioral Therapy (CBT) and Negative Core Beliefs (NCBs) – Treatment.”

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