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Sometimes I wonder whether this belief comes from the lack of regulation of psychological practice in the UK? CBT is often reduced to ‘challenging your negative thoughts’. The reality is, if we were to take that concept literally, we’d be significant worse off.
A study in 2020 by Popenk & Cheng identified that we have around 6,000 thoughts a day. It seems the estimated 60,000-75,000 thoughts per day is a gross over estimation. Regardless, that’s roughly 6 every minute. If your therapist encouraged you rationalise each and every thought that you noticed, I can imagine you’d be leaving the therapy room infinitely worse.
Though there may be times where it can help to challenge thoughts e.g. in moments when our emotions are high and the situation is specific. Such as the belief that everybody is staring at you when you go into a cafe. It wouldn’t hurt to challenge that view by looking up. However this isn’t always the reality of why we come to therapy.
Sometimes our thoughts are accurate. Burning out because life feels unmaneagble? Feeling that something is unjust because it actually is? Finding sensory environments overwhelming? Stuck in a relationship that really isn’t okay?
Those aren’t distortions. Those are signals and a therapy modality that highlights these points would help to put words to those experiences e.g. intellectualising and discounting our emotions, or minimising the situation, which in turn keeps us stuck. When thoughts are true, therapy is about connecting your thoughts and emotions with action and knowing how to get there.
There are also times when challenging our thoughts is contraindicated. Take generalised anxiety for example. Digging into the thoughts will only grow the quantity of thoughts at an accelerated rate. Rather, the approach would be to understand not the content, but the process of overthinking and worry. What is it that drives the worry for you? A need to prevent bad things from happening?
Understanding why the mind keeps returning there, not just batting thoughts away helps us to break free if that is the goal.
There are the times when we can say ‘I know this to be true’ but it doesn’t change how it feels inside; that’s often because what’s driving our emotional state isn’t cognitive at all. It’s held in the body, in the nervous system. That’s where approaches like ACT, Compassion Focused Therapy, EMDR or trauma-focused CBT can come in.
Good therapy isn’t a one size fits all. It starts with a thorough formulation. One that takes into account your biology, your nervous system, your history, your relationships, your health, hormonal factors and life circumstances.
Because you’re not a thought pattern to be corrected. You’re a whole person and the therapy you access should reflect that.
