Awareness and automatic thoughts

One of the often-cited benefits of CBT is that it can work quickly. Some people achieve their goals in just a few sessions; for others, the process can take a year or more. Some of the people who report rapid progress tell me it's because they feel more aware--aware of their own thoughts, feelings or even just the "issue" that brought them to therapy.

There are many paths to awareness: meditation, yoga, reading and group therapy are but a few. In CBT, people often start to increase their awareness by noticing their thoughts, or more specifically, their automatic thoughts.

Psychiatrist Aaron Beck coined the term automatic thoughts after noticing something interesting. His patients' moods, such as sadness or nervousness, didn't always match the thoughts that they were expressing to him. He discovered that people often have two streams of thought going at any given time--thoughts they are fully conscious of, and others that happen "automatically," without any real acknowledgement or reflection. People notice the moods that happen as a result of these automatic thoughts, but they don't stop to articulate or question the thoughts themselves.

CBT helps people get into the habit of noticing their automatic thoughts. You can try this the next time you experience a strong emotion, and aren't sure why. Ask yourself, "What was going through my mind when I started to feel this way?" Other questions to try include "What does this situation mean to me?" or "What do I think this says about my life?"

Identifying these thoughts is the first step. In CBT, people also learn how to evaluate their thoughts for accuracy. Of course, some thoughts are 100 percent accurate. But when depression or anxiety is part of the picture, people often focus on the worst or most scary things they can think of. CBT can help broaden the view, helping people see their lives in the most realistic, balanced way possible. They may still feel sadness or worry, but their feelings will be more appropriate to the situation.

And it all starts with awareness.