Cognitive Behavioural Therapy

Paul ( not his real name ) is married and has two small children.

He has a good job in a company where he is well regarded

and his career has progressed well. However he has suffered from 

generalised anxiety for many years .

Promotion in his job has meant longer hours , more responsibility

and in many respects less control over his work as he has to rely on

other people to get things done. Once a month he has to report to

the board of directors on sales results.This is often a stressful

situation and Paul has increasing felt he is living from one meeting

to the next in a state of continual anxiety finding it hard to switch off

at weekends when with his family. 

His health has suffered, he is often tired and he feels the anxiety and its

effects on him are starting to impact on his relationships with his family.

Following a discussion about his feeling with his wife he visited his GP

who suggested Cognitive Behavioural Therapy as an alternative to

medication.

The first CBT session focussed on an explanation of how CBT works, 

a full discussion of Paul's case history and gaining clarity on his

objectives .

In the second session the irrational beliefs Paul held about himself

that where causing his anxiety were identified and a set of rational

alternative beliefs developed. Homework exercises where agreed

in which Paul would practice during the week identifying examples

of his irrational beliefs and how they effect his reactions to situations.

In the third session the old irrational and new rational beliefs where

disputed, ie discussed and tested : did they pass the tests of logic ,

where they based in established facts and where they helpful beliefs

for Paul to hold. Homework this week was to test both the irrational

and rational beliefs as situations arose against the three tests of

logic, factual basis for the belief and whether the belief was helpful or

not.

In the fourth session the now tested and accepted rational beliefs

where worked with so that Paul could start to accept them not only

intellectually but also emotionally - and it is at this point that he could

really begin to see that he could start to act on them - that they could

become part of his everyday thinking and behaviour. Hypnotherapeutic

techniques of visualisation and direct suggestion were used to help

Paul internalise how it would feel for him to use the new rational beliefs

and to help him understand the benefits to him and others around him.

Homework this week was to start to practice behaving on the basis of

the rational beliefs only.

The fifth session concentrated on ways Paul could fully adopt these

rationally based beliefs into his everyday life both at work and at home.

Success was not instantaneous, it took hard work and practice but after

six weeks CBT helped Paul to creat a new set of rationally based beliefs

that allow him to deal more calmly and effectively with the pressures of

work and to be able to switch off at weekends and enjoy family life again.