Brain

Can CBT change your thinking?

You’ve probably heard of it, maybe you, or someone you know, has tried it. That’s because Cognitive Behavioural Therapy (CBT) is now the most widely used treatment for a range of issues including depression, anxiety, sleep disorders, addiction, compulsive obsessive disorders and phobias.

But there is something missing off the list. Britain’s biggest health problem – obesity – is virtually nowhere to be seen. In the rare cases CBT is coupled with a suitable weight-management plan, it has been shown to be highly effective in helping people lose weight and keep it off long term. So what is it and could it really be the helping hand so many people have been searching for?

The history of CBT

In the late sixties, American psychiatrist Aaron Beck listened to a patient describe a series of tortuous thoughts in her head. These thoughts (or inner voices) kept telling her she was socially inept.

Instead of following the usual Freudian response, which encourages patients to explore hidden, historic triggers for their situation, Beck decided to take a different tack. He asked his patient how she knew that her thoughts were true. He encouraged her to list the people that cared for her and as she reeled off the list, her mood began to lighten.

Beck was so pleased with her response that he decided to encourage more of his patients to detach from their challenging inner voices, discovering that when patients pause for a moment and change their thinking, they are far less likely to engage in compulsive behaviours.

CBT and weight management

One of the few NHS facilities to offer CBT is run by Dr Matt Capehorn at the Rotherham Institute of Obesity, which treats obese adults and children. Dr Capehorn says: “CBT has a very good evidence base, and is used in all aspects of the healthcare profession. It’s an ideal tool to use in weight management. It is particularly useful in addressing the underlying emotional causes for overeating and binge eating.

“There is evidence that combining CBT together with other interventions, such as Very Low Calorie Diet (VLCD), can increase weight loss.”

Features of CBT
  • It is relatively brief and time-limited, usually for a matter of weeks (traditional therapy can go on for years)
  • It is instructional in nature and ‘homework’ assignments are often given
  • It’s highly structured, often with mutually-set goals between counsellor and client
  • It focuses on the here-and-now as well as a person’s history
  • The relationship with the counsellor is not a focus of the treatment.
Features of traditional Freudian-based therapy
  • While it can be brief, it is often longer term and can run indefinitely
  • It is less structured, typically without homework assignments
  • The client, not the therapist, tends to set the agenda for the session by talking about whatever is on their mind
  • The relationship with the therapist is included as a focus of therapy.

Find out how CBT helped Kelly overcome her eating issues.