Cognitive Behavior Therapy (CBT)

CBT uses the relationship between what we think, feel, and do (i.e., what we experience) to identify helpful and unhelpful ways of being. Significant feelings and thoughts are typically present whenever we are doing anything meaningful to us. We can use CBT in therapy to take advantage of what we know about the way our minds work:

  • Much of the language and meaning of words, phrases, images, memories, and bodily sensations we experience every minute of every day are automatic.
  • These automatic thoughts and feelings increase the efficiency of our brain’s ability to use our past experiences to help us maneuver the world in which we live. Our experience with these automatic responses is often responsible for unhelpful habits of thinking, feeling, and doing.
  • Recognizing the source of these unhelpful experiences (e.g., confusion, irritability, panic, dread, fatigue, misery) can help when deciding how to intentionally respond to what we experience in our life.

Acceptance and Commitment Therapy (ACT)

ACT is a type of CBT that facilitates a way of being based on our values, strengths and abilities. ACT encourages psychological flexibility with our perceptions of past, current, and future experiences and discourages current avoidance of unpleasant emotions and feelings. Practicing ACT results in more freedom to engage in healthier habits of thinking and value-based action. ACT uses a technique called defusion to help us put less attention and effort into unhelpful thoughts, feelings, and actions. Expansion is used to create flexibility (i.e., space, freedom) to shift our attention toward helpful habits of thinking, feeling, and doing. In therapy, we also develop language associated with our values to enrich our repertoire of value-based actions. When we are making decisions to practice value-based actions, we develop habits that are more consistent with how we want to be. Exposure and response prevention (ERP) is a type of CBT helpful in management of anxiety and OCD to specifically target unhelpful avoidance of situations related to thoughts and feelings based on inaccurate language.

Motivational Interviewing

MI was developed in part by clinical psychologists William R. Miller and Stephen Rollnick in response to observations that people can want to change and not want to change health behaviors at the same time. Even though we may not be satisfied with our lives, we have reasons for not changing. MI can help us resolve this ambivalence to change and increase our motivation to be different in our lives. We are the experts at living our own life, but our brain’s ability to maintain status quo can result in us feeling like change is long, hard, and too much. Our unhelpful habits of avoidance and this powerful feeling of being stuck are actually evidence of very healthy brain activity. We want a brain that helps us build confidence in repeating what works. Therapy doesn’t fix people, because people aren’t broke. Motivational Interviewing can help us recognize compassion and autonomy while practicing change. Using CBT, ACT, and MI combined can enhance your motivation and ability to practice living the life you want.

Mindfulness

A definition of mindfulness (Jon Kabat-Zinn) is paying attention to the present moment, on purpose, non-judgmentally. Mindfulness is a skill that helps us practice our ability to return our attention to the present moment. The ability to return our attention to the present moment sharpens our ability to engage in CBT, ACT, and MI in profound ways. In the present moment…

  • we are better able to recognize accurate and inaccurate language
  • we can practice being with pleasant and unpleasant thoughts and physical sensations
  • we are better able to make decisions and take actions based on our values, strengths, and abilities

Most of the unhelpful habits we experience are based on inaccurate language related to our mind’s ability to attend to thoughts and feelings related to events that happened in the past or might happen in the future. Intentionally shifting our attention back to the present moment (which is always available) helps us to practice using accurate, value-based language so that we can be more consistent with how we want to be in our life.