COGNITIVE BEHAVIOURAL THERAPY IN SINGAPORE
The thought may not be the whole problem. The pattern between thought, feeling and behaviour often is.
You may know that a thought is unhelpful and still believe it.
You may know you are catastrophising and still feel anxious.
You may understand that avoiding something makes the fear worse and still find yourself avoiding it.
CBT — Cognitive Behavioural Therapy — helps people notice how thoughts, emotions and behaviours interact, and how certain patterns can keep distress going even when the person understands them intellectually.
At Staying Sane 101, CBT may be used on its own or alongside other approaches depending on the person and the problem.
THE CBT MODEL
What you think, feel and do can reinforce one another.
CBT is built around a simple but powerful idea: our thoughts, emotions, physical sensations and behaviours influence one another.
A situation happens.
You interpret it.
That interpretation affects how you feel.
How you feel influences what you do.
What you do then reinforces the original belief.
THE LOOP
The behaviour can keep the belief alive.
Imagine someone fears that they are going to fail at work.
They start checking every email repeatedly.
They over-prepare for meetings.
They avoid asking questions because they are afraid of looking incompetent.
They work late to make sure nothing goes wrong.
In the short term, these behaviours reduce anxiety.
But they also reinforce the belief:
“I can only cope if I stay hyper-alert.”
AUTOMATIC THOUGHTS
Not every thought deserves to be treated as a fact.
Automatic thoughts often appear quickly and feel true before we have had time to examine them.
Examples:
“I am going to embarrass myself.”
“They are upset with me.”
“If I make one mistake, everything will fall apart.”
“I should be coping better.”
“If I say no, they will reject me.”
CBT does not ask you to simply replace every negative thought with a positive one.
The aim is to examine the thought more carefully.
What is the evidence?
What are you assuming?
What else could be true?
What would you say to someone else in the same situation?
THINKING TRAPS
The mind has shortcuts. Some are useful. Some make distress worse.
Catastrophising
Assuming the worst possible outcome is likely.
Mind-reading
Assuming you know what another person is thinking without enough evidence.
All-or-nothing thinking
Seeing success and failure as absolute, with little room in between.
Overgeneralising
Taking one experience and turning it into a rule about everything.
Personalising
Assuming something is about you when there may be many other explanations.
Should statements
Holding yourself to rigid rules such as I should be stronger, I should know better, or I should never make mistakes.
WORRY VS PROBLEM-SOLVING
Worry can feel productive even when nothing is being solved.
Worry often gives the mind something to do.
If I keep thinking about the problem, perhaps I will be more prepared.
If I imagine every possible outcome, perhaps nothing will catch me off guard.
If I replay the conversation enough times, perhaps I will finally understand what I should have said.
That is why worry can be difficult to let go of. It can feel responsible.
But worry and problem-solving are not the same thing.
Problem-solving asks:
What is the actual problem?
What information do I have?
What can I do next?
Worry asks:
What if this goes wrong?
What if something happens that I have not prepared for?
What if I make the wrong decision?
What if I should be thinking about this more?
Problem-solving moves toward an action. Worry often moves toward another worry.
A problem-solving thought usually leads somewhere.
You send the email.
You make the appointment.
You ask the question.
You prepare what is realistically possible and then stop.
Worry often creates another branch:
“But what if…”
and then another.
And another.
The mind feels busy, but the problem has not necessarily become clearer.
Sometimes worrying feels safer than acting.
You can spend hours analysing whether someone is upset with you rather than asking them.
You can spend days thinking about whether you will fail rather than beginning the task.
You can mentally rehearse every possible conversation rather than tolerating the uncertainty of having the actual one.
In that sense, worry can reduce anxiety in the short term because it postpones the moment when you have to act, decide or tolerate not knowing.