Will CBT work for me?

Have you been considering seeking counselling or therapy recently and wondering will CBT work for me? When people think about seeking counselling or therapy, it can feel confusing and challenging to know what type of counselling to seek; there are so many models and approaches.

Before we address the question will CBT work for me, it’s important to first establish that there are different types of counselling therapies being practiced, all of which ultimately aim to help the client overcome a range of emotional problems. However this means it’s not surprising the waters can become muddied when taking the first step towards seeking support through couselling.

Cognitive and Behaviour Therapies are among the counselling therapies and psychotherapies that people usually seek.  They are recommended by NICE (The National Institute for Health and Care Excellence) for anxiety disorders, depression and many emotional problems, because of the wealth of research that has demonstrated their effectiveness and efficacy.

The ideas that underpin each counselling model have a profound effect on the techniques we develop and the way we ‘do’ our work or the way we counsel.  The model a counsellor uses, their ‘therapeutic bias or preference’, will even affect what is considered important or relevant during sessions. But just because there are different types, it does not mean one particular therapy is more ‘authentically’ counselling than the other.

Many models of counselling

There are many different theories of counselling available to choose from, whether as a practitioner or a client. Some of the most well-known include:

  • Psychodynamic therapies, which includes Psychoanalysis, developed by Freud, are influenced by Freud’s ideas and direct the therapy to the past and childhood in order to make sense of their problems in adulthood.  Emphasis is given to negative experiences of early development and the role of early parenting in the formation of the self and the other.
  • Learning Theory Approaches, which include behavioural therapy which aims to eliminate unwanted and unhelpful behaviours as a way to solve problems.  It is active and goal focused.
  • Perceptual – Phenomenological Approaches which includes Transactional Analysis, Gestalt Therapy and Client Centred Therapy. Client or Person Centred is a non-directive form of talking therapy.  The therapist remains non-directive, does not offer suggestions or solutions.  It is not goal focused but rather focuses on the relationship between the client and the therapist. The idea is that the therapeutic relationship could lead to insights and lasting changes in clients.
  • Existential Therapy is philosophical and focuses on free will, self-determination and the search for meaning.  It emphasises the client’s capacity to make rational choices. It is non directive and the therapist does not offer suggestions or solutions.
  • Cognitive and Behaviour Therapy which includes Rational Emotive Behaviour Therapy or REBT, Cognitive Therapy (also known as CT and CBT), and Cognitive Behavioural Modification.  These are goal directed and state that our emotional disturbances arise from unhealthy unhelpful beliefs, attitudes and thinking and behaviours and that these can be changed so that we can free ourselves from being stuck in emotional pain.  They concentrate on present problems and the current mindsets and behaviours that are creating them.

All of these are counselling theories. ‘Cognitive Behavioural Therapy (CBT)’ is an umbrella term for several different theories that share common principles, just as ‘Psychodynamic Therapy’ is also an umbrella term.

will CBT work for me

Will CBT work for me? Informed choice is key

When deciding on what type of counselling to seek, it is important to make an informed choice. It is helpful to do some research, speak to your GP and perhaps talk to your friends about what they have found helpful and whether they managed to free themselves from their emotional suffering.  Prospective clients should ideally choose the model that they think best suits them, their strengths, experiences and ways of working.

But equally important is questioning perceived ideas or misconceptions about different models.  So, some non-CBT counsellors think that CBT counsellors don’t pay any attention to the therapeutic relationship (the working relationship between the client and the counsellor), which is completely untrue.  Of course, a CBT-counsellor will work hard to develop an open, trusting and relaxed working relationship. We are, after all, encouraging our clients to be frank and honest with their experiences and beliefs. How could we expect them to share these things if they did not trust us?

In Psychodynamic counselling, for example, the therapeutic alliance is viewed as the most significant condition or the central vehicle through which change occurs.  In contrast, a CBT counsellor sees the therapeutic alliance as significant and very important, whilst believing that change occurs when a client changes their mindset and their behaviour.  This process of change starts from understanding emotional responsibility, emotions, facing our past, present and future and developing skills of critical thinking and healthy behaviours. Without a therapeutic alliance effective change would be limited regardless of the counselling model used.

Even under the CBT ‘umbrella’ there can be differences. REBT, for example, can be described as philosophical CBT.  In REBT, the process of therapy is an active and directive one but collaborative.  The therapist and the client work as a team and focus on the client’s goal.  It is a transparent process where problems and priority problems are agreed, goals set, and emotions assessed.  Then the unhealthy beliefs that are at the heart of the client’s emotional problems are identified.  Once this happens, the client learns to turn the spotlight on these happiness sabotaging beliefs so they can be questioned to check if they are realistic and helpful.  Once this skill is learned, their healthy alternative beliefs are discussed and formulated.  Then the process moves onto how to strengthen the healthy versions and weaken the current unhealthy ones through cognitive and behavioural exercise and homework.   It’s like planting a seed for the healthy version and doing what’s needed so the seed can flower.  The weeds that need to be kept in check are the unhealthy beliefs. The client learns this philosophy of change is universal.  Once learned and applied to the initial problems, it can be universally applied to whatever we experience in life.  REBT is an active-directive existential and humanistic CBT model that leads to consistent mental health and resiliency.

Avy Joseph is the author of Cognitive Behaviour Therapy: Your Route out of Perfectionism, Self-Sabotage, and Other Everyday Habits with CBT (third edition published by Capstone, April 2022). He is an experienced CBT/REBT Therapist and Director of the College of Cognitive Behavioural Therapies. He is a registered and accredited therapist with the British Association for Behavioural and Cognitive Psychotherapies (BABCP).

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How to heal emotional trauma

I have spoken to so many women in their 40s recently who are struggling. If you have some form of emotional trauma from somewhere in the past, the absolute truth is that eventually, somehow, someway, it will end up catching up with you. I know this to be only too true from my own personal experience at the beginning of the pandemic during the depths of the first lockdown. The emotional trauma from my childhood caught up with me in a pretty major way. On the break of utter self distruction and about to take everyone I love down with me, I realised I needed to go for therapy and it was one of the best decisions I made in my life.

I had been pretending thus far that the emotional trauma buried deep inside me did not exist, that I didn’t need help, and I certainly didn’t need therapy. Boy, how wrong was I!

So when I heard about Anna McKerrow’s The Path to Healing is a Spiral: One Woman’s Journey to Emotional Healing, I just knew this was something we had to talk about openly on 40 Now What. If more people acknowledge, open up about, and address their emotional trauma, just think how much lighter and happier we would all be.

And so let us start with this. A deep dive on all things emotional trauma – triggers, origins, recognition and of course the very hardest bit – taking that first step to healing your emotional trauma.

What is emotional trauma? Can you give some examples of triggers?

From a psychological standpoint, emotional trauma happens when either a person is involved in a current traumatic situation (anything from the death of a loved one to experiencing war, childbirth difficulties, baby loss, a terrorist attack, a humiliating experience, rape, mugging or climate change-related traumatic experiences) or witnesses it (this might include police officers viewing violent crime or abusive video footage, or someone working with the survivors of sex trafficking or some similar support role). It also refers to historic trauma experienced in childhood that an adult may (or may not) have blocked from their memory, but which is causing problems in their adult life. Last, something that causes ongoing stress, such as a heavy workload or a stressful relationship, can cause trauma. Any of these experiences can also lead to PTSD (post-traumatic stress disorder).

The symptoms of trauma can include depression, re-experiencing the traumatic event in flashbacks, insomnia, emotional detachment, loss of self-esteem, despair, self-destructive behaviours (i.e. drug taking and alcoholism), panic attacks, nightmares and intense anger among many others. Conventional treatments for trauma and PTSD currently include cognitive behavioural therapy (CBT) medication and counselling.

The holistic point of view agrees that trauma is caused by difficult life situations, but differs in the way that it conceptualizes what trauma does to a human being. In a variety of therapies, trauma is considered to be psychically “held” in the body and the energy field around the body, rather than just inside the brain, as in the more conventional psychological view.

The energetic model of healing explains that we are made up of a number of linked “bodies”, with the physical one being the densest. The physical body is (of course) visible to the eye. Around that, the emotional body surrounds us for several inches, followed by the mental and then psychic body in similar layers, growing ever more subtle in terms of vibration. When people see auras around the bodies of others, they’re seeing the denser levels of the energy body, most likely the emotional or mental energy body, often dominated by the colour of the chakra that person is most “in” at that time.

When trauma comes our way – be that some negative energy or a virus or a traumatic experience – the energetic model states that it will make its way in from the psychic energy body, to the mental, to the emotional and finally the physical where it will manifest as actual disease or pain. Similarly, when we heal, the trauma is sent back out through the system in the same way.

I was taught an interesting concept about the healing of the physical body under this rationale, which is that the dis-ease (symbolizing a virus/bacteria/trauma, etc) makes its way out of the physical body from the core and out to the extremities before continuing to depart through the emotional, mental and psychic bodies. For example, an illness might begin with sickness (core), but as the healing body pushes out the intruder, it becomes a rash that starts at the chest, moves down to the legs and then out through the toes and feet. It’s an interesting theory (and I’m not sure if it’s got the scientific seal of approval) but I have found it very useful to think about how people’s symptoms often morph over time.

Sometimes an emotional problem can even become a physical one or, sometimes, when emotional problems are dealt with, then physical symptoms disappear.

Following the energetic model to its logical conclusion, dis-ease will continue to go deeper into the body until it hits the bones and the internal organs, causing more serious complications. From a holistic viewpoint, then, it makes sense to ward off the nasties before they get that far, with regular deep healing of emotional trauma as well as psychic self-protection.

heal emotional trauma

Where does emotional pain/trauma come from? Why is it important to heal and recover from emotional trauma?

Trauma comes from being human and living life, in my opinion. I think it comes from big, one-off things like bereavement, illness, rape, miscarriage, loss, sometimes relationship breakups, all manner of things like that. But it also comes from ongoing situations like bullying, coercive relationships, domestic violence, addiction, ongoing illnesses, being a carer perhaps for an ill relative or partner over a long period of time, living in a war zone, working in a toxic environment, battling gender identity issues – the list goes on! Things that can wear you down over time and create traumatic responses and stored pain.

I personally have worked with resolving trauma resulting from my mum’s illness with cancer and her passing away; my own childhood; poverty and debt; motherhood; my son being seriously ill when he was little, and a lot about just being a woman in a sexist world too.

There are so many reasons why we need to heal emotional trauma. Holding onto it means that we have less energy or capacity for other things; we might avoid making good life choices out of fear, based on something bad that has happened to us before. We might also just not have the bandwidth to progress in our lives and leave relationships or jobs that aren’t really right for us, because carrying that emotional trauma makes us so bloody exhausted! In my book I say:

“When we release trauma, it gives our systems more energy to get on with everything else. Imagine carrying a really heavy box. Once you’ve put the heavy box down, it’s much easier to think about what you need at the shops, right? If you take the heavy box to the supermarket, all you can think about when you’re walking around the aisles is Christ, this box is heavy. It’s hard to focus on what’s the best wine to go with chicken.”

The other thing to consider is that emotional trauma, or emotional stress, starts to have an impact on the body after a while. We know that stress is bad for our physical body as well as our brains.

The first step is always the hardest. How can someone go about becoming aware/acknowledging/identifying that they have experienced emotional trauma?

I would say that most of us have, so it’s almost a given. I think it’s important for everyone to get healing. You shouldn’t actually wait until physical symptoms manifest, or until you have a breakdown. In an ideal world, everyone would have regular healing, whether that’s reiki or breathwork or whatever, and head off the problems before they become too troublesome. It’s a bit like how your dentist tells you to floss to avoid having a filling later on. Healing should be like flossing: preventative as well as transformative.

The other thing to say is that you’ll probably know if you’ve experienced a traumatic experience. In my experience, people usually know: it’s more that they just ignore it and think, if I just get on with life, this will go away! I’ll just forget about it! That’s when the problems happen, when you sit down and talk to people and they say, I don’t know why I’m crying all the time. And then further on in the conversation you find out that they had a miscarriage last year and never talked to anyone about it.

There are, of course, traumas that we might have consciously decided to forget, and can be affecting your life with, say, self-destructive behaviour or another difficult thing which is coming from the unconscious, which definitely hasn’t forgotten. All the more reason to do some healing just as part and parcel of your normal life.

In the UK at least, I think people are quite averse to the concept of emotional healing. Most people will say they don’t need it, or they don’t believe in it. I would say that healing works whether you believe in it or not, because most alternative healing modalities aren’t psychological, they’re working on a holistic model of the body-mind and the body’s energy systems which is different to psychology. That said, you can lead a horse to water but you can’t make it drink, as they say, and no healing professional would ever make anyone have whatever therapy they were offering, because everyone is on their own path. But if you are open to it, then pursue those instincts because it’s very worth doing and nothing to be scared of.

My other advice to people is, don’t assume that you can think your way out of traumatic experiences, and don’t expect to just get on with your life afterwards without needing to process and heal that experience. We have a very intellect-focused culture and most people think that, if they need to do anything, they need to rationalise a traumatic experience to understand it. I don’t think you do, actually. You need to feel it, and express your emotions as fully as possible. Emotions are not thoughts. They are much more primal and physical, and they won’t go away until you have allowed yourself to feel them in totality, whatever that means: screaming, punching a pillow, crying, whatever.

heal emotional trauma

What steps can be taken to alleviate the burden of trauma and heal emotional wounds?

There are many things you can do, and my main advice is try something out. If you hate it, then try something else. The worst thing you can do is nothing. I personally tried lots of healing techniques and therapists – some worked for me, some not so much, but overall, the best ones were the ones that held a space for me to cry and process my emotions in a safe environment. I didn’t like gong baths, but that might be your thing! And I have never had acupuncture, but I hear it’s great.

The other thing to say is that it’s important to share your experiences with other people. Sometimes, finding a support group of people who have experienced the same thing as you can be super helpful. I had a hysterectomy in 2020 and I found it really helpful to join a hysterectomy support Facebook group. I also joined one for endometriosis and adenomyosis sufferers, which was really helpful. I think there’s something very useful about sharing your story but also learning about what other people have experienced, and realising you’re not on your own.

Can you share a list of examples of alternative therapies you tried to heal your emotional traumas?

Yes! Reiki has been in my life for many years now. I started having reiki in 2004 and then became a practitioner myself, and then became a Reiki Master in 2021 (I was busy in the pandemic!). I’ve had shamanic healing, BodyTalk, reflexology, angelic healing, spiritual healing (they’re pretty similar tbh), crystal healing, I’ve done breathwork, all sorts. Plus I consider yoga to have helped me a lot too.

Were there some that were better for certain emotional wounds than others?

I have to say that Breathwork was probably the most profound in terms of processing really deep emotions that I’d been holding for a long time. It’s a breathing technique you do with a qualified therapist who guides you through the whole experience, and the way that you breathe puts you in a kind of trancey state where it’s easier for your emotions to come out. A session lasts about an hour or an hour and a half, and in that time you might “breathe through” a number of traumatic experiences or feelings, with the therapist supporting you gently. Like, they might hand you a pillow to hold, or they might say something very simple and non-intrusive like “it’s safe to feel this now” but really the focus is on you expressing these very deep emotions and breathing. Very powerful stuff.

heal emotional trauma

What does freedom from emotional trauma look and feel like?

Ha! I’ll let you know when I get there.

The thing is that even if you’ve done a lot of healing work, life still happens, so it’s not like there’s a point where you can become a guru and start wearing robes and all that, because there’s always a need for it. It’s more that you can find a greater sense of peace by clearing out certain emotional “weights” that you might be holding, and that we should have an awareness that engaging in a regular healing routine will be beneficial for us, whatever that looks like for us.

I think also that greater freedom from trauma looks like someone who is happier with the life they have, and is invested in making positive choices for themselves.

What advice would you give to people who are carrying an emotional wound – perhaps unknowingly – on how they can address their emotional health and needs?

Like I said before, the best thing is to actually do something! Thinking about it won’t change anything. Go to a reiki practitioner, do a breathwork session, find a support group, talk to someone, journal your feelings. Doing is the best thing, and my recommendation is do something that makes you cry a lot in a safe space. I’m a big fan of crying.

The other thing to say is look at your life, dispassionately, and think about whether you have any recurring themes. Like, do you always attract the same kind of partner, or do you have the same repeating issue happening to you at work? If these are things that you find to be negative experiences, that might be a sign that shows where an emotional wound is lurking. That emotional wound is creating a need that you are fulfilling with these dynamics in some way.

The thing is, I’ve found with emotional healing, it doesn’t really matter if you understand or deduct the reasons for your trauma intellectually or not. You might have a deep emotional trauma from a childhood experience you’ve consciously forgotten, but you discover when you heal it. The important this is that you heal it by doing rather than thinking, and process the experience.

Anything else you would like to add – words of encouragement/wisdom/inspiration?

You’ve got this! Any moment is a good moment to start investing in your emotional health – it’s never too late, and everyone needs to do this. Healing doesn’t mean you’re weird or seriously disturbed, it’s just something we all need as humans, living our human lives. I’ve found it truly transformational.

Anna McKerrow’s The Path to Healing is a Spiral: One Woman’s Journey to Emotional Healing is out on September 14th priced £12.99 and is available at all good book stores. Anna McKerrow is a YA author and Reiki Master. Connect with her on Instagram.

Photos by Alena Shekhovtcova, Monica Turlui, Liza Summer, Andres Ayrton