CBT Therapy

The development of Cognitive Behavioral Therapy was a major moment in the history of therapy. It was created by two different pioneers, Aaron T. Beck and Albert Ellis, who came up with similar ideas on their own.

In the 1960s, Dr. Aaron T. Beck, a psychiatrist, was trying to prove a different type of therapy, called psychoanalysis, was effective. But his research with depressed patients didn’t match the old ideas. Instead, he noticed that his patients had deep-seated negative beliefs that led to “automatic thoughts”—those quick thoughts that just pop into our heads. Beck discovered that by helping his patients question and change their distorted thinking, they felt better emotionally and were able to change their actions. To make this work, he famously moved his patients from the traditional therapy couch to a chair, symbolizing a shift from a passive style to an active, face-to-face partnership focused on solving problems.
At the same time, in the mid-1950s, Albert Ellis created Rational

Emotive Behavior Therapy (REBT), a type of CBT. Ellis was inspired by ancient philosophers who taught that events themselves don’t make us upset; it’s what we think about those events that causes us emotional distress. A core principle of REBT is that our emotional problems are mostly caused by our own rigid and unrealistic beliefs. Ellis’s therapy is a hands-on process that teaches people to identify and challenge their unhelpful beliefs to help them live a happier and more realistic life. The fact that these two different researchers came to the same conclusion about how important our thinking is for our emotions shows just how big a shift this was in psychology.

The main idea of CBT is called the Cognitive Model, which is often shown as a triangle. This model shows that our thoughts, feelings, and actions are all connected and constantly affect each other. A fourth element, physical body responses—like a faster heartbeat or tense muscles—is also connected and impacts the other three.
Thoughts: These are the beliefs, assumptions, and self-talk that shape how we see things. These thoughts can happen without us even noticing them, and a key idea of the model is that “just because you think something doesn’t mean it’s true.”

Feelings: These are our emotional responses, which are often triggered by our thoughts. For example, a negative thought can lead to feelings of anxiety or sadness.
Behaviors: These are the actions we take in response to our thoughts and feelings. Our actions can either make a bad cycle worse or help us break it.

This model shows how a simple event can start a complex, negative cycle. For example, a person with social anxiety who thinks, “Everyone will judge me,” might feel nervous and stand alone in a corner at a party. This behavior then makes them feel like others think they are unfriendly, which confirms their initial negative thought.

A classic example shows how powerful this is. Imagine two people get stung by a bee for the first time. One person might think, “I could be having a deadly allergic reaction!” This thought could cause fear and anxiety, leading them to scream for help. The other person, in the same situation, might think, “That didn’t hurt as much as I thought it would.” This thought could lead to feelings of curiosity and a calm action, like putting ice on the sting. This shows that the event itself is not what causes the problem; it’s how we think about the event that is the most important factor.

The table below gives a clear look at how the cognitive triangle works in both negative and positive cycles.

To understand where CBT fits in the world of therapy, it’s helpful to compare it to another approach, like psychodynamic therapy. The choice between them depends on what you want to achieve and your personal preferences.

CBT is a practical, short-term, and structured approach that focuses on solving problems in the here and now. It’s a great choice for people who want quick relief from their symptoms and practical skills to cope. Its clear plan, regular progress checks, and a limited number of sessions are appealing to those who like a goal-oriented process. The shorter time frame also makes it more affordable for many people.

On the other hand, psychodynamic therapy is usually a long-term, more open-ended process that can last for months or even years. It is based on the idea that our unconscious mind plays a big role in our behavior. The goal is to help you understand how past experiences, especially from childhood, affect your life today. This approach is better for people who want to understand the “why” behind their emotional struggles and are willing to commit to a longer journey of self-discovery.

The table below highlights the main differences between these two types of therapy.

Even though CBT is very popular and has a lot of research to support it, it has some limitations and has received some criticism. A common critique is that since it focuses on current problems, it might not fully address the deeper “root causes” of a person’s problems, like unresolved childhood trauma. Critics argue that while a person might learn skills to manage their symptoms, the deeper emotional issues might still be there, and symptoms could return later.

Some critics also say that the therapy can be too mechanical and structured, and that it doesn’t always look at the person as a whole. The reliance on homework can also be a problem for people who find it difficult to complete the assignments, which can affect how well the therapy works. This means that while CBT is a great strength for many, it might feel too strict for those who want a more flexible and personal exploration of their feelings.

It’s important to understand that these criticisms don’t mean CBT is bad; they just show that it’s not a perfect solution for every problem. For people whose issues are deeply connected to past trauma, a CBT-only approach might not be enough. In these cases, CBT can be used with other treatments, like trauma-informed care or medication, to provide a complete plan. Deciding which type of therapy to use is a personal choice that should be made with a therapist who can help you consider your unique situation and goals.