What is Cognitive Behaviour Therapy

Social Anxiety, part 2

Continued from The Zone of Normality and the fear of standing out.

This is primarily a link-back-to post which briefly outlines how Cognitive Behaviour Therapy (CBT) works. If you’re already familiar with it, you may as well skip this post. The next posts will describe experiences with specific CBT techniques.

CBT is a key psychological treatment concept for social anxiety disorders and depression. It is founded on the belief that most of our feelings and behaviours result from what we think and believe about ourselves and the world around us. Our inner system of cognitive beliefs guides our reactions to what happens to us and to how we can solve the problems the world present to us.

However, this inner system can develop distortions that impact our behaviours and attitudes in (self)destructive ways, and which result in a life dominated by irrational behavioural patterns and suffering*. That is where Cognitive Behaviour Therapy can help.

Rescue floater


Cognitive Behaviour Therapy […] is a form of, frequently brief, psychological therapy which involves a range of techniques aimed at altering patterns of thoughts, behaviour, and in turn, emotion. It is an approach that has been successfully applied to a wide range of psychological problems from anxiety disorders and depression, through to eating disorders and schizophrenia.



Cognitive Behaviour Therapy against Social Phobia

Social Anxiety/Phobia evolves around negative assumptions and excessive worries about the risk of social failure and being harshly judged by others, where the anxious person imagines that other people constantly focus on him/her in a negative manner. The worries loop around in stressful he-thinks-that-I-thinks-that-he-thinks types of thinking patterns which can consume enormous volumes of brain power, distract from important problem solving, and act as barriers to well being and life success overall.

Cognitive Behaviour Therapy aims to empower people to break the vicious circle of destructive thoughts and behaviour patterns by carrying out 3 types of therapeutic tasks:

  1. Cognitive Restructuring – Identify dysfunctional thinking patterns and replace them with better ones
  2. Behavioural Activation – Implement & reinforce the changes systematically in real life situations through practice
  3. Exposure – Desensitise triggers by means of controlled, gradual exposure to trigger situations


In real Cognitive Behaviour Therapy, you train yourself – Watch Video from 2.12 to get the point


Overall, CBT programmes for anxiety typically involve**:

  • Psychoeducation (learning about the mechanisms of dysfunctional thinking)
  • Relaxation techniques (breathing, muscle relaxation)
  • Realistic Thinking (cognitive restructuring)
  • Facing Fears (exposure)
  • How to Prevent a Relapse (behaviour activation)

In summary, CBT is goal oriented, now-oriented and evidence-based. It doesn’t look for deep, complex root causes of psychological problems, but focuses on ‘how’ rather than ‘why’. In concrete terms, that means that it***:

  • focuses on developing new skills
  • focuses on changing current behaviour patterns that are maintaining symptoms
  • outlines and works towards specific objectives
  • involves specific, structured home work between sessions that enables cognitive restructuring (become aware of irrational thought patterns and change them) and exposure (confront trigger situations and practice new skills)
  • is brief and time limited (in America: typically 12 to 16 sessions)
  • is structured. Each session has a specific agenda and objectives
  • is collaborative – therapist & client work together to develop strategies to overcome problems
  • aims to enable the client to ‘become his/her own therapist’
  • is research based (evidence based). CBT has proved effective against Social Phobia symptoms

Shrink cartoon

That’s it… Very simplified.

There exists a vast array of tried and tested Cognitive Behaviour Therapy techniques. CBT worksheet download sites like this one from GET.gg or this one from Oxford University Press gives an idea of the nature of typical cognitive restructuring techniques. In the next posts, I’ll write about personal experiences with some of these and other CBT techniques.

Disclaimer: I am not an expert in CBT. My knowledge about it is mostly based on Internet research, and is fairly superficial. If you are more knowledgeable about it than me and would like to convey a deeper knowledge of the topic, then please feel free to contribute with your insight in the comment section.


* Source: CBT techniques, part 1:  Cognitive restructuring by Nelson Binggeli

** Source: AnxietyCB

***Source: Social Anxiety Support



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