In previous articles I have described CBT as the process of writing down your thoughts, analyzing them to spot certain flaws in your thinking, and then devising new thoughts to replace the old ones. This is a common definition of CBT – “replacing” anxious thinking patterns with better, more helpful and more rational ones—so I used it in my first articles on CBT, which you can find here and here.
But I now think the process could be stated differently. Even if the concept remains the same in principle, HOW you describe it does matter.
If you practice CBT and find it is not working, do you get discouraged and think that the method is ineffective? Or that you aren’t doing it correctly? Or maybe you are beyond help entirely? Most likely it’s none of the above, but simply your approach that is giving you problems.
Hey, it’s therapy, not punishment!
One problem I encounter with people doing CBT to help with their insomnia is, they feel their existing thoughts are “wrong” or “incorrect.” It may be that the thoughts are misguided and presenting an inaccurate and unhelpful view of reality, and they need to be changed. But developing an urgency that you “must” or “should” change your thoughts often prevents CBT from working as well as it could.
Most insomniacs are hard on themselves, so it is important to know that CBT should not be done in a critical way or in a way that is felt as a “correction” of your existing way of thinking. You will find it far more effective to be compassionate and supportive rather than critical and demanding. If you tend to beat up on yourself, CBT will just become another nagging voice in your head telling you are wrong. It needs to be the opposite—a supportive, encouraging voice telling you that better times are ahead.
CBT is one of the most powerful self-help tools available to people. This is why it’s important not to give up on the practice but to keep trying until it starts to work.
So how do I want to describe the process of CBT now?
I now like to think of the process as an inner dialogue or conversation, whereby your anxious voice expresses itself, and then your rational voice, what I call the calming reassuring voice, challenges that statement using logical, creative, rational language.
This conversation needs to take place in writing, on paper, at least for the first few months. The purpose of this daily practice to get into a habit of ongoing dialogue where your anxious voice is recognized and given a chance to speak, then your rational reassuring voice points out the truth and persuades you to think in a different way.
Developing this habit is what changes the thinking and the behavior. With patient practice, it becomes more natural and automatic.
Why is the difference important?
Most anxious people see themselves or the world they live in (or both) as greatly flawed. Anxiety itself is a misguided attempt to fix things. So if you begin to harp on yourself to fix your thinking because it’s greatly flawed, you have given yourself an extra little burden to carry, that of “fixing” yourself in a different way. What happens is, the inner voice that is supposed to be calming, rational, logical, reassuring and helpful is instead scolding, critical, and demanding.
That is not what we want!
Some people understand this intuitively and realize that replacing anxious thoughts with rational ones is not something to beat themselves up about. If this is you, then you don’t need this article. But many people get anxious because they think they are not doing CBT the “right” or “correct” way or that when they have a “bad” thought they need to correct it with the “good” thought. This approach is rigid and can get in the way of progress. We need a little reminder that CBT is therapy, not something else to get anxious about.
I’m leaving the old articles as is but adding this one as an update, hopefully to make the practice of CBT more effective and (also important) more enjoyable, something to look forward to rather than a chore.
This is especially important for insomniacs with sleep anxiety because they so desperately want to fall asleep. The paradoxical nature of insomnia often puts people in near-panic mode, wanting quick fixes and immediate results. This attitude flows into everything they do, with a sense of time-urgency that gets in the way of the ultimate cure for insomnia, which is to relax and let go of the paradox of anxiety.
CBT works best when we don’t approach it with this same sense of urgency. New thinking patterns take hold faster when we feel relaxed and quiet.
It’s important to know how to use CBT effectively, meaning in a way that really works for you personally. Try the dialogue or conversation method and see if there’s improvement. Stay tuned for more tips and some real life examples in the next article.
This website has helped me more than any doctor or other tool in understanding my chronic insomnia. I still am struggling with it however I don’t feel quite so alone in this process and finally have some hope.