Taking control over chaos- the CBT Triangle can help!

Dr. Tami provides insight into a form of therapy called Cognitive Behavioral Therapy, developed by Aaron Beck, MD. She helps listeners understand the cognitive triangle and how to use it to empower them to control their thoughts, feelings, and behaviors.  It’s one of many CBT tools to discuss for everyone!

Check out this great article to learn more: https://positivepsychology.com/cbt/

The ND Human Services Community Engagement Unit brings this episode to you.  Miigwech (thank you)

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Transcript

Season 2 Episode 4


00;00;00;04 - 00;00;19;24
Rob Jollie
Following podcasts may contain sensitive themes not suitable for all audiences, and it is not a replacement for seeking or maintaining a professional health relationship. Listener discretion is advised to learn more information regarding additional disclaimers, privacy policies and terms and conditions. Please visit: hellodrtami.com


00;00;22;28 - 00;00;52;29
Dr. Tami
Boozhoo, Hello, this is Dr. Tami, host of PsychologistSay..., a podcast where we create conversations about everyday life from a clinical psychologist perspective. Thanks for joining me today. If you're new to the podcast, thanks for checking us out and welcome to our returning listeners. Today I'm going to going to talk to you about a therapy approach I mentioned often throughout the podcast, and it's called 'Cognitive Behavioral Therapy'.


00;00;53;12 - 00;01;12;00
Dr. Tami
I just want to I want to talk to you a little bit more about what it is so that you can do some of your own research and you can also then maybe feel like you can keep up. When I say the word 'CBT' on over, we're just talking about how we work with this type of treatment in our area.


00;01;12;16 - 00;01;53;17
Dr. Tami
So cognitive behavioral therapy, it's a it's a psychological treatment. And we have been trained, I have been trained in this approach. And it is a very common type of approach used by many psychologists yet, It's not the only one. But it's very it's shown to be very effective for helping treat things like a depression, if you're struggling with anxiety, a substance use disorder, motivation, and being able to guide your goals and your daily tasks and activities. It can definitely be used in all areas of life because we use this as a tool.


00;01;53;17 - 00;02;23;03
Dr. Tami
It's a tool for us as psychologists to guide and help you develop your tools in terms of how you're thinking and to understand how you are thinking patterns impact your behavioral patterns and how that further impacts your actions and your moods. I like to think of this as a triangle, and it's not just me. I think this is the way they present CBT, as is a triangle of thoughts, feelings and behaviors.


00;02;23;19 - 00;02;58;29
Dr. Tami

And every time I work with a patient or I'm doing a workshop or the way I deal with myself in an a daily basis, I repeatedly see this triangle in my mind and the arrows are going both ways. So it's it's just a reminder to myself of the way I work with people in general, but how I work with myself is this thought behavior actually mood, mood, behavior, behavior, thoughts, mood, that this is the way I'm interpreting and perceiving my world. 


00;02;59;21 - 00;03;30;26
Dr. Tami
And if something isn't going right, I have to really check in with one of these areas and I can manipulate them. I can manipulate one of these areas to one, improve my mood to to improve my thoughts, or three, to improve my behaviors. So in CBT, when we use the skill that's the that's the core, in my opinion, that is the core is being able to teach that to my patients and I use it daily myself.


00;03;31;00 - 00;03;58;12
Dr. Tami
I use it several times a day. Throughout the entire day. I would say I'm kind of going back and forth with what's going on for me right now. And is it working well? If it's working well, then you're what I'm thinking is you're, you're in line with what your your actions are. They're very consistent with the with what you're thinking and your mood is is right in sync.


00;03;58;26 - 00;04;31;14
Dr. Tami
And you're you have that energy. You just feel like you're in balance. So that's a really good word is is I feel that balance. I feel that comfort and those feelings come from my that I know that my ideas, the self-talk, my, my internal monologue or dialog or the conversation I'm having with myself within my my mind is really it's working for me because I can I can tell that by my behavior, I'm acting.


00;04;31;29 - 00;05;07;01
Dr. Tami
My actions are in a good way. Let's really just break this down. The the the psychological problem. And so if you're a new listener, you definitely want to go back and check out our earlier episodes so we can you can feel like, you know, how we can explain some of these problems. Anxiety is one of my areas of where I really like to hone in, and I think it's definitely I know it's one of the most common disorders that I see in the clinic and that I think that we are dealing with at a very high rate in society, especially after the COVID pandemic.


00;05;07;01 - 00;05;51;21
Dr. Tami
But it's always been here and anxiety right now is is elevated. I think people we we want to feel like we don't have it anymore or we want to feel that we're in control of this anxiety. Yet after 

experiencing something like COVID and we're still in this, it's normal, very normal to have an elevated awareness, maybe a feeling of uncertainty while you're trying to navigate how to cope and deal with something that's new, that's foreign, and it's been introduced into your life in such a massive way, and that that kind of change in our lives, it is considered a bit threatening for sure. 


00;05;52;02 - 00;06;26;16
Dr. Tami
And what we were experiencing was on a high, we were on high alert and our bodies, they may have a lot of trouble with coming down from that kind of a state of alert. If you're feeling like this, don't worry, you're not alone. Many, many people are trying to find a new state of what is what's a new level of acceptable, maybe anxiety or an acceptable level of comfort after everything about maybe what we knew or we thought we knew was challenged in some sort of way.


00;06;26;26 - 00;06;51;26
Dr. Tami
And I can definitely say that we we all were challenged. Our our our typical thinking maybe of the way we felt secure or safe, or that maybe we like to think that things could happen at this level. And when you're given a piece of data that says 'Oh boy, but now we have this, we went through this experience and it was it was it's critical


00;06;51;26 - 00;07;21;16
Dr. Tami
It was high. It was a level of uncontrollable ability that we all feel that we knew we were walking through something very intense and it was prolonged. And we're in it now. We're still navigating this.' And so when we think about this, if we were to add like unhealthy thoughts onto that situation, it can escalate a feeling of more anxiety, more anticipation, more uncertainty.


00;07;22;14 - 00;08;04;08
Dr. Tami
It's real important then it like a CBT model to say how can we go in and how can I help you understand the thinking patterns behind something as big as COVID, as big as a divorce, as big as the loss of a loved one, as big as a losing your home. You know, when we start to think of all of the things I just mentioned and so many more, the thoughts that we the way we choose to think about a situation is going to definitely help us walk through that in a way that that helps us, I guess, manage our steps.


00;08;04;29 - 00;08;39;28
Dr. Tami
So there all the research out there says there's no way to just overly positive to think something. Don't want to just 100% just think happy thoughts. That's definitely not what we're talking about. And I know there's research that shows that's not really helpful to, to just totally avoid of any 

realistic thoughts. And everything in life is not just take it to make it, but this is you just have to feel 100% positive about this. 


00;08;40;10 - 00;09;08;02
Dr. Tami
Your brain will know. It will figure out something's not right. It's okay to balance it. That's what CBT really does. It balances it. I always like to think of it as a like a teeter totter. And so if if your thoughts are really negative or even if you're having more negative than you are positive, then the feeling of anxiety is going to infiltrate your body or the feeling of depression or the feeling of overwhelm or uncertainty.


00;09;09;01 - 00;09;56;19
Dr. Tami
Changing up that thinking can be one way where you balancing it. It requires work. It requires some time having to even have a diagram in your head, like, that's what I do. I have this and I diagram it for my patients where they have this triangle and they am hoping what it does, because it does it for me, it's a it's a feeling of empowerment to know you can walk out into this world and know that it does not control you, that you have this magnificent tool and it's one of many like again, this is one of many that can help you navigate a world that feels very complex, that feels very unpredictable, and to


00;09;56;19 - 00;10;35;17
Dr. Tami
manage a life that is ultimately chaotic because that's what being a human is about. If human life was predictable, safe and secure. I'd be out of a job. I just have never met a person who has had all of that checked out for their life. And I've never met a person that has been 100% secure in their future. I've never met a person that has felt 100% safe, and I've never met somebody who felt like they were not apprehensive even in the slightest about whatever their their next move should be.


00;10;36;20 - 00;11;17;15
Dr. Tami
So I want to normalize this level of uncertainty. They're just just part of the chaos of living. These are my listeners. We all realize that we if you tune in to listen to me, you're one of those people out there that knows if we could do this all on our own, we would if we could. If we could solve our own problems, if we could understand all of this connection between the way what's happening in the world and the way we're behaving and our the way somebody is treating us in a certain way where we are maybe sabotaging some of the things we said we want to do in life, or sometimes we're our worst


00;11;17;15 - 00;11;42;26
Dr. Tami

enemy when we want to be our biggest cheerleader. These are all very relatable and you're my people. And so definitely don't feel alone in that. Know that that's part of daily life. That's part of who we are as as humans. And with this, this brain of ours that since early childhood we want to attach to to caretakers, we want to be we want to belong. 


00;11;42;26 - 00;12;10;14
Dr. Tami
We want to be part of something. We want to be valued. And so all of those things are ways of everyday thinking and behaving and reacting to this world that can feel really complex. Yet let's break it down again. So thinking if we're thinking that we are unlovable, what kind of behaviors could that generate for us? I could imagine that some of us might isolate.


00;12;11;12 - 00;12;38;02
Dr. Tami
We may we may be guarded. And a lot of times it's an invisible guard. People don't understand why maybe they can't get close to certain individuals. And if we're not verbalizing our if we're not even tracking our thinking, maybe I'm in lovable, unlovable, then we could be warding off people who are trying to love us without even knowing it.


00;12;39;04 - 00;13;13;02
Dr. Tami
And so that that behavior of of isolating our behavior is something that you can describe. It's an action. And so it's something that we are doing. The thought is something that it's that's our dialog in our head. That's what our mind is saying. It's based on our perception. And then now I want to take you to the mood that is that feeling that's internal that we we're now having a strong emotion connection to this.


00;13;13;21 - 00;13;40;06
Dr. Tami
So a thought. Remember, now that's what we say to ourselves in our head. It's it's our cognition. It's it's being aware of the voice inside of our head. And the voice inside of our head can be impacted by so many things. Everything that we say to ourselves. So that impacted by either by a mix and a rate of what other people have said to us, how other people has treated us.


00;13;40;06 - 00;14;03;22
Dr. Tami
These are the things that we pull from to identify how we structure and start seeing ourselves. And a lot of this majority, this will happen at a very young age. And so that's why in adulthood we can go back and try to say, 'How can we restructure what's wrong? Why do I why do I feel like I'm I'm not an easy person to love?


00;14;04;15 - 00;14;35;03

Dr. Tami 
Or why do I feel like when when someone tries to love me, I end up pushing them away or I end up finding excuses to not get close to them. So why do I act this way when somebody I think may care about me, but I don't trust it?' And so you start to I just want I'm giving you a lot of examples about the way our thoughts can impact this behavior and then the mood.


00;14;35;03 - 00;15;04;09
Dr. Tami
Some people can say, 'I feel really sad internally. I feel lonely. I feel like I'm alone in this world.' And so you start to link that, Well, what's situations are resulting in you starting to feel alone and then that's where you can start to backtrack. Now, CBT is very extensive. It involves, it involves homework. It's something that that's why I love it.


00;15;04;25 - 00;15;30;06
Dr. Tami
It's not up to your therapist to to fix problems or to fix relationships or even to fix you. It's up to your therapist to equip and to give you some tool to really equipped you with what you need in order to get out there and feel empowered and feel empowered with dealing with yourself and dealing with others. That's what life comes down to relationship building.


00;15;30;22 - 00;15;57;01
Dr. Tami
And so if you can have this little triangle in your head and go, okay, I want to change things up for me today and change is hard. I don't say, Yeah, I trust me, everybody out there, change is hard. And so when we when we make a commitment to just make one little change in our and maybe even starting today, if you have this model, it's just it's a way to just start to do a little bit of this work for yourself.


00;15;57;01 - 00;16;18;15
Dr. Tami
But it's not going to solve everything. But I can say you're going to you're going to feel like you have something in your back pocket. And so a lot of times are the work that we have to do is taking a thought and we have to work it. We can't just trust our thoughts. It's like trusting everything that you hear on the news.


00;16;18;15 - 00;16;49;06
Dr. Tami
It's like trusting everything because you feel like the internet was great. That was your best source to get it. So it has to be true. Our thoughts are totally flawed. We're distorted in them. Often times, oftentimes are irrational, especially if it's your first thought. So if it's your automat thought we call it, it pops into your head. And a perfect example of this would be if your phone rang at 3 a.m. and you have loved ones, what would your first thought be?

 
00;16;49;06 - 00;17;11;12
Dr. Tami
And for many it is that there's been some kind of catastrophic event. And why would they think that? Why would that be their first thought? Well, because maybe in the past they received a phone call of something that was in crisis nature that was alarming. And it came early in the early in the morning like that or late at night.


00;17;12;03 - 00;17;43;26
Dr. Tami
And so that one that one lit up that one piece of evidence that that's what it could be. Or maybe it happened more than once, or maybe that's what they see on the television. There's always a, there's seeing so much of this. Where there's this call in the middle of the night waking somebody out of their sleep. And the news that somebody is delivering is not good or there's a knock at the door late at night or early in the morning and the news is not good, whatever is being brought to you at that time.


00;17;44;19 - 00;18;15;06
Dr. Tami
So the brain is making this connection of that, a call at that time that's putting together that data. And the first automatic thought is something bad has happened. So let's just take that thought. With then your body triggering, most people will say they feel like their heart races. They may feel like they've been startled, they may get nervous and start having all of these fears thoughts, and they may rush to the phone and try to answer it.


00;18;15;11 - 00;18;46;12
Dr. Tami
Some may look at the phone kind of frozen and stare at it, scared to answer it. And all of these things are going on before knowing what the phone call is about. So that's showing you right there where your thought, if it's automatic without being challenged. A lot of times is an irrational thought. It's based on past experiences, past behaviors, witnessing of other other scenarios.


00;18;46;12 - 00;19;15;26
Dr. Tami
And then our mind is jumping. It can be jumping to conclusions. And so when you get that kind of situation, very important to pull of that triangle in mind and go, 'Okay, hold on, phone is ringing. It's 3 a.m.' to Then challenge, 'take it easy, take a deep breath and slow the thinking process down' and change it. You can go straight to that that thought and go, 'Let's let's take a moment to just relax.


00;19;16;19 - 00;19;55;02
Dr. Tami

Balance of thinking this could be really bad news or it could be a wrong number. It could be somebody that just maybe is locked out of the house and needs to get in.' And so just taking that moment to examine and balance that from it's an emergency, see, to maybe call that one thought and then trigger your body to relax a bit, to get out of that fight or flight and then to be able to change the behavior of freezing and staring at your phone to actually clicking it and saying hello. 


00;19;55;02 - 00;20;25;03
Dr. Tami
So that's how you change and manage that mood of thoughts, feelings and behaviors. You're starting to face. This will give you a tool to start facing fears that a lot of times we make up in our own head and it's not because we just want to be afraid of things. No, remember, this is because there's stuff that we've experienced or that we've watched on TV or we've heard about events that have impacted our perception.


00;20;25;03 - 00;20;45;27
Dr. Tami
And so one way for us to do that is to challenge that. And I think this is a really good time for you guys to think about other ways that you can start to challenge either what you're thinking, what you're doing now, or that's your behavior or what you're feeling. And so this is just one one step into us talking about it.


00;20;45;27 - 00;21;10;10
Dr. Tami
And when I bring it up now CBT and you'll know that it's challenging these behaviors in those three realms and that there's a lot of work that you do with yourself and with somebody else to make sure that you're you're doing your part to help yourself understand how to navigate this. Because if we let it run, it'll run.


00;21;10;29 - 00;21;38;12
Dr. Tami
And a lot of times our mind is skewed by this negative, and it's skewed to be feeling fear and anxiety and overwhelmed and unsure. And so the power of CBT, I think is being able to say, 'Okay, maybe I'm too anxious. I keep thinking these thoughts, even though she's telling me to try to balance them with maybe a more productive thought.'


00;21;38;29 - 00;22;10;01
Dr. Tami
My mind is just I just don't I don't do that. Well, then my next thought would be was can you change your behavior? Can you get up? If you're laying in bed and you're thinking and you're worrying and trying to balance your thinking of that with something more, more productive, this isn't working for you because that that anxiety thinking is so ingrained, then I would challenge 

you to get up and turn on some music, turn on the TV, pick up a book and start reading something else. 


00;22;10;12 - 00;22;47;19
Dr. Tami
Do 20 jumping jacks, you know? What did that do? Did that to anything cheer the way you were feeling? Some people would turn on a comedy and all of a sudden they may be laughing and their mind, they may realize instead of feeling angst, they're starting to feel a level of relief and just maybe satisfy action. Then their thoughts, they go, Oh, wow, now I'm starting to think of that where I don't feel as hopeless about this job interview that I was worrying about because now I'm laughing.


00;22;47;19 - 00;23;13;17
Dr. Tami
I've changed something in my in my behavior that's helping my mood and then helping me to balance myself, though I hope I know there was a lot of missing thoughts, feelings, behavior. That's I think that's great repetition. I want you to be thinking that thoughts, feelings, behavior. If I can change one, I can change the cycle. So thanks for checking in today.


00;23;13;17 - 00;23;36;24
Dr. Tami
I know there's a lot more information and I can't cover it all in one episode, but I'm glad that you're with me today and I sure hope you keep checking in. P.S. CBT is one of those things that we may feel is new to us or outside of our awareness, but it's it's all over the place and it's one tool that will really work for you to give it a shot.


00;23;36;29 - 00;23;52;00
Dr. Tami
Thanks for checking in.