Dr. Larry Larsen
---- — Dear Doctor,
Someone has suggested we have “cognitive behavior therapy” for our teen daughter. We think we know what it is, but wonder if maybe you could help us understand.
Cognitive behavior therapy, or CBT as it is often known, is nothing new. It rests upon the rather obvious assumption that how we think governs how we feel. Our neurology actually only involves three functions: what we do, think, and feel. Accordingly, if someone wanted to “feel” differently, one might change both behavior and thinking.
Most therapists use aspects of CBT, although they might not bill it as such. With teens, CBT, as a rigid method, may fail because homework and assignments are involved.
On the other hand the “method,” if one can call it such, is useful. Let me give you some examples: Suppose teens complain about people “making me mad.” It is important for them to think differently about anger. They control whether they are mad. Blaming anger on others gets you nowhere. When they recognize the ownership of their anger, they can begin to do something about it. That will involve changing how they think and altering their behavior.
Suppose again someone is very tough on him or herself and cannot abide making mistakes. When the nature of mistakes is understood to be a gateway for learning, behavior and feelings change. To make mistakes becomes OK, not a fatal flaw.
Many teens are especially negative about performance equaling value: “I am not worth much.” Challenging this often cherished belief results in a more mature understanding of self worth. Values and feelings change when one allows a different and less rigid definition of worth.
Make no mistake about it. Teens are especially resistant if they do not like the therapist. Securing a safe, warm, and accepting relationship is task number one, well in advance of whatever “CBT” may mean.
Dr. Larry Larsen is an Andover psychologist. Email him questions or comments at lrryllrsn@CS.com.