Through this series we’ve touched on the basics of how CBT works and what to expect if you seek help from a therapist who uses it.

The question I always ask when I start working with a therapist is, “How will I know when it’s helping?”

With CBT the answer is pretty obvious. You’ll know it’s helping when things aren’t bothering you as much. You’ll also see yourself handling situations differently. Let’s go back to the example of public speaking.

At the start of therapy, you dreaded speaking in front of a group so much you had missed opportunities because it was so anxiety inducing. Maybe you’ve even been overlooked when a promotion came up because no one had seen you in that position before.

Through therapy you discovered this fear was rooted in past experiences (your own or others) and that fear had become internalized. You discussed your thoughts, feelings, and actions around public speaking. Then, your therapist worked with you to help you learn how to reframe things, how to see yourself as capable of delivering a speech, preparing for a speech, and using rational thought to override irrational emotions. They’ll have taught you some skills to de-escalate your stress levels.

When someone asks for a volunteer to deliver a presentation at work, you hesitate, but raise your hand. Right after, you panic because of the old fear. Using the skills and continuing to work with your therapist you reduce the sense of dread. You envision yourself as capable and deserving, and you can now separate a business setting from the elementary classroom show-and-tell.

While you prepare your presentation, your therapist has you practice delivering it to first one person, then two, and so on, until you’re ready to go back to the meeting room looking cool and confident. You might be sweating buckets underneath it all, but it’s because it’s the first time you’re doing this.

That is when you know CBT is working. The way you see events, your ability to complete tasks, and your reduced anxiety around those items will be apparent.

Personally, I’ve used CBT to overcome a dread of handling large medical bills, managing my own finances, speaking up at work and stepping forward as a leader, and even taking a class in a subject I don’t feel confident with.

I’m currently using it again to learn to adapt to life with chronic fatigue and post-covid issues. I started it because walking around being mad at myself for no longer being able to function at pre-covid levels was not getting me anything good out of life. Instead it left me in anxiety and feeling worthless; thus the depression I’ve mentioned in more recent posts.

The goal is to change how I think about the things I expect of myself. I admit to being demanding of myself, and that part isn’t likely to change. At the same time, my expectations need to be realistic and fit with the body and mind Covid has left me with. I’ll probably throw in updates as we go along so you can see this form of therapy in action.