Is CBT gaslighting?

This criticism of Cognitive Behavioral Therapy (CBT) is an entertaining one because it intersects with another therapeutic issue of thera-speak and overuse of terms like gaslighting. My honest take? Sometimes, but less so when used properly. 

Cognitive Behavioral Therapy focuses on the interconnection between thoughts, feelings, and behaviors. It primarily focuses on changing thinking patterns, with the hopes of feelings and behaviors changing too (due to this interconnectedness). Its core premise is that the most useful thoughts are both helpful and accurate. It’s important that they’re both, because if you trade thoughts that are unhelpful and accurate for ones that are helpful but inaccurate, it honestly is gaslighting! 

Let’s try an example. A young woman experiences being cat called. Despite the interaction being relatively non-dangerous in that the man walks away afterwards, she finds herself dysregulated and afraid. 

Initial thought “what if he is following me? What if I get murdered”

Let’s be honest, this thought is not super helpful, but it's not 100% inaccurate either. Unlikely, sure, but not inaccurate.

A more helpful but potentially inaccurate replacement: “I am safe.”

This is intended to sound reassuring, and is likely true, but this is where the nuance is really really important, because most fears are grounded in some reality, which can not simply be erased.

A thought that is mostly helpful and accurate: “I am aware of my surroundings and doing everything I can to ensure I am safe”

This thought has a positive lean and focuses on what you can control. Helpful and accurate thoughts are the gold standard, unfortunately life has a lot of nuance and sometimes to hold all the truths while still being helpful results in wordy and complex thoughts (which, full circle, can sound like thera-speak at times).

Like any tool, CBT is useful, but needs to be applied thoughtfully. Just like a screwdriver is not the tool of choice to get a nail into a wall, CBT or cognitive restructuring may not be the most useful tool to deal with anxiety or depressed thinking that is grounded in an accurate depiction of reality. For trauma in particular, it’s important to keep in mind that some thinking can be both unhelpful and be coming from an adaptive/survival place. It’s a real mess to untangle, and to be honest, part of why therapy itself rather than just reading up on psychological theories, can be so important!

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