How Does Thought Replacement Work in Cognitive Behavioral Therapy?

In this article, we will take a look at how the practice of thought replacement works within Cognitive Behavioral Therapy.

We demolish arguments and every pretension that sets itself up against the knowledge of God, and we take captive every thought to make it obedient to Christ. – 2 Corinthians 10:5

What is Cognitive Behavioral Therapy?

CBT is an evidence-based form of psychotherapy that can be used to treat depression, mood disorders, anxiety disorders, severe mental illness, addiction, eating disorders, relational problems, and more. According to the American Psychological Association,

“CBT is based on several core principles, including:

• Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
• Psychological problems are based, in part, on learned patterns of unhelpful behavior.
• People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.”

Unhelpful thinking patterns (or sometimes called cognitive distortions) can greatly affect one’s mental, emotional, physical, spiritual, and relational health. Cognitive Behavioral Therapy helps people learn to find these unhelpful thinking patterns, evaluate them, and replace them with more helpful, truthful, life-giving thoughts.

This process can be how someone “takes every thought captive” and then “demolish arguments and every pretension that sets itself against the knowledge of God.” It is a process that honors God because it can replace lies with truth, truths that lead people back to Him. So, what does this process look like?

Thought Identification

Just like it is important for people to be able to pay attention to and identify their feelings, it is also important for a person to pay attention to their thoughts. Cognitive Behavioral Therapy also teaches that thoughts influence emotions which then influence behaviors. All three can influence one another, as shown in the Cognitive Triangle.

This means that someone’s thoughts can lead to feeling anxious or peaceful, sad, or joyful, angry, or calm. Unhelpful thinking patterns lead to more uncomfortable emotions, which then can lead (if not managed well) to negative decisions and behaviors.

“Automatic thoughts are the thoughts that automatically arise in our minds all throughout the day. Often, we are completely unaware we are even having thoughts.” Automatic thoughts, especially unhelpful thoughts, can be hard to identify because they happen so fast and are often gone before someone is aware.

It may be simpler to identify them after a situation is over, and then after practice, it will be easier to catch them more quickly. The goal is to identify the unhelpful thoughts so that one can then replace them, and therefore, feel better. For example, a person realizes that he is feeling angry. He pays attention to the thoughts he is having along with his anger that could be making his anger worse or that could have led to his anger in the first place.

When a thought is hidden, it cannot be dealt with, but when it is brought to the light, healing and restoration can begin. Again, the goal is to feel better, to not feel as angry, sad, or anxious, to think in a way that honors the Lord and isn’t hurtful and toxic.

Some questions to ask to identify past thoughts:

• What went through my mind just before I began feeling this way?
• How much did I believe it?
• Did any other thoughts or images come to mind?
• What is the “hot thought,” or the main one that triggers the emotion?

Some questions to ask to identify present thoughts (when feeling an uncomfortable emotion during an uncomfortable situation):

• What is going on in my mind right now?
• Does any part of me believe it?
• What other thoughts or images are coming to mind?
• What is the “hot thought?”

To continue with the example of the person feeling angry. He realizes that he is feeling angry after his boss makes him stay late all week. His automatic thoughts might be something like, “My boss is the worst. He doesn’t care about anything but money. He is selfish. I can’t stand him.” These thoughts are going to lead to even more anger and are not helpful in the situation.

Helpful thought identification tools:

• Thought record/ Log
• Automatic Thoughts Worksheet
• Cognitive distortions
• Apps (Moodfit, MoodMission, Depression CBT Self-help Guide, for example)

Thought Evaluation

Once a person has recognized the thoughts, then he can evaluate them to see how helpful they are. Many times, people begin to see how their thoughts are not rational or helpful. There are several ways to look at this process.

People can simply use the familiar THINK acronym of their thoughts: Is it true? It is helpful? Is it inspiring? Is it necessary? Is it kind? People usually use this when considering how their words or actions would affect others, but these simple questions can help to evaluate thoughts, too.

Another way to look at this is by reading Philippians 4, specifically verses 8-9.

“Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.”

Think on these things. Is this thought true? Is it honorable? It is just? Is it pure? Is it lovely? Is it commendable? Is it worthy of praise? Is it excellent? Other questions could be: is there any evidence that supports the “hot thought,” and is there any evidence that does not support the “hot thought”?

To go back to the angry employee, his hot thought probably is “My boss does not care about anyone but himself. I can’t stand him.” The first thought may not even be true, but the second is not kind, lovely, or praiseworthy or honorable. It is unkind and only stirs up more anger and bitterness.

It is important to evaluate automatic thoughts because the process can help a person see a situation from a different angle. Some evidence that does not support this person’s hot thought could be that boss does have some friends and family he cares about deeply, or that he takes diligent care of his employees.

Though there may be some truth at times to those thoughts, the key is being able to lead one’s mind into more helpful thinking so that the negative thinking patterns do not continue to affect one’s emotions and behaviors. One can use a thought record or apps to evaluate thoughts as well.

Thought Replacement

After evaluating those thoughts, one can replace them. This is not replacing them with false positives. For example, if there was unmistakable evidence to support the thought, “My boss does not care about anyone but himself,” it is not necessary to think something like, “He is the most amazing, selfless person I’ve ever known.”

That is not true and does not help the situation. This notion of thought replacement is not solely positive thinking. A more helpful thought, instead, could be “Even though my boss can be selfish sometimes, I am going to continue to do my work with integrity and genuine care for others. I can set better boundaries around my hours, too.”

The idea is to weed out the lies and toxic thoughts. There is no room for any of that in one’s mind. Write down a more balanced or alternative way of looking at the situation.

Though the Cognitive Behavioral Therapy method of thought identification, evaluation, and replacement can be effective in feeling better, it only touches the tip of the iceberg of uprooting unhealthy beliefs, managing emotions, and developing healthier habits.

However, this practice, when implemented often, can bring one’s mind back to obedience to Christ and help a person to honor Him. It can also bring about lasting change, and significantly affect one’s mental health and relationships for a long time. A mind is a powerful place, and it needs to be as healthy as possible.