Skip to content

CBT from a Christian perspective

Here's excerpts from a longer paper on my website appraising Cognitive Behavioural Therapy:

Cognitive Behavioural Therapy (CBT) is a

  • short-term,
  • practical,
  • client-based,
  • collaborative,
  • problem-solving,
  • life-skill learning

‘talking therapy’ which has had excellent and well documented success in alleviating certain emotional problems.

...

CBT represents a small number of different counselling schools which understand the process of change to involve the re-habituation of thoughts and (secondarily) behaviours.  The underlying assumption is that faulty emotions and behaviours flow from faulty thinking.

Thoughts =>  Feelings => Behaviours

These thoughts are themselves the result of faulty beliefs which underlie them and need to be confronted and changed.

...

The chief benefit of CBT for the church  is perhaps the myriad tools that have been developed to uncover faulty thought patterns and beliefs.

Christians have always known that beliefs and thought-patterns are life-altering, but three or four decades of clinical practice at ‘digging down’ into the beliefs of counsellees has produced very useful tools which can also be used by the Christian.

Identifying Negative Automatic Thoughts (NATs)

  • Ask directly – What are you telling yourself when you feel X…
  • Guided discovery (ask around the issues, get them to unearth)
  • Note emotional change as they speak – these are ‘hot cognitions’
  • Worst consequence scenarios – What would be so bad if…?
  • Imagery (some NATs are images) – Do you have a picture of yourself or of your environment when this is happening?
  • Exposure exercises – go to uncomfortable situations either physically or in your mind. How are you now thinking?
  • Offer multiple suggestions of what the NATs may be
  • Offer suggestions opposite to client’s expected response. They will usually say ‘No, no, I’m telling myself X’

Question the assumptions underlying the NATs:

  • What would be so terrible about X?
  • What would it be like for you not to do or feel X?
  • What does it say about you that you have done or felt X?
  • Are there verdicts being passed on you from God, the world and yourself associated with X?  What are they? Could you put them in words?
  • On what basis are these verdicts being passed?
  • On what basis are you believing them?

At this stage, CBT identifies the faultiness of such thinking as certain cognitive errors:

  • Arbitrary inference: e.g. ‘I was much happier when I happened to be X, therefore I must regain X’
  • Selective abstraction: e.g. ‘X (and nothing else) is what makes me special.’
  • Over-generalisation: e.g. ‘Everyone who has X is happier and more successful.’
  • Magnification (of the bad) and minimisation (of the good): e.g. ‘I may have Y and Z, but that’s nothing.  X is everything.’
  • Personalisation: e.g. ‘My performance of X wasn’t bad, I was bad. Everyone must hate me.
  • Absolutist, dichotomous thinking: e.g. ‘It’s black and white, all or nothing.  Either I’m X or I’m nothing.’
  • Mind reading: e.g. ‘I know what they’re all thinking…’
  • Crystal ball: e.g. ‘I know what’s going to happen now…’
  • Catastrophizing: e.g. ‘It’s all over now. X is out of the bag, all hell will break loose.’
  • Emotional reasoning: e.g. ‘I feel X so strongly, therefore it must be a fact.’
  • Self-labelling / blame: e.g. ‘X makes me an idiot!’ ‘X makes me ugly!’

Beneath these faulty cognitions are the schemas or core beliefs that feed such thinking. CBT also offers helpful techniques in bringing these to the surface.

To identify core beliefs, look for…

  • ‘If…, then…’ statements: ‘If I’m X, then I’m a failure.’
  • ‘Shoulds’ and ‘Musts’
  • Themes in the NATs
  • Family sayings, mottoes, memories

The CBT practitioner should then get the counsellee to put this core belief into words.  Make them identify it as a rule: e.g. “I need everyone in my environment to be ok with me or else I will be destroyed.”  Simply the process of articulating this rule – exposing it as the dominating force in a person’s every decision, act and feeling – is incredibly powerful.  In Christian contexts it should lead to heart-felt and deep confession.

...

[Summary of intervening points]  In John 16:9 Jesus identified the criterion by which the Spirit would condemn the world for its sin - "in that people do not believe in Me."  Through loving Christian community, the tools listed above can be a means of the Spirit uncovering those false faiths.

A key verse in Christian counselling is Proverbs 20:5: "The purposes of a man's heart are deep waters but a man of understanding draws them out."  When I encounter a Spirit-filled 'man of understanding' in these circumstances I am exposed for my sinful beliefs and purposes - not simply my behaviours - and therefore may be brought to a broken and contrite heart.

I say may because it is always the Spirit's work to convict me of sin - never simply the work of logic.  More on this below...

...

Perhaps the chief criticism that could be levelled at CBT from a Christian perspective is this: It is not wise and persuasive words that are required but a demonstration of the Spirit’s power.

At the core of CBT is the challenging of irrational beliefs with logical standards.  However the deceitful and unfathomable heart will take more than good reasoning to shake it from its madness.  The truth of God’s gospel must be driven home to the counsellee with living power by the Spirit.  Faith does not come by reasoning but by hearing and hearing through the word of Christ.  Therefore there ought to be a healthy dose of proclamation to pastoral counselling, a worshipping community to surround it and the regular table fellowship of the Lord’s Supper. All the means of grace ought to be employed by the Christian counsellor.  This goes far beyond pointing out faulty cognitions!

It is not our intellects that need changing but our hearts.  The heart is the centre of a person according to Jesus and the source of our thoughts and actions.  Our true hope is in the change of hearts.  This means:

a) we will not look for non-rational means (the heart is not an anti-intellectual concept in the Bible)

b) we will employ emotional, artistic, sensory means also

c) true change is ultimately the work of God

...

The whole article, including a potted history of the development of CBT, can be found here.

.

13 thoughts on “CBT from a Christian perspective

  1. Si

    One thing that you miss off is that introverts like me keep falling into the trap of looking within, thanks to CBT. I keep on working backwards as to why I'm doing something.

    Consequence
    - Looking inward to see why I'm doing something and what belief I should change, rather than to Christ (which would change my beliefs as his Spirit works in me) and whether I should be doing that something.

    Beliefs
    - I need to understand why I'm doing something to attack the root cause of the problem
    - CBT explains how I process events and behaviours

    Activating Event
    - 'Road to Maturity' course with my church, which spent four weeks of six really hammering the A-B-C process in, and getting you to work backwards. I knew the A-B-C process from before, but it was this course that started the consequence.

    I really struggle with looking in, when I should be looking out, because of my personality type (which is, of course, no excuse). I don't need an excuse to look within, and CBT gives me an excuse.

    Funnily enough I hadn't really realised until I read this post and twigged, going through the process, realised that the process was really damaging for me. Rather ironic.

  2. Tom Price

    Glen,

    Think you might have missed something quite important. The thinking that CBT tries to deal with, can come from the heart, rather than the intellect. As such, then the heart is a rational place.

    I'm not a huge fan of CBT personally - because it is like putting a plaster over the (usually) deeper problem, but I have seen some benefit in practice, for some people.

  3. Heather

    Good thoughts on the dangers of naval gazing, Si.

    I thought this article was a shining endorsement of CBT at first.
    Seemed a little out of place here, as the system seems to focus strongly on internal feelings, thoughts and "self".

    Guess it's prudent to read a post in it's entirety before getting agitated.

  4. John B

    I see a parallel between apologetics and the work of the gospel in evangelism in bringing unbelievers to *justification* in Christ through faith; and Christian counseling like CBT and the work of the gospel in building up the saints in guiding them to *sanctification* in Christ through the renewal of their minds.

    (John 17:17) "Sanctify them in the truth; your word is truth."

    Ultimately the faith that first unites sinners with Christ and then transforms us in Christ is the sovereign work of the Holy Spirit. But God condescends to use human means as instruments in working out his plan of redemption.

    The task of apologists and counselors is to meet the natural man and the old Adam where he is; in the dust of materialism. And there to till the hard soil of the heart to prepare it for the planting of the gospel seed.

    CBT sounds like a big improvement over exorcism!

  5. Glen

    Hi Si,

    Well CBT is meant to be a problem-focussed, short-term look at a particular dysfunction. Continuous, pro-active self-monitoring sounds like Bonhoeffer's line about 'always taking your spiritual temperature.' But more than this, it's not a particularly CBT way of proceeding which is by nature short-term.

    Having said that, I think I'll do a post soon about how addressing particular sins is not necessarily introspection. I know for myself that I'm so self-deceiving and self-absorbed that I've often happily travelled along in the Christian life with my "eyes on Jesus" and sinning in gross and destructive ways that were completely hidden from me. I've needed other Christians to arrest me and make me look at patterns of relating that have hurt other believers while I'm piously 'looking to Christ.'

    Much more to be said...

  6. Glen

    Hi Tom,

    Not sure I'm following you on the heart/intellect stuff. Not sure how to reply until I understand what you're saying.

    It's important to say that the full article gives quite a lot of "pros" to CBT along with some cautions.

  7. Glen

    Hi Heather,

    Hope the whole article gave some balance :)

    Hi John,

    Yes indeed, God uses means in the renewal of the mind - and the word of God through the people of God using directive techniques like those cited above seems a fair way forward when that pesky indwelling sin causes an acute problem somewhere.

  8. Si

    My name is Simon, and I'm a self-analysing DIY-fix myself addict. My fleshy mind loves solving problems (especially mine - which aren't necessarily sin, but perhaps - "why am I being tempted in that area, what belief is allowing this to happen?" or "why am I feeling really down today?"), introspection and thinking about how I think.

    I need to look out so so much, because I've made a sin of looking within and trying to do it myself (Glen - you point out belief legalism in your article). Looking in isn't in and of itself bad, it's the never looking out that is.

    The course I did asked me to do CBT on myself (never said it was short term - in fact it came across like "change your beliefs and the problem is gone") and bang I was hooked as if it was like crack. I was putting my trust not in the LORD, but in myself and in the Zeitgeist religion of psychotherapy.

    CBT has it's uses - I'm very far from denying that, but I really do think I've misused it in way that's very damaging to myself. Massively faith destroying. Thankfully, God has given me this epiphany, showing that I missed an absolutely huge problem while trying to solve my problems, and together we can work together to fix my bad beliefs and behaviours in this area.

  9. Heather

    Hope the whole article gave some balance :)

    Glen,

    My comment was misleading...I meant I had read the "whole" article as it is posted here.

    However, I did click over and have now finished reading the original piece. And yes, it does appear there is balance that is offered.

    The method seems pretty complex to me. I got a little lost.

    I'd agree, though that one's underlying belief is an important factor in emotional trauma.

    About 5 years ago, I was having severe anxiety and depression issues and counseled with a believing friend who, among other things, suggested I spend time in prayer and reading of my Bible daily. Seems like an obvious solution but I had abandoned any effort weeks earlier .

    I remember crying and admitting to the Lord that I was feeling wretched--begging for Him to give me something I could hold onto because I needed peace.

    Not knowing where I ought to start reading, I just went back to the place I had left off:

    John 14:1 "Let not your hearts be troubled; believe in God, believe also in me.

    The Lord made it very clear at that moment that my fearfulness and sadness had been of my own making because He had placed in my heart something I needed to do that I had ignored and resisted for months.

    My heart was troubled because I refused to trust that God's plan is best. I did not believe that His instruction is good and landed myself in a pile of misery.

  10. Glen

    Hi Si,

    Yes unfortunately one of the deadliest of all sins (self-absorption) is something which CBT will (in all likelihood) only feed! Having said that - CBT is the most 'shallow' of all therapies. It's not like getting lost in Freudian psychodynamics. But yes indeed - I recognize these problems.

    Hi Heather,

    Nothing beats a wise Christian friend and the word of Christ!!

  11. Pingback: Some tasty links from the last month «

  12. Robert

    Hi Glen, since you feel cbt is a shallow therapy, like you put can you please recommend a good christian therapy, possibly a website or book thanks for your time.

  13. Glen

    Hi Robert,
    I think CBT can be useful in many situations. I hope that comes across as well as the cautions. I like Larry Crabb's stuff - perhaps "Finding God" would be a good intro. CCEF are also good and have great online resources here:

    http://www.ccef.org/

    God bless,
    Glen

Leave a Reply

Your email address will not be published. Required fields are marked *

Twitter widget by Rimon Habib - BuddyPress Expert Developer