Evaluating cognitive-behavioural therapy and positive self-talk
- yourlistener249
- Jun 18
- 5 min read
Welcome to the June 2025 edition of the Your Listener Counselling newsletter! This month, we are explaining cognitive-behavioural approaches to psychotherapy and the role of self-talk in psychological change. These concepts are some of the most prominent in personal development and the helping professions, however they are not without limitations. Here, I explain their importance and how they could improve.
Cognitive-behavioural therapy (C.B.T.) refers to a range of related approaches and derives from a range of theories. In C.B.T. theory, our thoughts influence our emotions, the combined effects of which influence our actions. Those actions yield results that reinforce to us that the thoughts are valid, perpetuating them. If our thoughts are unhelpful, distorted, or untrue, they may inadvertently perpetuate the cycle of functioning that underlies psychological problems. C.B.T. teaches us to logically test these thoughts and replace them with more constructive ones. These theories of origin also may have brought to prominence the idea of self-talk — that is, the ideas that we believe about ourselves in relation to both life and specific situations, that largely influence our functioning. These unhelpful cycles are considered to underlie a range of psychological problems, commonly disorders such as depression and anxiety.
As an example, if a person believes themselves to be unlikeable, they may become depressed believing that life will never be enjoyable given their lack of social relations, and anxious in social interactions due to fear of being perceived negatively. They may avoid social interactions, believing that they will not be fruitful (called learned helplessness), or if they do socially interact, they may inadvertently present in a way that is disconcerting to others because their mentality is, unbeknownst to them, influencing their behaviour. They therefore undertake few, unsuccessful social interactions, which validates their belief that they are unlikeable. C.B.T. would involve educating this person on how these thoughts are involved in self-perpetuating the issue. It would help them to re-conceptualise themselves as having learned ineffective behaviours rather than being inherently unlikeable (called re-framing), and create plans to adopt healthier behaviours to cease the cycle.
C.B.T. has been thoroughly validated, and the theory is crucial. The mind has a powerful influence on how we function, even unconsciously, and believing a seemingly insignificant thought can have inadvertent consequences for our behaviour. Behaving adaptively (that is, in ways that contribute to psychological and physical health) relies on being cognisant of our mental events, actions, and choices, and regulating these for the best result. As such, most psychotherapists make some reference to self-talk or deliberate behavioural strategies even if they integrate a range of therapeutic approaches. While C.B.T. is important, there are a number of common shortcomings to address.
A component which may be excluded is education on the purpose of thoughts and emotions as human phenomena rather than simply whether given thoughts are rational. Given that clients are often daunted by not understanding why their psychological ailing is happening, this additional education helps them to feel understood by us and provides closure. It also helps develop problem-solving skills applicable to other domains of their life, and a sense of self-mastery that can instil motivating confidence. My clients often explore with me how we use heuristics (or "mental shortcuts") to make quick judgements about life for survival, which can become distorted due to using biased information and happen so quickly that the conscious mind does not examine them.
A similar omission is inherent in the common C.B.T. principle that "only the present matters". This is born of the supposition that events themselves, such as the past, do not affect us, but rather that our interpretations of them do. Paradoxically, this is both profoundly true and short-sighted. A healthy mind must understand that its interpretations are not necessarily objective truth. However, distorted functioning often develops from ideas instilled in us during early experiences, which we have unknowingly perpetuated throughout our lives via complex interwoven patterns of thinking, feeling, and behaving. Mastering our change processes, and our lives, necessitates understanding how these tendencies developed and how we can address them sensitively. Failing to explore the past (which appears startlingly common) risks wrongly conceptualising clients' problems and offering the wrong interventions. Clients may continue to be affected by psychological ailments which can not be overcome by simply focussing on the present with counteractive self-talk. As a trauma survivor, I was a recipient of this type of psychotherapy for some time and as a result of nobody properly educating me at a time when I was too inexperienced to know better, my own mental illness worsened and had serious implications for my life. Thankfully, I overcame this, allowing me to do what I do today. But this was preventable, and I am not the only person who has had this experience.
A further issue to consider is that correcting unhelpful thoughts may be rather loosely conceptualised as positive self-talk, and we must distinguish this from rational self-talk as they are vastly different concepts. Defaulting to positive self-talk assumes that any thoughts that one's life is problematic are unhelpful. While negative rumination worsens rather than solves problems, mindlessly dismissing problems with optimism ignores that they may worsen if we do not address them. This is called avoidance, a coping mechanism equally as distorted as the functioning which C.B.T. is meant to address. Instead, rational self-talk involves objectively analysing the problem and deciding what response is most helpful. If modifying our thinking is all that is needed to change the situation for us, then we can conclude this. But if there is a problem outside of our thinking that requires action to solve, we recognise this and choose actions with accompanying solution-focussed thinking.
This segues to a final issue in how C.B.T. is delivered, which is to distinguish its practice from victim-blaming. Victim-blaming involves positing either that the client does not actually have a problem but is imagining it, or that the client is the sole cause of the problem when they are not. Delivered haphazardly, C.B.T. can easily present this way. Delivered properly, it involves helping the client to understand that regardless of who is responsible for a problem, they often can not change what happens outside of them, in which cases the only real solution is to take action personally to change how they relate to the situation.
In psychotherapy, integrated approaches utilising more than one theory have become more common, and rightly so. As therapists, it is our role to recognise that theory can not replace nature or objective reality, but does form a necessary basis on which to understand it. As such, it is essential to choose techniques that most suitably match the problem, desired outcome, and the client in question. Done well, we are more likely to address the cause of the problem and teach our client skills for independent psychological problem-solving that will stand them in good stead beyond their relationship with us.