Change what you think to change how you feel. Not quite.

One of the most maddening things to hear as a therapist is the idea that people should just change the way they think so they can feel better. If it were only a matter of changing thoughts, I’m sure that most people would choose to feel better. The myth here is partly the fault of Cognitive Behavioral Therapy. While I’m sure that Aaron Beck didn’t mean to reduce emotional suffering into a series of “just” statements, CBT has been watered down by popular press to the statement above.

To be sure, any good CBT therapist will be able to help you deal with your automatic thoughts to make good use of thought challenging techniques and I can, and do, use “straight” CBT with clients for whom its appropriate. But for a number of clients, I find that an approach that provides an understanding of where emotion comes from to be the most validating way to teach and make significant progress.

Internal Physiological Experience

Emotion is, at its heart, a physiological reaction to stimuli. Without being too reductive, stimuli occur and brain chemicals are released. These brain chemicals create a physiological change. Muscle tense or relax. Heart rate increases or decreases. Pupils dilate, breathing quickens.

Each type of emotion has an attending physiological reaction. Some of these reactions may be mild and unnoticed and in these cases, but in the situations that you’re trying to deal with maladaptive emotion, you’re probably going to notice it.

External Physical Expression

Each emotion also comes with some behavior that we might engage in. Now we might not choose to engage in those behaviors but we probably want to. You might run, hit, hide, yell. These are all external physical expressions of an emotional experience.

Our heart rate increases when we’re afraid. We have the urge to run when we’re afraid. Now, you’ll notice that when you run, you’re heart rate increases. There is a feedback loop between the physiological experience and the behavior we engage in. We have to make sure we don’t inadvertently amplify our emotion when dealing with a situation.

Dealing with emotion

Each emotion has both the internal physiological experience and the external expression, in addition to potential thoughts/interpretations. We know that there is some benefit to challenging distorted thoughts. All of CBT is based around this notion. But also notice that there is benefit to dealing with your physiological reactions and working to change them through behavior. The corollary also follows: that if you don’t have success dealing with your emotion through one of those interventions, maybe there’s something else keeping it around.

Pay attention to more than just your thoughts and realize that there’s no guarantee that just changing your thinking will change how you feel.