CBT: Changing the Thoughts That Hold You Back

Most of us walk around with a narrator in our heads that we've never really questioned.

Our inner narrator comments on everything, like our performance, our worth, what other people think of us, what's going to go wrong, what we should have done differently. It fires off automatically, usually before we even realize it. It shapes how we feel, what we do, and how we experience our lives in ways we don't notice because it all happens so fast.

Cognitive Behavioral Therapy (or CBT for short) is one of the most well-researched approaches in psychology. It's a method that helps you learn how to notice the inner narrator, understand where it came from, and decide what you want to do with it.

Some Background on CBT

CBT was developed by psychiatrist Aaron Beck in the 1960s, originally as a treatment for depression. Beck asserted that depression was contributed to by specific, identifiable patterns of negative thinking. He proposed that if you could identify and examine the thoughts driving emotional distress, you could also change the emotions and behaviors that the thoughts were activating.

I have trained at the Beck Institute, the leading CBT training and research center in the world founded by Aaron Beck and his daughter Dr. Judith Beck.  And I’ve been practicing CBT for over 15 years.

At its core, CBT is based on the concept that our thoughts, emotions, and behaviors are connected, and changing one tends to affect the others.

Here's how the chain typically works:

A situation occurs and a thought fires off automatically, that thought sparks some emotions, those emotions motivate a behavior or reaction. For example: your boss sends a short, clipped email. Before you've consciously processed it, your brain has already generated a thought: “She's angry with me. I did something wrong.” That thought sparks anxiety, shame, or defensiveness. Those emotions motivate a behavior: you spend the next two hours avoiding her while your mind replays every recent interaction, looking for what you did wrong. Or maybe you allow more tasks onto your already full plate to prove your worth. Or maybe you get a little snippy because of resentment sparked by another automatic thought, “Doesn’t she see how much I do?!”

None of that happened because the email was threatening. It happened because of the thought your brain generated automatically in an instantly, before your thinking mind had a chance to weigh in.

The Pest Problem: ANTs

In CBT, we have a name for these automatic thoughts: Automatic Negative Thoughts, or ANTs for short (sometimes called Negative Automatic Thoughts or NATs). Like ants at a picnic, they show up uninvited, they're hard to get rid of once they've arrived, and left unchecked, they can take over the whole space.

The important thing to understand about ANTs is that they're not random. They developed for reasons, they’re instilled in us from the environments we grew up in, the relationships we had, the messages we received from family, teachers, peers, and the broader culture around us.

The thought patterns that now show up as ANTs, “I'm not good enough, I'm going to get in trouble, nobody actually likes me, if I'm not perfect something bad will happen”, were probably really necessary in the context where they first formed. They helped you deal with a particular environment, a particular set of relationships, a particular set of rules about how the world worked.

The problem is that your brain kept running those same thoughts after the original circumstances changed. You're no longer in that household, that classroom, that relationship. But the automatic thoughts are still responding as if you are.

"Name It to Tame It"

Before we can challenge a thought, we have to notice it. And before we can work with an emotion, we have to identify it.

Psychiatrist and neurobiologist Dan Siegel coined the phrase "name it to tame it" to describe something important: when we name an emotion, we can activate the prefrontal cortex (the thinking, regulating part of the brain) and begin to bring it back online after the amygdala (survival brain) has taken over.

The simple act of naming ("I notice anxiety," "this is shame," "there's anger here") creates just enough space between you and the feeling to be with it rather than swept away by it.

A few things worth knowing:

• It's rarely just one emotion. A single situation can spark a whole cluster of emotions like anxiety, shame, and anger all at once. Naming the emotions individually helps us untangle the emotions so they don’t run us over.

• Emotions are information, not the problem. The goal isn't to stop feeling. The goal is to understand what you're feeling so you can respond consciously instead of reacting automatically.

Once the thought is named and the emotions are identified, CBT asks: does this thought actually hold up? Not whether it feels true, because ANTs almost always feel true. But feeling true and being true are different things. Some useful questions: “What's the evidence for and against this thought? Am I making an assumption or do I actually know this? Is there another perspective or interpretation to consider?”

This isn't about replacing a negative thought with a forced positive one. It’s not just painting sunshine and rainbows on a garbage can and calling it happy times. It's about honest exploration and taking a pause in that space between thought, emotions, and actions. With that deliberate pause, the space opens up enough for you to make a choice. The pause and that choice is where change lives.

What the Research Says

Since Aaron Beck's pioneering work in the 1960s, CBT has become one of the most extensively studied treatments in psychology, and it consistently demonstrates effectiveness for anxiety, depression, PTSD, and ADHD, with effects that tend to hold solid long after therapy ends. Because CBT teaches skills rather than just managing symptoms, people continue using what they've learned well beyond the therapy room.

The Goal: A New Relationship with Your Thought Life

The aim of CBT isn't to eliminate all negative thoughts. It's to develop enough awareness of your own thought patterns so you're no longer at their mercy. You have the power to recognize the ANTs when they show up, name what they bring emotionally, examine whether they hold up, and make a conscious choice about how to respond.

You built your life outside of the circumstances that originally trained those thoughts. CBT helps you update your internal systems so they’re not running on outdated data.

CBT is one of the core approaches I draw from in my work with anxiety, ADHD, and trauma. I have trained at the Beck Institute and have been practicing CBT for over 15 years. If you're curious about whether it might help with what you're navigating, book a free 15-minute consultation and let's talk.