My post tends to oversimplify the nature of CBT because of the contrast I wanted to stress between the traditional approach to addressing neurosis versus the current approaches to addressing character disturbance. Indeed, there is an inextricable connection between thoughts and feelings also. That’s one of the reasons for the efficacy of cognitive restructuring in treating PTSD (as Diane so rightfully pointed out) and other anxiety disorders. Even in situations where CBT is used to address character issues, emotional self-regulation and management can dramatically improve, it’s just that “getting in contact with one’s feelings” as is typically done in more traditional therapies, is not a primary focus. Rather, examining the thinking processes that lead to negative attitude formation, emotional dysregulation, and problematic behavior patterns, is the primary focus. Also, most of the writing I’ve seen referencing CBT, including Burns’ devotes much attention to the cognitive component of CBT. It’s easy to forget that the most important component of CBT is the “B” part or “behavior” component. Adding the cognitive component only enhances the efficacy of behavior therapy, which has demonstrated itself consistently as superior to other therapies for the treatment of several conditions. Certain behaviors are well-known to not only reinforce patterns of thinking, but also to reinforce the experience of negative and unregulated emotions. If a person habitually runs out of the theater every time they experience panic, their disorder will only worsen and the actual level of anxiety they experience will remain high if not increase. Quell the escape behavior, convince the brain that there is no danger, and amazingly terror levels subside. Changing the behavior is paramount, but adding the component of examining the thought processes that fuel the behavior (e.g. “I’m having a heart attack”, “I need to get out of here”, “I’ll feel better if I go home or to the hospital”, etc.) really enhances the process.

In PTSD, cognitive restructuring is used as treatment. Can you explain the correlation between this. Does it work in both planes of this discussion or more as emotional memory that interferes with the entire individual core systems?