CBT skills

CBT skills

CBT top tips for clinicians!

I'd love to pass on reviews of workshops, books, research, and focus on the material that's clinically useful. It would be great if you could take away a new idea or technique that you could use straight away with your patients.

Summary of James Bergo ‘Why do I do that’

This might help your patients.Posted by Philip Kinsella Thu, November 17, 2016 09:52:59

Summary of James Bergo ‘Why do I do that’ (New Rise press)

This book explains the classic defense mechanisms as understood from psychodynamic perspective. These protect us from emotional pain, but may get in the way of growth and development. They are too painful to bear, may conflict with our morality, or undermine our self-image. They can be habitual. They may sometimes be useful. I have made a note as to what the CBT equivalent may be.

List of defenses:




Reaction formation






Repression: (when an uncomfortable feeling is pushed from awareness). Example, feelings of annoyance at child pushed out of awareness.

CBT equivalent: avoidance;

Denial (we deny that an uncomfortable fact is true). Example ‘There’s no way that I made that mistake’.

These mechanisms may be associated with anger.

CBT equivalent: avoidance of thoughts, thought suppression?

Displacement: (when a feeling such as anger is transferred to some other object e.g. kicking the cat instead of boss, anger at baby for crying, taken out on husband!).

CBT equivalent: ?

Reaction formation (turning a feeling into its exact opposite). This is associated with shame. Person who is gay starts a campaign against gays. The reformed ‘born again’ smoker.

CBT equivalent: over-compensatory rule, schema over -compensation.

Splitting: is a response to ambivalence, and strong feelings of hatred, serving to simplify the former and eliminate awareness of the latter. So when we are ambivalent/uncertain, there is a pull to resolve this. It is more comfortable to align ourselves with one, and completely reject the other.

CBT equivalent: black and white thinking/intolerance of uncertainty. Donald Trumpism!

Idealisation: (Seeing somebody as perfect to avoid uncomfortable feelings about them). Common in romantic relationships. Possibly in Bipolar disorder?? Idealizing ourselves to avoid uncomfortable feelings about self is common in Narcissism. Can be associated with splitting.

CBT equivalent: cognitive avoidance? Over-compensatory rule. Schema overcompensation.

Projection: Getting rid of a feeling and transferring it to some one else. ‘It’s not me that’s difficult it’s her’. May be associated with guilt. May be associated with splitting.

CBT equivalent: cognitive avoidance??

Control: try to gain complete control of things to ward off anxiety.

CBT equivalent: rule about control.

Thinking/Rationalising/intellectualising: repeatedly thinking about something as a way to avoid the discomfort of it. Thinking can have good or bad effects

CBT equivalent: Worry/rumination etc.

Defenses against shame (awareness of a serious defect in self): defenses are usually narcissism; blaming; contempt.

Fill in only if you are not real

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