What is Cognitive Processing Therapy, or CPT, and how can it help with processing estrangement?
Cognitive Processing Therapy is a type of cognitive behavioral therapy that helps you learn how to recognize, modify, and challenge unhelpful beliefs. It is effective in reducing symptoms of PTSD that have developed after experiencing traumatic events including child abuse, combat, rape, and natural disasters.
Using CPT to treat PTSD starts with learning to identify “automatic thoughts” that may be maintaining your PTSD symptoms. These can keep you locked into the same patterns of beliefs that you may have created because of your traumatic experiences. In order to address these thoughts, the patient writes an impact statement that details current understanding of why the traumatic event occurred and the impact it has had on their beliefs about themselves, others, and the world. The patient will think about how it impacts their views on safety, trust, power and control, their self esteem, and intimacy.
This process can be very challenging and bring up a lot of emotions. Feelings of not being good enough, thoughts about how you may not trust people as much as you wish you could, realizations about how out of control you may have felt, and more. It can provide a lot of clarity and reflection, though, to have it all in one place. It sets you up for the next step of CPT.
CPT allows you to be able to look back at the traumatic event with a new lens for trying to identify patterns in thoughts and feelings associated with that trauma. It allows you to ask, do these thought patterns contain any thought distortions? These include:
Catastrophizing: “the worst will happen”
All-or-Nothing Thinking: “I am a total failure.” or “No one is trustworthy.”
Emotional Reasoning: “I feel this way, so it must be true.”
Magnification of the Negative: “I ruined everything.”
Minimizing the Positive: “They didn’t really mean they care for me.”
Jumping to Conclusions: “She didn’t say hi, so she hates me.”
Fortune Telling: “I’ll fail my exam.”
Self-Blaming: “This is all my fault.”
Other-Blaming: “This is their fault.”
Filtering Out Positive: “Nothing good happened today.”
Overgeneralizing: “Everyone dislikes me.”
Labeling: “I’m a loser.”
Should/ Must Statements: “I should have done this.”
These thought patterns are called “Stuck Points.” They are spots that keep you set in your negative beliefs about yourself, others, and the world. By challenging these “stuck points” you can reprogram your brain and form new thoughts and beliefs.
For example, when I did CPT, one of my Stuck Points was the belief that “I will always live a lonely life.” But by using CPT methods, I can identify that this thought contains distortions. I am Fortune-Telling, using All-or-Nothing Thinking, and Catastrophizing. I can question my thoughts and ask myself, “do I know if this is true?” I don’t know for sure if I will be lonely forever. It is possible that I will make good and strong connections with others. Calling out that I am catastrophizing allows me to determine that this is an unhelpful belief I have created from my trauma that can keep me stuck in my ways.
Being estranged from family can bring a lot of unhelpful beliefs about yourself and your life. You learned to survive the way you had to, but now those survival instincts may cause you harm or keep you closed off. Not being cared for in the way you deserved, being neglected or abused, or experiencing other traumas from a young age has a great impact on the way you may view yourself and the world. Identifying these beliefs and finding their unhelpful patterns can lead to a lot of healing.
After identifying thought distortions in your beliefs, you then can ask yourself, “Next time I have this thought, what can I tell myself instead?” For my Stuck Point above, it could mean telling myself, “I am unlearning patterns of unhealthy relationships and I am creating healthy relationships now. I have new friends that I am growing closer with. It takes time to make meaningful connections and I will be patient with myself.”
Through CPT, you will create a list of Stuck Points and dive into whether they are realistic thoughts, what distortions they might have, and how you can challenge these thoughts. Through this practice you can begin to identify themes of your trauma. Does it impact your beliefs on safety, trust, power and control, esteem, or intimacy? For example, you may think you are never safe or that no one can be trusted. Often with trauma, especially with childhood trauma, one will notice more than one theme.
Cognitive Processing Therapy can be done guided with a therapist individually or in a CPT support group. CPT is usually broken down into sessions starting with PTSD education and awareness, working on an impact statement, identifying Stuck Points, and then processing the themes you discover through them. Workbooks are usually given during these sessions to fill out Stuck Point logs.
I did CPT through my Kaiser insurance over several weeks, but if you are unable to find a CPT program, there are resources online that can help if you think it could be helpful. I would also recommend the CPT Coach app. It provides resources on education, finding support, and a place to log your Stuck Points and questions to guide you through it.
For more resources on CPT for PTSD:
Article by Em, Together Estranged Newsletter Coordinator
***Disclaimer: Em is not a certified mental health professional. This article is written as peer-to-peer support for the Together Estranged Community. If you are having a psychiatric emergency, please seek professional help.