Cognitive Behavioural Therapy (CBT) helps people understand and change the patterns that keep low mood, anxiety, and stress going. Rather than focusing only on feelings, CBT looks at how thoughts, physical sensations, emotions, and actions are linked together in a cycle.

When this cycle becomes unhelpful, distress continues even when the original problem has passed. CBT provides practical tools to break this cycle.

The Vicious Cycle: How Mood Is Maintained

CBT begins by explaining how everyday situations can trigger a self-reinforcing loop.

A trigger situation occurs — something as ordinary as a phone call, a comment, or a memory. This triggers Negative Automatic Thoughts (NATs). These thoughts are quick, unintentional, and often overly critical or threatening.

Examples include:

• “No one cares”

• “I’m going to fail”

• “This means something is seriously wrong”

These thoughts lead to physical feelings such as tiredness, tension, heaviness in the chest, or restlessness. Physical sensations then influence emotions like sadness, anxiety, or hopelessness. Finally, these emotions drive unhelpful behaviours such as withdrawal, avoidance, or inactivity.

These behaviours feed back into the cycle, reinforcing the original negative thoughts.

It’s Not the Situation — It’s the Interpretation

A key CBT principle is that the situation itself does not directly cause emotional distress. Instead, it is our interpretation of the situation that determines how we feel and act.

For example:

• Situation: A phone call is missed

• Thought: “No one cares about me”

• Feelings: Sadness, fatigue

• Behaviour: Withdrawal, reduced activity

CBT works by intervening at multiple points in this cycle—especially thoughts and behaviours.

The CBT Toolkit: How to Break the Cycle

CBT offers structured tools to interrupt the cycle and create healthier patterns.

Changing Thoughts to Change Feelings

CBT teaches people to challenge distressing thoughts rather than automatically believing them.

This is done in three clear steps:

1. Catch the thought — identify the “hot thought” that triggers distress

2. Gather evidence — look for facts for and against the thought

3. Create a new, balanced thought — one that is realistic rather than extreme

The aim is not positive thinking, but accurate thinking.

Changing Actions to Change Mood

Low mood and depression often reduce motivation, leading people to wait until they “feel better” before acting. CBT reverses this pattern using Behavioural Activation.

The principle is simple:
Follow the plan, not the mood.

Activities are scheduled in advance and usually fall into three groups:

• Routine activities

• Necessary activities

• Pleasurable activities

By completing planned activities—even when motivation is low—mood gradually improves through action.

How the Cycle Is Broken

When thoughts become more balanced and behaviours become more active and purposeful, physical sensations and emotions also begin to change. Over time, the vicious cycle weakens and a healthier cycle takes its place.

CBT does not remove problems from life, but it reduces how strongly they control mood, behaviour, and self-confidence.

CBT in Everyday Life

CBT skills are not meant only for therapy sessions. They are designed to be used in daily life—during stressful conversations, periods of low motivation, anxiety-provoking situations, and moments of self-doubt.

With practice, these skills become automatic, replacing unhelpful patterns with more adaptive responses.

In Summary

CBT works because it is practical, structured, and learnable. By understanding the link between situations, thoughts, feelings, physical sensations, and behaviours, people regain a sense of control over their mental health.

Breaking the cycle is not about forcing change—it is about skillfully interrupting patterns that no longer serve you.

About the Author

Dr. Srinivas Rajkumar T, MD (AIIMS), DNB, MBA (BITS Pilani)
Consultant Psychiatrist & Neurofeedback Specialist
Mind & Memory Clinic, Apollo Clinic Velachery (Opp. Phoenix Mall)

Dr. Srinivas provides evidence-based psychotherapy, CBT-oriented interventions, and integrative psychiatric care for depression, anxiety disorders, OCD, ADHD, and stress-related conditions.

✉ srinivasaiims@gmail.com
📞 +91-8595155808