How Cognitive Behavior Modification Works

Donald Meichenbaum is a psychologist noted for his contributions to cognitive behavioral therapy (CBT). He developed a therapeutic technique called cognitive behavior modification (CBM), which focuses on identifying dysfunctional self-talk in order to change unwanted behaviors. In other words, Dr. Meichenbaum views behaviors as outcomes of our own self-verbalizations.

Panic disorder, agoraphobia or other anxiety disorders often result in certain thought patterns and behaviors that may hinder recovery. For example, let’s say you have to attend a meeting a work tomorrow. You’re anxious and fearful that you will have a panic attack at the meeting. You may tell yourself, “What if I have a panic attack and have to leave the meeting. I would be so embarrassed.” So, you call in sick to work the next day so that you can avoid the meeting.

But, what if you were able to change your thoughts? And, what if by changing your thoughts, you are able to attend the work meeting instead of avoid it?

Using CBM, changing thoughts and behaviors, including avoidance behaviors and panic responses, is a three-phase process:

This phase involves listening closely to your internal dialogue or self-talk and observing your own behaviors. You want to be especially aware of any negative self-statements that are actually contributing to your anxiety and panic symptoms.

For example, do you tell yourself negative messages, such as "I'm not smart enough," "People don't like me," or "Everyone can see how neurotic I am." 

To help you become more aware of your negative self-statements, it may be beneficial to write them down. Tracking this type of dialogue will help you become even more aware of when it's happening. If you can, try jotting it down in a notebook as soon as possible after it occurs. If that doesn't work for you, try journaling at the end of the day, writing down all the negative self-talk you can remember. You may be surprised to discover just how often you are setting yourself up for anxiety throughout the day.

Once you recognize your negative self-talk, you can begin to change it. As you “catch” yourself in familiar negative thought patterns, you recreate a new and positive internal dialogue. “I can’t” becomes “It may be difficult, but I can.” Scratch off the negative statements in your journal and write these down in their place. Practice saying them until you start to believe them.

These new self-statements or affirmations now guide new behaviors. Rather than using avoidance behaviors to cope with panic disorder and anxiety, you become willing to experience the anxiety-provoking situations. This leads to better coping skills, and as your small successes build upon one another, you make great gains in your recovery.

Each time you are able to identify and restructure your negative thoughts and change your response to panic and anxiety, you are learning new skills. When you are now acutely aware of your thoughts, you are better able to gauge your anxiety and react in a more useful manner.

When your negative thoughts control you, it becomes difficult to control your behavioral responses to unpleasant situations. But, CBM can give you back some lost control. As your thoughts change from negative to positive, you start to behave differently in many situations. And, you will likely find that others react differently to the new “positive” you as well.