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Elizabeth E. Celaya is a family therapist in Napa, CA specializing in family therapy.
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Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy, or CBT, is a form of psychotherapy or treatment for mental illness. It comes in a variety of methods, but the basic concept behind all CBT is the same -- thoughts cause feelings, which cause actions. If someone wishes to change problematic behaviors or emotions in their lives, they need to start by changing their thoughts. CBT examines ideas and looks for patterns that may be causing harmful actions. The therapist helps patients modify those thought patterns and, in doing so, helps them feel better and cope more effectively.
CBT is one of the most widely studied forms of psychotherapy, and it has been shown to be extremely effective for a variety of mental illnesses. Some of the issues that respond well to CBT include mood disorders, personality disorders, eating disorders, substance abuse, sleep disorders, and psychotic disorders. In some cases, CBT has been shown to be as effective or even more effective than medication. One of the interesting things that the scientific study of CBT has shown is that CBT actually changes the way the brain works, physically improving its function.
CBT differs from traditional psychotherapy in a few key ways. One of the most important distinctions is the emphasis on the power and responsibility of the patient in CBT. The patient will be encouraged to be the one asking the questions in CBT therapy, and most patients are assigned homework to complete outside of therapy sessions. There is a concept in CBT that everyone has power the power to change how they feel, even if they cannot control the situation, and this can be very empowering for patients. Because of this power shift, the therapist-client relationship is not as critical to success in CBT as it is in other modes of therapy. Patients should still get along well with their therapists, but they do not need a deep, dependent emotional connection to them. Finally, because CBT often treats a specific issue or problem, it is usually shorter in duration than traditional therapy. While some therapies may continue for years, CBT lasts on average just 16 sessions.
Couples Therapy
Couples therapy refers to a specific type of counseling where relationship issues are the focus of the treatment. It used to be referred to as marriage counseling and still may be called that in many places, but because participants are not always married to each other, couples therapy is a more accurate name.
Closely related to family therapy, couples therapy is a type of counseling that seeks to help couples improve their relationship. A therapist may teach each partner in the relationship specific skills, such as managing or expressing their emotions, conflict resolution, communication skills, and problem solving. Both people in the couple need to be committed to learning new skills themselves as well as putting effort into supporting the relationship. The typical goals of couples therapy are to decrease conflict, unhappiness, and resentment, as well as increase communication, intimacy, and connection.
Couples therapy may be offered privately, at a university, or in a group practice. It is usually short-term therapy, lasting a few weeks until the participants have learned new skills and have the ability to repair their relationship. Its effectiveness depends on the willingness of both participants to commit to therapy and make the relationship a priority. For many couples it can be extremely helpful.
Self-Esteem Issues
Self-esteem is the value one assigns to oneself based on a complex combination of factors such as confidence, identity, sense of belonging, and self-image, among others. Self-esteem plays a critical role in determining one's happiness and overall well-being. Those with a very positive self-perception are considered to have "high" self-esteem, whereas those with negative self-perception have "low" self-esteem. Self-esteem does not dictate one's true intelligence, skills, looks, or accomplishments, although it can undermine one's motivation and opportunities. Successful people can have low self-esteem, and in some cases, that low self-esteem might motivate people to work harder at establishing themselves. Self-esteem is also not a binary scale, but a broad spectrum that people may move up or down throughout the course of their lives.
Humans begin to gain self-esteem in childhood from being cared for by adults and reaching natural milestones such as learning how to tie one's shoes. Self-esteem evolves through adolescence and adulthood, and can change drastically based on one's positive and negative experiences. It's important to develop healthy self-esteem to navigate through challenges, make decisions, and gain motivation to pursue interests.
Self-esteem issues can influence one's emotions, behavior, relationships, and world view. Self-esteem issues frequently arise from low self-esteem. Low self-esteem can be caused by factors such as trauma, caregiver neglect, abuse, bullying, and academic, social, or professional difficulties. Stressful life events such as parental divorce, caregiver conflict, and financial problems may also contribute to low self-esteem. In recent years, researchers have highlighted the influence of social media in negatively impacting adolescents' mental health. Common signs of low self-esteem include:
Excessive self-esteem can also be problematic in that it can hinder one's ability to form relationships with others. People with extremely high self-esteem may appear to be conceited or entitled. Some researchers suggest very high self-esteem can lead people to engage in more risk-taking behaviors. Causes of excessive self-esteem are less well-known, but may include upbringing, personality, and cognitive biases.
Fortunately, self-esteem issues can be readily addressed at any time. Positive self-affirmations recognizing one's own accomplishments can raise low self-esteem. Accepting one's own weaknesses and imperfections can benefit those with both low and high self-esteem. People with self-esteem issues often find therapy is an effective means to improve their self-esteem and mental health. Cognitive behavioral therapy (CBT) can help people with self-esteem issues identify and change destructive patterns of thought. Support groups, family counseling, and antidepressant medication may also help with self-esteem issues.
Maintaining a positive outlook and belief in oneself can go a long way towards forming healthy self-esteem. Developing a strong sense of self can be important for well-being and contributes to overall happiness and success in life.
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Ms. Elizabeth Celaya specializes in family therapy and practices in Napa, CA. Her clinical interests include coaching, family therapy services, and couples therapy.