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If Everyone Likes You, You Do Not Know Very Many People

By Dr, Aldo Pucci

People often act as if they believe they have a need to be liked. They demonstrate that belief by making themselves miserable when someone does not like them or when someone has something negative to say about them. While being liked might be needed for some specific purpose (like to win a popularity contest), our survival obviously does not depend on it.

Furthermore, often times not being liked is not even a problem for us, we only think that it is. For example, if someone dislikes me who is irrelevant to my life and my goals, their disliking me is not even a problem for me let alone something that is horrible or catastrophic. So if it is not a problem, there is not much point to even spend much time thinking about their disapproval. Who cares? It is irrelevant.

But people have been brainwashed into thinking that they must have everyone’s approval and that it is a catastrophe if someone does not. It’s time to get over that nonsense. Some people matter much more to you than others do. Some people, if they acted on their negative opinions of you, will have a greater impact on your life and your goals. But even with that, there is no need to make yourself miserable over the results of their acting on their opinions, if they do.

June 9, 2025
FROM PHILOSOPHICAL TRADITIONS TO MODERN ERA CBT TREATING ANXIETY

FROM PHILOSOPHICAL TRADITIONS TO MODERN ERA

CBT TREATING ANXIETY

Introduction

Cognitive-behavioral therapy (CBT) represents a common evidence-based therapy for treating anxiety disorders. CBT draws its roots from three philosophical schools that include Stoicism and rational empiricism, and pragmatism to demonstrate how conscious thinking influences emotional responses and behavioral actions. Epicurus (341–270 BCE) declared that disturbances stem from our thoughts about things rather than the things themselves (Inwood & Gerson, 1997). According to Epictetus and Marcus Aurelius, Stoic philosophers demonstrated that human suffering originates from our interpretations and judgments of events rather than from the events themselves (Long, 2002). If a Stoic philosopher was to treat anxiety in ancient times, he would instruct his patients to distinguish their control boundaries from uncontrolled aspects and to assess thoughts rationally while accepting natural events as part of fate. The person would understand how to detect and transform harmful mental processes through their daily activities of reflection and meditation. The ancient philosophical ideas about mental wellness match exactly with the current CBT principles, which focus on structured mental reconstruction to treat anxiety. This article examines CBT’s philosophical origins alongside its effectiveness in treating anxiety while discussing cultural assessments and effective strategies for implementing CBT across various population groups.

Effectiveness and Adaptability Rooted from Philosophy

The core principle of CBT states that incorrect thinking patterns produce emotional suffering, which leads to undesirable actions. The therapeutic approach relies on empirical methods based on rational principles to help clients change their thinking and behavioral patterns (Beck, 2011). CBT’s philosophical foundation rests on three core principles, which make it easily accessible to clients by focusing on conscious thinking and rational problem-solving. Stoicism shares the same pragmatic focus, which examines internal rational processes rather than external factors (Leahy, 2017).

The majority of researchers consider CBT to be one of the most successful treatments for anxiety disorders. The identification and restructuring of incorrect or negative thoughts through CBT leads to reduced anxiety symptoms and enhanced client functioning (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). CBT treatment consists of 8–16 sessions, which enables clients to obtain practical skills they can apply after therapy ends to build their resilience. Cuijpers et al. (2016), together with Hofmann et al. (2012) show that CBT achieves moderate to large effect sizes through studies indicating anxiety disorder remission rates between 60% and 80%.

The broad acceptance of CBT has not stopped researchers from pointing out its Western foundations, which include self-concept and individualistic approaches and logical thinking (Hays, 2009). CBT faces criticism from critics who claim it does not properly consider different cultural approaches to thinking and emotional communication. Research demonstrates that the cultural integration of clients’ belief systems and values makes CBT an effective treatment. The effectiveness of CBT increases when treatment professionals incorporate both cultural values and beliefs of their patients. The treatment approach should derive from the belief systems and cultural context of the client. (Şar, 2013). According to Öztürk and Toprak (2017), CBT treatment effectiveness improves when therapists apply fundamental principles while adapting their approach to match clients’ cultural backgrounds. The CBT method does not exist with ineffective cultural applications because clinicians achieve better results through learning client values and beliefs before modifying CBT to match their cultural setting. When clinicians recognize cultural obstacles in CBT effectiveness, they should begin by comprehending the client’s belief system before using relevant cultural metaphors alongside other treatment approaches or community resources. Flexibility in therapy delivery leads to better patient engagement while producing more effective results.

The numerous interconnected elements explain why CBT achieves better results than other treatments in most clinical environments. The clinical evidence supporting CBT surpasses any other therapeutic approach since researchers have conducted more randomized controlled trials (Hofmann et al., 2012). CBT requires only 8–16 sessions for delivery, thus making it both accessible and cost-effective. The therapeutic approach uses logical thinking to solve problems, just like regular problem-solving, because it helps clients understand the process better. CBT provides clients with practical skills that they can apply after finishing treatment so they can develop self-reliance and sustain their mental well-being. The philosophical basis of CBT demonstrates its alignment with pragmatic and rational empiricism through these benefits. The observable and testable strategies of CBT replace abstract unconscious processes by providing practical tools to clients. The universal accessibility and modern evidence-based practice standards, and multicultural compatibility of this approach stem from its design. The principles of Stoicism apply directly to the practice of CBT. A Stoic philosopher would tell patients that their judgments about external events create their distress rather than the events themselves. The treatment plan would direct the person to establish what aspects of their life they control versus what aspects they do not control and devote their efforts to the controllable aspects. The therapeutic approach would promote both a logical assessment of distressing ideas and acceptance of destiny and natural laws. Regular practice of self-reflection and meditation allows people to identify negative thought patterns, which they can then modify. The cognitive restructuring methods in CBT demonstrate a continuous thread of thought that spans across thousands of years since they match the approach of CBT.

The effectiveness and adaptability of CBT stem from its philosophical base in Stoicism combined with pragmatism and rational empiricism. The combination of strong empirical evidence and client-oriented methods has established CBT as a preferred therapeutic approach for treating anxiety in different population groups. The core principles of CBT demonstrate enough flexibility to work within diverse cultural settings when therapists practice respectful understanding of client beliefs and values. The combination of ancient philosophical knowledge with contemporary clinical methods maintains CBT as a strong and useful therapeutic system.

References

Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.

Cuijpers, P., Karyotaki, E., Reijnders, M., & Purgato, M. (2016). Meta-analyses and mega-analyses of the

effectiveness of cognitive-behavioral therapy for anxiety disorders: A systematic review. Psychological Medicine,

46(10), 2163–2176.

Hays, P. A. (2009). Integrating evidence-based practice, cognitive-behavior therapy, and multicultural therapy.

Professional Psychology: Research and Practice, 40(4), 354–360.

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral

therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.

Inwood, B., & Gerson, L. P. (1997). The Epicurus reader: Selected writings and testimonia. Hackett Publishing.

Leahy, R. L. (2017). Cognitive therapy techniques: A practitioner’s guide. Guilford Press.

Long, A. A. (2002). Epictetus: A Stoic and Socratic guide to life. Oxford University Press.

Öztürk, M., & Toprak, İ. (2017). Kültürel adaptasyon ve bilişsel davranışçı terapinin etkinliği. Anatolian Journal of

Psychiatry, 18(1), 12–23.

Şar, V. (2013). Kültürel bağlamda psikoterapi ve tedavi süreçleri. Journal of Psychotherapy Studies, 6(2), 101–114.

June 8, 2025
Bridging the Gap: How CBT and Behaviour Cards Empower Individuals with Autism
Bridging the Gap: How CBT and Behaviour Cards Empower Individuals with Autism

Introduction

Navigating the world can be a complex journey for anyone, but for individuals on the autism spectrum, it often presents a unique set of challenges. Beyond the core characteristics of autism itself, many autistic children and adolescents frequently experience co-occurring mental health conditions like anxiety, panic attacks, and depression. These additional struggles can significantly impact their well-being and daily functioning. Fortunately, Cognitive Behavioral Therapy (CBT) has emerged as a powerful and adaptable therapeutic approach to help address these issues. When tailored to meet the specific learning and communication styles of autistic individuals, CBT, often enhanced by practical visual tools such as behaviour cards, provides a structured pathway to understanding and managing challenging thoughts, feelings, and behaviors. This article delves deeper into how CBT is applied to treat these conditions and the vital role that behaviour cards play in empowering autistic youth. For individuals on the autism spectrum, navigating the complexities of social interactions, emotional regulation, and unexpected changes can often lead to significant challenges. While autism is a neurodevelopmental condition, not a mental illness, people with autism are at a higher risk of experiencing co-occurring mental health conditions like anxiety, depression, and obsessive-compulsive disorder. This is where Cognitive Behavioral Therapy (CBT) steps in, often enhanced by practical tools like “behaviour cards,” to provide valuable support.

Understanding Cognitive Behavioral Therapy (CBT)

CBT is a widely recognized and evidence-based psychotherapy that focuses on the interconnectedness of thoughts, feelings, and behaviors. The core principle is that by identifying and changing unhelpful thinking patterns (cognitions) and maladaptive behaviors, individuals can improve their emotional state and overall well-being.

For autistic individuals, CBT is typically adapted to accommodate their unique cognitive styles and communication preferences. Traditional “talk therapy” approaches might be less effective for someone who processes information visually or struggles with abstract concepts. Therefore, CBT for autism often incorporates:
1. Visual Aids: Charts, diagrams, social stories, and visual schedules help illustrate concepts and sequences.
2. Structured Sessions: A clear, predictable format minimizes anxiety and helps maintain focus.
3. Concrete Examples: Abstract ideas are broken down into specific, tangible situations.
4. Special Interests: Incorporating a person’s specific interests can enhance engagement and motivation.
5. Focus on Skills: Emphasis is placed on teaching practical coping strategies and problem-solving skills.
CBT has shown promise in helping autistic individuals manage anxiety, improve social skills, regulate emotions, and address rigid thinking patterns. It empowers them to better understand their internal experiences and develop healthier responses to challenging situations.

The Role of Behaviour Cards

Behaviour cards, also known as cue cards, visual reminders, or social prompts, are highly effective visual supports that complement CBT principles for individuals with autism. They serve as a bridge between abstract therapeutic concepts and concrete, actionable steps.

Here’s how behaviour cards contribute:
1. Visual Reinforcement: Many autistic individuals are strong visual learners. Behaviour cards provide clear, concise visual cues that reinforce desired behaviors or strategies learned in CBT. For example, a card showing a calming technique (like deep breathing) can be a quick reminder during a stressful moment.
2. Non-Verbal Communication: In situations where verbal communication is difficult or overwhelming, behaviour cards offer a non-verbal way to prompt a desired action or remind an individual of a social rule. A card with a “quiet voice” image can be shown discreetly in a noisy environment.
3. Promoting Independence: By providing a tangible reference, behaviour cards help individuals internalize strategies and use them independently. Instead of relying solely on verbal prompts from others, they can consult their cards.
4. Managing Transitions and Unexpected Changes: Cards depicting a sequence of activities or offering options for coping with change can reduce anxiety during transitions, a common challenge for many autistic individuals.
5. Emotional Regulation: Some behaviour cards are designed to help individuals identify and manage their emotions. These might include a “feelings scale” or cards illustrating different emotions and corresponding coping strategies.
6. Social Skills Development: Cards can illustrate expected social behaviours in various situations, such as taking turns, making eye contact, or understanding personal space. They act as visual scripts for social interactions.
7. Token Systems: In some adapted CBT approaches, behaviour cards are used as part of a token system, where individuals earn cards as rewards for practicing new skills or managing challenging thoughts. This provides tangible reinforcement for progress.
Practical Examples of Behaviour Cards in Use:
1. “Break Card”: An individual feeling overwhelmed can present this card to request a break from a demanding situation.
2. “Calm Body Card”: Visuals showing a relaxed posture or deep breaths to remind an individual to self-regulate.
3. “First/Then Card”: “First [task to do], then [reward/preferred activity]” helps structure activities and motivate completion of less favored tasks.
4. “Expected/Unexpected Behavior Cards”: These cards can depict different social scenarios and prompt discussions about what behavior is expected or unexpected in that context.
5. “Thought Challenge Cards”: For older individuals, cards might present common cognitive distortions (e.g., “all-or-nothing thinking”) and prompts for reframing those thoughts.
Conclusion

CBT, with its emphasis on understanding the link between thoughts, feelings, and behaviors, offers a powerful framework for supporting individuals with autism. When skillfully adapted to leverage visual strengths and provide concrete tools, it can significantly improve emotional well-being and adaptive functioning. Behaviour cards serve as invaluable practical complements, translating abstract CBT concepts into accessible, actionable visual cues that empower individuals with autism to navigate their world with greater confidence and independence. As research continues to refine therapeutic approaches, the integration of such practical, visually-driven tools will remain a cornerstone of effective support for the autistic community.

Suggested Bibliography and Key Resources for CBT, Autism, and Mental Health

This bibliography is illustrative and represents the types of sources that would support the information presented. For a definitive academic paper, specific editions, page numbers, and publication details would be required.

Key Researchers and Clinical Experts:
1. Tony Attwood: A leading clinical psychologist specializing in autism spectrum disorder, particularly high-functioning autism and Asperger’s Syndrome. His work often discusses emotional regulation, anxiety, and social skills in autistic individuals. He has written extensively on CBT adaptations.
2. Susan White: Known for her research on anxiety and CBT in autistic adolescents, often exploring evidence-based interventions.
3. Judy Reaven: A prominent researcher focusing on anxiety in children and adolescents with autism spectrum disorder, and developing and testing CBT interventions.
4. Jessica Kingsley Publishers (JKP): This publisher has a vast catalog of books on autism, including many practical guides and clinical manuals on CBT for autistic individuals. Many respected authors publish through JKP.
5. Michelle Garcia Winner: Developer of the Social Thinking Methodology, which, while not strictly CBT, often complements CBT by providing frameworks for understanding social nuances that contribute to social anxiety in autistic individuals.
Foundational Texts and Clinical Manuals (Types of Resources):
1. Manuals for Cognitive Behavioral Therapy for Anxiety in Children and Adolescents (adapted for ASD): Look for texts specifically outlining CBT protocols for anxiety disorders (e.g., Generalized Anxiety Disorder, Social Anxiety Disorder, Panic Disorder) that have been adapted for children and adolescents with autism.
2. Example type: “Coping Cat” program adaptations for ASD.
3. Example type: “Facing Your Fears” program for children with autism.
4. Texts on Emotion Regulation and Social Skills for Individuals with ASD: Books that delve into strategies for identifying, understanding, and managing emotions, as well as navigating social situations.
5. Resources on Visual Supports and Communication Strategies for Autism: Books and guides detailing the effective use of visual schedules, social stories, visual cue cards, and other visual aids.
Relevant Academic Journals:
1. Journal of Autism and Developmental Disorders: A primary journal for research on autism, including clinical trials of interventions.
2. Autism Research: Another key journal publishing high-quality research on autism spectrum conditions.
3. Journal of Consulting and Clinical Psychology: Publishes research on psychological interventions, often including those adapted for specific populations.
4. Cognitive and Behavioral Practice / Behavior Therapy: Journals focused on CBT principles and their application.
Reputable Organizations:
1. Autism Speaks: Provides information, resources, and supports research related to autism.
2. Autism Society: Focuses on improving the lives of all affected by autism through advocacy, education, and support.
3. National Autistic Society (UK): A leading UK charity providing information and support for autistic people and their families.
4. Association for Behavioral and Cognitive Therapies (ABCT): A professional organization for CBT therapists and researchers.
General Search Terms for Academic Databases:

When searching for specific papers, use combinations of these terms:
1. “CBT Autism”
2. “Cognitive Behavioral Therapy ASD”
3. “Anxiety Autism Treatment”
4. “Depression Autism Therapy”
5. “Panic Attacks Autism”
6. “Behaviour Cards Autism”
7. “Visual Supports CBT Autism”
8. “Emotion Regulation Autism”
9. “Adolescents Autism Mental Health”
10. “Child Autism CBT”
Further develops the topic of the CBT approach to treating panic attacks, anxiety, and depression in autistic children and adolescents.

The challenges faced by autistic children and adolescents often extend beyond the core characteristics of autism itself. They are at a significantly higher risk of developing co-occurring mental health conditions such as panic attacks, anxiety disorders, and depression. This heightened vulnerability can be attributed to several factors, including difficulties with social communication, sensory sensitivities, challenges with routines and unexpected changes, and the sheer effort involved in navigating a world primarily designed for neurotypical individuals.

Cognitive Behavioral Therapy (CBT), when appropriately adapted, has emerged as a leading evidence-based intervention for these co-occurring conditions in autistic youth. It offers a structured and skills-based approach that resonates well with the learning styles of many individuals on the spectrum.

Adapting CBT for Autistic Children and Adolescents

Effective CBT for autistic youth isn’t a one-size-fits-all solution; it requires significant adaptations to address their unique cognitive and developmental profiles. Key modifications include:
1. Emphasis on Visual Supports:
2. Visual Schedules: Providing a clear visual representation of the therapy session (e.g., “Hello,” “Review Homework,” “New Skill,” “Practice,” “Homework,” “Goodbye”) reduces anxiety about unpredictability.
4. Emotion Scales/Thermos: Using visual scales (e.g., a “feelings thermometer” from 0 to 10) helps children quantify and communicate the intensity of their emotions, which can be challenging to verbalize.
6. Social Stories and Comic Strip Conversations: These tools are excellent for breaking down complex social situations, explaining expected behaviors, and helping to understand the perspectives of others, which is crucial for managing social anxiety.
8. Behaviour Cards: As discussed, these act as concrete reminders for coping strategies (e.g., a card showing a deep breath, a “take a break” card, or a card with a social cue like “wait for my turn”).
9. Concrete and Direct Language:
10. Avoiding Metaphors and Idioms: Abstract language can be confusing. Therapists use clear, literal language to explain concepts like “thoughts,” “feelings,” and “behaviors.”
11. Breaking Down Concepts: Complex CBT concepts (e.g., cognitive distortions) are broken into smaller, more manageable parts, often using simplified language and visual examples.
13. Incorporating Special Interests:
14. Enhanced Engagement: Leveraging a child’s special interest (e.g., dinosaurs, Minecraft, trains) can make therapy more engaging and relatable. Examples can be tailored to their interest, and rewards can be linked to it.
15. Motivation and Rapport: Discussing preferred interests at the beginning of sessions can help build rapport and create a safe, comfortable environment.
16. Flexible and Patient Approach:
17. Increased Processing Time: Autistic individuals may need more time to process information and formulate responses. Therapists allow for pauses and avoid rushing.
18. Sensory Accommodations: Creating a sensory-friendly environment (e.g., dimming lights, providing fidgets, allowing movement breaks) can help reduce sensory overload, a common trigger for anxiety and meltdowns.
20. Parent/Caregiver Involvement:
21. Psychoeducation: Parents and caregivers receive extensive education about autism, anxiety, depression, and CBT principles to support skill generalization at home and school.
22. Skill Practice: They are actively involved in practicing skills learned in therapy, creating a consistent environment for the child to apply new strategies.
23. Collaboration: Working as a team with parents, educators, and other professionals ensures a cohesive approach to supporting the child.
CBT for Panic Attacks in Autistic Youth

Panic attacks are sudden, intense surges of fear that can be particularly distressing for autistic individuals due to sensory sensitivities and challenges with interoception (perceiving internal bodily states). CBT addresses panic attacks through:
1. Psychoeducation: Explaining what a panic attack is (a false alarm from the body, not a sign of danger), including common physical sensations (racing heart, shortness of breath, dizziness) and their non-threatening nature. Visuals like a “panic attack thermometer” can illustrate the escalation of symptoms.
3. Breathing Retraining: Teaching controlled, diaphragmatic breathing techniques is crucial. Visual cues (e.g., “smell the flower, blow out the candle,” or a visual timer for inhale/exhale) are often used to guide the child.
4. Cognitive Restructuring: Helping children identify and challenge catastrophic thoughts associated with panic (e.g., “I’m having a heart attack,” “I’m going to die,” “I’m going crazy”). This might involve using behaviour cards with reframing statements like “This feeling will pass” or “I am safe.”
5. Exposure Therapy: Gradually exposing the child to feared situations or bodily sensations that trigger panic, in a controlled and supportive environment. This “stepladder” approach helps habituate the child to the discomfort and realize it’s manageable. For example, if a racing heart is a trigger, the child might practice running in place to intentionally induce a fast heart rate, learning to tolerate the sensation.
CBT for Anxiety in Autistic Youth

Generalized anxiety, social anxiety, and phobias are common in autistic children. Adapted CBT tackles these with:
1. Emotion Recognition and Regulation: Many autistic children struggle to identify and label their emotions. CBT works on building emotional literacy through visual aids, emotion cards, and practice scenarios.
2. Identifying Triggers: Helping the child and family identify specific situations, sensory inputs, or changes in routine that trigger anxiety. Creating “anxiety trigger lists” or visual maps can be helpful.
3. Coping Skills Development: Teaching a repertoire of coping strategies, often on behaviour cards:
4. Sensory Strategies: Deep pressure, fidget toys, sensory breaks, “sensory toolbox.”
5. Relaxation Techniques: Progressive muscle relaxation, guided imagery (often using scripts tailored to special interests).
6. Problem-Solving Skills: Breaking down overwhelming problems into smaller, manageable steps, using visual flowcharts.
7. Exposure and Response Prevention (ERP): For phobias or obsessive-compulsive tendencies, gradual exposure to feared objects or situations, coupled with preventing avoidance or rituals, is highly effective. This is carefully planned and implemented with strong visual support.
CBT for Depression in Autistic Youth

Depression in autistic children and adolescents can present differently than in neurotypical peers, sometimes manifesting as increased irritability, stimming, withdrawal, or difficulty engaging in preferred activities. CBT for depression in this population focuses on:
1. Behavioral Activation: Helping the child engage in activities that are enjoyable or provide a sense of accomplishment, even when they don’t feel motivated. This often involves creating structured visual schedules of activities.
2. Cognitive Restructuring: Addressing negative thought patterns common in depression (e.g., “I’m a failure,” “No one likes me,” “Things will never get better”). This involves:
3. Thought Records: Simplified visual templates for recording negative thoughts, identifying emotions, and challenging the thoughts with alternative, more balanced perspectives.
4. “Thinking Traps” Cards: Visual representations of common cognitive distortions (e.g., “all-or-nothing thinking,” “catastrophizing”) with examples relevant to the child’s life.
5. Social Skills Training: Since social isolation can contribute to depression, CBT may incorporate targeted social skills training, using role-playing, video modeling, and social stories to improve communication and interaction.
6. Self-Monitoring: Encouraging the child to track their mood, energy levels, and engagement in activities using visual charts or apps. This helps them recognize patterns and the impact of their behaviors.
7. Mindfulness and Self-Compassion: Adapting mindfulness exercises to be concrete and less abstract, focusing on sensory awareness in the present moment, and fostering self-kindness.
Conclusion

CBT, when thoughtfully and flexibly adapted, is a powerful tool in addressing panic attacks, anxiety, and depression in autistic children and adolescents. The judicious use of visual aids, concrete language, personalized examples, and a strong collaborative approach with families are crucial for success. By empowering autistic youth with practical strategies to understand and manage their internal experiences, CBT not only alleviates distressing symptoms but also fosters greater emotional regulation, independence, and overall well-being, enabling them to navigate the complexities of life with increased confidence.
June 7, 2025
Cognitive Behavior Therapy and Deeper Meaning

Cognitive-Behavioral Therapy (CBT) Can Go Deeper Than You Think. Thousands of studies each year validate its effectiveness in treating a broad range of psychological conditions. Its structured, time-limited nature makes it a favored approach in clinical research and practice. However, many practicing therapists have noted that clients often come to therapy with needs that go beyond what standard CBT protocols are designed to address.

One area where this is especially evident is in the realm of existential concerns—questions about meaning, purpose, identity, and mortality. Clients often bring to therapy a desire to understand what their lives mean, what values should guide them, or how to make peace with the limits of their time on Earth. These are not problems that always lend themselves to brief interventions or manualized treatment protocols. Yet they are deeply human and therapeutically essential.

Recent scholarship suggests that CBT can be expanded to incorporate these deeper existential themes. For example, Heidenreich and colleagues (2021) argue that CBT’s focus on cognition aligns well with existential therapy’s emphasis on meaning-making. Likewise, research by Golovchanova and Vanhooren (2022) highlights how therapists can effectively explore meaning in life, particularly with adolescents coping with trauma, by blending existential inquiry with cognitive-behavioral techniques.

In clinical practice, approaches like Acceptance and Commitment Therapy (ACT)—a form of CBT—have already started to move in this direction by emphasizing personal values. However, as the uploaded commentary notes, even ACT may fall short in helping clients deeply explore and define those values when they are grounded in life’s larger philosophical questions. What is the purpose of life? What makes life meaningful? These questions are more than abstract—they often surface in sessions when clients reflect on identity, loss, or the passage of time.

Far from being incompatible, CBT and existential therapy can complement each other. CBT provides structure and evidence-based strategies for change, while existential therapy offers a framework for grappling with life’s most profound dilemmas. Ghaemi (2023) underscores that addressing existential issues—such as death, freedom, and isolation—can enrich any therapeutic approach. In palliative care, as noted by Breitbart and Poppet (2022), existential-CBT interventions help clients face mortality with dignity and insight, demonstrating the clinical value of this integrative approach.

Therapists do not have to choose between addressing symptoms and addressing deeper aspects of the human individual. When CBT is practiced flexibly and creatively, it becomes a vehicle for helping clients do both. In fact, this integration may be one of the most promising directions for psychotherapy in the coming years.

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June 7, 2025
Rewriting the Wound: Cognitive Reframing in Clinical Hypnotherapy
In the quiet space between breath and belief, transformation can begin.

As a trauma therapist and clinical hypnotherapist, I have witnessed time and again how memory is not static—it is alive, adaptive, and, when held gently, open to reformation. One of the most powerful techniques I use in clinical hypnotherapy is cognitive reframing: a process of re-authoring internal narratives so that they serve a healing purpose rather than harm.

Cognitive reframing is not about erasing the past. It’s about shifting the lens through which we view it. And in hypnotherapy, where the subconscious becomes porous and receptive, this technique becomes effective and transformative.

The Gut-Brain Axis: A Two-Way Street of Survival and Safety

For clients living with chronic digestive conditions, understanding the gut-brain axis can be a decisive first step toward healing.

The gut is often referred to as the “second brain” for good reason. Through a complex network of over 100 million neurons in the enteric nervous system (ENS), it maintains constant bidirectional communication with the brain via the vagus nerve, immune system, and endocrine signals. This connection is known as the gut-brain axis (GBA).

When the brain perceives danger, whether through external stressors or internal trauma triggers, it sends alarm signals to the gut, disrupting motility, increasing inflammation, altering microbiota, and reducing nutrient absorption. The gut, in turn, sends feedback to the brain about its distress, often worsening anxiety and depression. This creates a self-reinforcing feedback loop between fear and inflammation, as well as memory and motility.

In trauma survivors, especially those with early adverse experiences, the GBA becomes conditioned to expect threat. The gut remembers, even when the conscious mind cannot. Clinical hypnotherapy allows us to interrupt this loop at the subconscious level, where much of this conditioning resides.

Cognitive Reframing as Nervous System Repair

Cognitive reframing, when used in a hypnotic trance state, does not simply offer new thoughts—it provides new biological instructions to the gut-brain communication system.

By helping the client generate new subconscious beliefs, such as:
1. “I am safe in my body,”
2. “My digestive system knows how to restore balance.”
3. “I do not have to brace for pain anymore,”
We begin to down-regulate the sympathetic nervous system, allowing parasympathetic functions like digestion, repair, and cellular healing to resume.

Hypnotic suggestions can also influence the vagal tone, enhancing vagal flexibility, which is crucial for reducing gastrointestinal hypersensitivity and promoting calm peristalsis. This is particularly effective in conditions like IBS, ulcerative colitis, Crohn’s disease, and non-celiac gluten sensitivity, where stress exacerbates symptoms.

Case Example: From Hypervigilance to Gut Resilience

A 29-year-old Ghanaian American woman came to me after years of undiagnosed GI pain, multiple colonoscopies, and mounting anxiety around food. She said, “My gut doesn’t trust me. And I don’t trust it.”

Through clinical hypnotherapy, we accessed an early memory of her hiding during a family conflict, too scared to breathe, too scared to move. Her gut had frozen with her. The narrative we reframed became:

“That freeze saved you then, but you are not in that room anymore. Your gut is safe now. It’s allowed to move.”

She repeated this affirmation under trance, accompanied by visualizations of fluid digestive rhythms and a protective inner caregiver figure. Within three months, she reported significantly fewer flares, returned to shared meals, and even began cooking again—something she had abandoned for years.

Why Hypnosis Accelerates Gut Healing

Traditional cognitive behavioral therapy (CBT) can be limited by the cognitive load it requires. But in hypnosis, the conscious mind relaxes, allowing suggestions and metaphors to bypass analytical filters and directly influence the body’s internal “control panels.”

Cognitive reframing in this state becomes more than mental rewording—it becomes cellular reorientation. The gut hears. The body believes.

And most importantly, the client begins to reclaim agency over their body’s story.

Ethical Considerations

Cognitive reframing is never about gaslighting the body or dismissing pain. We honor the symptom. We acknowledge the suffering. But we ask the subconscious, “What if this isn’t the only story? What else could be true?”

In this way, reframing becomes an act of reclamation, not erasure. Especially for those who have been misdiagnosed, disbelieved, or medicalized without being heard, this shift can be life-altering.

Final Reflections

In every session where I integrate hypnotherapy with somatic listening, I’m reminded that healing is not a linear path—it’s a spiraling return to safety. When the gut and brain begin to communicate in new ways, the entire body listens differently.

Cognitive reframing within hypnotherapy is not just a technique. It is a form of spiritual neuroscience. It is trauma-informed biology. It is the practice of speaking softly enough that the body finally feels safe to respond.

Let us continue to speak those softer truths—

until even the gut knows:

I am no longer in danger.

I am healing now.

References

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American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. APA.

Barlow, D. H. (2014). Clinical handbook of psychological disorders: A step-by-step treatment manual (5th ed.). Guilford Press.

Bennett, E. J., Tennant, C. C., Piesse, C., Badcock, C. A., & Kellow, J. E. (1998). Level of chronic life stress predicts clinical outcome in irritable bowel syndrome. Gut, 43(2), 256–261. https://doi.org/10.1136/gut.43.2.256

Bonaz, B., Bazin, T., & Pellissier, S. (2018). The vagus nerve at the interface of the microbiota-gut-brain axis. Frontiers in Neuroscience, 12, 49. https://doi.org/10.3389/fnins.2018.00049

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June 6, 2025
Rational Emotive Behavior Therapy (REBT) Is Not "Therapy"
Relationships

Rational Emotive Behavior Therapy Is Not “Therapy”
In a “Dear Annie” column in the Marin Independent Journal, a writer signs her query: “Through With Therapy in the Midwest.” She complains she’s fritted away thousands of dollars on a variety of therapists and concludes therapy is a “waste of money.” In the response, Annie observes: “Therapy does not work for everyone.”

Both Annie and the hapless client make a crucial error. They speak as if all psychotherapy were the same. But therapy comes in two major flavors.

Traditional therapy, popularized by Freud, assumes an adult’s psychological problems stem from their dysfunctional childhood. Treatment consists of months or often years of relating to your therapist the details of your misbegotten youth, along with your dreams, free associations, and transference feelings.

The Rational Emotive Behavior (REBT) approach, on the other hand, focuses on the here-and-now cause of your problems: your irrational self-talk. Numerous studies support the efficacy of this approach, more generally known as cognitve-behavior therapy CBT).

My client Tim, for example, felt insecure in his intimate relationships. A traditional therapist would likely conclude this insecurity came from being rejected by his parents at a young age, and would focus on having Tim discuss his early upbringing. This could go on for years.

Using the REBT/CBT approch, I helped Tim identify his unrealistic demands in his current relationship, including: “I NEED my partner’s approval, otherwise I’m unlovable.” Tim learned to change his view to: “I strongly PREFER to have my partner’s love, but don’t NEED it. It would be sad to lose it, but that only proves, at the worst, that I’m an imperfect human, not an unlovable loser. With practice, I can learn to accept myself with my flaws, and thereby considerably enjoy life whether or not I am loved.”

After nine sessions, Tim had largely overcome his irrational views, and was on his way to fully accepting himself and immensely enjoying his relationship.

Before attempting traditional therapy, first consider short-term REBT/CBT for a long-term solution.

–Dr. Michael R. Edelstein, www.ThreeMinuteTherapy.com
June 6, 2025
The Rational Living Therapy Certification Process

Prerequisites: A graduate degree in a mental health discipline or current enrollment in a mental health graduate program.

What is Rational Living Therapy?

Rational Living Therapy is a very systematic approach to cognitive-behavioral therapy, which means that the Rational Living Therapist knows where he or she is at any given point in the process of therapy.

Rational Living Therapy emphasizes both therapist skills and client rational self-counseling skills. Rational Living Therapy emphasizes Dr. Aldo Pucci’s belief that any approach to counseling or psychotherapy that emphasizes instruction becomes a “sales job.” The clinician has something to sell the client (the philosophy and techniques of rational self-counseling) and is hoping that the client will “buy” it. For that reason, Rational Living Therapy utilizes powerful persuasive techniques techniques to help decrease conscious resistance to the therapist’s suggestion of success in therapy.

Rational Living Therapy is highly motivational. If you dislike giving up on clients, and wish that there were some way to encourage any client to make changes, Rational Living Therapy is ideal for you. It is designed to tap into the client’s desires by utilizing Rational Motivational Interviewing techniques.

Rational Living Therapy is very instructive. The instructive nature of RLT helps produce long-term results for the client.

Rational Living Therapy also focuses on underlying assumptions. By doing so, therapy is much “deeper” thus making the results more long-term.

Rational Living Therapists are very concerned with irrational labeling. For this reason, we disagree with the labeling that results from mental health professionals’ use of the Diagnostic and Statistical Manual (DSM) of Mental Disorders. Many of these “diagnoses” actually are only labels for a set of behaviors. However, these labels often create a perception that the client “has” or “suffers from” a “disorder.” This perception can become very problematic for the client, leading to a great deal of hopelessness. Rational Living Therapists help clients avoid irrational labeling and hopelessness.

Rational Living Therapy takes the best of Rational Emotive Behavioral Therapy, Rational Behavior Therapy, and Cognitive Therapy and integrates knowledge and research findings in the areas of cognitive development, learning theory, general semantics, brain functioning, social psychology and perception, and linguistics. Rational Living Therapy takes advantage of special brain states to facilitate learning and progress.

Rational Living Therapy also rejects the common concepts of self-esteem and self-confidence, and also departs from the traditional CBT emphasis of “self-acceptance.” RTL’s replacement to these concepts (the “Four A’s”) is much more practical and useful.

The Certification Process

The entire certification process can be completed via home study. You may order each level separately, or order this package and receive a significant discount.

The RLT certification process requires the completion of four training levels and a practicum. The practicum can be completed via telephone consultation.

Included with each RLT home study program level is an examination. You simply listen to the audio included with each level and complete the exam as you listen to the lecture. The levels must be completed in numerical order (One – Four).

The practicum involves 6 months (24 sessions) of weekly 30-minute telephone or Zoom consultations. The trainee presents cases in which RLT is being implemented, and Dr. Pucci provides feedback in terms of the trainee’s use of RLT. The fee for each 30 minute supervision session is $25.

Once all levels and the practicum have been completed, the trainee receives the “Certified Rational Living Therapist” credential. This designation also fulfills the training requirement for the “Diplomate in Cognitive-Behavioral Therapy” credential provided by the National Association of Cognitive-Behavioral Therapists.

The Training Levels

1. RLT Level-One

(https://cbtonlinetraining.com/cbt-certification-rational-living-therapy-level-one-certification-webinar/)

Introduction to Rational Living Therapy

— Theoretical Basis of RLT, Including Evidence Supporting It

— Theory of Emotions and Behavior (Both “Healthy” and Maladaptive)

— Complete Presentation of the Entire Process of Therapy, from Assessment to Termination

Dealing with Resistance

— Complete Review of the Many Ways in Which Clients Can Have Difficulty

Benefiting from Therapy and how Resistance is Treated in RLT

Introduction to the Treatment of Specific Problem Areas, Such as Depression, Suicide, Anxiety, Substance Abuse, Bipolar Disorder, and Schizophrenia.

Introduction to Group Therapy

2. RLT Level-Two

( https://cbtonlinetraining.com/cbt-certification-rational-living-therapy-level-two-certification-webinar/ )

Treatment of “Personality Disorders”, from engagement to treatment and termination.

Advanced “Underlying Assumption / Core Belief” Therapy

Advanced Cognitive Modification Skills

Application to Mood / Anxiety Disorders

Group Therapy

3. RLT Level-Three

( https://cbtonlinetraining.com/cbt-certification-rational-living-therapy-level-three-certification-webinar/ )

Very Comprehensive approach to Marital Therapy, from assessment to termination

Substance Abuse Treatment

Treatment of Children

4. RLT Level-Four

( https://cbtonlinetraining.com/cbt-certification-rational-living-therapy-level-four-certification-webinar/ )

Comprehensive Review of the Rational Living Therapy Therapeutic Process

Dr. Pucci reviews, with great detail, the step-by-step RLT therapeutic process, as well as describing how to prevent potential problems and to correct already established problems / therapeutic resistance.

Teaching Important RLT Therapeutic Concepts

Dr. Pucci provides participants the opportunity to present how they would teach important concepts, like the ABCs of Emotions, Irrational Shoulds, and the Confusion of Needs and Wants. Then listen as he provides feedback and helps the participants fine tune their approach.

Recognizing the Top 40 Shoulds that Disturb People

Listen as Dr. Pucci teaches participants how to recognize and correct the top 40 irrational shoulds and musts and create an entitlement mentality and create significant disturbance.

Develop New Rational Replacement Thoughts

Learn with great detail how to use the continuum of thought change and the Successive Approximations of Thought Acquisition techniques to help clients replace irrational thoughts with new, rational thoughts.

May 28, 2025
Effective CBT Therapy Requires Therapist Rational Thinking

As president of the NACBT, I am very motivated to encourage the practice of Effective CBT. When I was in graduate school in the mid-1980s, Raymond Corsini claimed in his book, Current Psychotherapies, that at least 450 approaches to psychotherapy existed at that time. That is at least 450 different options from which potential clients may choose. Additionally, of course, there are many therapists whose practice does not resemble a recognized approach whatsoever.

The cognitive-behavioral therapies are well-known for being unique in a variety of ways. CBT approaches:

Are based on the cognitive model of emotional response;

Are briefer and time-limited;

Emphasize that a sound therapeutic relationship is necessary for effective therapy, but not the focus;

Emphasize a collaborative effort between the therapist and the client;

Are based on aspects of Stoic philosophy;

Utilize the Socratic Method;

Are structured and directive;

Are based on an educational model;

Rely on the Inductive Method.;

Emphasizes the important role of homework. (For more information, please visit: https://www.nacbt.org/whatiscbt-htm/

However, no approach to psychotherapy requires rational thinking on the therapist’s part more than the CBT approaches. Effective CBT requires rational thinking on the therapist’s part, as well as a strong belief in its tenets. This fact is problematic when we consider that therapists are human beings who both learn and are capable of developing their own irrational thoughts. It is also problematic given the fact that the professional mental health field attracts people who possess various disturbances in the hopes of healing themselves through their studies.

After at least 30 years of training and supervising therapists (hundreds of thousands, that is), I can assure you that self-healing through the graduate study of counseling/psychotherapy usually does not work. Some of the most disturbed people I have ever met have been therapists.

So how does irrational thinking on the therapist’s part interfere with effective CBT?

1. Therapists’ irrational thinking leads them to believe that the ABCs of Emotions apply to some emotional reactions, but not all.

For example, they believe that the ABC model applies to one’s angry reaction to being mistreated by one’s boss, but it does not apply to one’s reaction to having been raped. I have found that a main reason for that assumption is that the therapist has a sensitivity to the issue of rape. Perhaps they were raped themselves. When therapists hold to this erroneous assumption, they will necessarily inhibit the client’s healing as they will either directly state, or indirectly imply, that since the rape itself is causing the client’s distress, they will always have difficulty with it to some degree.

However, rational therapists understand that the ABCs of Emotions apply to all learned emotions and behaviors. In the case of rape, we seek to understand the meaning that the person has attached to the event. Why does the client continue to make himself or herself miserable over the event? It’s because of what they assume having been raped will mean for their present and future. If they assumed that it would have no impact whatsoever on the rest of their life, they likely would compartmentalize it as a very unfortunate experience for which they are thankful it is over.

2. Therapists’ irrational thinking leads them to think that they must experience what the client has experienced to be helpful to the client.

Frankly, sometimes what comes out of the mouths of therapists is not much different than what is expressed by many clients. During a recent training, when I taught about distress intolerance and the fact that panic is ONLY unpleasant and uncomfortable, NOT unbearable or life-threatening, a therapist asked me, “Have you ever had a panic attack?” That led me to suspect that the trainee most likely tended to panic herself. My suspicion was confirmed by her.

Rational therapists recognize that accurate empathy is NOT attempting to discover how the therapist would feel “in the client’s shoes.” Accurate empathy is working to understand how the client feels in his or her shoes. If the therapist has experienced something similar to the client’s experience, the therapist runs the risk of projecting his or her experience onto the client.

3. Therapists’ irrational thinking causes them to overlook the client’s irrational thoughts.

A client seeks therapy because they are painfully shy. Their reluctance to be around people is based on the belief that they must have everyone’s approval, yet they doubt that others will view them favorably. However, the therapist maintains the same irrational belief. What is the therapist likely to do in this situation? THE THERAPIST WILL AGREE WITH THE CLIENT! As a result, one of the two people in that situation is useless, and it is not the client.

Therapists who strive to perform effective cognitive-behavioral therapy must learn how to recognize irrational thoughts and apply that knowledge to their own cognitions. We need to work at eliminating our own irrational thoughts so that we may be in the best possible position to help the client recognize his or her own.

Rational therapists recognize that rational self-counseling is a life-long process and that we can always improve our ability to think and behave rationally. But doing so, our clients will benefit from our increased ability to recognize their irrational thoughts and to help them correct them.

For more information on training opportunities in CBT, please visit: https://cbtonlinetraining.com

May 28, 2025
What is CBT (Cognitive-Behavioral Therapy)?

by Dr. Aldo Pucci

Cognitive-behavioral therapy (cognitive behavior therapy) does not exist as a distinct therapeutic technique. The term “cognitive-behavioral therapy” is a very general term for a classification of therapies with similarities. There are several approaches to cognitive-behavioral therapy, including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy.

However, most cognitive-behavioral therapies have the following characteristics:

1. CBT is based on the Cognitive Model of Emotional Response.

Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this fact is that we can change how we think to feel/act better even if the situation does not change.

2. CBT is Briefer and Time-Limited.

Cognitive-behavioral therapy is considered among the most rapid in terms of results obtained. The average number of sessions clients receive (across all types of problems and approaches to CBT) is only 16. Other forms of therapy, like psychoanalysis, can take years. What enables CBT to be briefer is its highly instructive nature and the fact that it makes use of homework assignments. CBT is time-limited in that we help clients understand at the very beginning of the therapy process that there will be a point when the formal therapy will end. The ending of formal therapy is a decision made by the therapist and client. Therefore, CBT is not an open-ended, never-ending process.

3. A sound therapeutic relationship is necessary for effective therapy, but not the focus.

Some forms of therapy assume that the main reason people get better in therapy is because of the positive relationship between the therapist and the client. Cognitive-behavioral therapists believe it is important to have a good, trusting relationship, but that is not enough. CBT therapists believe that the clients change because they learn how to think differently and they act on that learning. Therefore, CBT therapists focus on teaching rational self-counseling skills.

4. CBT is a collaborative effort between the therapist and the client.

Cognitive-behavioral therapists seek to learn what their clients want out of life (their goals) and then help their clients achieve those goals. The therapist’s role is to listen, teach, and encourage, while the client’s roles is to express concerns, learn, and implement that learning.

For excellent cognitive-behavioral therapy self-help and professional books, audio presentations, and home-study training programs, please click here.

5. CBT is based on aspects of stoic philosophy.

Not all approaches to CBT emphasize stoicism. Rational Emotive Behavior Therapy, Rational Behavior Therapy, and Rational Living Therapy emphasize aspects of stoicism. Beck’s Cognitive Therapy is not based on stoicism.

Cognitive-behavioral therapy does not tell people how they should feel. However, most people seeking therapy do not want to feel the way they have been feeling. The approaches that emphasize stoicism teach the benefits of feeling, at worst, calm when confronted with undesirable situations. They also emphasize the fact that we have our undesirable situations whether we are upset about them or not. If we are upset about our problems, we have two problems — the problem, and our upset about it. Most people want to have the fewest number of problems possible. So when we learn how to more calmly accept a personal problem, not only do we feel better, but we usually put ourselves in a better position to make use of our intelligence, knowledge, energy, and resources to resolve the problem.

6. CBT uses the Socratic Method.

Cognitive-behavioral therapists want to gain a very good understanding of their clients’ concerns. That’s why they often ask questions. They also encourage their clients to ask questions of themselves, like, “How do I know that those people are laughing at me?” “Could they be laughing about something else?”

7. CBT is structured and directive.

Cognitive-behavioral therapists have a specific agenda for each session. Specific techniques / concepts are taught during each session. CBT focuses on the client’s goals. We do not tell our clients what their goals “should” be, or what they “should” tolerate. We are directive in the sense that we show our clients how to think and behave in ways to obtain what they want. Therefore, CBT therapists do not tell their clients what to do — rather, they teach their clients how to do.

8. CBT is based on an educational model.

CBT is based on the scientifically supported assumption that most emotional and behavioral reactions are learned. Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting.

Therefore, cognitive-behavioral therapy has nothing to do with “just talking”. People can “just talk” with anyone.

The educational emphasis of CBT has an additional benefit — it leads to long-term results. When people understand how and why they are doing well, they know what to do to continue doing well.

9. CBT theory and techniques rely on the Inductive Method.

A central aspect of Rational thinking is that it is based on fact. Often, we upset ourselves about things when, in fact, the situation isn’t like we think it is. If we knew that, we would not waste our time upsetting ourselves.

Therefore, the inductive method encourages us to look at our thoughts as being hypotheses or guesses that can be questioned and tested. If we find that our hypotheses are incorrect (because we have new information), then we can change our thinking to be in line with how the situation really is.

10. CBT emphasizes the important role of homework.

If a person wants to learn a musical instrument well enough to perform in a band, they will need to play that instrument more than during their weekly lesson. Daily practice will produce the learning and ability they seek.

The same is the case with psychotherapy. Goal achievement (if obtained) could take a very long time if a person were only to think about the techniques and topics taught for one hour per week. That’s why CBT therapists assign reading assignments and encourage their clients to practice the techniques learned.

May 28, 2025
Ask Dr. Pucci

Please feel free to submit questions to me concerning cognitive-behavioral therapy and mental health, and I’ll do my best to answer them. Use the form below. Additionally, below are questions from website visitors, along with my answers.

I am Dr. ALDO R. PUCCI, and I am President of the National Association of Cognitive-Behavioral Therapists. I was trained in Rational Behavior Therapy by its originator, internationally acclaimed psychiatrist Maxie C. Maultsby, Jr., MD. I then went on to develop my own form of CBT known as “Rational Living Therapy.” Thankfully, I trained thousands of mental health clinicians and presented my workshops and certification seminars on Rational Living Therapy and Rational Hypnotherapy throughout the United States. I have been blessed in that my seminars have received rave reviews. I hold the titles of Diplomate in Psychotherapy (The International Academy of Behavioral Medicine, Counseling and Psychotherapy), Diplomate in Cognitive-Behavioral Therapy (NACBT), Certified Medical Hypnotherapist (Institute of Medical Hypnosis), and Certified Clinical Hypnotherapist (National Board for Hypnotherapy and Hypnotic Anesthesiology). I am the author of many articles and two books, The Client’s Guide to Cognitive-Behavioral Therapy and Feel the Way You Want to Feel…No Matter What!

Question: Dr. Pucci, how can I get control over my emotions? –J.M.

Dr. Pucci’s Answer: Hello, J.M. Thank you for your question. Unless there is something wrong with those parts of our body that are responsible for our emotional and behavioral control, we are always in control of our emotions and behaviors. Sometimes we control ourselves rationally, while at other times we control ourselves irrationally. We control our emotions and behaviors by our thoughts. Our thinking causes our feelings and behaviors. I suspect that what you really want is to know how to consistently, intentionally rationally counsel yourself. A good cognitive-behavioral therapist can help you learn rational self-counseling. You may also find my book, Feel the Way You Want to Feel…No Matter What! helpful. Also, if you have not already done so, be certin to take that Rational Thinking Questionnaire ( https://rationalthinkingscore.com/rational-thinking-score-quiz/ ) I wish you well.

All responses to questions are for educational purposes only and are not to be used as a substitute for counseling, psychotherapy, or mental health treatment.

May 27, 2025