"After they've met with me the first time, people often tell me, 'That's not what I expected.' And they mean that in a good way," says Randa R. Soubra, L.I.C.S.W., M.S.W.
As a Mayo Clinic social worker, Soubra offers outpatient cognitive behavioral therapy (CBT) for people who are dealing with mental health issues like anxiety and depression.
People often picture therapy as a scene from television: a person lying on a couch, talking about their childhood while the therapist writes things down.
Soubra says this view of therapy isn't quite accurate. Therapy is a conversation and a partnership.
"We provide very human level support," she says. "We really just want to understand people's lives and the things that have happened to them that made them who they are. Plus their goals and needs. Where do they want to be?"
Beyond providing treatment for certain mental health conditions, CBT can be helpful for people who are feeling stuck, bogged down by stress or simply trying to make a positive change in life. Here's how it works.
Helping you challenge your thoughts
Soubra says CBT looks at the link between 3 things:
- What you think.
- How those thoughts make you feel.
- How that feeling impacts what you do and don't do.
"All these things are very tied up with one another," says Soubra. "And when those automatic thoughts go unchecked, they can create a cycle of distress."
For example, if you're criticized by someone at work, your automatic thought might be, "I can't do anything right." That thought could lead to feeling upset, sad or anxious. To avoid feeling this way, you might stop talking to people at work or even call in sick.
A therapist can help you learn to challenge those negative thoughts as they arise. For example, you might see criticism as an opportunity to improve your work, rather than evidence that you're a failure.
Once you see a situation clearly, you're more likely to respond in a healthy way and stop the cycle of distress.
"This is what we might instead call a coping cycle," says Soubra.
Turning anxiety into problem-solving
"I always tell people that anxiety itself isn't bad. You need anxiety to get up in the morning or to cross the street," says Soubra. "It's our brain's alert system and keeps us safe."
But when that alert system becomes overactive, anxiety can become a mental health issue.
"Sometimes our anxiety tells us that the worst thing is going to happen and we won't be able to cope," says Soubra. "CBT teaches you to recognize that the worst case is usually the least likely. And to step back and say, 'OK, if the worst did happen, how would I deal with it?' "
For example, you might feel anxious at work because your new dog is alone at home. You may have trouble concentrating on your job because you imagine him clawing out of his crate or hurting himself.
But CBT invites you to ask another question: What's another way things could go? If the dog makes a mess, you can clean it up after work and then ask a friend to check on him tomorrow. Or maybe the dog is just fine, sleeping the day away.
"Therapy can help you learn to pause and slow down your thoughts, so you have more room to problem-solve," says Soubra. "Just learning to do that can stop the cycle of distress."
Staying the course
Managing anxiety and depression is "an active practice," says Soubra. It takes some work to partner with a therapist, attend sessions and practice new coping skills.
But the effort is worth it.
"Anxiety and depression are both common and highly treatable," she says. "CBT is simply an effective treatment. It's just like taking medicine to manage a chronic illness like diabetes. You use these tools to help you live your life."