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Counselling, Psychotherapy, CBT & Mindfulness in Central London & Online

CBT Vicious Cycle Example: Emotions, Thoughts and Feelings influence each other

Cognitive Behavioural Therapy in London & Online

Cognitive Behavioural Therapy (CBT) is a common and effective therapy approach for a range of difficulties. It involves helping you to gain a good insight into specific difficulties and what is maintaining them. It also involves learning various coping strategies to help you address problematic thinking and behavioural patterns in order to improve the difficult feelings you are facing. This will stop you from being held back by your emotional difficulties and from doing what you want to be doing. Eventually, whether you’re struggling with mood, anxiety, stress or relationship issues, this process will help you to live a more satisfying and meaningful life! Read through to learn more about CBT. Get in touch for CBT Therapy in London today.

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What is CBT Therapy? (Cognitive Behavioural Therapy in London)

  • CBT basics: The interaction between Thoughts, Feelings, Physical Sensations (Body) and Behaviours

CBT suggests that an interlink exists between our thoughts, feelings, behaviours and physical sensations. Therefore, if one aspect is negative/unpleasant/unhelpful, then this has a knock-on negative effect on the other aspects thus forming a vicious cycle. The diagram below represents an example of a negative vicious cycle of anxiety. CBT helps you to gain a good understanding of your difficulties by identifying the vicious cycles you experience. 

Anxiety CBT Cycle, CBT Therapy in London

In the example above, we’re feeling anxious about having to give a presentation at work. The negative thoughts that appear lead to difficult emotions (anxiety, fear, etc.) and unpleasant physical sensations. As a response to that we decide to not show up at work and avoid the presentation. Unfortunately however, this behavioural response (known as ‘avoidance’) keeps us in a vicious cycle. When working in CBT, ‘Calling in sick’ would be seen as an unhelpful behaviour as, although it allows us to calm the anxiety feelings, it reinforces negative thoughts about ourselves (such as “I am a failure” or “I am a terrible presenter”). The reinforcement happens because the avoidant behaviour (calling in sick), doesn’t allow us to test the validity of our thought, leaving it unchallenged. CBT involves finding ways to breakdown such vicious cycles. As the name suggests, CBT aims to do this mainly by addressing cognitive processes (or thinking patterns) and behaviours (or actions).

  • CBT Cognitive Techniques

In terms of cognitive processes, CBT helps you to identify thinking patterns that you have developed that, although may have served you well at some point in your life, may now be unhelpful. Your CBT therapist will explore with you how to address unhelpful thinking patterns which can alleviate difficult emotions and help you to make choices that are helpful for you.

  • CBT Behavioural Techniques

Regarding the behavioural element of CBT, this involves exploring with you what your behavioural tendencies are and analysing to what degree these are useful and whether there are any costs in the short and long term. Together with your CBT therapist, you will determine whether it would be helpful for you to adjust some of your behavioural tendencies, particularly those that arise during difficult and emotive situations. Your CBT therapist will thus help identify and change such unhelpful behaviours.

How Effective is CBT?

When delivered by a trained clinician, such as an applied Clinical or Counselling Psychologist or CBT Therapist, Cognitive Behavioural Therapy has been shown to be helpful for many people with a range of difficulties, particularly depression and anxiety. CBT is the most researched therapy approach and there is a lot of evidence that supports its effectiveness. It is considered to be the ‘gold standard’ and is recommended for a range of difficulties [1].

What Are the Advantages of CBT Therapy?

  • CBT is the most evidence-based approach to psychotherapy and counselling. This means that there is more scientific evidence on the effectiveness of CBT than for any other therapeutic approach.
  • It usually takes less time than other approaches. This means fewer sessions are usually needed in order to see improvements
  • CBT helps you identify and change negative thinking patterns causing difficult emotions
  • It helps you identify and change unhelpful ways you currently react to circumstances
  • You learn practical, every-day strategies to deal with your distress
  • It teaches you to become your ‘own therapist’

What Problems Can CBT Therapy Help With?

CBT can help people with a range of difficulties including:

Depression & low mood counselling CBT Vicious Cycle

How long is CBT? How Many Sessions are Needed?

Each session is 50 minutes in length. The number of sessions needed in order to see significant change depends on your presenting difficulties and needs. However, the total number of sessions, in order to see significant improvement, is often between 6 and 24. You can decide with your CBT therapist how many sessions it would be helpful for you to aim towards in total and this can be reviewed as therapy progresses.

Common Concerns about CBT

  • CBT Only Looks at the Present and Not the Past

It is true that CBT is often focussed on the present moment. However, it can be highly valuable to explore your past and the influence this has on your present emotional struggles, beliefs and behavioural patterns. Therefore, in therapy it can be fruitful to spend time exploring your past and this can be done in CBT with your CBT therapist.

  • CBT Is Too Structured

CBT is also often deemed to be a structured therapy wherein:

  • You collaboratively decide with your therapist goals to work on and therapy will be focused on addressing these goals
  • At the beginning of each session agenda topics will be agreed upon and focussed on in that session
  • There is an emphasis on learning CBT coping strategies

Some people like this more structured CBT approach. In this case our CBT therapists can deliver therapy in a more structured way. However, others prefer for the therapy to be less structured i.e. to have less focus on goals and agenda items but rather the conversations are more free-flowing and organic. CBT can still be delivered in this less structured way. Whatever your preference, your CBT therapist can adapt the therapy to suit you.

  • I Didn’t Like all the Homework I Received in Previous CBT

Perhaps you have had CBT in the past and it felt that too much “homework” was set. You may not have liked this aspect of CBT as:

  • It felt like too much hard work
  • It felt there was too much pressure to complete this
  • You felt you didn’t have enough time to complete it
  • It felt like you were back at school!
  • You don’t enjoy and/or you perhaps struggle with reading and/or writing things down

CBT therapy can indeed involve collaboratively setting tasks, or “homework”, at the end of sessions which you practice between sessions. For example, you may agree with your CBT therapist to practice a coping strategy between sessions that you have just learnt in a session. This can sometimes involve keeping records.

Some people like this approach as they feel they are taking action to make changes. However, other people dislike this aspect of CBT maybe due to some of the reasons outlined above. If you do not like the idea of setting tasks or “homework” this will not be enforced upon you at Therapy Central! However, to make the most of therapy it is often helpful to reflect upon the discussions you had in therapy between your sessions. It is natural over the course of therapy to discuss with your therapist things that you wish to work on outside of therapy and it is helpful to make a start on this during the period you are receiving therapy whilst you have the support of your therapist. However, this does not need to be given the strict term of “homework”.

Is CBT Right For Me?

If you are struggling with emotional or physical health difficulties, they are having a significant impact upon your life and you feel stuck, now is the right time for you to receive therapy. We can help you to decide if CBT could be a good therapy approach for you to help you fight off those demons.

As a rule of thumb, CBT is right for you if you are willing to:

  • Commit to working with your therapist as a team
  • Put things into practice in between sessions (e.g., homework. This is also how you learn to become your ‘own CBT therapist’)
  • Look at and understand your issues, including long-standing beliefs about yourself and others, critically and with curiosity
  • Confront some negative emotions. It is generally through this process that difficulties become less scary and gradually more manageable.


Anger Management Issues CBT Vicious Cycle

Anger Management Issue, CBT Vicious Cycle Example: Thinking that we’ve been treated unfairly produces angry feelings, which are also felt in the body. Shouting and an urge to hit out emerge as a response to those difficult feeling. However these responses may be counterproductive. Leading to others devaluing us, treating us with less respect or not wanting to spend time with us, which can keep us stuck in a vicious cycle.


How Much does CBT Therapy in London Cost? Can I Use my Insurance Provider for CBT in London?

As one of the most evidence-based approaches to psychotherapy and counselling, CBT is a very popular choice these days. Costs per session can vary greatly between practitioners and clinics. However, at Therapy Central CBT will cost just as much as any other approach. We believe that therapy should not a be privilege and thus our fees are among the most competitive in Central London. CBT (self-funded) will cost a maximum of 95£ per 50-minute session. See a full list of fees, including discounted rates here.

We regularly deliver CBT for clients who wish to use their private healthcare insurance cover to pay for their sessions. AXA PPP, AVIVA, CIGNA, WPA and VITALITY, are amongst our insurance partners. Visit our Fees & Insurance page for more information about using your private healthcare insurance to cover your CBT sessions.

How We Like to Practice CBT in London at Therapy Central

For some people it is helpful for therapy to be largely based upon CBT. However, for others it is more helpful for elements of CBT to be integrated into therapy alongside elements from other approaches. An example of this is that in therapy your therapist may help you to understand your difficulties from the CBT perspective by looking at the links between your thoughts, feelings, behaviours and physical sensations. You may then be introduced to CBT coping strategies as well as coping strategies drawn from other therapy approaches to help you breakdown the vicious cycles you experience. You can discuss with your therapist at Therapy Central whether it is more helpful for therapy to be solely based upon CBT or whether a more integrative approach would be better for you.

As outlined in other sections on this page, our therapists at Therapy Central work in a flexible way. Therapy can be structured or not be very structured, homework can be or not be explicitly set – it all depends on your needs and preferences.

CBT Therapy in Central London

If you are looking for expert CBT therapy in London at Therapy Central we can help you learn the strategies you need to start dealing with the challenges of mood, anxiety, work and relationship issues. As a result, you’ll be enabled to make the crucial changes to bring balance and fulfilment back into your life. You are not alone.

Start Dealing with your issues with a CBT Therapist in London Today

Get professional CBT therapy in London today. Contact us for a free 15 min consultation with a CBT Therapist to see if our help would fit your needs. You can also get in touch via email at or call us at (+44) 020 348 82797.

Our comfortable and confidential therapy rooms are conveniently located 3 min walk from Oxford Circus station, in Central London (see map below). Change starts with Talking!



Dr Amy Smith, Counselling Psychologist

Dr Raffaello Antonino, Counselling Psychologist


Learn more:

Issues we work with at Therapy Central

Tips to deal with Anxiety – Blog post

NHS info on CBT



[1] Hoffman et al. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy Research. 36, 427-440.

[2] David et al. (2018). Why Cognitive Behavioral Therapy is the Current Gold Standard of Psychotherapy. Front Psychiatry. 9: 4.

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