CBT proposes that our thoughts are produced when a core belief is generated. A core belief is an inherent pattern of thinking of ourselves, others, the world, and the future based on our cumulative past experiences. It can be unhelpful (e.g. “I cannot trust anybody”, and “I am not good enough”), or helpful (e.g. “There are people that I can trust”, and “I am valuable to some people”).
When we experience a threatening situation, our unhelpful beliefs tend to activate in an attempt to protect us in a way that we are not even aware of. Most times it makes matters worse by producing negative thoughts. As a result, we feel bad (e.g. depressed and anxious) and exhibit physical distress (e.g. headaches, shaking, and sweating). This process is illustrated in the diagram below.
The pressure of these negative thoughts, feelings, and unpleasant physical sensations invariably leads to problem (i.e. dysfunctional or inappropriate) behavior. We all try to cope with distress somehow and typical choices are aggression, withdrawal, risky behavior, and substance use. Such behaviors are met negatively by others, and their reactions actually reinforce our negative beliefs and thoughts. And so the cycle becomes ever more destructive.
Next, we briefly discuss considerations of interacting with a mentally ill person.