How to Avoid Using CBT to Gaslight Clients
I am a predominantly Cognitive Behavioral Therapy (CBT), Humanistic Therapy, and Existential Therapy provider. They’re well researched evidence-based modalities, easily adaptable to a wide variety of presenting concerns, etc. I’m a proud practitioner and have so many good things to say about CBT.
The C in CBT focuses very heavily on unpacking negative core beliefs (deeply rooted negative views of ourselves) and cognitive distortions (errors in thought patterns). Often times we latch onto these errors in thinking as truths and forget to question their validity.
One of my favorite tools for assessing the validity of certain thought patterns is using Socratic Questioning. I like to joke that famed ancient Greek philosopher Socrates (circa 470-399 B.C.) approached problem solving with the curiosity of a toddler - asking “Why?” over and over until he’d get to the bottom of things. To demonstrate, here’s how I imagine conversations went between Socrates and a fretting war general.
“We lost the battle of trying to invade X territory.” “Why?” “Because they had better weapons.” “Why?” “Because they have access to more metals.” “Why?” “Because they’ve owned territory over important metal deposits for centuries.” “Why?” “Because they got lucky…I don’t know?” “No, why have they owned that territory for so long?” “Because once they realized the value of the resources on their land, they took extra precautions to protect it from being invaded.” “So you really lost the battle because their precautions worked? George Washington was right - the best offense is a good defense?” “…Who??”
Dammit Jim, I’m a counselor, not a historian.
In all seriousness, this train of thought can be used for challenging cognitive distortions too. Let’s look at a student who gets an F on one test and concludes, “I must be stupid.” (The cognitive distortion here being overgeneralization, that the result of one experience can be generalized to all experiences). Let’s look at how a conversation between the student and Socrates might go.
“I got an F on my test so I must be stupid.” “Why did you get an F?” “Because I didn’t understand the material.” “Why?” “Because the teacher’s lecture didn’t make sense to me and I didn’t ask for help.” “Why didn’t you ask for help?” “Because I didn’t have time.” “Why?” “Because I’m balancing other homework, work, hobbies, and chores. I only have so much time in a day.” “So you got an F because you ran out of time to ask for help, not because you're stupid?” “I suppose.” “And have you gotten F’s on every test?” “No, but I tend to do worse in this class than all my others.” “So even if you had made time to ask for help and still failed, it’s hardly generalizable to all of your intelligence, just this particular class subject?” “True.”
So we can see how challenging cognitive distortions can be really helpful for a lot of our distorted thinking. People with perfectionistic tendencies who believe they have to be perfect or else they’re a failure; people who pressure themselves to be responsible for everyone else’s happiness; people with rigid expectations of how themselves and others “should” behave at all times; people who have a hard time accepting the mountains of positive feedback as true and focus on the couple of negative feedback as reason to believe they’re inadequate, etc.
Truly, it’s immensely helpful to take a pause to ask where some of our negative core beliefs come from, why we believe them to be universal truths, what alternative explanations are equally (if not more) plausible, why we are resistant to changing those beliefs, and what it would look like for us to reframe how we see ourselves as we interact with the world.
With all that said, I want to focus today on how this can accidentally translate to gaslighting clients who have experienced chronic trauma.
To gaslight someone means to manipulate them into questioning their own sanity and perceptions of reality. An example would be: Bob screams at their partner Joe, and when Joe later confronts them about it, Bob says, “I never screamed at you” or “It wasn’t that bad, you’re exaggerating.” Gaslighting happens at varying degrees of severity, and when it happens repeatedly, it can be a form of emotional abuse.
It is also relevant to note that the person perpetuating the initial harm and the person gaslighting can be the same or different people. Gaslighting can also accidentally occur without malicious intent. For example: Bob screams at Joe, and when Joe tells their friend Ray about it, Ray says, “That doesn’t sound like Bob to me, you must have misunderstood.” Ray isn’t trying to cause Joe to question their reality, yet that is the result.
Unfortunately, in this same way, some clients who undergo CBT treatment experience gaslighting from their therapist who is trying to help them challenge negative core beliefs but misses the mark on what exactly needs to be challenged. Instead of exploring why the client holds certain beliefs about themselves, the therapist’s Socratic questions can undermine the client’s lived experience.
To showcase what I mean, let’s talk about a common occurrence of chronic trauma - bullying. If a kid is physically bullied by a significant chunk of peers for years of their life, are they really having distorted thinking when they see a peer walk toward them and think “I must be in danger” (magnification) or “This is going to be a disaster” (catastrophizing)? If that kid is too scared to go to school because they have classes with several of these bullies who harass them daily, are they really exhibiting distorted thinking of mind reading or fortune telling by suspecting going to school = getting hurt?
And from a therapist perspective…are we really helping that kid if we try to challenge the intensity or severity of this issue, in which turn we gaslight them into thinking they’re overreacting to a serious issue?
Keep in mind, the conclusion isn’t “We should avoid CBT with chronic trauma survivors.” This is a reminder to target the dysfunctional core beliefs, not the lived experience, in challenging cognitive distortions.
The thoughts worth challenging here, with our bullied client, would be if that kid voiced negative core beliefs such as, “I deserve to be treated like this”, “It’s okay to be treated like this to make others happy,” or “All people will always treat me like this.” We are not here to question if the chronic trauma is really as severe or frequent as they say, we are here to help them cultivate a sense of self-worth and self-respect outside of the trauma they endure, especially when there are significant factors outside of their control.
When we do Socratic questioning with clients to challenge the validity of their thoughts, we have to acknowledge certain beliefs will indeed be valid and not distorted. In which case the question is no longer, “Is this errored or biased?” It’s “What do we want to do about it, and what do we have the power to do about it?”
Let’s take a conversation with Socrates in which he is NOT gaslighting a teen about their bullying experiences.
“Going to school is going to be a disaster because I always get bullied.” “Why?” “Because a group of kids hit and shove me every single day.” “Why?” “Because they can, they never get in trouble for it.” “Why?” “Because when I used to tell the teacher, the kids would hurt me worse, so I stopped saying anything.” “Sounds like it is indeed a disaster every day, what do you have the power to do about it?” “Tell my parents and see if they’ll talk to those kids’ parents, but that might have the same problem as telling teachers.” “What else can you do?” “I can talk to the principal, an SRO, or a counselor for advice, or ask my parents to let me maybe transfer.” “And if all else fails, if these adults do not protect you like you deserve, are there safe peers you can spend time with to offset the bullies?” “Yes, I can spend time with friends to not be so isolated or as easy of a target for the bullies.”
In this example, the Socratic questioning turns into problem-solving instead of undermining the severity of the issue. We’re not suggesting the teen is overreacting to being hit/shoved, diminishing their fears of getting teachers/parents involved, or telling them what they “should” do. They have sufficient evidence to support their belief and therefore the belief is valid, not errored. Empowering problem-solving becomes more effective than trying to “change” their way of thinking.
Now let’s take a conversation with Socrates in which he again is NOT gaslighting a teen about their experiences while actively challenging distorted beliefs (note - this is based on dozens of conversations I’ve had with bullied adolescents).
“I deserve the way they treat me.” “Why?” “Because I’m weird and different.” “Do you hit people who are weird and different?” “Well, no.” “Why?” “Because I don’t think it’s nice to treat people that way.” “So you don’t think you deserve the basic kindness you extend other different people?” “No.” “Alright, what makes someone deserving of kindness?” “Just being a person, I guess. Being nice themselves.” “As a person, especially one who is nice to others, why do you not deserve kindness?” “Why would my bullies treat me that way every day if I didn’t deserve it? They don’t hurt everyone the way they hurt me.” “Can you think of reasons someone would bully someone different from themselves?” “Seeing someone different makes them feel insecure about their own choices?” “So I ask again, why does being different mean you deserve to be hurt?” “…It doesn’t.” “And do you get harassed by every peer or just some of them?” “Just this one group.” “So could we say a majority of your peers don’t believe you deserve to be bullied for being different?” “True.” “It doesn’t change the awfulness of how you currently endure this group’s bullying, but it does change our lens of viewing you as deserving of it.”
The important line to ride as therapists is not to challenge their perception of what is happening TO them, but rather challenge their perception of their own worth, abilities, rights, and responsibilities as they experience that interaction. What are the specific conditions in which they are likely to experience or successfully steer clear of similar harmful interactions? What is theirs to own and what can they release from themselves?
No therapy modality is perfect, and I’d argue it’s essential for us to understand our modalities’ shortcomings in order for us to be effective practitioners. We can love and critique something at the same time…in fact, I’d suggest that loving something without critiquing it is not love at all but rather idolatry.
And all of this goes to say, as therapists we need to pay attention to what is the actual distorted thinking when clients present negative core beliefs resulting from chronic trauma. Let’s avoid accidentally gaslighting them into questioning if they experienced their own reality correctly, affirm their emotions surrounding traumatic events, and challenge beliefs that impair their functioning instead of protect them.
