Cognitive Behavioral Therapy (CBT)

What this is

Cognitive behavioral therapy — CBT — starts from a simple observation: the thought you have about a situation does more damage than the situation usually does. Your phone buzzes, you see a name, and before you have read a word your stomach drops. The message turns out to be nothing. The drop was real anyway.

In this work we slow that sequence down until you can see each part of it. What happened. What you told yourself it meant. What you felt in your body. What you then did — or, more often, what you avoided doing. Written out like that, the story you have been telling yourself at speed stops sounding like a fact and starts sounding like a version.

CBT is one of the two areas I work in most, alongside psychology more broadly. It is more structured than open-ended talking: we work on something specific, we try things between sessions, and we check whether they made a difference. I like it because it hands you something you can use on a Tuesday afternoon when I am not there. Where the pattern turns out to be older and deeper than the current situation, we can go there too — you are not locked into one method with me.

What it can help with

• Worry that loops — the same three scenarios, every night, no new information
• Panic attacks, and the fear of having one in public
• Avoidance that has quietly narrowed your life: driving, flying, elevators, crowds, the highway
• Social anxiety — replaying a conversation for two days afterward
• Low mood, and the withdrawal that makes it heavier
• Trauma, and living with PTSD — particularly the parts that show up as constant alertness, avoiding places and situations, and sleep that does not settle
• The inner voice that calls you stupid in a tone you would never use on anyone else
• Perfectionism and procrastination, which are usually the same problem wearing two coats
• Health anxiety — checking, googling, needing reassurance that never lasts
• Checking and rechecking rituals that have started costing you time
• Anger that goes from zero to full in a second
• Trouble falling asleep because your mind starts working the moment you lie down
• Exam, interview, or presentation nerves that do not match your actual ability

Where trauma is involved, the CBT work stays on what is happening now — the reactions, the avoidance, the sleep — rather than on making you walk back through the event. I work with people living with PTSD; I do not diagnose it, and a diagnosis is a matter for a doctor. You decide how far we go and how fast, and no step happens without your agreement.

What a session is like

Sessions are at Center St. Elie in Antelias, in a private room where nobody sees you arrive and nobody else is present.

The first session is mostly me listening. I want to know what is happening, when it started, what you have already tried, and what you want to be different. By the end of it we usually agree on one or two things to work on, in your words rather than mine.

After that, sessions have a loose shape. We look at how the week went, pick one situation that got to you, and take it apart together — often on paper, because seeing a thought written down does something that thinking it never does. Then we work out what could be tested before we meet again.

You control what comes up. If I ask about something and you would rather not go into it, say so — that is a full stop, not a detour, and I will not go around the back of it. If a subject is too raw this month, we leave it and come back when you want to.

The between-session part is small and practical. Noticing something. Writing one line down. Trying a short walk you have been dreading, not a long one. If you arrive having done none of it, we talk about what got in the way, because that is often more useful than if you had done it.

You will not be asked to think positively or to say things you do not believe. Telling yourself everything is fine when it is not does not work, and I will not ask you to try.

Practical details

• Session length: Ask when you message — I’ll tell you before you book
• Fee: Ask when you message — I’ll tell you before you book
• How many sessions: It depends on what you come with. We review as we go, and you decide whether to continue
• Languages: Ask when you message — I’ll tell you before you book
• Where: In person at Center St. Elie in Antelias, or online
• Cancellations: Ask when you message — I’ll tell you before you book
• To book: Message me on WhatsApp or call 03-267-243

Common questions

Is this just going to be homework?

No. The between-session part is small and we agree on it together — usually one thing, chosen because it fits your week. Nothing is graded and nothing is checked up on. If it does not get done, that is information, not a failure.

I already know my thinking is irrational. Why hasn’t knowing that helped?

Because understanding a pattern and being free of it are different things. Most people who come to me can describe their problem accurately and are still stuck inside it. Insight on its own rarely shifts anything. What shifts it is doing something different while the old feeling is still present.

Will you make me face the thing I am afraid of?

Not without your agreement, and never before you are ready. If avoidance is part of what keeps a fear alive, we will talk about approaching it — but you choose the step and the size of it, and you can stop at any point. I will not spring anything on you.

Can CBT help with trauma?

It can help with how trauma is affecting you day to day, and that is how I use it. I am not going to tell you it undoes what happened or that it resolves PTSD. If you have a diagnosis, or you are seeing a psychiatrist, we work alongside that rather than in place of it — and if I think you need a different kind of support, I will say so.

Does it have to be CBT?

No. I work in other approaches, and we can change direction if this one is not fitting you. No method suits everyone, and part of the first session is working out whether this is a sensible starting point for what you are dealing with.

If you want to ask something before booking, message me on WhatsApp or call 03-267-243.

If you are in immediate danger or thinking of harming yourself, please do not wait for an appointment. Call the Embrace Lifeline on 1564 (free and confidential) or the Lebanese Red Cross on 140. This page is not an emergency service.