Dr Joanne Stuart
The basics of CBT: The five area model.
What is it?
The five area model is a model of how human’s function. If we can develop the ability to notice the connections between how we feel, think, our physical reactions and what we do then we can bring small changes to these areas and influence the whole system.
We all think about things. When we wake up in the morning we begin to think and we rarely stop thinking until we go to sleep at night. Our thoughts can be either useful to us or not useful to us. We may worry continuously about the future or we may ruminate and regret the past.
We also all experience emotions: There are a multitude of emotions that we might experience in one particular day: fear, happiness, sadness, surprise, guilt are but a few.
Physical Sensations in the Body:
Particular emotions also impact on our physical body.
· Fear: Fear causes our heartbeat to raise and our breathing to change; we tense up and may feel hot and sweaty. We may feel nausea or butterflies in our stomachs. We also may experience dizziness or a sensation that we feel faint.
· Sadness: Generally sadness is associated with a lack of energy in the body. People who are extremely low in mood don’t normally skip through the day.
· Guilt: Guilt is another emotion that is felt in the body. It is difficult to describe exactly where or how but we each know the sensations that are around when we feel guilty.
What we do or how we behave is also a part of this system. When we experience the emotion of fear, we may want to avoid the thing that we fear. When we feel sad, we may want to hide away in bed or avoid socialising. If we are worrying about our health, we may check our body or seek medical advice. If we are worried about getting fat, we may avoid eating certain foods. If we feel stressed we may drink more alcohol. If we feel lonely we may call a friend. If we worry about how our partner feels about us we may seek affection. The list is endless.
Anxiety or Fear:
Here is an example of how anxiety fits with the five area model. When we are anxious or feel fear, it makes sense that our thoughts will generally involve worrying about something in the future or the past. Relaxed thoughts are not associated with being anxious. If we feel anxious, our body sensations will change: breathing becomes shallow, heartbeat and the temperature of the body increase, etc. If we feel anxious it may make us do particular things or behave in particular ways, like seek reassurance, or avoid things that we fear.
When we feel sad, our body energy goes down. Our thoughts are normally negative and our behaviours are also affected: we may want to stay in bed or avoid social contact.
What can be seen from this is that how we feel, our thoughts, our bodily sensations and our behaviours are all interconnected. Although this system can make us feel worse, if we understand it, we can also impact on things to feel better. For example, when we are sad, we may feel like staying in bed but if we get up and have a shower, we won’t feel suddenly wonderful but we may feel a bit more energy. If our energy is raised we may choose to do some other things that we were avoiding and thus feel a bit better about what we have achieved.
If we are anxious, there are things we can do to reduce down the physical symptoms of anxiety, such as changing our breathing or exercising. Equally, if we face our fears and overcome them we can feel a real sense of achievement.