PTSD Living With CBT Coping Skills and Strategies Positive ways to deal with negative feelings By Matthew Tull, PhD Matthew Tull, PhD Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial process Updated on July 27, 2024 Learn more." tabindex="0" data-inline-tooltip="true"> Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Akeem Marsh, MD Medically reviewed by Akeem Marsh, MD Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities. Learn about our Medical Review Board Print Table of Contents View All Table of Contents How CBT Works Self-Monitoring Diaphragmatic Breathing Progressive Muscle Relaxation Behavioral Activation Listing Pros and Cons Cognitive Restructuring Setting and Managing Goals FAQs Trending Videos Close this video player What do you do when you're feeling anxious? Angry? Scared? Negative feelings are an inevitable part of life, but how you *deal* with them can make or break your mental well-being. CBT coping skills are tools that can help you handle negative emotions in a healthy way. They provide strategies for getting through difficult situations with less tension, anxiety, depression, and stress. CBT coping skills help you deal with uncomfortable emotions (anxiety, depression, etc.) so you can feel better physically, make better decisions, and more. These cognitive strategies are especially important if you are dealing with certain mental health conditions, such as post-traumatic stress disorder (PTSD). At a Glance CBT (aka 'cognitive behavioral therapy') focuses on changing negative thoughts and behaviors. It's a highly effective treatment for many mental health conditions, but you can also use CBT techniques anytime, anywhere. When you implement these tactics in your everyday life, handling stressful situations and negative thinking will be a breeze. So, let's learn how to ditch those unhealthy coping techniques—goodbye avoidance, social withdrawal, and substance use; hello diaphragmatic breathing, progressive muscle relaxation, and behavioral activation! By learning how to use these CBT skills, you'll be better able to manage your negative feelings in positive ways. How CBT Works Tom M Johnson / Blend Images / Getty Images Cognitive behavioral therapy (CBT) is based on the idea that psychological problems arise from the way we interpret or evaluate situations, thoughts, and feelings. Negative interpretations and evaluations can lead to unhealthy behaviors. CBT works by changing how you think. By replacing maladaptive ways of thinking and negative interpretations of events, you can reduce unhealthy behavioral patterns. It also teaches you the skills and cognitive strategies needed to better cope with whatever life throws your way. How to Get Started If you are looking to replace some of your unhealthy ways of handling problems with more helpful ones, consider trying some of the following CBT skills, including diaphragmatic breathing, progressive muscle relaxation, self-monitoring, behavioral activation, listing pros and cons, cognitive restructuring, and goal setting. Self-Monitoring Self-monitoring is a basic CBT coping skill. To a large extent, is at the core of all the cognitive-behavioral coping strategies described here, so this is a great place to start. It works like this: in order to address a problem or a symptom, we need to first become aware of it. Self-monitoring can help with this. With this awareness, we can then take action to regulate our behaviors so we have more positive outcomes. You can develop this skill by paying attention to your own thoughts, behaviors, and reactions. To do this, you might try writing in a journal or using a mood tracker. As you do this, you may start to notice certain patterns and triggers. It also allows you to track your progress as you work toward implementing healthier CBT skills. How to Develop and Practice Self-Regulation Diaphragmatic Breathing Diaphragmatic breathing, also called breathing retraining or deep breathing, is a basic cognitive coping strategy for managing anxiety. It is a simple technique but can be very powerful. Diaphragmatic breathing involves pulling your diaphragm down while taking a deep breath in. You should see your abdominal area rise with each breath, which is why it is sometimes referred to as "belly breathing." These 9 Breathing Exercises Can Help Relieve Anxiety Progressive Muscle Relaxation Relaxation exercises with a CBT app can be an effective way to reduce your stress and anxiety. One such exercise is called progressive muscle relaxation (PMR) and involves alternating between tensing and relaxing different muscle groups throughout the body. With PMR, complete muscle relaxation is obtained by first going to the other extreme (that is, by tensing your muscles). You'll hold your muscles tight and then slowly release the tension so it feels like a wave of relaxation pouring over your body. By tensing your muscles—a common anxiety symptom—and immediately relaxing them, over time, the symptom of muscle tension may become a signal to relax. How to Do Progressive Muscle Relaxation Behavioral Activation When people feel depressed or anxious, they may be less likely to do the things they enjoy. That's exactly why it is important to learn how to be more active. Behavioral activation is a CBT coping skill that helps you get more active, even when you might not be feeling it. The goal of behavioral activation is simple: Get more active in areas of your life that you find pleasurable and enjoyable. Being more involved with and engaged in these experiences improves your mood. As your mood improves, so will your thoughts and coping behaviors. Plus, being engaged in things you enjoy is a great way to distract yourself from feelings of rumination and anxiety. How to Instantly Lift Your Mood Listing Pros and Cons Making decisions can be hard, especially if you're having a hard time with negative thinking, anxiety, or depression. It might leave you feeling paralyzed or trapped. When this happens, you may not know the best choice. Or you might make decisions that aren't good for you in the long-term. One way to move forward in situations like this is to weigh the short—and long-term pros and cons. This cognitive coping strategy can help us identify the best path to take—that is, a path associated with less risk and consistent with our goals and priorities. Cognitive Restructuring Cognitive restructuring is a common CBT coping skill. How we evaluate and think about ourselves, other people, and events can have a major impact on our mood. This cognitive strategy focuses on identifying negative thoughts or evaluations and modifying them. Cognitive restructuring involves gathering evidence about certain thoughts and recognizing how they may be misinterpreted or distorted. Then, you work on systematically replacing them with more positive affirmations. By modifying our thoughts, we can improve our mood and make better choices regarding our behaviors. Positive Affirmations for Anxiety Setting and Managing Goals Goals (or things that you want to accomplish in the future) can give your life purpose and direction, as well as motivate healthy behaviors focused on improving your life. However, they can also be very overwhelming and a source of stress. Because of this, you want to be careful when setting goals. So, how can you put this CBT coping skill to use? Start by approaching your goals in a way that improves your mood and quality of life without increasing distress. This could be by setting smaller goals versus bigger ones, for instance, or breaking larger goals down into more manageable chunks. How to Set and Manage Goals Takeaways Sometimes, you just need a little extra help to manage the problems that life throws your way. That's when CBT coping skills come in handy. They can help you better handle and manage difficult emotions and situations. By changing how you interpret feelings and events, you'll feel better able to manage your emotions. If you are struggling with anxiety, stress, depression, or other challenges, CBT coping skills can be a great tool to help you start feeling better. However, if you aren't getting adequate relief from these approaches, talk to a mental health professional. Frequently Asked Questions What coping skills can CBT teach? CBT coping skills teach you how to better deal with difficult situations, such as how to relax your body (so your mind can also relax), also changing how you look at circumstances and events so you have more positivity. These processes use the same types of strategies like those used in cognitive behavioral therapy (CBT). Learn More: CBT Types, Techniques, and Benefits How do you improve cognitive skills? Regularly practicing cognitive coping strategies such as these can help improve your skills. It can also be beneficial to work with a mental health professional as they can focus directly on improving your CBT coping skills in the therapy session. Taking care of your physical health, such as through a healthy diet and exercise, can also help improve your cognitive health. Learn More: Types of Therapists and How They Help How can CBT coping skills help with anxiety? CBT coping skills such as cognitive restructuring can help change thought patterns that lead to anxiety. Other skills, like diaphragmatic breathing and progressive muscle relaxation, help relax your body when in an anxious state, thereby reducing your feelings of anxiousness. Learn More: Ways to Cope With Anxiety 9 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Psychological Association. Cognitive behavioral therapy (CBT). Nakao M, Shirotsuki K, Sugaya N. Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. Biopsychosoc Med. 2021;15(1):16. doi:10.1186/s13030-021-00219-w Hirano M, Ogura K, Kitahara M, Sakamoto D, Shimoyama H. Designing behavioral self-regulation application for preventive personal mental healthcare. Health Psychol Open. 2017;4(1):2055102917707185. doi:10.1177/2055102917707185 Ma X, Yue ZQ, Gong ZQ, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Front Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874 Toussaint L, Nguyen QA, Roettger C, et al. Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation. Evid Based Complement Alternat Med. 2021;2021:5924040. doi:10.1155/2021/5924040 Hirayama T, Ogawa Y, Yanai Y, Suzuki SI, Shimizu K. Behavioral activation therapy for depression and anxiety in cancer patients: a case series study. Biopsychosoc Med. 2019;13:9.doi:10.1186/s13030-019-0151-6 Crum J. Understanding mental health and cognitive restructuring with ecological neuroscience. Front Psychiatry. 2021;12:697095. doi:10.3389/fpsyt.2021.697095 Bailey RR. Goal setting and action planning for health behavior change. Am J Lifestyle Med. 2017;13(6):615-618. doi:10.1177/1559827617729634 National Institute on Aging. Cognitive health and older adults. By Matthew Tull, PhD Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit