Research on Cognitive Behavioral Therapy: Changing Core Beliefs

BY NICOLE LAU

The Psychology of Internal Locus: Why Most Suffering is Optional

Cognitive Behavioral Therapy (CBT) is one of the most evidence-based approaches for shifting from external to internal locus. CBT works by identifying and changing core beliefs - the deep assumptions about self, others, and world that shape our experience. When core beliefs are conditional ("I'm only valuable if I succeed"), they create external locus. CBT helps restructure these into unconditional beliefs ("I'm inherently valuable"), supporting internal locus.

The Cognitive Model

Core Premise: Our thoughts, not external events, determine our emotional and behavioral responses. By changing thoughts, we change feelings and behaviors.

Three Levels of Cognition:

1. Automatic Thoughts: Surface-level thoughts that pop up in situations

2. Intermediate Beliefs: Rules, attitudes, assumptions ("If I fail, I'm worthless")

3. Core Beliefs: Deep assumptions about self, others, world ("I am worthless")

Connection to Locus: Core beliefs about self-worth determine locus. Conditional core beliefs = external locus. Unconditional core beliefs = internal locus.

Common Core Beliefs Creating External Locus

Helplessness Theme:

- "I'm powerless"

- "I'm inadequate"

- "I'm a failure"

These create external locus by locating control and worth outside yourself.

Unlovability Theme:

- "I'm unlovable"

- "I'm defective"

- "I'm not good enough"

These create external locus by making worth conditional on others' approval.

Worthlessness Theme:

- "I'm worthless"

- "I don't matter"

- "I'm bad"

These are the value vacuum - complete external locus with no perceived worth.

CBT Techniques for Changing Core Beliefs

1. Identifying Core Beliefs

Downward Arrow Technique: Start with automatic thought, keep asking "What does that mean about me?" until you reach core belief.

Example: "I failed the test" → "What does that mean?" → "I'm not smart" → "What does that mean?" → "I'm worthless" (core belief)

2. Examining Evidence

Socratic Questioning: "What's the evidence for and against this belief?"

Often reveals that core belief is not supported by evidence - it's an assumption, not fact.

3. Behavioral Experiments

Testing Beliefs: Design experiments to test whether core belief is true.

Example: If belief is "People will reject me if I'm authentic," experiment with being authentic and observe actual responses.

4. Developing Alternative Beliefs

Creating Balanced Beliefs: Replace extreme conditional beliefs with balanced unconditional ones.

Old: "I'm only valuable if I succeed"

New: "I'm inherently valuable. Success is nice but doesn't determine my worth."

5. Core Belief Worksheets

Systematic Restructuring: Rate belief strength, list evidence for/against, develop alternative, rate new belief strength. Track over time.

Research Effectiveness

Meta-Analyses Show:

- CBT is highly effective for depression, anxiety, and many other conditions

- Effects are durable - gains maintained long-term

- Works by changing core beliefs, not just symptoms

- Comparable to medication for many conditions, without side effects

Mechanism Studies: CBT works by changing core beliefs. When core beliefs shift from conditional to unconditional, symptoms improve. This is shifting from external to internal locus.

Schema Therapy: Deep Core Belief Work

Jeffrey Young extended CBT to focus specifically on core beliefs (schemas):

Early Maladaptive Schemas: Deep patterns formed in childhood that create suffering. Many involve conditional worth (external locus).

Schema Modes: Different states we shift between. "Vulnerable Child" mode often holds external locus beliefs.

Schema Therapy Techniques:

- Imagery rescripting (healing childhood experiences that created schemas)

- Limited reparenting (therapist provides what was missing)

- Chair work (dialoguing between modes)

Research: Schema therapy particularly effective for personality disorders and chronic depression - conditions with deeply entrenched external locus patterns.

Neuroscience of Cognitive Change

Brain imaging shows CBT changes the brain:

Before CBT: Hyperactive amygdala, underactive prefrontal cortex

After CBT: Normalized amygdala activity, increased PFC activity

This shows CBT creates neuroplastic changes - the brain literally rewires from external to internal locus patterns.

Why This Matters

CBT research matters because:

1. It's the most evidence-based therapy. Decades of research validate CBT's effectiveness across conditions and populations.

2. It directly addresses locus. CBT explicitly works to change core beliefs from conditional (external locus) to unconditional (internal locus).

3. It's teachable. CBT techniques can be learned and self-applied. You don't always need a therapist.

4. It creates lasting change. By changing core beliefs, CBT creates structural change, not just symptom relief.

The Bottom Line

Cognitive Behavioral Therapy is one of the most effective approaches for shifting from external to internal locus. CBT identifies conditional core beliefs ("I'm only valuable if...") and systematically restructures them into unconditional beliefs ("I'm inherently valuable"). Research validates CBT's effectiveness, showing it changes both symptoms and underlying core beliefs. And neuroscience shows it creates brain changes. This is evidence-based cognitive restructuring from external to internal locus.

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This concludes the initial therapeutic modalities research of Part III.

The Psychology of Internal Locus series explores why most psychological suffering is optional and how internal locus of value prevents it at the root cause.

— Nicole Lau, 2026