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Cognitive Behavioural Therapy in Mississauga

Pathways Counselling & Life Coaching Centre in Mississauga strives to provide effective therapy to help you deal with emotional and behavioural issues. The types of therapy offered at our centre include:

CBT (Cognitive Behavioural Therapy)

CBT Cognitive Behavioural Therapy (CBT) is a focused approach to the treatment of many types of emotional, behavioural and psychiatric problems. The application of CBT varies according to the problem being addressed, but is essentially a collaborative and individualized program that helps individuals identify unhelpful thoughts and behaviours and learn or relearn healthier skills and habits. CBT has demonstrated effectiveness with a variety of emotional psychological and psychiatric difficulties.

Cognitive Behavioural Therapy (CBT) is a short-term approach (usually 8-20 sessions) that emphasizes the importance of thinking in determining our emotions and actions. The basic principle of CBT is that the way a person thinks has a powerful effect on his or her feelings and behaviour.

CBT focuses on the relations among a person's thoughts, feelings, and behaviours. It also addresses the role those thoughts, feelings, and behaviours play in a person's symptoms, daily functioning, and quality of life in order to help bring about a positive emotional and behavioural change.

Thoughts, Feelings, and Behaviour
Through CBT, you will learn to understand the relations among what you are thinking, feeling, and doing. Most people agree that what we do affects how we feel and what we think. For example, if we succeed at something, we feel good and think, "I'm a winner!" If we fail, we feel bad and think, "I'm a loser!" The more we avoid and withdraw from doing, the worse we feel, which usually leads to more social withdrawal, avoidance, and apathy.

In CBT sessions, you will spend time talking about your feelings. The presence of strong feelings usually means that the discussion is about something important. However, in CBT we do not challenge emotions. Feelings just "are." Feelings are "true." In contrast, thoughts, assumptions, beliefs, and behaviours can be challenged and changed.

CBT focuses on the here and now, rather than on the past. You and your therapist may spend some time discussing your past in order to better understand your current problems. However, the primary emphasis will be on helping you to overcome your current difficulties.


DNMS is a therapeutic approach based on what is known about how a child's brain develops within a healthy family. It was designed to treat present-day problems that originated with unmet childhood needs. The DNMS has been found helpful in treating depression, anxiety, panic disorder, social phobias, substance abuse, complex post-traumatic stress disorder, relationship problems, obsessions/compulsions, sexual abuse, eating disorders, dissociative disorders, borderline personality disorder, sexual addiction, self-injurious behavior and complicated grief. It has also been used to resolve memories of painful physical, emotional, or sexual traumas that were inflicted by a person.

The DNMS is based on the assumption that the degree to which developmental needs were not adequately met is the degree to which a client is stuck in childhood. It starts by guiding clients to establish three internal Resources: a Nurturing Adult Self, a Protective Adult Self, and a Spiritual Core Self. Together these Resources gently help wounded child ego states get unstuck from the past by meeting their unmet developmental needs, helping them process through painful emotions, and by establishing an emotional bond. Alternating bilateral stimulation (made popular by EMDR therapy) is applied at key points in the process. The DNMS focuses special attention on healing maladaptive introjects (ego states that mimic abusive, neglectful, or dysfunctional caregivers). Since these wounded ego states cause the most trouble for clients, their healing results in a significant benefit. As introjects heal, clients report unwanted behaviours, beliefs, and emotions diminish.

How Does the DNMS Work?
The strengths or weaknesses in a relationship between a parent and a child will affect the development of the child's brain. Loving, attuned caregivers will positively influence the way a young brain develops the neural pathways that facilitate the self-regulation of emotions. When present, these neural pathways ensure that a child will be able to explore the world, separate from parents, and mature in healthy ways. If these neural pathways are not formed, or not formed well enough, a child will grow up feeling insecure, and the development of normal behaviours (play, exploration, and social interactions) may be impaired. DNMS therapy appears to construct - in wounded adults - the neural pathways for the regulation of emotions that should have been formed in childhood. After DNMS therapy, clients report feeling more integrated and whole, and better able to manage their emotions.

Before the DNMS begins, wounded child parts, who are isolated and stuck in the past, suffer with painful issues from unresolved childhood wounds. During the DNMS, they make a healing connection with loving, attuned Resources who are grounded in the present. When the healing is complete, the child parts report feeling totally unstuck. As they interact with the Resources they too come into the present moment. The resulting emotional repair may be accomplished by neural integration.


EMDR is an innovative clinical treatment that has been successful in helping individuals who have survived trauma, including sexual abuse, domestic violence, combat, crime, and those suffering from a number of other complaints including depressions, addictions, phobias and a variety of self-esteem issues.

EMDR - Eye Movement Desensitization and Re-Processing
EMDR was developed by Dr. Francine Shapiro in 1987, who noticed that while walking down a boulevard, looking right and left at the trees, she was able to reduce the intensity of some disturbing thoughts that she was experiencing. She went on to study this effect and do research on the technique that she subsequently developed. She reported her successful treatment of trauma victims in the Journal of Traumatic Stress, in 1989. Since that time, it has been well researched and used by therapists all over the world.

How Does it Work?
It is not known exactly how EMDR works, but there are a number of theories about this. We know that when someone is extremely upset, the brain does not process incoming information or make decisions as usual. People often feel that they 'freeze' or panic. Sometimes they just feel the feelings, but can't make logical decisions about what to do. Or, they might act in an automatic, almost robotic, way to deal with the situation, but find that they do not experience their feelings.

EMDR seems to allow the person to remember, but not to re-experience the distress, in a safe environment, allowing them to view it and process it more calmly.

It may function in the same way that sleep does - in rapid eye movement (REM) sleep, our eyes go back and forth. We often find that a difficult decision can be made more clearly after we 'sleep on it'.

It may assist the left and right sides of the brain to communicate about, and thus process, trauma.

Having past trauma is like having a very messy drawer - clothes jump out at you when it is opened a crack. EMDR seems to neatly press and fold the clothes, so that they now fit in the drawer and it can be opened when the person chooses to do so - they don't jump out unbidden.

The Process of This Therapy
One or two sessions are usually needed to assess the situation and make sure that EMDR is the appropriate treatment. It is difficult to say exactly how many sessions will be needed, as it depends on the type of trauma, and the client's previous experience. Many clients take 3 to 10 sessions of EMDR to clear the trauma, but it may also be used with other forms of 'talk therapy' and skill building strategies. For more complex problems, the therapy takes longer.

About the EMDR Session
The therapist and client decide what will be the focus of the session. They determine the details of the disturbance - what was seen, felt, heard etc. - and what beliefs the client still holds about themselves related to this event. Then the desensitization is started using bilateral stimulation - either using eye movements, sound (back and forth between the ears), or alternate tapping on the back of the clients' hands. The client focuses on the event and notices what comes to mind. The trauma is reprocessed in the client's own unique way, based on their values and experiences. There is no right or wrong way for clients to do this. Eventually, the memory is less disturbing and the person comes to change the negative belief that they held about themselves. Throughout the session, strong emotions may come up, but at the end of the session, most people say they feel much less distressed.

Does it Work?
Many studies have shown that it is an effective technique - for example, the Journal of Consulting and Clinical Psychology, December 1995, published research by Wilson, Becker and Tinker showing successful treatment of 80 subjects with post-traumatic stress syndrome. Further research can be found on the EMDRIA website.

EMDRIA is a non-profit international organization whose primary objective is to 'establish, maintain, and promote the highest standards of excellence and integrity in Eye Movement Desensitization and Reprocessing practice, research and education'.

What Problems Does EMDR Treat?
EMDR relieves many kinds of psychological distress:

  • Post-traumatic stress
  • Panic attacks
  • Performance anxiety
  • Phobias
  • Complicated grief
  • Stress reduction
  • Dissociative disorders
  • Addictions
  • Past sexual and/or physical abuse
  • Anxiety disorders
  • Disturbing memories

ImTT (Image Transformation Therapy)

Image Transformation Therapy is a new approach to resolving emotional challenges. Image Transformation Therapy (ImTT) uses a breathing and visualization technique to release feelings and clear out negative memories. Using ImTT involves the following two basic, simple ideas: One, feelings of pain and fear underlie all emotions such as guilt and shame and, two, memories can be cleared with a simple breathing/visualization protocol. The result is that traumatic memories and feelings of guilt, shame, pain, and fear can be gently and easily released. The unique advantage of this approach over other therapies is that the intense feelings of pain, fear, guilt, and shame do not have to be experienced to be released.

Images in the mind are considered to be the origin of people's behaviour. The definition of "images" includes memories of events, beliefs, and conscious and unconscious fantasies that are strongly held. The goal of lmTT is to change feelings and behaviours by removing destructive and dysfunctional images. Images linked with pain or terror are usually not easily changed by addressing them directly. The pain and terror that energizes the images must be released first. ImTT works by releasing the pain and terror linked with the images. Then the images are deconstructed. The result is an effective and reliably permanent change in the feelings and behaviours previously linked with the now deconstructed image.

ImTT Basics

  • Negative events create pain and terror (P/T) related images.
  • The images include memories, feelings, and beliefs that are created by the negative events and that are energized by the P/T.
  • The Pain/Terror Release Technique (P/TRT) releases the P/T underlying the negative memories, feelings, and beliefs.
  • When the P/T is released, the images will lose power and can be deconstructed.
  • The Image De-construction Protocol releases the image.
  • The negative feelings and dysfunctional behaviour will automatically begin to disappear.

Stages of Change
Unprompted healthy, functional behaviour will emerge naturally, providing the self with abundant evidence for spontaneous and positive feelings about the self and the world. The amount of change that occurs after doing lmTT depends on how much the image has influenced a person's behaviour. On the one hand, a person may experience relatively small emotional repercussions from the loss of a recently acquired job or relationship because the sphere of influence of the affected feelings and behaviours is limited. On the other hand, if the image-creating event occurred many years earlier or if a person's response to the event was intense, far-reaching, and resulted in a significant behaviour change, then releasing the image may result in a significant change in behaviour and feelings.

The most obvious effect of ImTT treatment is that a person no longer has any intense negative reaction to the memory of the event or its representative image. The image diminishes in intensity, loses its "gripping" quality, and no longer preoccupies a person's feelings or memories.

The second result is less immediately obvious because painful events vary in their foundational importance. For example, if a person experiences a significant negative event during their teenage years, many feelings/thoughts/behaviours may have been driven by the image of that event. When the image is released, the driving force behind those feelings/thoughts/behaviours is no longer present.

A consequence of the releasing of a foundational image is that the person may feel unmotivated for several days. The motivation to do old behaviours has been eliminated, but not enough time has passed for new behaviours to emerge. For a few days after the image has been released, the person may feel tired and have no desire to do anything. There is often sadness and/or grief or regret about choices made and lost years because of the negative event. This occurs because, without the image and the psychological patterns driven by the image, the person can examine his behaviour through a different lens.

While the new feelings and behaviours are emerging, the person experiences something wonderful, a feeling of expansion and growth. The feeling has been described as a release from an unknown bondage and a new, deeper sense of a self with feelings and wants more truly aligned and more freely expressed than previously. Awareness of this experience is most acute in the first few weeks. After a few weeks, the most obvious changes have taken place and have become a predictable part of a person's repertoire, and the new way of looking at the inner and outer world has normalized to the extent that the person takes for granted the changes and new behaviour.

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