The 'head-heart lag' in therapy

When you are working with a CBT therapist (or any other kind of therapist, for that matter), it's very common to understand why, say, it's not logical to think of yourself as a failure, but on a gut level that still feels true. This is known as the 'head-heart lag' – your head (logical self) understands something to be true, but your heart (emotional self) refuses to believe it. Although this can be frustrating, remember that it's a normal part of the therapeutic process – we must get our heads round something first, or how will we ever learn and then change it?

And, more importantly, just because something doesn't feel true at first, that doesn't mean it won't resonate with you at a deeper level as time passes. This also explains another common idea in cognitive therapy, that we often get better before feeling better - we are changing, growing, healing, even when we don't quite feel it yet. So if you are feeling stuck and frustrated at the pace of change in your therapy, remember that the most important thing is to first gain intellectual understanding of your problem and how to resolve it.

Let's take an example: The (common) idea that someone is entirely at fault for all the setbacks and problems they have experienced in their life. An idea like this often stems from a deeper belief, which may be something like, It's all my fault, or Bad things always happen to me. These beliefs were probably formed in childhood, so this person may have been thinking this way for decades. In order to change these (inaccurate) ways of thinking about themselves, they first have to become aware of these beliefs, then work steadily and persistently at modifying them and replacing them with more realistic, helpful and adaptive beliefs.

This process always starts with the intellectual understanding that the evidence doesn't really support such harsh or self-critical ideas. Only once someone has this understanding, and starts reinterpreting both their past and present experience, will it resonate emotionally – they begin to truly believe, at a gut level, that they are not such a bad person after all. And then they can start to feel better – hopefully lighter, more cheerful and optimistic. The heart has caught up with the head and real change has occurred.

So, if you are in therapy or trying to make changes in yourself, remember that such change takes time, patience and persistent effort - keep at it and you will soon start to feel better. If you would like to book a session with me please call 07766 704210 or email

Best wishes,


Tags: CBT, Cognitive Therapy