Sandra Paolini is a psychotherapist, coach, and trained Immunity to Change™ facilitator with more than twenty years of experience helping people understand and change persistent patterns. Her work integrates the Immunity to Change™ mapping process with evidence-based psychological approaches and mind-body practices.

The Benefits of Knowing What You’re Up To

Ever catch yourself predicting a negative future, assuming someone’s judging you, or thinking in all-or-nothing terms?

These are just a few examples of the kinds of habitual thought patterns that modern psychotherapy refers to as distortions: automatic loops that can keep us anxious, stuck, or reactive.

Thinking is one of the most familiar — and least questioned — things we do.

We use it to plan, explain, predict, rehearse, and communicate.

And perhaps most interestingly, we tend to assume our thoughts are about reality — that they’re accurate, meaningful, and true.

But at a certain point — maybe even right now — you might start to wonder: What is this constant stream in the background of my life?

Is it helping? Hindering? Is it even necessary in the moments I reach for it most?

And is there a cost to assuming that thinking is always the path to clarity?

Recognizing your own mental shenanigans can be surprisingly powerful — if you know what to do with what you find.

Let’s take a brief look at how modern psychotherapy and ancient insight traditions approach the concept of thinking — and then I’ll offer something else to consider.

The Roots of CBT: From Psychoanalysis to Practical Tools

Psychotherapy has spent decades trying to understand this inner stream;  to map it, diagnose it, and help people suffer less because of it.

One of the most influential efforts: Cognitive Behavioral Therapy.

This theory didn’t emerge in a vacuum. It was born in the mid-20th century as a deliberate break from psychoanalysis — the dominant therapeutic model at the time.

In the 1950s, Aaron T. Beck, a psychiatrist trained in Freudian theory, was working with depressed clients.

He expected to uncover hidden conflicts, repressed wishes, and unresolved childhood material,  but instead, he kept encountering something else: a stream of harsh, automatic thoughts. “I’m worthless.” “Nothing will ever work out.” “I always mess things up.”

These weren’t buried in the unconscious. They were right there on the surface, shaping emotion and behavior in real time.

Rather than interpret them symbolically, Beck began working with them directly.

He encouraged clients to identify, examine, and challenge their thoughts,  and noticed something radical. Their symptoms started to improve.

In 1967, Beck formally published Depression: Clinical, Experimental, and Theoretical Aspects, laying the groundwork for what he called Cognitive Therapy, a practical, structured approach that focused on distorted thinking patterns as the primary cause of emotional suffering.

Around the same time, Albert Ellis was developing Rational Emotive Behavior Therapy (REBT), which emphasized irrational beliefs and rigid self-demands.

While Ellis’s approach was more confrontational, both men were pioneering a new wave of behavioral therapy, one that moved away from analysis and toward direct engagement with the thinking mind.

By the 1980s, behavioral strategies (like exposure therapy and reinforcement) merged with these cognitive models to form CBT as we know it today — the most widely taught, researched, and reimbursed modality in the field.

What CBT Gets Right

Let me be clear: CBT has helped many people, including myself.

It gave many of us something psychoanalysis rarely offered: tools. A way to track what’s actually happening, name it, and interrupt it.

It brought structure. It made the therapy room a more collaborative space. It translated vague emotional experiences into patterns we could observe.

And for people who live in their heads (which is most of us, thanks to culture, education, and social conditioning), it felt like home.

That moment of naming something — of seeing a distorted thought for what it is —offered a kind of relief. A shift in perspective. A sense that there’s something you can control and manage.

And in a system that often makes people feel pathologized, overwhelmed, or helpless, CBT offers a map and a direct way to track what’s happening.

But it also does something more subtle — and less helpful. It reinforces the idea that your mind is the problem and that if you can just get it working correctly, everything else will fall into place.

The Core Problem: How Fix Reinforces the Frame

CBT offers a process that feels like progress.

But even with all its strengths, CBT rests on an underlying assumption that’s easy to miss and harder to escape: If you change your thoughts, your emotions and behaviors will follow.

Here, the unspoken corollary assumes that your thoughts are the problem, and better thoughts are the solution.

For example, if you feel anxious, hopeless, or stuck, the model suggests your thinking is faulty.

But that approach subtly pathologizes normal human experience.

It treats difficult thoughts and emotions as if they are mistakes to be fixed — not weather to be moved through.

And worse, it reinforces the very thing it’s trying to address: The belief that managing, controlling, or being distracted from thinking is the royal road to freedom.

That’s the mental habit so many of us already live inside, believing that if we could just think better, we’d feel better.

That our suffering is a thinking error.

That there’s a more “rational” way to be human.

That’s where CBT starts to fall apart —when the very tool you’re using to break the pattern ends up reinforcing it.

And that’s when newer third-wave cognitive behavioral therapies, like ACT, begin to widen the frame.

ACT: A Shift in Direction (But Not All the Way)

Acceptance and Commitment Therapy (ACT), first developed by Steven C. Hayes in the 1980s, was a response to the limitations of traditional cognitive approaches.

Rooted in Relational Frame Theory, ACT doesn’t try to correct thoughts. It works on changing your relationship to them.

While CBT teaches you to identify, challenge, and reframe negative thoughts as cognitive errors to be corrected, ACT takes a different approach.

It doesn’t fight with thoughts at all. Instead, it offers tools that help you observe thoughts without getting entangled in them.

This is known as cognitive defusion, and it includes practices like:

• Prefacing a thought by saying, “I’m having the thought that…” to create distance
• Imagining the thought in a silly voice
• Visualizing it as a leaf floating down a stream

These aren’t gimmicks. These are ways to see thoughts as what they are: temporary mental events, not absolute truths.

Where CBT aims to change your thoughts, ACT helps you create distance from them so they no longer run your life.

ACT encourages acceptance — not in the sense of resignation, but in the sense of allowing thoughts and feelings to come and go, without letting them dictate your actions.

This shift is subtle but profound. It de-pathologizes thinking. It dissolves the need to reframe everything. And it re-centers the work not on fixing the content of your mind, but on freeing yourself from fusion with it.

In this sense, ACT has far more in common with Buddhist psychology than with traditional CBT.

Buddhism Was Already There

Long before modern psychotherapy started working with thoughts, Buddhist traditions were pointing beyond them.

Not just to different thoughts — or more rational ones — but to a different mode of being entirely.

In Buddhism, the mind is understood as the generator of conditioned phenomena, including stories, labels, predictions, and judgments. But these aren’t seen as problems to be fixed — they’re seen as empty (śūnyatā). Not just untrue, but lacking independent reality. They arise, they pass. They’re not who you are.

You’re not asked to debate them, replace them, or improve them.

You’re asked to see through them — and, eventually, to let go of the whole mechanism.

The goal isn’t “returning to the present moment.” It’s dissolving the very identification with thought as self.

From this vantage point, even insight can be seen as subtle grasping — a kind of “better thought” still caught in the web of mental formation.

And yet, many of us are not monks. We live in the world. And we need a way to step back from thought without needing to renounce the whole game.

Maybe there’s a middle ground — one that blends the best of modern psychological theory with a deeper spiritual dimension.

And one that remains accessible to anyone, regardless of background or belief.

That’s the territory I’ve been exploring for decades.

And it leads us to one of the biggest blind spots in psychological traditions.

The Real Blind Spot: The Body Isn’t Even in the Room

Even with ACT’s emphasis on awareness and acceptance, the body often remains on the sidelines.

CBT rarely mentions the body at all.

And even mindfulness-based therapies, which claim to emphasize “present moment awareness”,  often keep the work in the head, asking clients to notice or name body sensations, but never truly enter them.

However, from my perspective, this misses the mark.

Because many of the most persistent thought patterns — especially the ones that never respond to reframing or defusion-  aren’t mental to begin with.

They arise from subconscious imprints left behind in the body. From patterns stored in the nervous system, the fascia, and the breath.

In yogic and subtle-body traditions, these are known as samskaras — energetic residues of lived experience that shape perception long before a conscious thought appears.

These imprints don’t yield to logic.
They don’t respond to reframing.
And they’re not visible through inquiry.

But they do begin to release through the cultivation of willingness, acceptance, and self-compassion — qualities that allow you to stay with embodied experience long enough for a shift to happen.

Not through effort or analysis, but spontaneously and effortlessly, without the direction of thought.

And when these tensions begin to unwind, through practices like Yoga Nidra, breathwork, or subtle-body awareness, we discover that the thought never had to be confronted. It simply stops arising with the same charge.

This is a different order of change.
It’s not cognitive or emotional, but rather, energetic.

Unfortunately, the very idea of energy work remains largely off-limits in traditional psychotherapy, where discussions of energy are either dismissed or repackaged into clinical language that avoids the very territory where transformation actually occurs.

What Happens When We Stop Trying to Fix?

Over the years — both in my own experience and in my work with clients as a psychotherapist and coach, I began to see the limits of staying in the head.

No matter how many insights someone had, or how well they could identify their cognitive patterns, something deeper remained untouched. The old thoughts would keep showing up. The body would stay braced. The loop would continue,  just with a new language.

This is where my work began to shift.

I stopped trying to change thoughts.

I started noticing the impact they had on the body; the subtle tightening, bracing, or shutdown that would follow certain beliefs.

And I saw that the most meaningful shifts didn’t come from reframing or insight.

They came from staying with the raw sensation underneath the thought — and being willing to feel what had never been fully felt.

That’s not mindset work. It’s subtle-body technology. 

It’s learning to be in your life — without defaulting to thought as the master interpreter of everything.

Final Thought

CBT is helpful for learning to identify, challenge, and reframe the loop.

ACT is helpful for learning to step outside of it.

And for those drawn to a deeply spiritual path, Buddhism offers profound insight into the nature of mind, and the possibility of resting in something beyond it.

My work might be considered a middle ground.

It’s based on the understanding that the mind and body aren’t separate — and that patterns often live in both.

Rather than approaching change solely through thoughts or insight, it invites a fuller, more embodied process that includes sensation, energy, and awareness.

One that honors psychological clarity while also allowing for something deeper to unfold.

Real change often begins not with fixing the thought, but with listening to what the body has held in silence for years.

Want more like this?

Subscribe to The Change Lab — my weekly newsletter on breaking loops, retraining patterns, and discovering what’s possible when mind, body, and energy align.

No fluff. No psychobabble. Just honest insight and practices that actually change things.

Subscribe now!