Psychotherapy helped Robert understand how his relationships, professional stress, and societal pressures were intricately linked to his sleep issues. A comprehensive biopsychosocial mapping process helped him see his hyperarousal not just as a personal ailment but as an understandable outcome influenced by a myriad of internal and external factors.
Incorporating Cognitive Behavioural Therapy for Insomnia (CBTi) into his therapeutic journey, Robert began to address the cognitive and behavioural aspects contributing to his sleep disturbances.
CBTi techniques, such as challenging unhelpful beliefs about sleep and establishing a consistent sleep-wake schedule, empowered him to tackle insomnia with evidence-based strategies.
Simultaneously, Robert engaged in circadian rhythm realignment, adjusting his daily routines and exposure to natural light to reinforce his body’s natural sleep-wake cycle. This approach complemented the CBTi interventions, providing a holistic strategy for enhancing sleep quality.
Psychotherapy and CBT-i both help with sleep, but they do it in different ways.
Psychotherapy is a longer-term process where we explore what’s happening beneath the surface – your emotions, patterns, relationships, and past experiences. It helps you understand why you might be struggling and supports change that touches every part of your life, not just your sleep.
CBT-i (Cognitive Behavioural Therapy for Insomnia) is more structured and focused specifically on improving sleep. It works by changing the thoughts and behaviours that keep you awake, using evidence-based tools and practical strategies. It’s often short-term and results-driven, designed to help you rebuild healthy sleep patterns.
In practice, I often combine these approaches – using the structure and effectiveness of CBT-i alongside the depth and reflection of psychotherapy – so you get both immediate support for your sleep and lasting change for your overall wellbeing.
Psychotherapy:
Facilitates open exploration of any issue you introduce, including insomnia. The therapeutic trajectory spans various personal concerns, memories, emotions, and patterns.
CBTi:
An action-driven therapy exclusively targets insomnia, reworking the dialogue, beliefs and actions regarding sleep.
Goal orientated or not?
In psychotherapy, the primary aim is holistic, aspiring for overall well-being, enriched self-understanding, conflict resolution, or enhanced relationships. Sleep improvement is a beneficial by-product – the reasons for sleep issues often have profound roots.
CBTi, the primary goal is explicit: enhancing sleep quality and duration.
Duration:
Psychotherapy: Sessions can be indefinite, extending as long as you feel necessary.
CBTi: Usually short-term, 8-10 weeks.
Circadian realignment: individual responsiveness to these interventions can vary.
Evidence Base:
Psychotherapy: I have a masters in a mindfulness-based modality with further training in trauma, acceptance, breathwork and body-focused practices. Each of these areas has a body of research supporting its use in therapeutic settings.
CBTi: the gold-standard recommended therapy for chronic insomnia, fortified by substantial empirical evidence.
While traditional psychotherapy extends insights and relief across a spectrum of psychological challenges, including sleep issues, CBTi emerges as a specialised, structured, and evidence-grounded approach devised explicitly for insomnia.
Homework:
Psychotherapy: While I may suggest tasks or reflections, it’s not a staple component.
CBTi: Assigning homework is essential. You may need to maintain sleep diaries, adhere to specific sleep schedules, or undertake specific practices.
Strategies & Techniques:
Psychotherapy: Unstructured as it unfolds in response to what you might bring, for example, trauma, addiction, familial backgrounds, or other profound concerns.
CBTi: Employs specialised techniques, including sleep restriction, stimulus control, cognitive restructuring regarding sleep beliefs, relaxation training, and sleep hygiene education.
My approach is flexible and responsive – we start from where you are. Sometimes that means focusing on practical steps and specific sleep strategies; other times, it’s about going deeper to understand what sits beneath the surface.