Two Arrows
It’s the second and subsequent arrows that cause “suffering”
Context
The process in CBT4T consists of FOUR elements that reflect the Stages of Change:
Element 1: Preparation (Build strong foundations)
Element 2: Moving forward (Action: Making Changes)
Element 3: Meaning & Belief (Action: Meaning & Beliefs)
Element 4: Consolidation & Completion (Maintaining changes)
I intend to cover Element 1 in future articles. It is, after all, foundational to all that is built upon it.
However, the first “Cognition tool” used in the CBT4T process is the Two Arrows exercise (Element 2: Stage 4B Section “Cognitive Fusion 2”). I have chosen to include it as an early CBT4T Substack post for three main reasons:
The Two Arrows exercise is frequently described by those using the CBT4T programme as having “a lightbulb effect”
The Two Arrows concept also lends itself well to those “suffering” with tinnitus due to the wide use of the word within the tinnitus community, for example: “tinnitus sufferer”, “suffering from tinnitus”
How we experience an event (our emotional response) is “Second Arrow”; only the event itself is “First Arrow”. The First Arrow is rarely a choice, because it is an experience that happens to us. Second and subsequent arrows, however, are LEARNED RESPONSES that we can TRAIN OURSELVES TO CHANGE
There are three types of response we can have to an event
Pleasant
Unpleasant
Neutral
Two Arrows Explained
The Two Arrows teaching purportedly comes from the teachings of Buddha some two thousand years ago, where the First Arrow (the event) is pain; the Second Arrow (unpleasant response) and subsequent unpleasant “arrows” is suffering.
Watch and listen to the following YouTube video that explains it well:
Distress Tolerance & Pain Without Suffering
After watching the video
You can write about and send in an example of a recent experience that you now realise may have led to “Second Arrow” suffering. Your example can be related to tinnitus, but it can be any recent experience that caused you to feel ‘unpleasant’ emotions (2nd and subsequent arrows).
Two Arrows Practice Exercise (Click the link to go to the exercise in the CBT4T website)
Note: After you press Send, you should receive a copy of what you have sent by return email. Please check your Spam email if it doesn't arrive in your inbox.
A Note for CBT4T Users already enrolled*
*You may be beyond this stage in the CBT4T course! If so, perhaps you would leave a comment below this article about the Two Arrows exercise - for example, what help did it give you when you were in Stage 4; what has its impact been since continuing to later stages in the CBT4T process? REAL EXPERIENCES are important - thank you!
Some additional links that may be of interest
To view the CBT4T full programme Outline: https://courses.tinnituseprogram.org/cbt4t-2025
To view CBT for Tinnitus Distress for Audiologists, Hearing Therapists (soon to be updated) https://courses.tinnituseprogram.org/cbt-for-tinnitus-distress
To view CBT for Tinnitus for Advisors & Support Workers (soon to be updated) https://courses.tinnituseprogram.org/tinnitus-advisors