Cognitive therapies in adults

Origin of cognitive therapy

Cognitive therapy (CT) was developed by American psychiatrist Aaron T. Beck in the 1960’s. Cognitive therapy seeks to help overcome emotional difficulties by identifying and changing dysfunctional thinking, negative emotional responses and subsequent unfavorable behavior stemming from them. This process involves helping clients develop skills to modify beliefs, identifying distorted thinking and relate to the environment in newer and different ways.

Role of thoughts

Cognitive counsellors say faulty thinking is a source of emotional dismay and unproductive behavior. Different events occur in each person’s life; some are positive and accomplishing while many may be negative and traumatizing. Positive ones do not damage thinking in any way however negative ones like loss, disappointment and failure to achieve valued goals can have lasting impressions. Cognitive therapists believe that people who are able to think effectively about their experiences are able to put negative events in perspective but those who do not reason with them tend to perseverate on negative happenings and allow them to disrupt happiness and effectiveness for the future.

Cognitive therapy constructs

Cognitive therapy is structured and demands a level of intelligence in the client to accept, introspect and mitigate personal change. Therapy tests the assumptions and identifies how unquestioned thoughts may be distorted, unrealistic and unhelpful. These are challenged and opposed. Once those thoughts have been confronted, the individual’s feelings about the subject matter of those thoughts are more easily subject to change. Beck identified several patterns of erroneous thinking some of which can be described below:

  • Selective Abstraction: focusing only on certain details while ignoring others
  • Dichotomous thinking: believing that everything is either good or bad, black or white
  • Overgeneralization: Arriving at far reaching conclusions on the basis of little data
  • Magnification: Overestimating the importance of an event when it is unreasonable
  • Arbitrary inference: Drawing conclusions that things are very bad with no evidence
  • Personalization: Viewing events as related to oneself when they are realistically not

Mood repairing strategy of CT

CT works where we see that mood has been wrongly wired and we need techniques to ‘repair’ this faulty wiring. If an individual fails in a job interview, he or she may believe: ‘I am no good for this job, I will never be hired!’ This triggers faulty reorganization of thinking, alters emotions and subsequent behavior in all situations. It reinforces the belief in the person that he or she is ‘useless’ and can do nothing right in life (although it was triggered by a one-time failure in an interview). Further on adaptive responses become unlikely. This reinforces the original belief of being ‘useless’. Thus a ‘self fulfilling prophecy’ or negative cascade begins. The mood needs to be ‘repaired’ by cognitive restructuring.

Cognitive Counseling Process

Cognitive restructuring is a mechanism for facilitating change. The first step is to have the person describe the stressful situation in his or her life and to identify the faulty thinking that underlies the undesirable feelings. The counsellor identifies the automatic negative thoughts and silent assumptions to identify fallacies in perception, inaccuracies in information and redundancy of the self-defeating behavior. The individual’s goal of becoming more effective in managing troublesome aspects of his or her life becomes clearer. The individuals goes back into their world and behave differently, by implementing newly discovered thinking or by experimenting with finding new information about their beliefs relating to themselves or others. Scientific problem solving, with the client as an active participant, leads to changes in a relatively short time and assures long term wellness. Man has the highest cognitive functional ability. Yet man is the one animal who uses this for one’s own peril. Cognitive restructuring is the path to peaceful living.

Cognitive distortions

These are ways in which thinking gets twisted and negativity ensues.

  • Magnification-Minimization
  • Labeling and Mislabeling
  • Personalizing and blaming
  • The ‘should’ absolutism
  • Mind reading/ Fortune telling
  • Filtering and Disqualifying

Where CT works

Cognitive restructuring can offer help in these conditions:

  • Addictions and substance use
  • Specific fears and phobias
  • Social anxiety and phobia
  • Suicidal ideation
  • Depression and Dysthymia
  • Adjustment problems
  • Relationship problems
  • Sexual dysfunction
  • Impulse control disorders
  • Anger and aggression
  • Personality disorders

Frequently Asked Questions

What is CBT?
CBT or Cognitive-Behavior-Therapy is a form of cognitive restructuring exercise in which the therapist aims to correct faulty cognitions and at the same time target the behaviors that lead to negative outcomes. Combination therapy is used by most therapists today.

Frequently Asked Questions

What is this latest perfectionist-pessimist debate?
The desire for perfection stems from the thought of wanting things in a specific manner. When the perfectionist encounters a small setback, he or she perceives it as a much bigger failure owing to the cognitive distortion and develops pessimism. CT helps one learn of distortions and successfully eliminate them in order to build realistic optimism.