Theories of Counseling-Cognitive Therapy

The following information on Cognitive Therapy is mostly from Wikipedia, which provides a wonderful overview, and is a great place for those curious about Cognitive Therapy to start their work.

I have been weaving basic information from cognitive therapy, although I indiscriminately call it cognitive behavioral therapy too, throughout my work in domestic violence and anger management classes for years.

In order to make it very clear about who or what causes a client to perceive a certain way, I ask them where they see me.

Most are very confused, until I explain that their experience of vision happens in the back of their brain.

We follow this same train of thought through the other sensory systems, all of which are processed and interpreted in the brain.

Then I tell them that while they may think that I am outside them, I am simply a function of their sensory systems and their interpretations, or cognitions about me, and since all that happens within them, they are responsible for it, and must learn to make very fast choices, because the brain works fast, which involves taking care of their brain fitness.

At this point, clients are ready to begin taking a look at their cognitions, although especially for those prone to victim thoughts, there will be a need for many reminders about where those thoughts about the external world exist and who is responsible for them.

Overview of Cognitive Therapy

Cognitive therapy seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking, behavior, and emotional responses. This involves helping clients develop skills for modifying beliefs, identifying distorted thinking, relating to others in different ways, and changing behaviors.

Treatment is based on collaboration between client and therapist and on testing beliefs. Therapy may consist of testing the assumptions which one makes and identifying how certain of one's usually-unquestioned thoughts are distorted, unrealistic and unhelpful.

Once those thoughts have been challenged, one's feelings about the subject matter of those thoughts are more easily subject to change.

Beck initially focused on depression and developed a list of "errors" in thinking that he proposed could maintain depression, including arbitrary inference, selective abstraction, over-generalization, and magnification (of negatives) and minimization (of positives).

A simple example may illustrate the principle of how CT works: Having made a mistake at work, a person may believe, "I'm useless and can't do anything right at work." Strongly believing this then tends to worsen his mood. The problem may be worsened further if the individual reacts by avoiding activities and then behaviorally confirming the negative belief to himself. As a result, any adaptive response and further constructive consequences become unlikely, which reinforces the original belief of being "useless."

In therapy, the latter example could be identified as a self-fulfilling prophecy or "problem cycle," and the efforts of the therapist and client would be directed at working together to change it. This is done by addressing the way the client thinks and behaves in response to similar situations and by developing more flexible ways to think and respond, including reducing the avoidance of activities. If, as a result, the client escapes the negative thought patterns and dysfunctional behaviors, the feelings of depression may be relieved over time. The client may then become more active, succeeding and responding adaptively more often; further coping with or reducing his negative feelings.

Historical development

Becoming disillusioned with long-term psychodynamic approaches based on gaining insight into unconscious emotions and drives, Beck came to the conclusion that the way in which his clients perceived, interpreted and attributed meaning in their daily lives—a process scientifically known as cognition— was a key to therapy.

Albert Ellis was working on similar ideas from a different perspective, in developing his Rational Emotive Behavior Therapy (REBT).

Beck outlined his approach in Depression: Causes and Treatment in 1967. He later expanded his focus to include anxiety disorders, in Cognitive Therapy and the Emotional Disorders in 1976, and other disorders and problems.

He also introduced a focus on the underlying "schema"—the fundamental underlying ways in which people process information— about the self, the world or the future.

The new cognitive approach came into conflict with the behaviourism ascendant at the time, which denied that talk of mental causes was scientific or meaningful, rather than simply assessing stimuli and behavioural responses.

However, the 1970s saw a general "cognitive revolution" in psychology. Behavioral modification techniques and cognitive therapy techniques became joined together, giving rise to Cognitive Behavioral Therapy.

Although Cognitive therapy has always included some behavioral components, advocates of Beck's particular approach seek to maintain and establish its integrity as a distinct, clearly-standardized kind of cognitive behavioral therapy.

Cognitive therapy and depression

According to Beck’s theory of the etiology of depression, depressed people acquire a negative schema of the world in childhood and adolescence; children and adolescents who suffer from depression acquire this negative schema earlier. Depressed people acquire such schemas through a loss of a parent, rejection by peers, criticism from teachers or parents, the depressive attitude of a parent and other negative events. When the person with such schemas encounters a situation that resembles the original conditions of the learned schema in some way, even remotely, the negative schemas of the person are activated.

Beck also included a negative triad in his theory.

A negative triad is made up of the negative schemas and cognitive biases of the person.

A cognitive bias is a view of the world. Depressed people, according to this theory, have views such as “I never do a good job.”

A negative schema helps give rise to the cognitive bias, and the cognitive bias helps fuel the negative schema. This is the negative triad.

Also, Beck proposed that depressed people often have the following cognitive biases: arbitrary inference, selective abstraction, overgeneralization, magnification and minimization.

These cognitive biases are quick to make negative, generalized, and personal inferences of the self, thus fueling the negative schema.

Cognitive Therapy at Wikipedia

Cognitive Therapy and Your Brain

The following information is from the Beck Institute Blog, and I was struck by it because I had read about it an article by Sharon Begley in an excerpt of her book Train Your Mind, Change Your Brain,

"A major clue to how Cognitive Therapy affects the brain came out in this study two years ago — researchers were interested in seeing how Cognitive Behavior Therapy affected the brains of depressed people as compared to medication. They hypothesized that since both CBT and medication were effective for depression, both treatments would affect the same part of the brain. Using brain imaging technology, they scanned participants’ brains before and after the course of treatment."

"And they were in for a surprise. Researchers found that antidepressants affected one part of the brain among depressed patients, and CBT treatment affected another part altogether. Antidepressants dampened activity in the limbic system — the emotional center of the brain. Conversely, CBT calmed activity in the cortex — the brain’s seat of reason."

"In other words, antidepressants reduced emotions, whereas CBT helped patients process their emotions in a healthier manner."

"Which explains why those on antidepressants have a much higher likelihood of relapse if they go off of their meds — negative emotions can flood back in. But with CBT, patients gain the skills to respond to their emotions more effectively — for long-term benefits."

From the Beck Institute 

Can Computerized Brain Fitness Programs Help in Cognitive Therapy

One of the key points I make to my anger management and domestic violence clients, once they understand that all their thoughts are their responsibility, is that they typically have about 200 hot thoughts a day, (averages out to about one every five minutes) out of about 60,000 thoughts, and that they need to be aware of how rapidly thoughts and physiology happen.

As our reference point, remember that it takes about 1/10th second to blink your eye.

Michael Merzenich,Ph.D., one of the current leading researchers in the neuroplasticity field, reports that Senior drivers need to be prepared for visual changes while driving in 1/45th second, Paul Ekman,Ph.D. says that we respond to facial expressions in 1/25th second, Mihalyi Csikszentmihalyi, Ph.D. in his book FLOW says that we process packets of seven bits of sensory data simultaneously and the shortest amount of time between packets is about 1/18th second.

In other words, the more aware of how fast my cognitions are, the quicker I can recognize and change them, whether they are

automatic negative thoughts or one of the limited patterns of thinking.

In fact, we will do better at identifying ANTS or limited patterns of thinking when relaxed, and one of the best relaxation tools, recommended by brain fitness expert Alvaro Fernandez, is the emWave tool.

The emWave, which is a heart rate variability tool, will teach me to pay attention to the time between heart beats, and that will be a great aid in attending to cognitive therapy.

Please see the Heartmath link in the right column.

There are also a number of computerized brain fitness tools available which will aid in cognitive therapy because they keep us tuned into our attention while we practice.

While this is not the page for brain fitness per se, the computerized tools below, which I own and use, have good side effects, including enhanced neurogenesis, neuroplasticity, both recently discovered and important capacities of the human brain, increased IQ, and the Posit Science Program has excellent research and benefits for Senior Citizens.

The attention to my attention can have nothing but excellent benefits for my cognitive therapy.

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