Think of something that you believe in... something REALLY important to you.
This can be…• Religious• Related to raising children• Education• Politics• Beliefs or rituals you learned as a child• Etc.
Now we are going to try and change your mind... andmake you believe something different!
How does that make you feel?
What is CT?• Developed by Aaron T. Beck (work with depression)• Similar to Rational Emotive Behavior Therapy (REBT) and Behavior Therapy (BT)• “Stems from faulty thinking, making incorrect inferences on the basis of incorrect information, and failing to distinguish between fantasy and reality”• Dysfunctional/distorted thinking arises from both biological and psychological influences• Modifying dysfunctional thinking and behavior leads to improvement in symptoms.• Short-term focused treatment
Rationale for CBT• Negative emotions are elicited by cognitive processes developed through influences of learning and temperament.• Adverse life events elicit automatic processing, which is viewed as the causal factor.• Cognitive triad: Negative automatic thoughts center around our understanding of: – Ourselves – Others (the world) – Future• Focus on examination of cognitive beliefs and developing rational responses to negative automatic thoughts. Beck et al., 1979
Cognitive Distortions (Faulty assumptions/Misconceptions)• Arbitrary inferences: making conclusions without supporting evidence• Selective Abstraction: forming conclusions based on an isolated detail or event• Overgeneralization: generalizing beliefs based on a single incident• Magnification or minimization: perceiving a situation in a greater or lesser light than it deserves• Personalization: tendency to relate external events to yourself• Labeling and mislabeling: portraying your identity based on imperfections and mistakes made in the past, and allowing them to define your true identity• Emotional reasoning: Feelings are facts• All-or-nothing thinking/Black-or-white: All good or all bad• Mental filter: Ignoring the positive• Anticipating negative outcomes: The worst will happen• Mind-reading: Knowing what others are thinking
Examples of Cognitive Distortions• Cognitive Distortions – Emotional Reasoning: “I feel incompetent, so I know I’ll fail” – Catastrophizing: “It is going to be terrible” – Personalization: “It’s always my fault” – Black or white thinking: “If it isn’t perfect, it’s no good at all.”
Core Beliefs• Core beliefs underlie and produce automatic thoughts.• These assumptions influence information processing and organize understanding about ourselves, others, and the future.• These core beliefs remain dormant until activated by stress or negative life events.• Categories of core beliefs (helpless, worthless, unlovable) Core Beliefs Automatic Thoughts
Examples of Core Beliefs• Helpless core beliefs – I am inadequate, ineffective, incompetent, can’t cope – I am powerless, out of control, trapped – I am vulnerable, weak, needy, a victim, likely to be hurt – I am inferior, a failure, a loser, defective, not good enough, don’t measure up• Unlovable core beliefs – I am unlikable, unwanted, will be rejected or abandoned, always be alone – I am undesirable, ugly, unattractive, boring, have nothing to offer – I am different, flawed, defective, not good enough to be loved by others• Worthless core beliefs – I am worthless, unacceptable, bad, crazy, broken, nothing, a waste – I am hurtful, dangerous, toxic, evil – I don’t deserve to live
What are Automatic Thoughts? What was going through your mind? • Happen spontaneously in response to situation • Occur in shorthand: words or images • Do not arise from reasoning • No logical sequence • Hard to turn off • May be hard to articulate NegativeStressful Automatic ThoughtsSituation Emotions
The Cognitive Model Core Beliefs Assumptions Compensatory/coping strategies Situation Automatic thoughts/imagesReaction (emotional/behavioral physiological)
Example Physiology Heart racing Lump in throatSituation Automatic Thoughts FeelingsPartner says: Automatic response: Sadness“I need time to “Oh no, he’s losing interest Worrybe with my friends” and is going to break up Anger with me….” Behavior Seek reassurance Withdraw Cry Underlying Assumptions CompensatoryChildhood & Core Beliefs StrategiesExperiences “I’m flawed in numerous ways, Be independent andParental neglect which means I’m not worthy of you’ll be safe.and criticism consistent attention and care. Watch out – people People only care when they want are careless with you. something.”
Therapist Role• Emphasis on therapeutic relationship• Genuine• Warm• Empathetic• Accepting• Creative Active• Knowledgeable of cognitive and behavioral strategies• Guide• Help client understand how their beliefs and attitudes influence the way they feel and act• Promote cognitive change• Assist client in acquiring new skills• Clients bring up topics to explore• Ask open-ended questions• Identify distortions in their thinking• Devise homework assignments• Teach client how to be their own therapist
Client’s Role• Active• Participate• Do homework (very important)• Complete outside readings• Bring up topics to explore• Identify distortions in their own thinking• Summarize important points in the session