The Cognitive of Cognitive Behavior Therapy (CBT)

CBT

Cognitive Behavior Therapy (CBT) is a term that is bandied around in psychology, mental health, and even trending blog circles.

While some behaviorists see it as pertaining only to theories and therapies where cognitive restructuring is considered the primary mechanisms of change, other scientists and therapists view it as an umbrella term to capture all cognitive and behavioral therapies, and recently some think of it specifically as Tim Beck’s therapy, which was once called Cognitive Therapy.

Regardless of how it is used, it is important for clinicians to be able to identify the different kinds of beliefs that are described by different psychotherapy schools, since many clients have now read about them and may use the terminology.

Depending on a therapist’s theoretical and technical knowledge, they may choose to challenge the thoughts, consider alternatives, defuse from them, accept them, or get cognitive distance. In any event, there are many different schools which categorize, label, and emphasize different ones.

Here are three common schools of psychotherapy that have a specific set of beliefs associated with them. Each has a specific form of psychotherapy that emphasizes different techniques and exercises. All of these do emphasize the role of various kinds of cognitions, e.g., core beliefs, automatic thoughts, schemas, inferences, etc. Whether emotions and behaviors are associated, or caused or maintained by cognitions is hotly debated amongst psychotherapists and scientists. 

Having familiarity with the various kinds of cognitions and thinking about the role they play in mental health, suffering in general,  and life satisfaction, as well as how to approach them can help all therapists help their clients.

Cognitive Therapy by Aaron T. Beck

Cognitive Therapy, developed by Aaron T. Beck, focuses on identifying and changing negative and distorted thought patterns that contribute to emotional distress and behavioral problems. It is based on the premise that our thoughts influence our emotions and behaviors. Beck’s therapy aims to help individuals recognize and challenge their automatic negative thoughts, replacing them with more realistic and positive ones. The therapist works collaboratively with the client to examine evidence for and against the negative thoughts, develop alternative perspectives, and promote healthier cognitive and behavioral responses.

All-or-nothing thinking: Viewing things in extreme, black-and-white terms without considering the gray areas or possibilities in between.

Cognitive Distortions

Always being right: Insisting on being right in every situation and refusing to consider alternative perspectives or possibilities.

Catastrophizing: Exaggerating the potential consequences of a situation and imagining the worst-case scenario.

Control fallacies: Believing that you are completely powerless or responsible for everything that happens, either external events or other people’s behaviors.

Disqualifying the positive: Discounting or disregarding positive experiences, feedback, or accomplishments as if they don’t count or are insignificant.

Discounting the positive: Minimizing or dismissing positive experiences, qualities, or achievements as irrelevant or unimportant.

Emotional reasoning: Assuming that your feelings or emotions reflect objective reality or basing judgments solely on how you feel.

Fallacy of change: Expecting that other people or external circumstances should change to meet your needs or preferences, without considering the need for personal growth or adaptability.

Fallacy of fairness: Believing that life should be inherently fair or just, and feeling resentful or upset when it doesn’t meet those expectations.

Fortune-telling: Predicting negative outcomes or events in the future without sufficient evidence or considering other possibilities.

Jumping to conclusions: Making negative assumptions or predictions about oneself, others, or situations without sufficient evidence.

Labeling: Applying negative, judgmental, or global labels to oneself or others based on specific behaviors or mistakes.

Magnification and minimization: Exaggerating the importance or significance of negative events, characteristics, or mistakes while downplaying or dismissing positive ones.

Mental filtering: Focusing solely on negative details while ignoring or discounting positive aspects of a situation.

Mental rehearsal: Repeatedly imagining or replaying negative situations, failures, or distressing events in your mind, reinforcing negative beliefs and emotions.

Mind reading: Believing that you know what others are thinking or assuming negative thoughts or intentions without concrete evidence.

Overgeneralization: Drawing broad negative conclusions based on limited experiences or isolated incidents.

Personalization: Assuming responsibility or blaming oneself for events or outcomes that are beyond one’s control or not primarily related to oneself.

Should statements: Using “should,” “must,” or “ought to” statements that impose rigid, unrealistic expectations on oneself or others.

Unfair comparisons: Comparing oneself unfavorably to others or to unrealistic standards without considering individual differences or context.

Rational Emotive Behavior Therapy (REBT) by Albert Ellis

Rational Emotive Behavior Therapy, created by Albert Ellis, emphasizes the connection between thoughts, emotions, and behaviors. REBT holds that it is not the events themselves that cause emotional disturbances but rather the irrational beliefs and interpretations individuals hold about those events. Ellis believed that by challenging and replacing irrational beliefs with rational ones, people can experience emotional well-being. REBT is an active and directive therapy that involves disputing irrational beliefs, exploring the consequences of such beliefs, and adopting more rational and functional ways of thinking and behaving.

Irrational Beliefs

Demands (DEM):I have to always deliver interesting presentations

Low-Frustration Tolerance (LFT):  I can’t stand disappointing people

Awfulizing (AWF):  It is awful if people think I’m inadequate

Global Evaluations of Worth (GEW):  I’m a failure if I perform poorly 51% of the time

Schema Therapy by Jeffrey E. Young:

Schema Therapy, developed by Jeffrey E. Young, combines elements of cognitive-behavioral therapy (CBT), psychodynamic principles, and attachment theory. It focuses on identifying and changing maladaptive schemas or deeply ingrained patterns of thoughts, feelings, and behaviors that develop early in life and can cause long-standing emotional difficulties. Schema therapists work to help individuals understand the origins of their schemas, challenge and modify them, and develop healthier coping strategies. This therapy often involves experiential techniques and aims to address core emotional needs that were not met in childhood, fostering emotional healing and well-being.

Abandonment/Instability: Feeling a pervasive fear of abandonment or the belief that significant others will not be able to provide consistent care or support.

Mistrust/Abuse: Believing that others are untrustworthy, exploitative, or abusive, and expecting to be taken advantage of or harmed by them.

Emotional Deprivation: Experiencing the belief that one’s basic emotional needs will not be met by others, leading to a sense of emptiness and longing.

Defectiveness/Shame: Feeling fundamentally flawed, defective, or unworthy, often accompanied by intense shame and self-criticism.

Social Isolation/Alienation: Feeling fundamentally different or disconnected from others, leading to a sense of social exclusion and difficulty forming meaningful relationships.

Dependence/Incompetence: Feeling unable to handle life’s challenges independently, often accompanied by a belief that one is incapable or incompetent.

Vulnerability to Harm or Illness: Believing that the world is a dangerous place and that harm or catastrophe is imminent, leading to excessive worry and hypervigilance.

Enmeshment/Underdeveloped Self: Experiencing a lack of boundaries and a blurred sense of self due to excessive emotional closeness or over-involvement with significant others.

Failure: Having a pervasive belief of being a failure or inadequate in achieving personal goals or meeting societal expectations.

Entitlement/Grandiosity: Feeling a sense of entitlement, superiority, or specialness, often accompanied by a disregard for the needs and feelings of others.

Insufficient Self-Control/Self-Discipline: Struggling with impulsivity, self-control issues, and difficulty in delaying gratification or sticking to long-term goals.

Subjugation: Tending to surrender power and personal needs to others, often to avoid conflict or to gain approval, resulting in a loss of autonomy.

Self-Sacrifice: Overprioritizing the needs and wants of others at the expense of one’s own well-being and personal fulfillment.

Approval-Seeking/Recognition-Seeking: Seeking excessive approval, validation, or recognition from others, often at the cost of neglecting one’s own values and needs.

Negativity/Pessimism: Holding a pervasive negative outlook on life, expecting the worst outcomes, and experiencing difficulty in finding positive aspects.

Emotional Inhibition: Struggling with expressing emotions freely and openly, often due to a fear of being overwhelmed or rejected.

Unrelenting Standards/Hypercriticalness: Setting excessively high standards for oneself and others, accompanied by a tendency to be overly critical and judgmental.

Punitiveness: Having a tendency to be excessively harsh, critical, or punitive towards oneself or others when perceived mistakes or failures occur.

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