What is Cognitive Therapy?
Cognitive Therapy is based on the premise that what we think affects our emotions, what we choose to do or avoid, and our physiological reactions. (See Diagram A.) In fact, most situations remain neutral until we assign meaning based on how we interpret the situation.
Many of us grew up hearing “Don’t believe everything you read”, because of the potential bias in how stories are written. Cognitive therapy teaches a similar philosophy: “Don’t believe everything you think, because your thinking may be biased.”
Generally, we are not aware of the connection between our thoughts and emotions because the situation is so absorbing. Even if we are aware of our thoughts we seldom stop to question if they are accurate.
Research has shown that much of negative emotion is related to inaccurate thinking. Cognitive therapy involves learning skills that allow you to see the connection between thoughts and upsetting feelings, to appraise the accuracy of these thoughts that are creating upsetting feelings, and if they are inaccurate, to make them more accurate.
Cognitive therapy is not merely positive thinking but is the pursuit of accurate thinking. The problem with positive affirmations are that they re often not very believable or true. For example, if you are having “one of those days” filled with frustration and disappointments, saying to yourself: “Each day can be a little better, each and every way” is not likely to make you feel better. The reason why this positive statement wouldn’t make you feel better is because you have data that indicates that this thought is clearly inaccurate. Changing your thinking in ways that are most accurate and believable generally does make you feel better.
MAJOR GOALS OF COGNITIVE THERAPY
The major goal of cognitive therapy is to teach you a method for testing the accuracy of your thoughts so that you are able to “lighten your load of unnecessary emotional baggage” and use the extra energy to pursue more productive courses in life.
Cognitive therapists don’t tell clients that their thinking is wrong, but instead teach them methods to discover , using their own experiences and behavioral experiments, the types of thinking that make them feel worse and less able to cope with difficulties. By learning to test your thoughts through real life experiments, you can discover more balanced ways of thinking. More balanced thinking will enable you to control a variety of emotions that, prior to therapy, seemed overwhelming.
HOW COGNITIVE THERAPY IS DIFFERENT FROM OTHER THERAPIES
A. COLLABORATIVE THERAPEUTIC RELATIONSHIP
Cognitive therapy is based on the philosophy that people can learn to be their own therapist. The relationship with your therapist will be a collaborative one. Rather than a doctor-patient role, where you are often not a part of treatment planning and goal setting, we will emphasize a teacher-student relationship where you assume an active role. This reduces the likelihood of dependence and empowers you to solve future difficulties independently.
B. TIME LIMITED TREATMENT
Cognitive therapy is usually short-term with the average treatment being 8-16 weeks. Maladaptive emotions, beliefs, and behaviors are measured when you begin therapy. These are then measured again at frequent intervals during treatment to assure that therapy is working. If appropriate progress is not accomplished then adjustments are made.
The required length of treatment depends upon the nature of the difficulty. However, even when longer term treatment is required, short term goals are mutually agreed upon and reviewed periodically. It is imperative that at all times you understand and agree with the goals and methods of therapy.
C. SKILL ACQUISITION
Once the goals and methods are mutually agreed upon, your therapist will teach you skills that can be applied not only to your present difficulties but to future problems as well. This enables you to more effectively maintain progress and continued healthy growth in the future.
Cognitive-Behavior Therapy involves learning a variety of skills to provide you with tools to manage emotional difficulties. One skill that is central to Cognitive Therapy is the Thought Record. Thought records are utilized in a process designed to understand the connection between thoughts, emotions, behaviors and physiological reactions. Once this connection is established and clarified, Thought Records are then used to appraise the accuracy of those thoughts that are central to distressing emotion or maladaptive behavior. If these thoughts are determined to be inaccurate, then the goal is to replace them with more accurate thoughts that are believable. If thoughts are determined to be accurate, then the goal is to problem solve. A manual that describes this process is available in printable PDF format.
PROBLEM AREAS WHERE COGNITIVE THERAPY IS HELPFUL
Research over the last decade has isolated specific cognitive errors that are unique to different emotional problem areas. Cognitive therapy can be helpful in the following areas:
- Relationship Issues
- Chronic Pain
- Eating Disorders
- Obsessive-Compulsive Disorder
- Panic Disorder
- Stress Related Medical Disorders
- Stress Management
- Substance Abuse