Where Does Cognitive Therapy Sit Within the Broader
Context of CBT? Cognitive Behavioural Therapy brings together the theoretical frameworks and established research from the separate fields of Cognitive and Behavioural psychology. It recognises the interlinks and connections between our thoughts, our behaviours, our emotional state and physiological sensations. Whilst there are a number of established and clinically validated approaches under the broad umbrella of CBT, the “Cognitive” aspect of all forms of CBT, provides a single unifying concept that is broadly recognised as the catalyst for psychological change.
The Central Premise of Cognitive Therapy
“Men are disturbed not by things but by the views they take of them” (Epictetus - The Enchiridion AD 125) What this means is that our interpretation of a situation can have a significant influence over our subsequent emotions and behaviours. The purpose of Cognitive Therapy is to help us to make the most adaptive and realistic interpretation of the situation and think, feel and act in a way that is consistent with our wishes and goals.
A helpful way to think about this is the “Camera" metaphor. We all come fully equipped with different lenses, filters and settings. Therefore we are not qualitatively different to other people, but our experience in life can sometimes determine the lenses, filters and settings that we use to view and interpret the situation. When we experience enduring emotional distress or unwanted behaviours, it's usually a sign that we have our "Camera" set to take unrealistic or distorted pictures of the situation. Cognitive Therapy involves changing our "Camera" settings to capture and interpret the situation from a more realistic perspective, which in turn helps us to think, feel and act in a healthy, rational and balanced way.
Some Key Assumptions
Cognitive Therapy is founded on three main assumptions:
1. Our emotional state is primarily, but not exclusively determined by the way we think.
2. Negative and unrealistic patterns of thinking give rise to emotional and behavioural problems.
3. Altering negative or unrealistic thinking patterns can reduce emotional disturbance, unwanted behaviour and physical distress. Cognitive
Common Thinking Errors
We are evolved to use a number of cognitive filters, processes and short-cuts to handle the multitude of stimuli, signals and demands made by our environment. These common cognitive processes are subject to distortions or processing errors when we are exposed to maladaptive learning, are placed under pressure or experience distress. Aaron Beck first proposed the theory behind cognitive distortions and David Burns was responsible for popularizing it with common names and examples for the distortions. The following categories are not exhaustive, however they provide some common examples of how we can trip into thinking errors that maintain negative emotions and unwanted behaviours:
Mental Filter - We take the negative details and magnify them while filtering out all positive aspects of the situation. For example, we may pick out a single unpleasant detail and dwell on it exclusively so that our idea of reality becomes darkened or distorted.
Polarized / Dichotomous / Black and White Thinking) - In polarized thinking, things are either “black-or-white.” We have to be perfect or we’re a failure — there is no middle ground. We place people or situations in “either/or” categories, with no shades of grey allowing for the complexity of most people and situations. If our performance falls short of perfect, we see ourselves as a complete failure.
Overgeneralization - We come to a general conclusion based on a single incident or a single piece of evidence. If something bad happens only once, we expect it to always happen in future. We may see a single, unpleasant event as part of a never-ending pattern of defeat.
Jumping to Conclusions - Without individuals saying so, we just know what they are feeling and why they act the way they do. In particular, we are able to determine how people are feeling toward us. For example, we may conclude that someone is reacting negatively toward us but we don't actually find out if they are correct. Another example is where we anticipate that things will turn out wrong and we are completely convinced that our prediction is already an established fact.
Catastrophic Thinking - We expect disaster to strike, no matter what. This is also referred to as “magnifying or minimizing.” We hear about a problem and use what if questions (e.g., “What if tragedy strikes?” “What if it happens to me?”). For example, we might exaggerate the importance of insignificant events (such as our own mistake, or someone else’s achievement). We may inappropriately shrink the magnitude of significant events until they appear tiny, for example, our own desirable qualities or someone else’s imperfections.
Personalization - We believe that everything others do or say is some kind of direct personal reaction. We also compare ourselves to others trying to determine who is brighter, better looking, wittier, etc. When we engage in personalization, we may also see ourselves as the cause of some unhealthy external event that we were not actually responsible for. For example, “We were late for dinner and caused our friend to overcook the meal. If I had only insisted that my partner leave on time, this wouldn’t have happened.”
Blaming - We hold other people responsible for our pain, or default to blaming ourselves for every problem. We assume that every problem has to be personally attributed to ourselves or someone else.
Shoulds / Musts / Demands - We hold rigid rules about how people should or should not behave, or how things must or must not turn out. People who break the rules make us angry or hurt and we often feel personally guilty or a failure when we violate these rules ourselves. For example, “I really should exercise. I shouldn’t be so lazy. they can't or mustn't treat me this way.”
Emotional Reasoning - We believe that what we feel must be true. If we feel stupid and boring, then in fact we must be stupid and boring. We assume that our unhealthy emotions reflect the way things are in reality. “I feel it, therefore it must be true.”
Control Fallacies - If we feel externally controlled, we see ourselves as a helpless victim of fate. For example, “I can’t help it if the quality of the work is poor, my boss demanded I work overtime on it.” The fallacy of internal control means that we also tend to assume responsibility for the pain and happiness of everyone around us.
Fairness Fallacies - We feel resentful because we think we can decide what is fair, but other people won’t agree with us. As our parents tell us, “you should always be fair.” The problem with this, is that we then turn this around to demand that we should always feel fairly treated ourselves. People who go through life applying a measuring rule to judge “fairness” often feel negative and resentful because of what they see as a breach of the standards they demand. Feeling negative and resentful does not change whether something is or is not fair.
Change Fallacies - We expect that other people will change to suit us if we just pressurise, cajole or manipulate them enough. We believe that we need to change people because our hopes for happiness seem to depend entirely on them.
Reward Fallacies - We expect our sacrifice and self-denial to ultimately pay off and be acknowledged, as if someone is keeping score. We feel bitter if we are not recognised or rewarded.
Global Labelling - We generalize individual qualities or characteristics into a negative global judgment. These are extreme forms of generalizing, and are also referred to as “labelling” and “mislabelling." For example, using a label (‘stupid’, ‘useless driver’) to describe behaviour - and then imputing all the meanings the label carries.
Always Being Right - We are continuously attempting to demonstrate or prove that our opinions and actions are correct. Being wrong is absolutely unthinkable and we will go to any lengths to demonstrate that we are right and others are wrong. Winning the argument becomes more important than the original point or the impact it has on the situation. Sometimes we find that being right is more important than getting what we want.
These cognitive errors or traps are really just a side-effect of our attempts to simplify and make sense of a highly complex environment. The problem is, that when we are under pressure or experiencing distress, they can trip over into problematic ways of thinking that create or perpetuate unhelpful behaviours and emotional states. Cognitive Therapy can be used to identify, understand and alter negative or maladaptive thinking patterns, so that we can process situations in a healthier and realistic manner. This involves applying the “Triple C” - Catching, Checking and Changing negative thoughts, rules, assumptions and beliefs that perpetuate our distress and limit the achievement of our potential. The above examples of thinking errors provide one helpful insight into the way our thoughts can influence the way we see ourselves, the world and the future. Ultimately, they help to explain how what we think, shapes how we act and how we feel about the world around us. If you want to find out more about how Cognitive Therapy techniques are being used to improve the management of a wide range of psychological, emotional and behavioural problems, visit www.thinkcbt.com and explore our Conditions pages.
Think CBT is committed to providing access to affordable independent Cognitive Behavioural Therapy. Our aim is to support tangible improvements in the psychological health and well being of our clients, contributing to better lives worth changing for.
There are many psychotherapists and counsellors offering cognitive behavioural therapy. Always ensure that your therapist is professionally accredited with the British Association of Behavioural and Cognitive Psychotherapy (BABCP).