Classic Cognitive Therapy Approaches

Brief overviews of sample cognitive therapy approaches

Classic Cognitive Therapy Approaches

Tom G. Stevens PhD

For a complete self-development program using Dr. Stevens Cognitive Therapy approach, go to:
    1-his free online book, You Can Choose To Be Happy: "Rise Above" Anxiety, Anger, and Depression (with Research Results)  and
    2-his free online questionnaire to get feedback about what personal factors to focus your efforts to change/develop.
        Take his Success and Happiness Attributes Questionnaire (SHAQ) here.
 

For an outline on Dr. Stevens professional paper, Spiritual Cognitive Therapy, click here.

STEPS TO COGNITIVE RESTRUCTURING--Follow these steps to change your own thinking.

1. Identify FEELINGS/EMOTIONS and other CONSEQUENCES/OUTCOMES.

> Identify both positive (reinforcing) and negative outcomes

> Identify both internal (emotional/feedback) and external outcomes.

2. Identify SITUATIONS & STIMULI/CUES initiating the sequence of events. Also, identify similar situations where you use similar unproductive ways of dealing with events. See what these situations have in common and identify how they are different (a la Kelly)_ from situations where you use more productive means of dealing with them.

3.. Identify UNPRODUCTIVE BEHAVIORS (eg. Avoidance, aggression, defensiveness, addictive behaviors, etc)

4. Identify THOUGHTS that preceded the unproductive behaviors and feelings. Also, search for UNDERLYING BELIEFS or COGNITIVE BIASES which are generating the unproductive thoughts.

5. Question the "rationality", productiveness, and consistency with your newer "higher self" belief system.

6. Develop NEW, more constructive UNDERLYING BELIEFS and SPECIFIC THOUGHTS that can be used in that or similar situations.

MORE POSITIVE STRATEGIES:

> FOCUS ON MY THOUGHTS AND ACTIONS. I realize that I can only control my thoughts and actions--I have no control or responsibility for what others or the world does. I will learn to focus on my thoughts and actions and "let go" of the effects of my actions.

> All humans make lots of mistakes--I am only human.

> An overall goal is my personal growth and learning. In order to learn I must risk and make mistakes. I can learn from even the worst of events.

> I am experimenting with new approaches and will learn through trial and error--errors are important.

7. PRACTICE using these new beliefs and thoughts. Keep repeating this process until the new beliefs and thoughts become completely automatic responses to these types of situations/cues.

1. George Kelly-The Psychology of Personal Constructs

2. RATIONAL EMOTIVE THERAPY--ALBERT ELLIS

SOME COMMON "IRRATIONAL" BELIEFS

* I must be LOVED/APPROVED OF by ALMOST EVERYONE.

* I must be THOROUGHLY COMPETENT at ALMOST EVERYTHING.

* Some people are "BAD" PEOPLE and must be SEVERELY PUNISHED.

* If things aren't the way they "SHOULD" be or the way that I want them, then it is CATASTROPHIC. (Eg. "I cannot live without being loved by someone, life would be too terrible to face.")

* EXTERNAL FORCES (including other people) largely control human (or my) happiness. There is little I can do to change my feelings.

* It is EASIER (and less painful) to AVOID difficult feelings or situations than to face them directly.

* People (or I) am a slave to my PAST HISTORY. (Eg. "My parents divorce, rejection, alcoholism, abuse, etc. has affected me so much that it has ruined my chances for happiness forever.")

"MUSTERBATION"==> "SHOULDS" & "MUSTS" that are internalized without understanding and agreeing with the reasons and consequences are "irrational". In general it is better to rephrase these sentences--see below.

3. COGNITIVE THERAPY (or "Cognitive Restructuring")--AARON BECK, et al.

OUTCOMES

* Best evidence of any approach for dealing with depression (including persons who are suicidal).

* Strong evidence of effectiveness in dealing with anxiety and panic disorders.

* Scattered evidence of success in many other applications.

IMPORTANT TYPES OF COGNITIVE BIASES IN DEPRESSION & OTHER DISORDERS

* NEGATIVE BIAS--a tendency to look at the more negative side.

> Perception of Events (past, present, etc) (Eg. See "dark" side.)

> Expectation of outcomes for self/world (Eg. Pessimistic)

> Self-evaluations (Eg. Very self-critical)

> Negative explanations (Eg. Assume worst of peoples motives)

INSTEAD--I will think:

> I will be happier and more motivated if I assume the best.

> If I make a mistake in the direction of being too negative I will have worried and been negative for nothing. If I make a mistake in the direction of being too positive, at least I will have been happy and motivated up until the time I found out the truth. Even then I can deal with the negative events.

> Positive self-fulfilling prophesies tend to create positive outcomes and self-fulfilling prophesies tend to create negative outcomes.

> Negative self-evaluation leads to depression, guilt, anxiety, or frustration. It is de-motivating and unproductive in meeting my goals and making me happy. Positive self-motivation creates energy, direction, and happiness.

> Negative explainations of my own or other peoples "underlying motives" cause me to intensify my anger or other negative feelings toward that person. It builds conflict, distance, and animosity in relationships. Assuming the best, is more often accurate with those we are close to, and builds harmony, trust, and closeness.

> Assuming the world is a hostile, unfriendly, negative place creates feelings of fear, anxiety, and anger toward. Viewing the world as more positive and accepting even the worst as necessary and out of my control gives me a feeling of peace and acceptance of the world.

> If I view my current state as deprived, unfair, and not begin given the opportunties others have had, then I will be constantly resentful and unhappy. If I view my current state as being a gift that I was not "owed", and am grateful for all I have and every minute of my existence, then I will feel happy.

* SELECTIVE ABSTRACTION--Taking negative features of a situation out of context and exaggerating their significance while downplaying positive features. Eg. If a Sam gets 4 "A"s and one "C", he focuses on the "C".

> I will list at least one positive for each negative.

* OVERGENERALIZATION (or magnification)--assuming far-reaching conclusions from very limited data. For example, making an "F" on a test and getting thoughts of how you will flunk the entire course, flunk out of school, and how you are a very stupid person.

INSTEAD:

> I will put the negative event into its proper perspective.

> I will step into the future one or more years and look back and see how important this event really was.

> I can keep "blowing" up this event until it becomes ridiculous and I can see how ridiculous "overgeneralizing" really is.

* THINKING IN EXTREMES--exaggerating differences. Everything is either good or bad, wonderful or awful, always or never. A person who thinks this way often uses this radical categorization of their own and other persons behavior--leading to exaggerated emotional reactions.

> I will learn to realize that there are no "NEVER", "ALWAYS", 100% your fault or my fault events. Instead I will always try to be accurate in balancing out "causation" or "blame". If I state an absolute, I will immediately begin LOOKING FOR EXCEPTIONS to that rule, not find more supporting evidence.

4. "STRESS INOCULATION" -- DONALD MEICHENBAUM

Use of imagery and cognitive restructuring to prepare yourself for anticipated stressful events--such as surgery. It works in reducing peoples anxiety level.

5. LINGUISTIC THERAPY METHODS--Example: Rudestam

(Ideas overlap cognitive therapy ideas above.)

LINGUISTIC HABITS WITH "IRRATIONAL BELIEF" INFERENCES

* "SHOULD", "MUST"--can imply internal or external "authority" that cannot be questioned or understood.

OUTCOMES-- give up your power & deny responsibility

REPLACE WITH--"I WANT" or give reasons/outcomes why you choose it.

* "CAN'T", "WON'T"--can imply inability/incompetence.

OUTCOMES-- deny its a problem of choice or motivation. Lower self-confidence.

REPLACE WITH--"I CAN, BUT I CHOOSE NOT TO TAKE THE TIME/ENERGY TO.."

* "YOU MAKE ME [feel, etc]..."-- implies that others control you or your feelings.

OUTCOMES -- deny responsibility for own feelings. Lowers self-confidence and self-control over own feelings, etc.

REPLACE WITH -- "WHEN YOU ..., I ALLOW MYSELF (or "choose") TO FEEL ..."

* CONFUSING FEELINGS WITH THOUGHTS -- implies that you are not really in touch with your feelings [are "intellectualizing"]. Eg. "I feel that I am not going to finish this paper on time."

OUTCOMES -- avoids facing or dealing with, or telling others of threatening or embarrassing feelings.

REPLACE WITH-- ACCURATE USE OF FEELING WORDS. Eg. "I feel embarrassed and angry with myself, because I am not going to finish this paper on time."

* UNCLEAR OR MISUSE OF PRONOUNS or INDEFINITE NOUNS -- Eg. "Lifes a bitch, and then you die." "The administration makes life miserable for us." "We (you and I) would never believe such a stupid thing."

OUTCOMES -- can lead to avoiding responsibility or manipulation of others.

REPLACE WITH-- CLEAR, HONEST, STATEMENTS USING I, YOU, ETC PROPERLY. "I AM very unhappy with MY life." "I DON'T UNDERSTAND why MY BOSS asked ME to redo this report." "I would like for YOU to BELIEVE..."

* INAPPROPRIATE STATEMENTS OF DEFERENCE TO OTHERS

> "LET ME"-- can imply seeking permission and approval.

> INAPPROPRIATE APOLOGIZING-- can imply insecurity and lack of self-confidence.

OUTCOMES -- deference to other's, lowered self-esteem.

REPLACE WITH -- "I WOULD LIKE TO..." Replace apologies for behavior you are really glad you did with attempts at helping others deal with THEIR unhappiness or problem about what you did.

* MIXED MESSAGE AGREEMENTS [such as "okay" or "all right"] often said in with reluctant overtones. A form of "passive aggression".

OUTCOMES--"dishonest", "hidden", "passive" message to self and other that you do not really want--and possibly do not really intend--to do it. Or negative messages of your unhappiness to "get even" with the other for coercing you into doing it.

REPLACE WITH--Deal DIRECTLY WITH YOUR NEGATIVE FEELINGS/RESERVATIONS until they are resolved. Either EXTERNALLY deal with them directly with the other person until they are resolved, or truly INTERNALLY ACCEPT THAT YOU WILL TO WHAT YOU HAVE AGREED and work at motivating yourself to do it enthusiastically.

6. DIRECT DECISION THERAPY -- HAROLD GREENWALD

DECISIONS-CHOICES ARE FUNDAMENTALLY IMPORTANT FOR CURRENT ENVIRONMENTS, HABITS, IMPORTANT LIFE SITUATIONS

* CURRENT COMMITMENTS made by past decisions.

* PROCESS OF RE-EXAMINING CURRENT COMMITMENTS

* MAKE NEW DECISIONS

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