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Why Does Cognitive Therapy Work?
by James Krehbiel Cognitive
therapy, pioneered by Aaron Beck, is a structured, time-limited and
pragmatic approach to dealing with a variety of psychological
disorders. Most
therapists using this approach employ an exploratory, discovery model
designed to ferret out maladaptive thinking, cognitive distortions, and
faulty underlying beliefs which are based upon prior experience. Prior
experience is only explored as it relates to present functioning.
There may be “hot buttons” from one’s past that perpetuates a cycle of
self-defeating behavior. These
faulty underlying beliefs are viewed as stumbling blocks to present
awareness and adaptive functioning. Spontaneous,
automatic thoughts represent the free-flowing stream of self-defeating
thoughts that are associated with an individual’s psychological
symptoms. For
example, those who suffer from panic attacks believe that their
symptoms surface uncontrollably without related triggers. In
other words, panic sufferers do not make a connection between their
thinking and their symptoms. They do not realize that it is the
panicky thinking about the panic that keeps the symptoms alive. An
individual may begin to sweat, have heart palpitations, and dizziness
during a business meeting. This person may unwittingly say, “Oh
my God, here it comes again, those nasty feelings. Everybody here
must know that I am panicking – how embarrassing. I better find a way
to get out of this meeting before I pass out!” Once
the patient is taught to recognize the connection between symptoms and
nonsensical thinking, he can be taught to find more rational ways to
respond to his dilemma. This
person might say, “Here comes those symptoms again, just relax and take
some deep breaths. This too shall pass. You know, people
are too busy listening to what’s going on in their lives to be
concerned about my inner thoughts and feelings. Just hang in
there and the panic will subside.” Panic
no longer has power over a client once they realize that the way they
think about it determines its impact. Once a patient comes to the
understanding that panic is time-limited and the symptoms are benign,
progress can be made in minimizing and eventually resolving the
syndrome. Understanding
that her disorder is based upon body misperception, cognitive
therapists help the patient to reattribute her thinking to the
disorder. An
anorexic in treatment might be coached to say, “One of the cardinal
features of my disorder is my insistence that I am too fat. This
is my clouded thinking about my disorder speaking. I am much more
than my body and yet I need to learn rational ways to think about my
body.” Cognitive
distortions include ways of thinking, such as magnifying events,
personalizing feelings, using emotional reasoning, and rigid,
dichotomous thinking. These
underlying schemas emerge in counseling as client coping
strategies. For
example, a patient might say, “I must avoid conflict at all
costs. If I don’t, I could get hurt or disappointed.” Such
powerful thinking may shape one’s relationships and other patterns of
behavior in the present. Patients
are participants in therapy, not passive spectators.
Therapists utilize specific techniques to untwist the client’s
self-defeating thinking. All techniques are directed toward
challenging the patient’s faulty thinking and providing more rational
ways of approaching problems. The
therapist makes no value judgments but assists the patient in
evaluating the reasonableness of his thinking. Since
old patterns die hard, it takes courage on the part of the patient to
work toward modifying thinking and behavior so that it is more
self-satisfying. Because
cognitive therapy provides the patient with coping skills and rational
self-talk, clients leave therapy feeling confident and
self-directed. Former patients are able to maintain and
enhance their progress because they have completed the work that was
required for recovery. It is
a powerful model because it follows the scientific method by testing
hypotheses and the empirical usefulness of various thoughts, feelings,
and behaviors. Tests can be constructed to measure the impact and
effectiveness of specific thinking and behavior. Patients
can qualitatively test the validity of specific cognitions.
For example, an anorexic patient may be asked to survey her friends to
see how they feel about her current weight. She may then be asked to
report her findings to the therapist for exploration. It is
applicable to a myriad of disorders which gives it efficacy and
comprehensive utility as a model for changing human behavior. The
Client's Guide to Cognitive-Behavioral Therapy: How to Live a Healthy,
Happy Life...No Matter What! by Aldo R. Pucci ~ ~ ~ related
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