Cognitive Model Cognitive Therapy Cognitive Behaviour Therapy Cbt

Cognitive, which translates roughly as “thinking”, has two connotations in modern psychology.  One is “cognitive psychology” which studies mental functions such as sensation, perception and memory.  The other is “cognitive therapy” or “cognitive-behaviour therapy”,  a form of psychotherapy that looks at how our understanding of events can affect how we feel and react. We people speak of a cognitive view, they’re usually referring to the therapeutic model introduced by Aaron Beck from his work with depressed patients in the 1960’s.

At the core of the cognitive view is the relationship between thoughts and feelings. If someone is looking at you, for example, you’ll feel quite different if you believe they are “staring” or “glaring” than assuming they’re gazing mindlessly in your direction. The link goes both ways. Suppose you’re walking through a park on a bright sunny morning and a small branch falls off a tree behind you. Now imagine the same thing happening on a moonless night just after you’ve watched a horror film. You’ll probably jump because you’re primed to think of things as scary. So what you tell yourself is happening affects how you’ll react, and what you’re already feeling can determine the first thoughts that jump into your head.

These are day-to-day examples we all experience. There’s a rhubarb of thoughts swirling around in our heads all the time, some good, some bad. On an average day when your mood is fine or good, you can still get negative thoughts popping in but you run through other explanations as well and do a quick reality check to see which best fits the facts.

When some is feeling low or anxious, on the other hand, their negative impressions are harder to shake off, even if they don’t fit the facts. The result is a vicious circle or self-fulfilling prophecy. Feel low tips the balance in favour of negative “self-talk” and being more convinced by it which makes them feel worse. Someone who comes home from a “bad day” at work, for example, will be able to count everything that’s gone wrong, but might struggle a bit to remember what well or could have gone wrong but didn’t. But just as we can be primed to adopt a certain perspective by the day’s events, we can be predisposed to think in certain ways by life experiences.

Like most psychological approaches, the full cognitive model begins with our early experiences. But in the cognitive view we’re not just passively shaped by events; we also act as personal scientists – drawing conclusions from what happens to us and trying to figure out what it all means. Over time these conclusions become a canon of beliefs. Some beliefs are useful and well-founded in fact, like “fire is hot”. Others are not. A child who grows up with constant criticism, for example, may come to believe “I can’t do anything right”.

There are two levels of underlying beliefs. Core beliefs or schema, are what appear to us as facts, like “people are basically good” or “the world is a dangerous place”. Conditional beliefs are more about how things work and the assumptions we make about cause and effect. Conditional beliefs are what we use to make predictions. So from the core belief “fire is hot”, comes the conditional belief “if I touch fire, I’ll get burned”. In the case of the child growing up in the critical home, he or she can develop a core belief that people are unforgiving and a conditional belief that the only way to gain acceptance is to do everything perfectly.

Life, however, is full of different people and experiences which can dilute the affects of early messages. Conditional beliefs can also provide strategies for keeping painful core beliefs at bay. Problems can arise, however, if the conditionals of conditional beliefs aren’t met or new experiences come dangerously close to unhappy old ones. This can awaken dormant negative schemas and once re-activated they act like a filter or fun-house mirror that distorts what a person is able to see.

As a therapy, the aim of CBT is to help people remove these filters which are biasing their perspectives. It’s not positive thinking; overly positive views are just as biased as negative ones – it’s realistic thinking. To do this, people are encouraged to return to the role of personal scientist and look at the facts with fresh eyes, keeping assumptions to a minimum and “following the evidence” like psychological CSI’s.
 
The ideas at the heart of the cognitive view are not new. The notion of testing beliefs against known facts, weighing up evidence and argument, and looking for proof rather than conjecture is found in our legal systems, our parliaments and, of course, in the scientific method. Drawing a link between thoughts and feelings is much older. It was around 100 AD that the Greek philosopher Epitectus observed that “men are not so much disturbed by things as their perception of things”.