Psychologists and other mental health providers use a variety of psychotherapeutic techniques to help patients with their psychological difficulties. The type of technique to be used will depend on the diagnosis, severity and treatment plan. One of the most prominent talking therapy techniques is cognitive behavior therapy.
Aaron T. Beck, M.D. in the 1960s developed this therapeutic approach. Cognitive therapy has been used with a wide variety of patients suffering from problems with alcohol and substance abuse and dependence, anxiety and depressive disorders. Many other types of psychological problems also have been treated with cognitive therapy. Dozens of books have been written describing cognitive therapy and its application to psychological disorders. Only a brief description of cognitive therapy can be presented here.
A main principle of cognitive therapy is that patients have developed dysfunctional ways of thinking, often called cognitive styles. These cognitive distortions, of which there are about 12 that have been identified, are automatic habitual ways of thinking that lead one to have certain feelings and then act on them. When an individual is faced with a situation, he or she may automatically predict (or think) that a catastrophic result will occur (this also is called misfortune telling). For example, a student faces a situation such as an upcoming algebra test. The student’s quick automatic distorted cognition is: “I will fail the test because I never do well on tests. I will never graduate from college.” This type of feeling can lead to test anxiety.
Typical anxiety-reducing behavior, when one predicts a catastrophe, is to avoid the situation — in this case studying algebra. Perhaps he or she will not study for the test and skip school on the test day. Predicting catastrophic outcomes or misfortunes leads to anxiety and other feelings, and then to behaviors that are maladaptive. Catastrophic thinking is one of many examples of distorted thinking habits. Others include all or nothing thinking, mind reading and discounting the positive.
A main goal of cognitive behavior therapy is to teach patients new thinking styles and behaviors, and help them discard long-standing distorted thinking and maladaptive behavior. Thus, in the above example more adaptive thinking might be something like, “ I know the test will be hard so I need to do some extra studying or I will ask the teacher for help or I will get a tutor.” Such thinking may reduce anxiety and lead to more adaptive behavior (studying hard) and to a more successful outcome on the test and thus more positive feelings about oneself.
Cognitive therapy is often used along with medication. Patients benefit from a treatment plan that includes cognitive therapy and medication. There are two reasons for this. First, some patients are so upset that they need medication to settle them down, thus permitting them to engage in cognitive therapy. Second, medication does not change cognitive styles and long-standing behavior patterns. Only with cognitive therapy can distorted thinking styles be replaced by adaptive thinking styles and behavior.
Martin Manosevitz, Ph.D., ABPP is a clinical psychologist and practices in Aspen. He provides services to adults, adolescents, couples and families. He is board certified in clinical psychology and in psychoanalysis. To contact Dr. Manosevitz, call 925-2552, or email at email@example.com .