0.18 Cognitive perspectives on personality development  (Page 24/30)

Another important aspect of the depressive syndrome is known as the cognitive triad , three cognitive patterns that cause the person to view themselves in a negative manner. First, the individual has a negative view of themselves. Primarily, the depressed individual sees themselves as defective in some psychological, moral, or physical way, and because of the presumed defects they are undesirable and worthless. Second, the depressed person has a tendency to interpret their ongoing experiences in negative ways. These negative misinterpretations persist even in the face of incompatible evidence. And finally, they tend to hold a negative view of the future. They anticipate continued difficulty, failure, emotional suffering. As a result, they lack motivation, they become paralyzed by pessimism and hopelessness. According to Beck, suicide can be viewed as an extreme attempt to escape problems that depressed individuals believe cannot be solved and the unbearable suffering that the future holds! These negative cognitive patterns are not something that the depressed person plans or has much control over, since they typically occur in the form of automatic thoughts (Beck, 1967; Beck, Rush, Shaw,&Emery, 1979; Beck&Weishaar, 1995; also see Beck, Resnick,&Lettieri, 1974).

Discussion Question: Beck described a number of common cognitive distortions, including dichotomous thinking, personalization, overgeneralization, and catastrophizing. Think about situations in your own life when you made these distortions. What sort of problems resulted from these cognitive errors, and how often do you make them?

Beck’s Cognitive Therapy

Cognitive therapy, according to Beck, “is an active, directive, time-limited, structured approach used to treat a variety of psychiatric disorders” (Beck, Rush, Shaw,&Emery, 1979). With regard to depression, it is most effective after a major depression has lifted somewhat, though it can also be helpful for some patients during depression, particularly if the depression is of the reactive type (as opposed to endogenous depression; Beck, 1967). As mentioned above, the basic procedure is to help the individual break out of the trap of negative schemas, automatic thoughts, and cognitive distortions that support the client’s problem. The techniques employed are designed to identify, test the reality of, and correct the cognitive distortions and schemas that lead to dysfunctional automatic thoughts. It involves an active collaboration between the therapist and the client, such that the client learns to reduce their symptoms by thinking and acting more realistically.

Beck referred to the constant interaction between the client and the therapist as collaborative empiricism , and contrasted this approach to both psychoanalysis and client-centered therapy. His intention was to provide the client with a series of specific learning experiences that would teach the patient the following skills: (1) monitoring their own negative, automatic thoughts; (2) recognizing the connections between thought, emotion, and behavior; (3) examining evidence for and against their cognitive distortions; (4) substituting reality-based interpretations for their cognitive distortions; and (5) learning to identify and alter the dysfunctional schemas that lead to the cognitive distortions (Beck, Rush, Shaw,&Emery, 1979). The interaction with the client is not superficial, as it involves discussing the very rationale of the therapy to the patient and, ultimately, providing the client with techniques to monitor their dysfunctional thoughts on their own. The therapist teaches the client to recognize the nature of cognition, particularly the client’s dysfunctional cognitions, all with the goal of eventually neutralizing the automatic thoughts. Somewhat related to collaborative empiricism is the concept of guided discovery . Guided discovery is the process by which the therapist serves as a guide for the client, in order to help them recognize their problematic cognitions and behaviors and also help them design new experiences (behavioral experiments) in which they might acquire new skills and perspectives (Beck&Weishaar, 1995). In addition, the therapeutic relationship provides an opportunity for the client to begin to make progress: