Therapy began in the 1960s when Aron Beck tried to prove that
depression was anger turned inward. A psychoanalytically trained
psychiatrist, Beck listened to the free associations, dreams and
conversations of depressed people. He was surprised to find that
depressed people had many depressing or negative thoughts which
objectively appeared to be false. His curiosity led him to develop ways
to question these thoughts and change beliefs. People were less
depressed when their thoughts were more accurate.
Research has improved on the techniques and enlarged their applicability. Today Cognitive Therapy is useful for depression anxiety, post-traumatic stress disorder, panic attacks, phobias, personality disorders and relationship difficulties. Children, teens, adults, individuals and couples can all be helped using Cognitive Therapy.
Life experiences require that we somehow make sense of them. The resulting beliefs affect our behavior and mood. A child growing up in a home where he is constantly criticized may grow up with the core belief "I'm not good enough." This core belief is the root of behaviors, thoughts and moods. This person may be unassertive, may be an under-achiever, may think he is not adequate in his career, relationships or sports, and his moods might include depression and anxiety. The same core belief could result in different behavior, thoughts and moods in another person.
Cognitive Therapy is collaborative--client and therapist bring their expertise into the therapy. Clients are taught to notice their moods, then to become aware of the thoughts that accompany them. These skills are first taught in the session. The client then practices until the skill is able to be used in even the most difficult situations. Next the client is encouraged to approach his thoughts with curiosity, rather than from belief in a thought. There is a questioning: "What evidence supports my belief?" Clients also find that they may do a behavioral experiment outside of the session to collect more information.
Sometimes the client discovers that he needs to learn more skills, such as how to be assertive, how to make small talk at a party, or how to arrange his time to be productive at school or work. Role play, reading, classes, and talks with friends may be ways of gaining skills. Together the client and therapist use their expertise and creativity to customize the correct tools for the client.
When problems have been long-standing, other methods are used to change beliefs. These include a thorough review of the client's childhood in a much different way than most other therapies employ. Other techniques are used to change the prejudicial beliefs. Courage and tenacity are required to form more accurate beliefs.
Cognitive Therapy can come to a close when the client no longer jumps to his old conclusions, but instead considers the evidence to find out what is true. He has learned tools to prevent or decrease the severity of relapse.
Carol Hasenick is a licensed Marriage Family Child Counselor with a practice in Santa Rosa, California.
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