Implementing Cognitive Behavioral Therapy for the Treatment of Depression and Anxiety.
Symptoms of depression includes: depressed mood most of the day, markedly diminished interest or pleasure in activities, significant weight loss or gain, insomnia or hypersomnia, fatigue or loss of energy, psychomotor retardation or agitation, feelings of worthlessness or guilt, recurrent suicidal ideations or thoughts and diminished concentration.
Symptoms of anxiety includes: irritability/easily keyed up, restlessness, fatigue, difficulty concentrating and muscle tension. Please refer to a mental health professional for purposes of diagnosis/treatment.
Cognitive-behavioral therapy (CBT) is a form of psychotherapy that treats emotional disturbances by modifying dysfunctional emotions, behaviors, and thoughts. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications. CBT revolves around the idea that our thoughts about a situation affect how we feel (emotionally and physically) and how we behave in that situation. The interpretation we give to life events and situations play a bigger role at determining how we feel than the event itself.
CBT is based on several core principles, including:
Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
Psychological problems are based, in part, on learned patterns of unhelpful behavior.
People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives
Identify triggers such as marital conflicts, work-related stress, parenting difficulties, family issues and so on. Another good strategy to implement is identifying and challenging irrational and dysfunctional thoughts and beliefs systems.
Cognitive distortions are irrational and dysfunctional ideas and thoughts that sabotages our minds. These inaccurate thoughts normally reinforce negative thinking or emotions — telling ourselves things that we think are logical and rational, but really only leads to emotional suffering and pain.
The main goal of CBT is to help clients identify and modify cognitive distortions into more functional and rational ones. Once we are able to change the way we think, we automatically change the way we feel and hence, our behavior and interaction with the ourselves and others change.
The Most Common Cognitive Distortions:
In 1976, psychologist Aaron Beck first proposed the theory behind cognitive distortions and in the 1980s, David Burns was responsible for popularizing it with common names and examples for the distortions.
1. Filtering.
We take the negative details and magnify them while filtering out all positive aspects of a situation. For instance, a person may pick out a single, unpleasant detail and dwell on it exclusively so that their vision of reality becomes darkened or distorted.
2. Polarized Thinking (or “Black and White” Thinking).
In polarized thinking, things are either “black-or-white.” We have to be perfect or we’re a failure — there is no middle ground. You place people or situations in “either/or” categories, with no shades of gray or allowing for the complexity of most people and situations. If your performance falls short of perfect, you see yourself as a total failure.
3. Overgeneralization.
In this cognitive distortion, we come to a general conclusion based on a single incident or a single piece of evidence. If something bad happens only once, we expect it to happen over and over again. A person may see a single, unpleasant event as part of a never-ending pattern of defeat.
4. Jumping to Conclusions.
Without individuals saying so, we know what they are feeling and why they act the way they do. In particular, we are able to determine how people are feeling toward us.
For example, a person may conclude that someone is reacting negatively toward them but doesn’t actually bother to find out if they are correct. Another example is a person may anticipate that things will turn out badly, and will feel convinced that their prediction is already an established fact.
5. Catastrophizing.
We expect disaster to strike, no matter what. This is also referred to as “magnifying or minimizing.” We hear about a problem and use what if questions (e.g., “What if tragedy strikes?” “What if it happens to me?”).
For example, a person might exaggerate the importance of insignificant events (such as their mistake, or someone else’s achievement). Or they may inappropriately shrink the magnitude of significant events until they appear tiny (for example, a person’s own desirable qualities or someone else’s imperfections).
With practice, you can learn to answer each of these cognitive distortions.
6. Personalization.
Personalization is a distortion where a person believes that everything others do or say is some kind of direct, personal reaction to the person. We also compare ourselves to others trying to determine who is smarter, better looking, etc.
A person engaging in personalization may also see themselves as the cause of some unhealthy external event that they were not responsible for. For example “ My son obtained a bad grade in his homework; iIf only I had helped him more he would’ve have gotten an A.”
7. Control Fallacies.
If we feel externally controlled, we see ourselves as helpless a victim of fate. For example, “It is out my control that you did not like the meal, I did my best to follow the recipe ” The fallacy of internal control has us assuming responsibility for the pain and happiness of everyone around us. For example, “Why are you upset? Is it because of something I told you?”
8. Fallacy of Fairness.
We feel resentful because we think we know what is fair, but other people won’t agree with us. As our parents tell us when we’re growing up and something doesn’t go our way, “Life isn’t always fair.” People who go through life applying a measuring ruler against every situation judging its “fairness” will often feel badly and negative because of it. Because life isn’t “fair” — things will not always work out in your favor, even when you think they should.
9. Blaming.
We hold other people responsible for our pain, or take the other track and blame ourselves for every problem. For example, “Stop making me feel useless” Nobody can “make” us feel any particular way — only we have control over our own emotions and emotional reactions.
10. Shoulds.
We have a list of ironclad rules about how others and we should behave. People who break the rules make us angry, and we feel guilty when we violate these rules. A person may often believe they are trying to motivate themselves with shoulds and shouldn’ts, as if they have to be punished before they can do anything.
For example, “I really should be more proactive, I should not be so passive.” Musts and oughts are also offenders. The emotional consequence is guilt. When a person directs should statements toward others, they often feel anger, frustration and resentment.
11. Emotional Reasoning.
We believe that what we feel must be true automatically. If we feel stupid and boring, then we must be stupid and boring. You assume that your unhealthy emotions reflect he way things really are — “I feel it, therefore it must be true.”
12. Fallacy of Change.
We expect that other people will change to suit us if we just pressure or cajole them enough. We need to change people because our hopes for happiness seem to depend entirely on them.
13. Global Labeling.
We generalize one or two qualities into a negative global judgment. These are extreme forms of generalizing, and are also referred to as “labeling” and “mislabeling.” Instead of describing an error in context of a specific situation, a person will attach an unhealthy label to themselves.
For example, they may say, “I’m a loser” in a situation where they failed at a specific task. When someone else’s behavior rubs a person the wrong way, they may attach an unhealthy label to him, such as “He’s a real jerk.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded. For example, instead of saying their son visits his parents on a monthly basis, they would say “his son barely takes care of his parents ”
14. Always Being Right.
We are continually on trial to prove that our opinions and actions are correct. Being wrong is unthinkable and we will go to any length to demonstrate our rightness. For example, “I don’t care how badly arguing with me makes you feel, I’m going to win this argument no matter what because I’m right.” Being right often is more important than the feelings of others around a person who engages in this cognitive distortion, even loved ones.
15. Heaven’s Reward Fallacy.
We expect our sacrifice and self-denial to pay off, as if someone is keeping score. We feel bitter when the reward doesn’t come.
Beck, A. T. (1976). Cognitive therapies and emotional disorders. New York: New American Library.
