Psychology and Psychiatry

Cognitive psychotherapy

Cognitive psychotherapy - is a form of a structured, short-term, policy-oriented, symptomatic-oriented strategy for stimulating the transformations of the cognitive structure of the personal “I” with evidence of transformations on the behavioral level. This direction generally refers to one of the concepts of modern cognitive behavioral studies in psychotherapeutic practice.

Cognitive-behavioral psychotherapy studies the mechanisms of perception by an individual of circumstances and the personality’s thinking, and contributes to the development of a more realistic view of what is happening. Due to the formation of an adequate attitude to the events that occur, a more consistent behavior is born. In turn, cognitive psychotherapy is focused on helping individuals find solutions to problem situations. It works in circumstances where there is a need to search for new forms of behavior, build the future, fix the result.

Techniques of cognitive psychotherapy are constantly used at certain phases of the psychotherapeutic process in combination with other methods. The cognitive approach to the defects of the emotional sphere transforms the point of view of individuals into their own personality and problems. This type of therapy is convenient in that it is harmoniously combined with any approach of a psychotherapeutic orientation, it is able to complement other methods and significantly enrich their effectiveness.

Beck's Cognitive Psychotherapy

Modern cognitive-behavioral psychotherapy is considered to be the common name for psychotherapy, the basis of which is the statement that dysfunctional views and attitudes are a factor that provokes all psychological deviations. The creator of the direction of cognitive psychotherapy is Aaron Beck. He gave a start to the development of cognitive trends in psychiatry and psychology. Its essence lies in the fact that absolutely all human problems are formed by negative thinking. A person interprets external events according to the following scheme: the stimuli act on the cognitive system, which, in turn, interprets the message, that is, thoughts are born that give rise to feelings or provoke certain behavior.

Aaron Beck believed that the thoughts of people determine their emotions, which determine the appropriate behavioral reactions, and those, in turn, shape their place in society. He argued that the world is not initially bad, but people see it as such. When the interpretations of the individual strongly differ from external events, mental pathology appears.

Beck observed patients suffering from neurotic depression. During the observations, he noted that in the experiences of the patients there were constantly heard themes of defeatist mood, hopelessness and inadequacy. As a result, he derived the following thesis that a depressive state develops in subjects who comprehend the world through three negative categories:

- a negative look at the present, that is, regardless of what is happening, the depressive person concentrates on the negative aspects, while everyday life gives them a certain experience, which brings pleasure to the majority of individuals;

- the hopelessness felt in relation to the future, that is, the depressed individual, presenting the future, finds in it exclusively gloomy events;

- reduced self-esteem, that is, the depressed subject thinks that he is an untenable, nothing worthless and helpless person.

Aaron Beck in cognitive psychotherapy has developed a therapeutic program of behavioral orientation, which uses such mechanisms as self-control, modeling, homework, role-playing games, etc. He mainly worked with patients suffering from various personality disorders.

His concept is described in the work entitled: "Beck, Freeman, cognitive psychotherapy of personality disorders." Freeman and Beck were convinced that each personality disorder is characterized by the predominance of certain attitudes and strategies that form a certain profile inherent in a particular disorder. Beck made the claim that strategies can either compensate for certain experience or flow from it. Depth correction schemes for personality disorders can be derived from a quick analysis of an individual's automatic thoughts. The use of imagination and the secondary experience of a traumatic experience can trigger the activation of deep patterns.

Also in the work of Beck, Freeman "Cognitive psychotherapy of personality disorders", the authors focused on the importance of psychotherapeutic relationships in working with individuals suffering from personality disorders. Because quite often in practice there is such a specific aspect of the relationship that is built between the therapist and the patient, known as "resistance."

Cognitive psychotherapy of personality disorders is a systematic, direction of modern psychotherapeutic practice that resolves problem situations. Often it is limited by time frames and almost never exceeds thirty sessions. Beck believed that the psychotherapist should be benevolent, empathic and sincere. The therapist himself must be the standard of what he seeks to teach.

The ultimate goal of cognitive psychotherapeutic care is to detect dysfunctional judgments that provoke the occurrence of depressive moods and behavior, and then their transformation. It should be noted that A. Beck was not interested in what the patient thinks about, but how he thinks. He believed that the problem is not whether the patient loves himself, but what categories he thinks depending on the conditions (“I am good or bad”).

Cognitive psychotherapy methods

The methods of the direction of cognitive psychotherapy include combating negative thoughts, alternative strategies for perceiving the problem, secondary experience of situations from childhood, and imagination. These methods are aimed at creating opportunities for forgetting or new learning. Practically, it was revealed that the cognitive transformation is dependent on the degree of emotional experience.

Cognitive psychotherapy of personality disorders involves the use of both cognitive methods and behavioral techniques that complement each other. The main mechanism for a positive result is the development of new schemes and the transformation of old ones.

Cognitive psychotherapy, applied in its generally accepted form, counteracts the desire of the individual for a negative interpretation of the events taking place and themselves, which is especially effective in depressive moods. Since depressed patients are often characterized by the presence of thoughts of a certain type of negative orientation. Identification of such thoughts and victory over them is of fundamental importance. For example, a depressed patient, recalling the events of the past week, said that then he still knew how to laugh, but today it has become impossible. The psychotherapist who practices the cognitive approach, instead of accepting such thoughts without question, encourages the study and challenge of the course of such thoughts, suggesting to the patient to recall situations when he defeated a depressive mood and felt great.

Cognitive psychotherapy is aimed at working with what the patient communicates to himself. The main psychotherapeutic step is the recognition by the patient of certain thoughts, as a result of which it is possible to stop and modify such thoughts until their results have taken the individual very far. It becomes possible to change the negative thoughts on others who are able to have a positive effect.

In addition to countering negative thoughts, alternative strategies for perceiving a problem also have the potential to transform the quality of experiences. For example, the general feeling of a situation is transformed if the subject begins to perceive it as a challenge. Also, instead of desperately seeking to succeed, producing actions that the individual is not able to perform well enough, you should set yourself an immediate goal of practice, as a result of which much greater success can be achieved.

Psychotherapists who practice the cognitive approach use the concepts of challenge and practice to counter certain unconscious premises. The recognition of the fact that the subject is an ordinary person, who has disadvantages, can minimize the difficulties created by the attitude towards absolute striving for perfection.

Specific methods for the detection of automatic thoughts include: recording such thoughts, empirical testing, reevaluation techniques, decentration, self-expression, decatastrophication, targeted repetition, the use of imagination.

Cognitive psychotherapy exercises combine actions to research automatic thoughts, their analysis (which conditions provoke anxiety or negative) and the performance of tasks in places or conditions that provoke anxiety. Such exercises contribute to the consolidation of new skills and gradually modify the behavior.

Cognitive psychotherapy techniques

The cognitive approach to therapy is inextricably linked with the formation of cognitive psychology, which places the main focus on the cognitive structures of the psyche and deals with personal elements and logical abilities. Education cognitive psychotherapy today is widespread. According to A. Bondarenko, the cognitive direction combines three approaches: A. Beck’s directly cognitive psychotherapy, A. Ellis rational emotive concept, and V. Glasser’s realistic concept.

The cognitive approach is structured learning, experimenting, training in the mental plane and behavioral aspect. It is intended to assist the individual in mastering the operations described below:

- detection of own negative automatic thoughts;

- Finding the relationship between behavior, knowledge and affects;

- finding the facts "for" and "against" the identified automatic thoughts;

- finding more realistic interpretations for them;

- training in the identification and transformation of disorganizing beliefs leading to the deforming of skills and experiences.

Learning cognitive psychotherapy, its basic methods and techniques helps to identify, disassemble and, if necessary, transform the negative perception of situations or circumstances. People often begin to fear that they have predicted themselves, as a result of which they expect the worst. In other words, the subconscious of the individual warns him of a possible danger until he enters a dangerous situation. As a result, the subject is frightened in advance and seeks to avoid it.

By systematically tracking one’s own emotions and striving to transform negative thinking, one can reduce premature fear, which is capable of being modified in a panic attack. With the help of cognitive techniques, there is the possibility of changing the fatal perception of panic attacks that is typical of such thoughts. Due to this, the duration of a panic attack is shortened, and its negative impact on the emotional state is reduced.

The technique of cognitive psychotherapy consists in identifying the attitudes of patients (that is, their negative attitudes must become apparent to patients) and helping to understand the destructive impact of such attitudes. It is also important that the subject, based on his own experience, make sure that because of his own beliefs he is not happy enough and that he could be happier if he were guided by more realistic attitudes. The role of the psychotherapist is to provide the patient with alternative guidelines or rules.

Cognitive psychotherapy exercises for relaxation, stopping the flow of thoughts, managing impulses are used in conjunction with the analysis and regulation of daily activities in order to enhance the skills of subjects and their emphasis on positive memories.