Cognitive Theory and Associated Therapies
Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C.E. Zupanick, Psy.D. and Mark Dombeck, Ph.D.Although behavioral learning theory offered promising therapeutic techniques, there were some significant problems. Behaviorism sought to make psychology a respected science by studying observable (measurable) human behavior. To achieve this goal using systematic, scientific methods of research it was necessary to discount internal, mental events such as thoughts, beliefs, motivations, feelings, and perceptions. This is because these internal events, called cognitions, are not observable, nor readily measurable. Cognitive theorists have since recognized the importance of these internal events (collectively referred to as cognitions). They subsequently developed methods to study their effects.
Cognitive therapy also rose in popularity due to the public's misinterpretation that behaviorism had the potential to control and manipulate people. People were philosophically opposed to the notion that human beings could be reduced to a collection of behaviors that could be easily manipulated through environmental rewards and punishments. Other factors also contributed to the decline of pure behaviorism, such as the increasing awareness of genetic influences on behavior.
Cognitive Theory:
In the 1950's, a psychologist named Albert Ellis, and a psychiatrist named Aaron Beck, independently developed two very similar theories. Both of these theories resulted in effective forms of cognitive therapy. These therapies continue to be widely practiced today. While behavioral learning theory emphasizes the role of the environment, cognitive theory emphasizes the key role of the mind's cognitions in determining behavior. These cognitions include a person's thoughts, feelings, beliefs, and perceptions.
According to cognitive theory, our dysfunctional thoughts lead to extreme emotions. These extreme emotions in turn, lead to maladaptive behaviors. To illustrate the powerful effect of these thoughts, consider the following example. Suppose I am preparing to take a difficult test. While doing so I think to myself "I can't do anything right, I'll probably fail this test." This thought will likely cause me to feel apprehensive. When I eventually take the test, this degree of anxiety will affect my ability to concentrate and earn a good grade. In addition, these negative thoughts will affect the amount of effort I put forth when studying for the test. When I incorrectly believe that I will certainly fail, it seems rather futile to invest a great deal of energy in attempting to succeed. As a result, I may indeed fail, simply because I didn't invest much time and energy in preparation for the exam. Ironically, this failure will serve to strengthen my faulty belief; i.e., my poor test score "proves" my belief is correct- I am a failure. However, the true reason for my failure was due to my lack of effort and preparation, and not because I am inherently a failure. Quite a different outcome would occur if I were to think to myself, "Yes, this test is going to be quite difficult but I have succeeded before. I will study hard and put forth my best effort. Besides, I am just as competent as any of the other students in the class." These thoughts would cause me to feel confident and ready to face the challenge. I would put forth the extra effort needed to succeed. Clearly, these two different ways to think about the same event result in very different behaviors and outcomes.
Albert Ellis's cognitive therapy is called Rational Emotive Behavior Therapy (REBT). He believed peoples' intense suffering from negative emotions was caused by their irrational core beliefs. Core beliefs refer to the basic beliefs people have about themselves and the world around them. For instance, in the previous example my thought "I'll probably fail this test" may stem from a core belief "I must always achieve complete success or else I am a complete failure." Irrational core beliefs cause the negative emotions that lead to dysfunctional behaviors.
Albert Ellis focused on irrational core beliefs by identifying beliefs for which there was no evidence. Thus, they are irrational. According to REBT, teaching therapy participants to think in a more rational, balanced manner eliminates the extreme emotions that result from these irrational beliefs. In so doing, this rational thinking eliminates dysfunctional behavior. Ellis identified common, irrational, core beliefs such as: 1) I must do well and win the approval of others or else I am no good. 2) Everybody should treat me kindly. (3) Life must be fair. Ellis noticed that irrational beliefs often contained words like "must," "should," and "can't." REBT has a systematic and direct way of teaching therapy participants to identify, challenge, and replace these irrational core beliefs with more rational and balanced ones.
Around this same (1950's), Aaron Beck was practicing as a psychoanalyst. He realized that people's internal thoughts and perceptions had a large influence on their emotions. He also believed that a more active and directive approach to modify thoughts would positively influence behavioral change. His theory takes a slightly different approach than REBT, and the terminology is somewhat different. Nonetheless, both Beck and Ellis sought to modify an individual's dysfunctional thoughts, in order to produce a change in emotions and behavior.
According to Beck, problems occur when distorted thinking patterns influence our interpretation of environmental events. In other words, our behavior is not really determined by what is actually happening in the environment. Instead, our behavior is determined by our thoughts about what is happening. Therefore, behavior is significantly influenced by our perceptions and interpretations of the environment. Let's illustrate this important distinction. Suppose someone walks past me and steps on my foot. I could interpret this as an accidental, clumsy act. Alternatively, I could interpret it as an intentional, hostile act. Each interpretation would likely elicit a very different emotional and behavioral response.
According to Beck, the way we interpret environmental events is a function of our core schema. A core schema is a central assumption about oneself, others, and the world. These assumptions influence our feelings and behavior. Examples of core schema include: 1) The world is a dangerous place. 2) I am unlovable. 3) I am inadequate. Notice how similar Ellis's concept of core beliefs is to Beck's concept of core schema. According to cognitive theory, when cognitive distortions and core beliefs are modified, behavioral change naturally follows. This principle forms the foundation for cognitive therapy techniques.
Resources
-
Articles
- What is Anxiety?
-
The Biopsychosocial Model of Anxiety
- The Biopsychosocial Model: Causes of Pathological Anxiety
- Biological Explanations of Anxiety Disorders
- Biological Explanations of Anxiety: Part II
- Biological Explanations of Anxiety: Part III
- Biological Explanations of Anxiety: Part IV
- Psychological Explanations of Anxiety Disorders
- Psychological Explanations: Part II
- Social Explanations of Anxiety Disorders
- Development & Maintenance of Anxiety Disorders
-
Classification & Diagnosis of Anxiety Disorders
- The Classification and Diagnosis of Anxiety Disorders
- Panic Attacks: A Classic Symptom of Several Anxiety Disorders
- Panic Disorder
- Separation Anxiety Disorder
- Selective Mutism
- Agoraphobia
- Specific Phobias and Social Anxiety Disorder (Social Phobia)
- Generalized Anxiety Disorder (GAD)
- Other Anxiety-Related Disorders
- Anxiety and Other Psychiatric Disorders
-
Anxiety Disorder Theories and Therapies
- Anxiety Disorders: Theories and Therapies
- Behavioral Learning Theory and Associated Therapies
- Operant Conditioning
- Operant Conditioning and Avoidance Learning
- Contemporary Views of Behavioral Learning Theory
- Behavioral Therapies for Anxiety Disorders
- Cognitive Theory and Associated Therapies
- Cognitive Therapy
- Cognitive-Behavioral Therapy
- Adjunct Therapies
- Pharmacologic Treatments (Medication)
-
Treatment of Anxiety Disorders
- Treatment for Separation Anxiety Disorder
- Treatment for Selective Mutism
- Treatment for Panic Disorder
- Treatment for Specific Phobias and Treatment for Social Anxiety Disorder (Social Phobia)
- Treatment for Generalized Anxiety Disorder (GAD)
- Treatment for Obsessive-Compulsive Spectrum Disorders (OCSDs)
- Conclusion
- Anxiety Disorder References & Additonal Resources
-
News
-
Questions and Answers
- Anxious About Opinions
- Possible OCD and Anxiety issues
- Fear
- Stay in Therapy Because I Like it?
- Is My Anxiety a Normal Reaction?
- What am I Supposed to do With a Hypochondriac Step Daughter?
- Need Help
- Husband Continually Annoyed/Angry With Me
- How Can I Overcome my Debilitating Shyness and Fear of Life?
- Really Desperate..Please Help
-
111 more
- OCD and Trauma?
- Depression
- I Don't Care For Anything, I Feel as Though I'm Wasting my Life.
- Unwanted Thoughts
- Anxiety Has Taken Over My Life...
- CBT Therapy and Transference
- Transference II
- OCD
- 19 Yr Old Naive Daughter
- Fear of Choking
- Help
- Should I be Worried?
- Too Much Time doing Homework
- Falling Apart
- Can't Stand Noise
- What Is Intimacy, Exactly?
- Is She Ill?
- Social Anxiety, Depression and More...
- Do I Have Just Social Anxiety or Other Diagnoses Combined with SA?
- Need To Ask Someone
- False Memories
- Help! Please!
- Two Year Old Son Wandered
- Infections and The Brain
- Are Personality Disorders For Life?
- I am Terrified of Death.
- Anhedonia
- Our 23 Year Old Son Refuses to Get Help for His Anxiety Attacks and Depression.
- Anxiety
- Anxiety Disorder vs. Personality Disorder: Differences?
- Restroom Phobia
- I'm Afraid I'm Going Crazy
- Post Brain Surgery Mental Problems
- Would Medication Help?
- obsessive strange thoughts about life and existentialism
- Am I Crazy?
- Is it Anxiety? Is it Normal to Be Like That?
- Depressed 19 year old college student
- Depression helps to contribute to my unemployment! - Paula
- Relationship Anxiety
- Disconnected
- I'm Scared
- Please help fix my mom. - Kenny
- OCD?
- Saving my Son
- Scary thoughts, dark feelings, help?
- Swallowing fear
- Is there something wrong with me?
- I have PTSD and I feel nothing
- OCD Cure
- Repressed Memory
- I have OCD. Will this increase my child's chance of developing Autism?
- Crazy Thoughts
- 20 Year Old Female: no friends, depressed, what should I do?
- unwanted thoughts!
- crazy thoughts... all the time
- A very low threshold for stress tolerance
- Why can't I get gross images out of my head?
- fear of expiration
- SPECIFIC PHOBIA
- anxiety or going crazy?
- OCB
- visions of what could have been
- about depersonalization
- obsessive compulsive disorder
- OCD/ANXIETY while pregnant
- Amnesia
- Social Phobia
- Constant Counting Disorder
- Anxiety
- Is this OCD?
- Worried about my therapist
- No Friends
- Teenager...angst vs. mental health issue
- phobia regarding uncertainty
- Obsessed with running out of things
- Do I Have OCD?
- Do environmental factors hold a person back?
- Never Had a Relationship
- Shy Rural Student
- Nursing Student's Anxiety
- I'm Afraid They Are Judging Me
- Part Time Work and Stress
- Anxiety
- Panic
- Bathroom Phobia
- Anxiety?
- Mastery Of Anxiety And Panic
- Very Determined Panicker In The South
- Panicking Boyfriend
- Alternatives For Anxiety Treatment
- Is Anxiety A Hereditary Factor?
- Unable To Keep Eye Contact
- Is It Really Panic? And How Do We Get Help
- A Cure For Claustrophobia?
- Panic Attacks
- Shyness And The Post Partum Blues
- Klonopin
- Alternative Treatment
- Can't Afford Therapy
- Driving Phobia
- Indecisive
- Agoraphobia?
- Social Fear
- A Cure For Anxiety?
- Panic Attacks
- Fear of Driving
- Shy Guy
- Anxiety?
- Social Anxiety
- Linda writes:
-
Book & Media Reviews
- 8 Keys to Stress Management
- A Brief History of Anxiety
- Anxiety
- Anxiety
- Anxiety Disorders
- Anxiety, Phobias, and Panic
- Been There, Done That? DO THIS!
- Calm Beneath the Waves
- Elsewhere
- Exercise for Mood and Anxiety
-
31 more
- Getting Control
- Helping Students Overcome Depression and Anxiety
- Just Checking
- Mind-Body Workbook for Anxiety
- Monkey Mind
- My Age of Anxiety
- Overcoming School Anxiety
- Panic Disorder
- Passing for Normal
- Phobic and Anxiety Disorders in Children and Adolescents
- Repressed Spaces
- Self-Coaching
- Stress
- Stress Survival Guide
- Textbook of Anxiety Disorders
- The 10 Best Anxiety Busters
- The Age of Anxiety
- The Anxieties of Affluence
- The Dutiful Worrier
- The Emotional Eater's Repair Manual
- The Male Stress Survival Guide
- The Places That Scare You
- The Stress Cure
- The SuperStress Solution
- Treating Affect Phobia
- Under Pressure and Overwhelmed
- Viniyoga Therapy for Anxiety
- When Words Are Not Enough
- Wish I Could Be There
- Yoga for Anxiety
- Yoga Journal's Yoga for Stress
-
Self-Help Groups
-
Links
-
Videos
- How to Manage ADHD and Anxiety
- What You Need to Know about Students with ADHD and Anxiety
- How To Make Room For Gratitude In An Anxious Brain
- How to Stay Calm When You Know You'll Be Stressed
- Anxiety and Teen Girls with Lisa Damour, PhD
- Is it Anxiety or a Heart Condition?
- Identifying and Treating Anxiety in Kids and Teens
- Child Anxiety, It’s Real
- Helping Children Cope with Anxiety
- Anxiety, Trauma and How Prolonged Exposure Therapy Works For PTSD
-
26 more
- OCD, Phobias and Anxiety
- How Weighted Blankets May Lift Anxiety
- Controlling Anxiety
- Too Scared: Social Anxiety Disorder
- Panic Disorders Video
- Phobias Video
- Treating Anxiety Disorders: A Unified Protocol
- Treating Youth Anxiety and Social Phobia
- Overcoming Anxiety in Children and Teens
- Treating Anxiety in Children and Teens with ASD
- Back-to-School Anxiety
- No More Shame: My life with Anxiety and Depression
- Adolescent Depression and Anxiety
- What is Social Anxiety Disorder?
- Living Without Fear
- What is Generalized Anxiety Disorder?
- What is Generalized Anxiety Disorder?
- School Anxiety! Activities To Help Kids and Teens Manage It
- Recognizing and Treating Problematic Fear and Anxiety in Children
- How To Stop Overthinking When You Have Anxiety
- My Anxiety Is Making Me Anxious!
- Evidence-Based Treatment Planning for Generalized Anxiety Disorder Video
- Managing Anxiety in Youth: More Action Than Talk
- Treatment of Social Anxiety Disorder
- Cognitive Behavioral Therapy for Anxiety
- Recent Advances in Anxiety - Children/Adolescents
-
More Information
- Wise Counsel Interview Transcript: An Interview with David Barlow, Ph.D. on the Nature and Treatment of Anxiety and Panic Disorders
- Wise Counsel Interview Transcript: An Interview with Dr. Michelle Craske on Anxiety Disorders Research and Treatment
- Wise Counsel Interview Transcript: An Interview with Richard Heimberg, Ph.D. on Anxiety Research and Treatment
Topics
-
Related Topic Centers
-
Addictions
-
Aging & Elder Care
-
Assessments & Interventions
-
Career & Workplace
-
Emotional Well-Being
-
Life Issues
-
Parenting & Child Care
-
Abuse
-
ADHD: Attention Deficit Hyperactivity Disorder
-
Adoption
-
Autism
-
Child & Adolescent Development: Overview
-
Child & Adolescent Development: Puberty
-
Child Development & Parenting: Early (3-7)
-
Child Development & Parenting: Infants (0-2)
-
Child Development & Parenting: Middle (8-11)
-
Child Development & Parenting:Adolescence (12-24)
-
Child Development Theory: Adolescence (12-24)
-
Child Development Theory: Middle Childhood (8-11)
-
Childhood Mental Disorders and Illnesses
-
Childhood Special Education
-
Divorce
-
Family & Relationship Issues
-
Intellectual Disabilities
-
Learning Disorders
-
Oppositional Defiant Disorder
-
Parenting
-
Self Esteem
-
-
Psychological Disorders
-
Anxiety Disorders
-
Bipolar Disorder
-
Conversion Disorders
-
Depression: Depression & Related Conditions
-
Dissociative Disorders
-
Domestic Violence and Rape
-
Eating Disorders
-
Impulse Control Disorders
-
Intellectual Disabilities
-
Mental Disorders
-
Obsessive-Compulsive Spectrum Disorders
-
Personality Disorders
-
Post-Traumatic Stress Disorder
-
Schizophrenia
-
Sexual Disorders
-
Somatic Symptom and Related Disorders
-
Suicide
-
Tourettes and other Tic Disorders
-