2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
Author: Zaikovsky Pavel
Psychologist, Cognitive Behavioral Therapist
Tashkent city (Uzbekistan)
The cognitive model assumes that it is not the situation itself that influences our emotions, bodily reactions and behavior, but how we perceive the situation. Undoubtedly, there are events that can really upset everyone, such as cheating or rejection. But it often happens that people misinterpret neutral and sometimes positive events. This suggests that their perception of the situation does not correspond to reality.
The work on correcting cognitive errors consists in critically assessing thoughts and responding to them correctly, which can significantly improve the client's condition. Therefore, therapy begins with a detailed analysis of the cognitive model, which is best explained using examples from the client's life.
How to explain the cognitive model
First, you need to identify the situation, by the example of which we will analyze the cognitive model.
Therapist: I have already mentioned that our thoughts affect our mood. Let me try to show you exactly how this happens. Please remember some recent situation when you noticed that your mood has changed dramatically, for example, you are upset. Did you have anything like that?
Client: Yes, just last week there was an incident. We talked with a friend in a cafe, she said that she was getting married. I was very happy for her, but then for some reason I felt bad.
Now let's try to understand how thoughts affect mood and behavior.
Therapist: Remember what you thought then?
Client: “This is such a big and important step. Everything is good in her life: she has a job, a loved one, now she will have a family. And my personal life does not add up. Why am I always so unlucky?
Therapist: That is, you thought: "She is doing well, but your personal life is not working out." How did you feel at this moment?
Client: I was upset. I felt very sad.
Therapist: And what did you do after that?
Client: Hastened to end the conversation and went home.
Therapist: We have now analyzed an example that shows how thoughts have influenced your mood. Let's draw a diagram to make it clearer for you how it works.
We clarified the situation, identified automatic thoughts (AM), emotional reaction to them and behavior. You can now draw a visual diagram to help solidify your understanding of the cognitive model.
Next, I need to make sure the client understands how automatic thoughts affect their emotional responses.
Therapist: So, you learned from a friend that she is getting married, and you thought that your personal life is not working out. The thought made you sad and so you rushed to end the conversation.
Client: Yes, it was.
Therapist: You see that not the situation itself, but your assessment of this situation led to the emergence of automatic thoughts that influenced your state. Do you understand how this mechanism works?
Client: Seems to be yes. What I thought influenced how I felt.
Therapist: Quite right.
It is not enough to simply understand the mechanism of the cognitive model. Automatic thoughts are the flow of thought that everyone has. Most of the time, we are simply not aware of our automatic thoughts, and even if we are, we do not question them, especially when we are in a depressed state.
Our task is to learn how to track their appearance in everyday life, outside the therapy session. To do this, I propose a sequence of actions that will help bring automatic thoughts to a conscious level.
Therapist: We have just discussed how the cognitive model works and the importance of identifying automatic thoughts. What assignment could you give yourself before our next session?
Client: I could pay attention to my thoughts when I feel worse.
Therapist: Well done! That is, literally, when you notice that your mood has worsened, ask yourself a question: "What am I thinking about right now?" and write these thoughts in your journal.
Client: Good.
Therapist: If in the course of our work it turns out that your thoughts correctly reflect reality, then we will solve the problem because of which your thoughts turned out to be correct. But, most likely, we will find many distorted thoughts and therefore it is very important that you remember now: your thoughts are not always true.
And in the next session, we will together evaluate them for reliability and learn to look at things more realistically. This way you can feel better.
Next, we draw up a coping card that will remind the client to identify automatic thoughts when his condition worsens.
Developing the skill of identifying AM
Identifying and evaluating automatic thoughts is a skill that comes with practice. The more the client practices, the better he gets at it.
Therapist: We discussed with you why it is important to track and record your thoughts. What question will you ask yourself when you notice that your mood has worsened?
Client: When I feel worse, I ask myself, "What am I thinking right now?"
Therapist: Right! And one moment. You may not immediately get used to asking yourself this question and will not always pay attention to your automatic thoughts. You will get better and better over time. If you can't immediately track automatic thoughts, you can briefly describe the situation., and we will reveal thoughts together with you at the session.
Client: Yes, I understand.
Therapist: Therefore, I invite you to remind yourself that identifying automatic thoughts is a skill just like driving a car, you will develop it gradually and the more you practice, the better you will get.
I suggest the client write down another coping card and refer to it from time to time.
I recommend using coping cards for independent work. Print them out on a printer or write by hand on paper and refer to them when you feel your mood has changed dramatically.
Conclusion
Understanding the cognitive model helps clients to consciously track their automatic thoughts and evaluate them for validity. Over time, clients get used to asking themselves a question about their thoughts and this skill becomes automatic, which helps them to better see the real state of affairs.
In preparing the article, the following materials were used:
Beck Judith. Cognitive Behavioral Therapy. From basics to directions. - SPb.: Peter, 2018.-- 416 s: ill. - (Series "Masters of Psychology").
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