A thought process for developing healthier thinking.
Cognitive behavior therapy is based on a cognitive theory of psychopathology. The cognitive model describes how people’s perceptions of, or spontaneous thoughts about, situations influence their emotional, behavioral (and often physiological) reactions. Individuals’ perceptions are often distorted and dysfunctional when they are distressed. They can learn to identify and evaluate their “automatic thoughts” (spontaneously occurring verbal or imaginal cognitions), and to correct their thinking so that it more closely resembles reality. When they do so, their distress usually decreases, they are able to behave more functionally, and (especially in anxiety cases), their physiological arousal abates.
Individuals also learn to identify and modify their distorted beliefs: their basic understanding of themselves, their worlds, and other people. These distorted beliefs influence their processing of information, and give rise to their distorted thoughts. Thus, the cognitive model explains individuals’ emotional, physiological, and behavioral responses as mediated by their perceptions of experience, which are influenced by their beliefs and by their characteristic ways of interacting with the world, as well as by the experiences themselves. Therapists use a gentle Socratic questioning process to help patients evaluate and respond to their automatic thoughts and beliefs—and they also teach them to engage in this evaluation process themselves. Therapists may also help patients design behavioral experiments to carry out between sessions to test cognitions that are in the form of predictions. When patients’ thoughts are valid, therapists do problem solving, evaluate patients’ conclusions, and work with them to accept their difficulties.
The Cognitive Model
The cognitive model describes how people’s thoughts and perceptions influence their lives. Often, distress can distort people’s perceptions, and that, in turn, can lead to unhealthy emotions and behaviors. CBT helps individuals learn to identify and evaluate their “automatic thoughts” and shift their thinking to be healthier. The cognitive model is at the core of CBT, and it plays a critical role in helping therapists use gentle Socratic questioning to develop treatments.