Evaluating Unhelpful Automatic Thoughts in CBT

During a recent Beck Institute Workshop, Dr. Aaron Beck and Dr. Judith Beck discuss addressing clients’ automatic thoughts that may be true but unhelpful. They describe how therapists can help clients evaluate whether thoughts are productive in helping them reach their goals.

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Automatic Thoughts in CBT (Part 2)

In this video from a recent Beck Institute Workshop, Dr. Aaron Beck explains which types of automatic thoughts are important to address with clients. He then uses an example to explain the difference between affect laden thoughts and goal interfering thoughts, and notes that clients are often easily able to differentiate between the two.

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Automatic Thoughts in CBT

In this video from a recent Beck Institute Workshop, Dr. Aaron Beck explains that it is not useful to address all automatic thoughts. Rather, salient automatic thoughts, such as those that lead to unpleasant affect, should be identified, evaluated, and modified when appropriate.

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Ways to Elicit Automatic Thoughts

In this video from a recent Beck Institute Workshop, Dr. Aaron Beck discusses ways to elicit relevant automatic thoughts from clients. He gives examples of using imagery and in-vivo role-plays to teach clients how to identify automatic thoughts in session. Once clients learn how, they can begin to identify and modify interfering automatic thoughts throughout life.

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Cognitive Therapy and Psychodynamic Therapy

In this video from a recent Beck Institute workshop, Dr. Aaron Beck discusses the similarities and differences between cognitive therapy and modern psychodynamic therapy.  Both theories delve into the significance of automatic thoughts and their meanings, and both utilize action plans in therapy.  Dr. Beck explains, however, that cognitive therapy is based on the generic cognitive model and requires a structured, action-oriented session, while wpsychodynamic therapy utilizes a more discursive, free-flowing session oriented toward listening. To watch an additional video of Dr. Beck discussing the generic cognitive model, click here.

Suppressing Thoughts and Obsessions

Dr. Aaron Beck explains the research on suppressing thoughts and obsessions. He explains how taking a negative stance towards thoughts can ultimately make them worse in frequency and severity of the negativity of the thoughts themselves. For more information about CBT training directed by Drs. Judith and Aaron Beck visit our CBT Workshops page.

Case Conference with Aaron T. Beck, M.D.

Judith_Aaron BeckEarlier this week, students, faculty and professionals from local universities and mental health organizations visited the Beck Institute for Cognitive Therapy and Research to watch a live patient session, conducted by Dr. Aaron Beck, followed by a case conference. Although we cannot disclose the particulars of the case, below are some of the general points that came up, from participants in attendance, in a Q & A session with Dr. Beck:

Aaron Beck

That patients often need to test their automatic thoughts and beliefs by doing behavioral experiments in order to fully change their ideas. Dr. Beck also emphasized the importance of the therapeutic alliance in facilitating patient progress. Dr. Beck observed where anxiety is concerned there are often images and thought patterns. Dr. Beck explained how he discovered images and their application to the Cognitive Model (see video clip here). He explained why it’s critical to build a patient’s confidence so that he or she can take some control over his or her symptoms, including anxious images. Thanks to all the professors, students and professionals who came to visit the Beck Institute!

When patients get angry in session

Judith S. Beck writes in:

Some therapists are quite concerned about their patients becoming angry at them. Yet when therapists respond sensitively, they can help patients learn important lessons.

The first thing I do when a patient becomes angry is to elicit their automatic thoughts and positively reinforce them, in a genuine way. “I’m so glad you told me that.” And I am glad. If there’s a problem, I want to know about it, so I can fix it.

Next, I conceptualize the problem in order to decide what to do. If I think the patient is correct, I’ll apologize – and in so doing, become a good role model. For example, a patient might be annoyed because he felt I was interrupting him too much. If he had that reaction, he’s right. I overestimated his tolerance for interruptions, so I can – again genuinely – say, “You know, I think you’re right. I did interrupt you too much. I’m sorry.”

If I don’t think I made a mistake, I can still genuinely say, “I’m sorry you’re feeling distressed,” because I truly am sorry if something I’ve said or done (or not said or done) made the patient feel worse. Then I try to figure out how to solve the problem, which might involve helping the patient evaluate his negative ideas about me or suggesting we change what we’re doing in the session.

Demonstrating to patients that interpersonal problems can be solved is sometimes one of the greatest benefits of therapy.

Using Cognitive Therapy to treat Delusions

Dr. Aaron Beck recently responded to an interviewer’s questions about addressing delusions among Schizophrenic patients. One of the central tenets of Cognitive Therapy is that individuals learn to evaluate their thinking and look for evidence that supports and/or contradicts their perceptions. The interviewer asked Dr. Beck how this pursuit of evidence plays out when individuals are having delusions and literally ‘seeing’ objects/people that aren’t really there.

Interviewer: How… do you persuade someone to ignore the evidence of their own eyes and believe you? 

Dr. Aaron Beck: The treatment of delusions and schizophrenia is a very tricky one. One of the definitions of delusions is that they do not yield to corrective feedback from other people. Consequently, attempting to persuade an individual that the delusion is incorrect is obviously self-defeating. There is a whole body of literature on how to address delusions. In brief, questioning the patient like a journalist without indicating disbelief is one way. This tends to get the patient into a questioning mode. Read more