Intro to CBT - Core Beliefs

Core Beliefs

The central ideas about self and the world.

• Rigid beliefs (+ or -) in 1-2 words

• Fundamental

• Inflexible

• Absolute

• Generalized beliefs

• May result in biases in attention, information processing, and memory

• Can come from only early childhood experiences, trauma

• Not necessarily accurate or helpful

Examples of Core Beliefs

• Self-related

• Related to others

• World-related

Examples of dysfunctional core beliefs:

“I am unlovable”

“I am inadequate”

“The world is a hostile and dangerous place”

Intermediate Beliefs

• Attitudes, rules, or assumptions

• Stem from core beliefs

• Fuel automatic thoughts

Examples of dysfunctional intermediate beliefs:

“To be accepted, I should always please others.”

“I should be excellent at everything I do to be considered adequate.”

“It is best to have as little as possible to do with people.”

Belief System

• Outer: automatic thoughts

• Middle: Intermediate beliefs

• Center: core beliefs

Core Beliefs and Schemas

• Schemas: flexible

• Core beliefs: inflexible

• Core beliefs are within schemas

Reactions and Behaviors

Can reinforce core beliefs

Why Modify Core Beliefs?

• Adds flexibility/sense of self-kindness to a patient’s rules/assumptions

• Decreases likelihood that unhelpful or inaccurate automatic thoughts will be activated during stressful or challenging situations

• Decreases extremity of unhelpful information processing biases

Identifying Core Beliefs 

• Few patients will be able to articulate their core beliefs early in treatment

• Automatic thoughts that provoke a great deal of affect have the potential to be core beliefs in and of themselves, or be a direct manifestation of a core belief

• Look for themes in thought records across weeks and situations to begin to identify core beliefs

• Be aware of common core beliefs for certain diagnoses

• Downward Arrow Technique

Downward Arrow Technique

Repeatedly ask about the meaning of situational automatic thoughts until you arrive upon a core belief, whose meaning is so fundamental that there is no additional meaning associated with it

Modifyng Core Beliefs

• Takes time, effort, and persistence.

• This is not going to happen in a handful of therapy sessions

• There is flexibility with the steps

Modifying Core Beliefs - Step 1 

Operationalize the components that make up the core belief

Modifying Core Beliefs - Step 2

Examine the evidence that supports and goes against the core beliefs

Modifying Core Belief - Step 3

Restructuring early memories

• Relook and reevaluate

• Give another perspective on the early memories

• Give you a balance view on backdrop and the hurtful and distressful memories 

Modifying Core Beliefs - Step 4

Advantages and disadvantages analysis

Modifying Core Beliefs - Step 5

Behavioral experiments

• Clients might believe something intellectually and not emotionally

  • So they need concrete evidence

Modifying Core Beliefs - Step 6

Acting as if

• Acting “as if” is a specific type of behavioral experiment in which patients behave in a manner consistent with a new, healthier belief (even if they are not fully invested in the new belief) and evaluate the effects of this new belief.

• Questions patients can consider after acting “as if” include

  • (a) What were the effects on my mood (e.g., happier?, less anxious)

  • (b) How did others respond to me?

  • (c) What negative consequences came from my acting “as if”?

  • (d) What positive consequences came from my acting “as if”?

Cultural Responsiveness

• Cultural effectiveness (the what)

• Cultural humility (the how)