PSYC251 LECTURE 5
Today's agenda
Different approaches to Psychotherapy:
Cognitive Behaviour Therapy (CBT)
Mindfulness
Narrative Therapy
What is Psychotherapy?
Definition: A form of talk therapy, counseling, or simply therapy.
Nature: It's a personal, relationship-based help given by trained therapists.
Purpose: To assist people with life challenges, mental health issues, or relationship problems.
Assumptions: It focuses on the psychological reasons behind distress.
Goal: To lessen distress and improve a person's overall well-being.
Psychotherapy Intervention Techniques
Psychotherapy uses different theories to explain why people feel distressed.
Each type of psychotherapy is based on a specific theory.
Example: Psychodynamic therapy uses psychoanalysis theory. It suggests that distress often comes from old, hidden problems from childhood.
Understanding these hidden problems helps people gain insight.
Types of Psychotherapy
Behavioral Therapy:
Helps people find and change harmful or unhealthy behaviors.
It's based on how we learn, suggesting our distress and actions come from what we've been rewarded or punished for.
Looks at actions we can see and how our surroundings affect them.
Cognitive Therapy:
Focuses on finding and changing negative thought patterns to change unwanted behaviors or treat mood issues like depression.
Cognitive-Behavioral Therapy (CBT)
Definition: A combined approach that mixes cognitive therapy (changing unhelpful thoughts) with behavior therapy (changing actions).
The Common Sense Model and Cognitive Model
In an anxiety-provoking situation (e.g., public speaking):
Event: Public Speaking
Cognition: "What if I make a fool of myself?"
Outcome: Leads to anxiety, avoiding the situation, and physical feelings (e.g., faster heart rate).
Cognitive Therapy Philosophy
Epictetus (Greek Stoic Philosopher): "People are disturbed not by things, but by the view which they take of them."
Shakespeare (Hamlet): "There is nothing either good or bad but thinking makes it so."
Karen Horney (1950): Concepts of the "Tyranny of the shoulds."
Albert Ellis: "People make themselves miserable."
Beck (1991): How individuals interpret life events strongly shapes their emotional responses.
Core Assumption in Cognitive Therapy
Our thoughts shape our emotional reactions, and distress comes from thinking in unhelpful ways.
How Cognitive Therapy sees Disorders:
Our past experiences influence how we interpret events and our emotions. For example, losing a job can lead to different feelings depending on whether someone believes they are worthless or stays optimistic.
Cognitive Distortions
Beliefs & Schemas: Our beliefs and mental shortcuts can get twisted into "cognitive distortions." This is a key idea in cognitive therapy.
Cognitive therapy helps to:
Lessen emotional pain.
Change unhelpful thoughts and beliefs.
Key Assumptions:
Thoughts are learned.
Negative thoughts cause negative emotions.
Automatic negative thoughts (ANTs) are often illogical and lead to actions that harm ourselves.
Cognition and Negative Thinking Patterns
Examples of Erroneous Thinking:
“I must have love or approval from all important people in my life.”
“I must perform important tasks perfectly.”
“If I don’t get what I want, it’s terrible, and I must be a failure.”
Impact of Self-Talk: Unhelpful beliefs can come from our own suggestions or old beliefs (superstitions).
Emotional Problems: Blaming ourselves or others makes emotional problems worse. Getting better means stopping the blame.
Cognitive Model of Depression (Beck, 1979)
Components of the Model:
Early experiences shape core beliefs and assumptions.
Negative Automatic Thoughts (NATs): Can lead to feelings and behaviors consistent with depression.
Negative Cognitive Triad of Depression:
Negative views of oneself, the world, and the future.
Remembering past events and seeing them in a bad light.
Cognitive Distortions Table
Cognitive Error | Description | Example |
|---|---|---|
All-or-nothing thinking | Viewing events as entirely good or bad | “If I don't get this job, I am a failure.” |
Arbitrary inference | Assuming negative outcomes without evidence | “My neighbor didn’t say hello to me, she must be mad at me.” |
Emotional reasoning | Assuming negative emotions are accurate without questioning | “I feel fat, so I must be fat.” |
Overgeneralization | Applying negative conclusions from one event to unrelated areas of life | “I messed up on my math test, so I won’t do well in other subjects.” |
Labeling | Applying negative global labels to oneself or situations | “I can't do anything right, so why should I try?” |
Personalization | Attributing negative events to oneself without evidence | “My parents are in a bad mood because they have an idiot for a son.” |
Selective abstraction | Focusing solely on a negative aspect while ignoring more significant factors | “It doesn't matter that I got a raise; I have to go to work an hour earlier.” |
Cognitive Therapy Process
Course of Therapy Components
Basic Goals: Unique for each client, for example, to challenge negative ways of thinking.
Assessment: Understanding the client's current issues, including past experiences and twisted thoughts.
Formulation: Continuously evaluating what might make someone vulnerable (predispositions), what started the problem (precipitants), what keeps it going (perpetuating factors), and what helps (protective factors).
Therapy Process Steps
Calming the client: Helping with immediate upset to reduce acting on impulse.
Identifying Problems and Goals: Helping clients set clear, reachable, important, and time-bound goals.
Psychoeducation: Teaching clients about Automatic Negative Thoughts (ANTs) and how they affect actions and feelings.
Thought Monitoring: Clients write down events, thoughts, feelings, and what they did.
Cognitive Restructuring: Helping clients question and change unhelpful (irrational) thoughts.
This includes asking for proof for their unhelpful beliefs.
Behavioral Activation: Encouraging clients to do positive activities to fight the lack of energy from depression.
Mindfulness of Self-defeating Beliefs: Helping clients notice and question their unhelpful beliefs.
Homework in CBT
Clients are encouraged to do homework like keeping thought monitoring records, activity schedules, and cognitive restructuring exercises.
Mindfulness
Definition and Philosophy
Ability to manage feelings: Focusing on what's happening now without judging it, believing that accepting things can lead to big changes.
Comes from Eastern Buddhist Psychology, which values inner peace.
Practices: Accepting your thoughts, being fully aware in the moment, and not getting stuck in old ways of thinking.
Core Concepts of Mindfulness
Knowing that thoughts are just thoughts, not always true facts.
Fully focusing on everyday tasks as ways to feel better.
Paying attention to all experiences with an open and curious mind.
Mindfulness Techniques
Formal Practices: Meditation, body awareness, exercise (Yoga, Tai Chi).
Informal Practices: Being present during activities such as eating and walking.
Mindful Attitudes: Non-judging, acceptance, patience, trust, openness, gentleness.
Narrative Therapy
Overview
Focus: Sees life as stories. The therapist tries to understand the client's real-life experiences instead of labeling them with a disorder.
Core Assumptions: People have many stories about themselves, which are often influenced by big stories told in society.
The Therapeutic Process in Narrative Therapy
Key Actions: Working together with clients, separating the person from their problem, and showing how problems control their lives.
Restorying: Helping clients find and strengthen different stories about themselves that bring out positive feelings and help them change their actions.
Externalization Technique
This is a way of talking about problems without blame, treating them as things separate from the person.
Example: In family therapy, naming the problem (like "The Worry Monster") so everyone can talk clearly about how to handle it together.