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PSY210H1 Lecture Notes - Systematic Desensitization, Cognitive Therapy, Cognitive Model

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Lecture #31
Psychotherapy (part II)
ŸCognitive therapy is a very distinct form of psychotherapy, very different
ŸBetween two possible explanations, choose the more simpler one, cognitive theories is more cleaner
model, more simple, symptoms are the problem whereas in psychoanalysis therapist is almost
ambiguous, and the symptoms are underlying of the disease
ŸCognitive theorist are more in your face, confrontation, talk about themselves to model appropriate
ŸCognitive therapy is different because it is very structured, goal directed environment, every session
has an agenda, with goals to fulfill
ŸThe therapy is time limited, distinguishes it from psychoanalysis which can go often for months or
years, cognitive is limited to weeks
ŸIn that time frame, therapy is present focused, at least in the beginning, not that past is not important,
they come up later in the therapy, the focus is understanding, focusing on symptoms of here and now
ŸIts focus on the problem, in psychoanalysis, the symptom is viewed as a sign or indication of a disease,
but for cognitive therapeutic case, the symptoms is the problem, you treat the symptoms, you solve the
ŸIn this framework the patients and therapists work collaborate, work together to build an alliance,
agree on the terms, topics, problems to be addressed, and the approach that is taken is one that is
ŸSome level patients thoughts and beliefs are responsible for the cause of behaviour
ŸCognitive therapy tries being educational, with respect to the nature of their disorder, what is the cause
and nature of it, but beyond that, one of the primary goals is to train the patient to become their own
therapist in their own life
ŸThe cognitive model is profoundly simple, the principle is that underneath every emotion is a thought,
every response or behaviour reflects some thought on our part, our thoughts determine how we react
and behave, and when we saw patients one of our objectives is to target the thoughts and beliefs that
cause these behaviours
ŸSome of the central targets of therapy is reaching the core beliefs of the patient, often things that we
don’t say out loud, underlying beliefs we hold of how we see ourselves, not situational (I tend to act in
this way in situations like that)
ŸBeliefs of how you finish sentences beginning with I am (I am incompetent, I am unlovable, etc.)
ŸThese core beliefs are acquired early on in developmental, these are those that we try to target in
therapy, but they don’t come readily to mind, most patients have all kinds of others beliefs that are
undetected, having gone through the world believing these, they have strategies to compensate for
these negative core beliefs (attitudes, rules, expectancies called intermediate beliefs that try to protect
patient from negative core beliefs)
Ÿe.g. its essential that I succeed, I must work as hard as I can all the time, if I don’t understand
something then I am stupidàhelp us to be in the world, negotiate with our negative core beliefs with
the experience we have of the world (intermediate beliefs)
ŸMost common things we see from cognitive therapy are automatic thoughts, which are the running
stream of words and images as we go through our lives day to day, things that run through your head
right now
ŸWhat is really important is how our automatic thoughts determine how we feel and how we respond
ŸImportant that we do not respond to situations as it is objectively in the world, we are responding to as
how we think about the situation that determines how we feel and act, thoughts we have about that
ŸWe need to know what thoughts they are having to explain why they are reacting the way the are
Ÿe.g. I failed, this is terrible, I cant handle thisà not objective cues but properties and features of the
patients thoughts about that situation
ŸAutomatic thought that is someway the intermediary between the situation and our reaction to it
Ÿ3 kinds of cognitive structures, core beliefs, intermediate beliefs and automatic thoughts
ŸThese ideas can be organized into a core conceptual framework (slide of cognitive model)
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