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Lecture #31

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Psychology 2011A/B
Tom Haffie

Lecture #31 Psychotherapy (part II) Ÿ Cognitive therapy is a very distinct form of psychotherapy, very different Ÿ Between 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 Ÿ Cognitive theorist are more in your face, confrontation, talk about themselves to model appropriate behaviour Ÿ Cognitive therapy is different because it is very structured, goal directed environment, every session has an agenda, with goals to fulfill Ÿ The therapy is time limited, distinguishes it from psychoanalysis which can go often for months or years, cognitive is limited to weeks Ÿ In 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 Ÿ Its 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 problem Ÿ In 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 collaborated Ÿ Some level patients thoughts and beliefs are responsible for the cause of behaviour Ÿ Cognitive 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 Ÿ The 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 Ÿ Some 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) Ÿ Beliefs of how you finish sentences beginning with I am (I am incompetent, I am unlovable, etc.) Ÿ These 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) Ÿ e.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) Ÿ Most 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 Ÿ What is really important is how our automatic thoughts determine how we feel and how we respond Ÿ Important 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 situation Ÿ We need to know what thoughts they are having to explain why they are reacting the way the are Ÿ e.g. I failed, this is terrible, I cant handle thisà not objective cues but properties and features of the patients thoughts about that situation Ÿ Automatic thought that is someway the intermediary between the situation and our reaction to it Ÿ 3 kinds of cognitive structures, core beliefs, intermediate beliefs and automatic thoughts Ÿ These ideas can be organized into a core conceptual framework (slide of cognitive model) Ÿ Core beliefs which influence our intermediate beliefs, these intermediate beliefs influence automatic thoughts which in turn explain how we react and why we react to the situation, between the situation and reactions are the thoughts Ÿ e.g. imagine a student listening to the prof explaining, and deep down have some negative core belief (I am incompetent) and an intermediate belief (if I don’t understand this, I am stupid), and while in the lecture she felt this lecture was too hard to understand, and so she gives up on listening to the lecture and goes on internet to distract herself from feeling the way she does (sadness)àautomatic thoughts influenced by the various beliefs, expectancies and rules that she has about herself Ÿ Behind every feeling is a thought, thoughts come in all shapes and varieties Ÿ Peculiar and systematic way in which patient is distorting in thinking about conflict Ÿ In thinking we use all sorts of shortcuts, we are exposed to way too much information, so we use shortcuts, used regularly Ÿ Sometimes these shortcuts work against us, and have particular ways for thinking of things that lead us into trouble, when such feelings aren’t necessary Ÿ So one goal cognitiv
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