Cognitive psychology and psychotherapy. What is the peculiarity of the method of cognitive-behavioral psychotherapy

First application experience behavioral therapy was based on the theoretical positions of I. P. Pavlov () and Skinner (Skinner V. F.), ().

As new generations of physicians have adopted behavioral techniques, it has become clear that a number of patient problems are much more complex than previously reported. Conditioning did not adequately explain difficult process socialization and learning. Interest in self-control and self-regulation within behavioral psychotherapy brought "environmental determinism" (a person's life is determined primarily by his external environment) closer to reciprocal determinism (personality is not a passive product of the environment, but an active participant in its development).

The publication of the article "Psychotherapy as a learning process" in 1961 by Bandura A. and his subsequent work was an event for psychotherapists seeking more integrative approaches. Bandura introduced in them theoretical generalizations mechanisms of operant and classical learning and at the same time emphasized the importance of cognitive processes in the regulation of behavior.

The conditioning model of human behavior has given way to a theory based on cognitive processes. This trend was evident in the reinterpretation of systematic desensitization by Wolpe (Wolpe J.) as an anti-conditioning technique in terms of such cognitive processes as expectation, coping strategy and imagination, which led to such specific areas of therapy as covert modeling (Cautela J., 1971 ), training skills and abilities. Currently, there are at least 10 areas of psychotherapy that focus on cognitive learning and emphasize the importance of one or another cognitive component (Beck A.T., 1976; Ellis A., 1977; Meichenbaum D., 1986). Here are their general principles.

1. Many symptoms and behavioral problems are the result of gaps in training, education and upbringing. To help the patient change maladaptive behavior, the psychotherapist must know how the patient's psychosocial development took place, to see the violations of the family structure and various forms of communication. This method is highly individualized for each patient and family. So, in a patient with a personality disorder, highly developed or underdeveloped behavioral strategies (for example, control or responsibility) are found, monotonous affects predominate (for example, rarely expressed anger in a passive-aggressive personality), and at the cognitive level rigid and generalized attitudes are presented in in relation to many situations. Since childhood, these patients fix dysfunctional patterns of perception of themselves, the world around them and the future, reinforced by their parents. The therapist needs to study the family history and understand what keeps the patient's behavior in a dysfunctional manner. In contrast to patients diagnosed with 1st axis, those with personality disorders it is more difficult to form a “benign” alternative cognitive system.
2. There is a close relationship between behavior and environment. Deviations in normal functioning are supported mainly by reinforcement random events in the environment (for example, the style of raising a child). Identification of the source of disturbances (stimuli) is an important stage of the method. This requires functional analysis, i.e., a detailed study of behavior, as well as thoughts and responses in problem situations.
3. Behavioral disorders are quasi-satisfaction of basic needs for security, belonging, achievement, freedom.
4. Behavior modeling is both an educational and psychotherapeutic process. Cognitive-behavioral psychotherapy uses the achievements, methods and techniques of classical and operant learning from models, cognitive learning and self-regulation of behavior.
5. The behavior of the patient, on the one hand, and his thoughts, feelings and their consequences, on the other, have a mutual influence on each other. The cognitive is not the primary source or cause of maladaptive behavior. The patient's thoughts affect his feelings to the same extent as feelings affect his thoughts. Thought processes and emotions are seen as two sides of the same coin. Thought processes are only a link, often not even the main one, in the chain of causes. For example, when a psychotherapist is trying to determine the likelihood of recurrence of unipolar depression, he can make a more accurate prediction if he understands how critical the patient's spouse is, instead of relying on cognitive indicators.
6. Cognitive can be considered as a set of cognitive events, cognitive processes and cognitive structures. The term "cognitive events" refers to automatic thoughts, internal dialogue, and imagery. This does not mean that a person is constantly talking to himself. Rather, we can say that human behavior in most cases is meaningless, automatic. A number of authors say that it is "according to the script." But there are times when automatism is interrupted, a person needs to make a decision under conditions of uncertainty, then it “turns on” inner speech. In cognitive behavioral theory, it is believed that its content can influence the feelings and behavior of a person. But, as already mentioned, how a person feels, behaves and interacts with others can also significantly affect his thoughts. Scheme is a cognitive representation of past experience, unspoken rules that organize and direct information relating to the personality of the person himself. Schemas affect event evaluation processes and accommodation processes. Because of the importance of schemas, the main task of the cognitive behavioral therapist is to help patients understand how they interpret reality. In this regard, cognitive behavioral therapy works in a constructivist way.
7. Treatment actively involves the patient and family. The unit of analysis in cognitive-behavioral therapy is currently examples of family relationships and belief systems shared by family members. Moreover, cognitive-behavioral therapy has also become interested in how belonging to certain social and cultural groups affects the patient's belief systems and behavior, includes the practice of alternative behavior in the psychotherapy session and in the real environment, provides a system of educational homework, an active reinforcement program, records and diaries, i.e. the methodology of psychotherapy is structured.
8. Prognosis and treatment outcomes are defined in terms of observed behavioral improvement. If earlier behavioral psychotherapy set as its main task the elimination or exclusion of unwanted behavior or response (aggression, tics, phobias), now the emphasis is shifted to teaching the patient positive behavior (self-confidence, positive thinking, achieving goals, etc.), activation of the resources of the individual and his environment. In other words, there is a shift from a pathogenetic to a sanogenetic approach.

Cognitive-behavioral psychotherapy (behavior modeling) is one of the leading areas of psychotherapy in the United States, Germany and a number of other countries, and is included in the training standard for psychiatrists.

Behavior modeling is a method that is easily applied in outpatient settings, it is problem oriented and more commonly referred to as training, which attracts clients who would not like to be referred to as "patients". It stimulates to independent decision problems, which is very important for patients with borderline disorders, which are often based on infantilism. In addition, many cognitive-behavioral psychotherapy techniques provide constructive coping strategies to help patients acquire social adaptation skills.

Cognitive-behavioral psychotherapy refers to short-term methods of psychotherapy. It integrates cognitive, behavioral and emotional strategies for personality change; emphasizes the influence of cognitions and behaviors on emotional sphere and functioning of the organism in a broad social context. The term "cognitive" is used because violations of emotions and behavior often depend on errors in the cognitive process, deficits in thinking. The "cognitions" include beliefs, attitudes, information about the individual and the environment, forecasting and evaluating future events. Patients may misinterpret the stresses of life, judge themselves too harshly, come to wrong conclusions, and have negative self-images. A cognitive-behavioral psychotherapist, working with a patient, applies and uses logical techniques and behavioral techniques to solve problems through the joint efforts of the psychotherapist and the patient.

Cognitive behavioral therapy has found wide application in the treatment of neurotic and psychosomatic disorders, addictive and aggressive behavior, anorexia nervosa.

Anxiety can be a normal and adaptive response to many situations. The ability to recognize threatening events and avoid them is a necessary component of behavior. Some fears disappear without any intervention, but long-term phobias can be assessed as a pathological response. Anxious and depressive disorders often associated with a pseudo-perception of the world and the requirements of the environment, as well as rigid attitudes towards oneself. Depressed patients evaluate themselves as less capable than healthy individuals due to such cognitive errors as "selective sampling", "overgeneralization", "all or nothing principle", minimization of positive events.

Behavioral psychotherapy serves as a means of choice for obsessive-phobic disorders and, if necessary, is supplemented by pharmacotherapy with tranquilizers, antidepressants, and beta-blockers.

The following behavioral medicinal purposes carried out in patients with obsessive-phobic disorders: complete elimination or reduction of obsessive symptoms (thoughts, fears, actions); its translation into socially acceptable forms; elimination of individual factors (feeling of low value, lack of confidence), as well as violations of horizontal or vertical contacts, the need for control by a significant microsocial environment; elimination secondary manifestations illnesses such as social isolation, school maladaptation.

Cognitive behavioral therapy for anorexia nervosa has the following short-term and long-term treatment goals. Short-term goals: Restoring premorbid body weight as necessary condition for psychotherapeutic work, as well as the restoration of normal eating behavior. Long-term goals: creation of positive attitudes or development of alternative interests (other than dieting), renewal of the behavioral repertoire, gradually replacing anorexic behavior; treatment of phobia or fear of loss of weight control, body schema disorders, consisting in the ability and need to recognize own body; elimination of uncertainty and helplessness in contacts, in relation to gender identity, as well as problems of separation from the parental home and the adoption of the role of an adult. it key tasks psychotherapies that lead not only to weight changes (symptom-centered level), but also to resolution psychological problems(personally-centered level). The following algorithm of psychotherapeutic measures is widespread: cognitively-oriented behavioral psychotherapy at first in an individual form. It consists of self-control techniques, goal scaling, training confident behavior, problem solving training, signing weight loss contracts, progressive Jacobson muscle relaxation. Then the patient is included in group psychotherapy. Intensive supportive psychotherapy is practiced. In parallel with this, systemic family psychotherapy is carried out.

Addictive behavior can be assessed in terms of positive (positive reinforcement) and negative consequences (negative reinforcement). When conducting psychotherapy, the distribution of both types of reinforcements is determined in assessing the mental status of the patient. Positive reinforcement includes the pleasure of taking a psychoactive substance, pleasant experiences associated with it, lack of unpleasant symptoms abstinence in the initial period of substance use, maintenance through drugs social contacts with peers, sometimes conditional pleasantness of the role of the patient. Negative consequences addictive behavior - more common cause referral to a specialist. This is the appearance of physical complaints, deterioration of cognitive functions. To include such a patient in the treatment program, it is necessary to find a "substitution behavior" without the use of psychoactive substances or other types of deviant behavior. The scope of psychotherapeutic interventions depends on the development of social skills, the severity of cognitive distortions and cognitive deficits.

The goals of cognitive-behavioral psychotherapy are presented as follows:
1) conducting a functional behavioral analysis;
2) change in self-image;
3) correction of maladaptive forms of behavior and irrational attitudes;
4) development of competence in social functioning.

Behavioral and problem analysis is considered the most important diagnostic procedure in behavioral psychotherapy. Information should reflect the following points: specific signs of the situation (facilitating, aggravating conditions for the target behavior); expectations, attitudes, rules; behavioral manifestations (motor, emotions, cognition, physiological variables, frequency, deficit, excess, control); temporary consequences (short-term, long-term) with different quality (positive, negative) and with different localization (internal, external). Information gathering is aided by observation of behavior in natural situations and experimental analogies (eg, role play), as well as verbal reporting of situations and their consequences.

The goal of behavioral analysis is a functional and structural-topographic description of behavior. Behavioral analysis helps to plan therapy and its course, and also takes into account the impact on behavior of the microsocial environment. When conducting problem and behavioral analysis, there are several schemes. The first and most developed is as follows: 1) describe detailed and behavior-dependent situational features. Street, house, school - these are too global descriptions. A finer differentiation is needed; 2) reflect behavioral and life-related expectations, attitudes, definitions, plans and norms; all cognitive aspects of behavior in the present, past and future. They are often hidden, so at the first session it is difficult to detect them even for an experienced psychotherapist; 3) reveal biological factors manifested through symptoms or deviant behavior; 4) observe motor (verbal and non-verbal), emotional, cognitive (thoughts, pictures, dreams) and physiological behavioral signs. The global designation (for example, fear, claustrophobia) is of little use for subsequent psychotherapy. A qualitative and quantitative description of the features is required; 5) evaluate the quantitative and qualitative consequences of behavior.

Another option for functional behavioral analysis is the compilation of a multimodal profile (Lazarus (Lazarus A. A.)) - a specifically organized version of the system analysis, carried out in 7 areas - BASIC-ID (in the first English letters: bechavior, affect, sensation, imagination, cognition, interpersonal relation, drugs - behavior, affect, sensations, ideas, cognition, interpersonal relationships, drugs and biological factors). In practice, this is necessary for planning options for psychotherapy and for training novice psychotherapists in the methods of cognitive-behavioral psychotherapy. The use of a multimodal profile allows you to better enter into the patient's problem, correlates with the multiaxial diagnosis of mental disorders, and makes it possible to simultaneously outline options for psychotherapeutic work (see Lazarus Multimodal Psychotherapy).

In dealing with a typical problem, it is necessary to ask the patient a series of questions to clarify the difficulties: Does the patient correctly evaluate events? Are the patient's expectations realistic? Is the patient's point of view based on false conclusions? Is the patient's behavior appropriate in this situation? Is there really a problem? Did the patient manage to find all possible solutions? Thus, questions allow the psychotherapist to build a cognitive-behavioral concept, which is why the patient experiences difficulties in one area or another. During the interview, ultimately, the task of the psychotherapist is to select one or two key thoughts, attitudes, behaviors for psychotherapeutic intervention. The first sessions are usually aimed at joining the patient, identifying the problem, overcoming helplessness, choosing a priority direction, discovering the connection between irrational belief and emotion, clarifying errors in thinking, identifying areas of possible change, including the patient in a cognitive-behavioral approach.

The task of a cognitive-behavioral psychotherapist is to make the patient an active participant in the process at all its stages. One of the fundamental tasks of cognitive-behavioral psychotherapy is the establishment of partnerships between the patient and the therapist. This collaboration takes the form of a therapeutic contract in which the therapist and the patient agree to work together to eliminate the symptoms or behavior of the latter. Such joint activity has at least 3 goals: first, it reflects the confidence that both have achievable goals at each stage of treatment; secondly, mutual understanding reduces the patient's resistance, which often arises as a result of the psychotherapist's perception of the aggressor or his identification with the parent if he tries to control the patient; thirdly, the contract helps to prevent misunderstanding between the two partners. Failure to take into account the motives of the patient's behavior can make the psychotherapist move blindly or lead the first to false conclusions about the tactics of psychotherapy and its failure.

Since CBT is a short-term approach, this limited time must be used carefully. The central problem of "psychotherapeutic education" is the determination of the patient's motivation. To increase motivation for treatment, take into account following principles: joint definition of goals and objectives of psychotherapy. It is important to work only on those decisions and commitments that are verbalized through "I want" and not "I would like"; drawing up a positive action plan, its achievability for each patient, careful planning of stages; manifestation by the psychotherapist of interest in the personality of the patient and his problem, reinforcement and support of the slightest success; the “agenda” of each lesson, the analysis of achievements and failures at each stage of psychotherapy contributes to strengthening motivation and responsibility for one’s result. When signing a psychotherapeutic contract, it is recommended to write down the plan or repeat it using positive reinforcement techniques, communicating that it is a good plan that will promote the fulfillment of desires and recovery.

At the beginning of each session, during an interview, a joint decision is made on which list of issues will be addressed. The “agenda” contributes to the formation of responsibility for one’s result, thanks to which it is possible to consistently work out psychotherapeutic “targets”. "Agenda" usually begins with short review the patient's experience since the last session. It includes feedback psychotherapist for homework. The patient is then encouraged to comment on what issues they would like to work on in the session. Sometimes the therapist himself suggests topics that he considers appropriate to include in the "agenda". At the end of the lesson summarized (sometimes in writing) the most important findings psychotherapeutic session, the emotional state of the patient is analyzed. Together with him, the nature of the independent homework, the task of which is to consolidate the knowledge or skills acquired in the lesson.

Behavioral techniques are focused on specific situations and actions. In contrast to rigorous cognitive techniques, behavioral procedures focus on how to act or how to deal with a situation rather than how to perceive it. Cognitive-behavioral techniques are based on changing inadequate stereotypes of thinking, ideas with which a person reacts to external events often accompanied by anxiety, aggression or depression. One of the fundamental goals of every behavioral technique is to change dysfunctional thinking. For example, if at the beginning of therapy the patient reports that he is not happy with anything, and after conducting behavioral exercises he changes this attitude to a positive one, then the task is completed. Behavioral changes often occur as a result of cognitive changes.

The most famous are the following behavioral and cognitive techniques: reciprocal inhibition; flood technique; implosion; paradoxical intention; evoked anger technique; stop tap method; the use of imagination, hidden modeling, self-instruction training, relaxation methods at the same time; assertiveness training; methods of self-control; introspection; scaling reception; study of threatening consequences (decatastrophization); Advantages and disadvantages; interrogation of testimonies; study of the choice (alternatives) of thoughts and actions; paradoxes, etc.

Modern cognitive-behavioral psychotherapy, emphasizing the importance of the principles of classical and operant learning, is not limited to them. In recent years, it has also absorbed the provisions of the theory of information processing, communication, and even large systems, as a result of which the methods and techniques of this trend in psychotherapy are being modified and integrated.

Psychology is of great interest today among ordinary people. However, the real techniques and exercises are carried out by specialists who understand what they use all the methods for. One of the areas of work with a client is cognitive psychotherapy.

Specialists of cognitive psychotherapy consider a person as an individual personality that shapes his life depending on what he pays attention to, how he looks at the world, how he interprets certain events. The world is the same for all people, but what people themselves think about it may differ in different opinions.

In order to know why certain events, sensations, experiences occur to a person, it is necessary to deal with his ideas, attitude, views and reasoning. This is what cognitive psychologists do.

Cognitive psychotherapy helps a person deal with their personal problems. These can be individual experiences or situations: problems in the family or at work, self-doubt, low self-esteem, etc. It is used to eliminate stressful experiences as a result of disasters, violence, wars. It can be used both individually and when working with families.

What is cognitive psychotherapy?

In psychology, many techniques are used on how to help a client. One of these areas is cognitive psychotherapy. What it is? This is a purposeful, structured, directive, short-term conversation aimed at transforming the inner "I" of a person, which is manifested in the sensation of these transformations and new behaviors.

That is why one can often come across such a name as cognitive behavioral therapy, where a person not only considers his situation, studies its components, puts forward new ideas for changing himself, but also practices new actions that will support new qualities and characteristics that he develops himself.

Cognitive Behavioral Therapy performs many useful features that help healthy people transform their own lives:

First, a person is taught a realistic perception of the events that happen to him. Many problems are taken from the fact that a person distorts the interpretation of events happening to him. Together with the psychotherapist, the person reinterprets what happened, now being able to see where the distortion occurs. Together with the production adequate behavior there is a transformation of actions that become consistent with situations.
Second, you can change your future. It depends solely on the decisions and actions that a person makes. By changing your behavior, you can change your entire future.
Thirdly, the development of new models of behavior. Here the psychotherapist not only transforms the personality, but also supports it in these transformations.
Fourth, fixing the result. For a positive outcome to exist, you need to be able to maintain and maintain it.

Cognitive psychotherapy uses many methods, exercises and techniques that are applied to different stages. They are ideally combined with other directions in psychotherapy, supplementing or replacing them. Thus, the therapist can use several directions at the same time, if this helps in achieving the goal.

Beck's Cognitive Psychotherapy

One of the directions in psychotherapy is called cognitive therapy, the founder of which was Aaron Beck. It was he who created the idea, which is the main one in all cognitive psychotherapy - the problems that arise in a person's life are the wrong worldview and attitudes.

Various events happen in the life of each individual. Much depends on how a person perceives the promises of external circumstances. The thoughts that arise certain character, provoking the corresponding emotions and, as a result, the actions that a person performs.

Aaron Beck did not consider the world to be bad, but people's views of the world as negative and wrong. It is they who form the emotions that others experience, and the actions that are then performed. It is actions that affect how events unfold further in the life of each person.

Mental pathology, according to Beck, occurs when a person distorts external circumstances in his own mind. An example would be working with people who have suffered from depression. Aaron Beck found that everyone depressed persons the following thoughts were noted: inadequacy, hopelessness and a defeatist attitude. Thus, Beck brought out the idea that a depressive state occurs in those who comprehend the world through 3 categories:

Hopelessness, when a person sees his future exclusively in gloomy colors.
Negative view, when the individual perceives the current circumstances exclusively from a negative point of view, although for some people they may cause pleasure.
Reduced self-esteem, when a person perceives himself as helpless, worthless, insolvent.

Mechanisms that help in correcting cognitive attitudes are self-control, role-playing games, homework, modeling, etc.

Aaron Beck worked with Freeman mostly on people with personality disorders. They were convinced that every disorder is the result of certain beliefs and strategies. If you identify thoughts, patterns, patterns and actions that automatically appear in your head in people with a specific personality disorder, you can correct them by transforming your personality. This can be done by re-experiencing traumatic situations or by using the imagination.

In psychotherapeutic practice, Beck and Freeman considered important a friendly atmosphere between the client and the specialist. The client should have no resistance to what the therapist is doing.

The ultimate goal of cognitive psychotherapy is to identify destructive thoughts and transform the personality by eliminating them. What is important is not what the client thinks, but how he thinks, reasons, what mental patterns he uses. They should be transformed.

Methods of cognitive psychotherapy

Since a person’s problems are the result of his incorrect perception of what is happening, inferences and automatic thoughts, the validity of which he does not even think about, the methods of cognitive psychotherapy are:

Imagination.
Fight negative thoughts.
Secondary experience of childhood traumatic situations.
Finding alternative strategies for perceiving the problem.

Much depends on the emotional experience that the person has experienced. Cognitive Therapy helps in forgetting or learning new things. Thus, each client is invited to transform old patterns of behavior and develop new ones. It uses not only a theoretical approach, when a person studies the situation, but also a behavioral one, when the practice of committing new actions is encouraged.

The psychotherapist directs all his efforts to identify and change the negative interpretations of the situation that the client uses. Yes, in depressed state people often talk about what was good in the past and what they can no longer experience in the present. The psychotherapist suggests finding other examples from life when such ideas did not work, remembering all the victories over one's own depression.

Thus, the main technique is to recognize negative thoughts and modify them into others that help in solving problems.

Using the find method alternative ways action in stressful situation, the emphasis is on the fact that man is an ordinary and imperfect being. You don't have to win to solve a problem. You can just try your hand at solving a problem that seems problematic, accept a challenge, not be afraid to act, try. This will bring more results than the desire to win the first time.

Cognitive Psychotherapy Exercises

The way a person thinks affects how he feels, how he treats himself and others, what decisions he makes and actions he performs. People perceive the same situation differently. If only one facet stands out, then this significantly impoverishes the life of a person who cannot be flexible in his thinking and actions. This is why cognitive psychotherapy exercises become effective.

They exist a large number of. All of them can look like homework when a person consolidates in conditions real life new skills acquired and developed in sessions with a psychotherapist.

All people from childhood are taught to unambiguous thinking. For example, "If I can't do anything, then I'm a failure." In fact, such thinking limits the behavior of a person who is now not even going to attempt to refute it.

Exercise "Fifth column".

In the first column on a piece of paper, write down the situation that is problematic for you.
In the second column, write down the feelings and emotions that you have in this situation.
In the third column, write down the “automatic thoughts” that often flash through your mind in this situation.
In the fourth column, write down the beliefs that trigger these "automatic thoughts" in you. What attitudes are you guided by, because of what you think this way?
In the fifth column, write down the thoughts, beliefs, attitudes, positive statements that refute the ideas from the fourth column.

After identifying automatic thoughts, it is proposed to perform various exercises where a person will be able to change his attitudes by performing other actions, and not those that he did before. Then offered in real conditions follow these steps to see what result will be achieved.

Cognitive Psychotherapy Techniques

When using cognitive therapy, three techniques are actually used: Beck's cognitive psychotherapy, Ellis's rational-emotive concept, and Glasser's realistic concept. The client mentally argues, performs exercises, experiments, fixes models at the level of behavior.

Cognitive psychotherapy aims to teach the client to:

Identification of negative automatic thoughts.
Finding the connection between affects, knowledge and actions.
Finding arguments "for" and "against" automatic thoughts.
Learning to identify negative thoughts and attitudes that lead to wrong behavior and negative experiences.

For the most part, people expect a negative outcome of events. That's why he gets fears, panic attacks, negative emotions, which make him not act, run away, fence off. Cognitive psychotherapy helps in identifying attitudes and understanding how they affect the behavior and life of the person himself. In all his misfortunes, the individual is guilty himself, which he does not notice and continues to live unhappily.

Outcome

Even a healthy person can use the services of a cognitive psychotherapist. Absolutely all people have some kind of personal problems with which he cannot cope on his own. The result of unresolved problems is depression, dissatisfaction with life, dissatisfaction with oneself.

If there is a desire to get rid of an unhappy life and negative experiences, then you can use the techniques, methods and exercises of cognitive psychotherapy, which transforms people's lives, changing it.

Cognitive psychology studies and works with the cognitive processes of the human psyche. Most often, psychologists work with memory, attention, features of thinking, decision making, and much more.

History of occurrence

Cognitive psychology did not originate overnight. This section first appeared in the 1960s in response to the now popular behavioral movement. Ulrik Neisser is considered the founder of behavioral psychology. His monograph "Cognitive Psychology" was the beginning of the development and popularization of this branch of science.

A huge breakthrough in the field of studying cognitive processes was the development of a holographic model of not just the human brain, but the functioning of the psyche. Its authors were neurophysiologist Carl Pribram and physiologist Carl Spencer Lashley. It is material evidence that the memory of an individual is preserved even after resection of certain parts of the brain. With the help of this invention, scientists received confirmation that memory and other cognitive processes are not “fixed” to a separate area.

Currently cognitive psychology practiced quite successfully by clinical psychologist Yakov Kochetkov. He has set up a huge psychological center that uses cognitive therapy methods to treat many disorders. He is the author of many articles on the rational treatment of panic attacks, obsessive-compulsive disorders, depression and many other problems.

Cognitive psychology in modern science closely related to neuroscience. Many cognitive processes cannot be studied without understanding the subtlest matters of neurophysiology. This connection gave birth to an experimental science called cognitive neuroscience.

Main goals

Cognitive psychology considers a person as an object whose activity is aimed at finding and processing new information. All cognitive processes (perception, memory, rational thinking, decision making) are involved in different stages information processing. Scientists draw an analogy between the work of the brain and the work of a computer process. Psychologists have even borrowed the term "information processing" from programmers and successfully apply it in their scientific writings.

For practical application often use the information processing model. With its help, the memorization process itself is decomposed into several separate components. Thus, you can study the whole process: from receiving information to issuing a certain reaction to it.

Practitioners, using cognitive psychology techniques, try to prove that knowledge primarily affects the behavior and response of the individual to environmental stimuli. The difference in the perception of verbal and non-verbal stimuli, the duration and strength of the effect of a particular image are also being studied.

This is what cognitive therapy is based on. It is based on the opinion that the causes of all violations mental processes as well as a number of diseases nervous system, lie in the erroneous processes of thinking and perception.

Cognitive Psychotherapy

Cognitive therapy is often used as complex treatment many mental illness. It is customary to distinguish between several goals:

Fighting the symptoms of the disease (elimination or reduction of manifestations);
Prevention of relapse;
Improving the effect of the prescribed drug treatment;
Help the patient to adapt in society;
Changing maladaptive psychological patterns and incorrect "anchors".

In the process of treatment, the doctor tries to explain to the patient the power of influence of his own thoughts and judgments on actions and behavior. In cognitive therapy, the ability to distinguish between automatic thoughts, that is, those that appear quickly enough and are not fixed by the subconscious, plays an important role. They are not reflected in the internal dialogue, but can greatly affect the reaction and actions. Most often, a certain automatism is acquired by those thoughts that are often repeated by loved ones or by the patient himself. Affirmations that were invested in childhood by parents or loved ones are very strong.

The patient must learn not only to identify such negative images, but also to learn how to analyze them. Some may be useful, especially if they are considered and evaluated from a different perspective. This further helps to replace erroneous judgments with correct and constructive ones.

Cognitive psychology distinguishes two kinds of "schemes" or thoughts: adaptive, that is, those that lead to constructive behavior, and maladaptive. The latter only interfere with life and lead to the emergence of cognitive disorders.

Patient-doctor relationship

Cognitive therapy and its methods are effective only when the correct relationship is established between the attending physician and his patient. Together they must decide on the problem they want to solve. The psychotherapist must be able not only to properly build a conversation, but also to have a certain amount of empathy.

One of the most common exercises for finding problems is the so-called "Socratic dialogue". The doctor asks the patient a series of questions in order to clarify the problem and help the patient identify emotions and sensations. The psychotherapist thus determines the way the patient thinks and tries to choose the most effective tactics conducting further conversations.

Techniques

There are a number of basic techniques that Aaron Beck brought out and structured.

Recording thoughts. Regular recording helps the patient structure his feelings and highlight the main thing. Also, with their help, you can retrospectively follow the sequence of thoughts and actions corresponding to them;
Keeping a diary. With its help, it is possible to identify those events or situations to which the patient reacts quite sharply;
"Remote". With the help of this technique, the patient can look at his thoughts from the outside and try to give them an objective assessment. It becomes easier to separate productive thoughts and impulses from maladaptive ones, that is, those that cause fear, anxiety and other negative emotions;
Reappraisal. The doctor asks the patient to find alternative options for the development of a particular situation;
Purposeful repetition. The patient is asked to play the situation many times in a row, looking for new options for its development. Such an exercise allows you to strengthen new affirmations in the mind of the patient.

Cognitive Behavioral Psychotherapy

This type of therapy arose on the basis of cognitive psychology and some theses of behaviorism. Cognitive-behavioral therapy or cognitive-behavioral therapy is based on the opinion that the reaction to a certain situation (feeling and choice of behavior) depends entirely on the perception of this situation. That is, only how the individual reacts to the problem matters, not the problem itself. Cognitive- Behavioral therapy sets itself a specific task: to correct the thoughts and perceptions of the patient and direct them in the right direction. Doctors try to identify negative thoughts and reactions. The important thing is what assessment the patient himself is ready to give to these thoughts and how objective and realistic he considers them.

In addition to everything, it is necessary to simulate the rhythm of the patient's life and try to get rid of negative factors. First of all, the normalization of nutrition, the rejection of negative habits (even if they are externally attractive) and excessive workload are important. Often, chronic fatigue syndrome leads patients to an incorrect perception of the surrounding reality.

Cognitive Behavioral Therapy is structured in such a way that most work has to be done by the patient. The psychologist gives him "homework". Nice results brings the maintenance of detailed records and their subsequent analysis in a psychotherapeutic session.

Last update: 17/07/2014

Cognitive behavioral therapy (CBT) is one type of treatment that helps patients understand the thoughts and feelings that influence behavior. It is commonly used to treat a wide range illnesses, including phobias, addictions, depression, and anxiety. Cognitive behavioral therapy is usually short-lived and focuses on helping clients with a specific problem. During the course of treatment, people learn to identify and change destructive or disturbing thought patterns that have a negative impact on behavior.

Fundamentals of Cognitive Behavioral Therapy

The basic concept implies that our thoughts and feelings play a fundamental role in shaping our behavior. For example, a person who thinks too much about plane crashes, runway accidents, and other air disasters may begin to avoid air travel. The goal of CBT is to teach patients that they cannot control every aspect of the world around them, but that they can control their interpretation of and interaction with that world.
In recent years, cognitive behavioral therapy has become increasingly popular among both clients and therapists themselves. Because this type of treatment usually does not take much time, due to which it is considered more affordable than other types of therapy. Its effectiveness has been empirically proven: experts have found that it helps patients overcome inappropriate behavior in its most diverse manifestations.

Types of cognitive behavioral therapy

According to the British Association of Behavioral and Cognitive Therapists, “Cognitive behavioral therapy is a range of treatments based on concepts and principles formulated on the basis of psychological models human emotions and behavior. They include both a wide range of treatment approaches emotional disorders and self-help opportunities.
The following are regularly used by professionals:

rational-emotional-behavioral therapy;
cognitive therapy;
multimodal therapy.

Components of Cognitive Behavioral Therapy

People often experience thoughts or feelings that only reinforce them in a wrong opinion. Such opinions and beliefs can lead to problematic behavior that can affect numerous areas of life, including family, romantic relationships, work, and school. For example, a person suffering from low self-esteem may have negative thoughts about himself or his own abilities or appearance. As a result, a person may begin to avoid situations of social interaction or refuse, for example, opportunities for promotion at work.
In order to combat these destructive thoughts and behaviors, the therapist begins by helping the client identify problematic beliefs. This stage, also known as functional analysis, has importance to understand how thoughts, feelings and situations can contribute to inappropriate behavior. This process can be challenging, especially for patients who struggle with overintrospection tendencies, but it can ultimately lead to self-discovery and insight, which is an integral part of the healing process.
The second part of cognitive behavioral therapy focuses on the actual behavior that contributes to the development of the problem. The client begins to learn and practice new skills, which can then be used in real situations. For example, a person suffering from drug addiction can learn skills to overcome cravings and ways to avoid or cope with social situations that could potentially trigger a relapse.
In most cases, CBT is a gradual process that helps a person take additional steps towards behavior change. A social phobic may start by simply imagining himself in social situation, disturbing. He may then try talking to friends, family members, and acquaintances. With constant movement towards the goal, the process seems less complicated, and the goals themselves seem quite achievable.

Application of CBT

I use cognitive behavioral therapy to treat people suffering from a wide range of illnesses - anxiety, phobias, depression and addiction. CBT is one of the most studied therapies, in part because the treatment focuses on specific problems and results are relatively easy to measure.
Cognitive Behavioral Therapy is often best for those clients who tend to be introspective. In order for CBT to be effective, a person must be ready for it, and must be willing to put in the time and effort to analyze their thoughts and feelings. This kind of introspection can be difficult, but it's a great way to learn more about how internal state affects behavior.
Cognitive behavioral therapy is also well suited for those who need short-term treatment that does not involve the use of medication. One of the benefits of CBT is that it helps clients develop skills that can be useful now and in the future.

In the experiences of people, themes of hopelessness, a gloomy perception of the world and dissatisfaction with oneself often sound. Cognitive psychotherapy helps to identify established stereotypes through working with thinking and replacing "automatic" negative thoughts with positive ones. The patient is an active participant in the therapy process.

Cognitive Therapy - What is it?

Aaron Beck, an American psychotherapist, one of the founders of the direction in 1954, while studying depression in the framework of psychoanalysis, did not receive any encouraging reliable results. Thus, a new direction of psychotherapeutic assistance with panic attacks, depression, various addictions. Cognitive therapy is a short-term method aimed at recognizing negative thought patterns that lead a person to suffering and replacing them with constructive thoughts. The client learns a new perception, begins to believe in himself and think positively.

Methods of cognitive psychotherapy

The therapist initially negotiates and establishes a relationship based on cooperation with the patient. A list of target problems is formed in order of the significance of the study for the patient, automatic negative thoughts are revealed. Methods of cognitive-behavioral therapy cause positive changes at a fairly deep level, include:

struggle with negative thoughts (“this is pointless”, “this is useless”, “nothing good will come of this”, “unworthy of being happy”);
alternative ways of perceiving the problem;
rethinking or living a traumatic experience from the past that affects the present and the patient does not adequately assess reality.

Cognitive Psychotherapy Techniques

The therapist encourages the patient to actively participate fully in therapy. The goal of the therapist is to convey to the client that he is unhappy with his old beliefs, there is an alternative to start thinking in a new way, to take responsibility for his thoughts, state, behavior. Homework is required. Cognitive therapy for personality disorders includes a number of techniques:

Tracking and recording negative thoughts, attitudes when you need to take some important action. The patient writes down on paper in order of priority the thoughts that come up during the decision.
Keeping a diary. During the day, the thoughts that most often occur in the patient are recorded. A diary helps you keep track of thoughts that affect your well-being.
Testing the Negative Install in Action. If the patient claims that "he is not capable of anything," the therapist encourages small successful actions to begin with, then complicates the tasks.
Catharsis. Technique of living emotions from the state. If the patient is sad, in self-loathing, the therapist suggests expressing the sadness, for example, by crying.
Imagination. The patient is afraid or not confident in his abilities in order to perform an action. The therapist encourages you to imagine and try.
Three column method. The patient writes in columns: situation-negative thought-corrective (positive) thought. The technique is useful for learning the skill of replacing a negative thought with a positive one.
Recording the events of the day. The patient may believe that people are aggressive towards him. The therapist suggests keeping a list of observations, where to put "+" "-", during the day with each interaction with people.

Cognitive Therapy - Exercises

A stable result and success in therapy is ensured by the consolidation of new constructive attitudes and thoughts. The client completes homework and exercises that the therapist will assign him: relaxation, tracking pleasant events, learning new behaviors and self-change skills. Cognitive psychotherapy exercises for self-confidence are necessary for patients with high anxiety and in a state of depression from dissatisfaction with themselves. In the course of working out the desired “self-image”, a person tries on and tries different behaviors.

Cognitive therapy for social phobia

Fear and high unreasonable anxiety do not allow a person to carry out their tasks normally. social functions. Social phobia is a fairly common disorder. Cognitive psychotherapy for social phobia helps to identify the "benefits" of such thinking. Exercises are tailored to the specific problems of the patient: fear of leaving the house, and so on.

Cognitive Addiction Therapy

Alcoholism, drug addiction are diseases caused by a genetic factor, sometimes it is a behavior model of people who do not know how to solve problems and see stress relief in the use of psychoactive substances, without solving the problems themselves. Cognitive behavioral psychotherapy for addictions is aimed at identifying triggers (situations, people, thoughts) that trigger the mechanism of use. Cognitive therapy successfully helps a person cope with bad habits through awareness of thoughts, elaboration of situations and behavior change.

Cognitive Behavioral Therapy - Best Books

People may not always be able to seek help from a specialist. Techniques and methods of well-known psychotherapists can help to independently move forward on the path to solving some problems, but will not replace the psychotherapist himself. Cognitive behavioral therapy books:

"Cognitive therapy for depression" A. Beck, Arthur Freeman.
"Cognitive psychotherapy of personality disorders" A. Beck.
"Psychotraining according to the method of Albert Ellis" A. Ellis.
"The practice of rational-emotional behavioral psychotherapy" A. Ellis.
"Methods of behavioral therapy" V. Meyer, E. Chesser.
"Guide to Cognitive Behavioral Therapy" S. Kharitonov.