Cognitions Flashcards
(25 cards)
Cognitive distortions
JAMMED with SLOP C
JAMMED with SLOP
Jumping to conclusions (mind reading and fortune telling)
All or nothing thinking / black and white
Mental Filter - focusing on one bad thing
Magnify/minimize - exaggerating the importance of negative events and underestimating the importance of positive events.
Emotional reasoning - assuming that feelings reflect fact
Disqualifying positive - rejecting, downgrading or dismissing as unimportant any positive event.
Shoulds/ musts (unrealistic expectations)
Labelling - Attaching harsh and demeaning names to self (or others) - see as totally bad
Overgeneralising - seeing a single event as indicating everything is negative (eg never always)
Personalising - attributing others’ feelings, actions or external events to yourself
Catastrophising - predicting the worst, overestimating probability and cost/coping
Two main components of CT
Identify and modify NATS
CT sequence
Identify the Activating Events (A) or situations
Identify the Consequences (C):
Assess Consequences (C): rate intensity and SUDS
Elicit the Beliefs or Thoughts (Bs) and rating
Make the B-C connection
Become familiar with cognitive errors
Dispute the unhelpful beliefs
Develop helpful beliefs
Re-rate the strength of belief and intensity of emotion.
Set homework
Rationale
Based on CF and links between components
CBT principles
how think det how feel - thoughts can be rational or not
life experiences teach us to think rationally or not
change emotions by change thinking and behavior
realistic thinking reduces your emotional distress
The cognitive principle
it is how we make meaning of what happens to us not what happens to us that influences emotions and behavior
The behaviour principle
CBT considers what we do as crucial in maintaining – or in changing – psychological states.
The cognitive model based in early learning
Core beliefs
V
Assumptions/rules
V
A > NAT > Consequences
Core beliefs based on early life experiences, usually dormant until a triggering life event that matches schemas are activated - then NATS’s in response to these. Eg asked to trivia IF
Assumptions protect from negative core beliefs being activated by high risk situation
Too broad - and rigid
Cognitive therapy sequence
Mood signal thoughts present
Write down what thinking or doing
Assess duration and intensity of consequences - use SUDS
ID NATS - use recent example
Difficulties in ID thought
What does this situation mean?
What does this mean about others?
What does it tell you about life, self, world, future?
Thoughts
Emotion is road to cognitions
in session emotion usually indicate NATS
Guided discovery or socratic questioning to get cognition
Asking good questions to elicit more awareness
Use questions that stimulate emotion
target one recent specific situation to elicits NAT’S
Dig deeper
use empathy
use the CF for direction and to make suggestions
use imagery in the present tense to uncover hot thoughts
Role play
worst case scenario
Empty chair technique
in vivo experiments elicit cognition’s
Strategies for cognitions
Distraction using pleasant thoughts and activity - self safe hypnosis - reduce physiology and distracts
Mindfulness to redirect attention
Defusion
Action towards a goal
Problem solving
Using coping statement to replace thoughts
2 column method of thought appraisal
learning how to cope with distressing but realistic thoughts
Challenging unhelpful thoughts
Distraction
Self safe hypnosis - reduce physiology and distracts
Focus on environment
count breathing
Serial sevens
ABC game
Remind yourself that it is important to stay task oriented
Visualize your favorite place in detail
Combine any of these attention diversion strategies with a physical activity eg whilst going for a brisk walk, count your breathing, and focus on the environment around you
Decentring
ability to observe one’s own thoughts – to view cognition as mental events rather than an expression of reality
label the thinking process rather than dwelling on the content.
Thought replacement
Self Coping statement
It is sometimes useful early in treatment to use positive self-statements with physiological and behavioral strategies
2 column method of appraisal
using ABC but column for irrational belief and one for evidence based rational response and one for outcome
Themes of assumptions
Control, approval, fairness and justice, perfectionism, love, achievement
What are assumption
Rigid, overgeneralised and extreme Prevent goals Dont reflect reality Should must or IF then not easily accessed
Techniques for assumption
Use downward arrow techniques-
behaviour experiments
Questions to ask - what way unhelpful, unreasonable, where did it come from, what would be a more moderate alternative??
In what way is the assumption unreasonable?
“What is evidence?” calls for an assessment of the facts as far as they can be ascertained.
Does the assumption fit the way the world works?
In what way does it fail to reflect the reality of human experience?
For example, it is unreasonable to demand that life should always be fair, because the fact of the matter is that it is not.
In what way is the assumption unhelpful?
Does it help you to get what you want out of life, or does it hinder you?
A valuable strategy here is to list the advantages and disadvantages of holding the belief and weigh them up.
For example, perfectionistic assumptions may genuinely produce high quality performance on occasions.
However, they often arouse a degree of anxiety, which is incompatible with quality performance and may lead to avoidance of challenges and opportunities.
Where did the assumption come from?
Understanding how your dysfunctional assumptions were formed can help you to get a distance from them and prevent any tendency for self blame.
Think of childhood memories, family sayings, messages from your upbringing. (Don’t be selfish).
Example:
A woman recalled that as a child she believed that her survival depended upon ensuring that she, at no time displeased her mother. Re-evaluation as an adult showed her that these conditions no longer applied. She could modify her assumption that she must please others to avoid rejection or worse
What would be a more moderate alternative, one that would confer the advantages of the dysfunctional assumption without its disadvantages?
Formulating an alternative, which takes account of shades of grey, will prepare a person to deal more effectively with those situations, which currently, in terms of their original assumption, would count as failures and lead to depression.
