Intro to CBT Therapies Flashcards
(24 cards)
What is at the start of any problem going into CBT?
a triggering event
- can be internal, external, expected, unexpected
- comes before low mood
Thought Record Activity
Jotting down your thoughts/behaviours/emotions for any situation at any moment
- Can be done on phone, notes app, title = situation (and then thoughts, emotions and behaviours)
- Not interpretations of the thoughts, but as the exact quote
Ex: getting back a midterm grade
- Thoughts: “I didn’t study enough”, “I’m a failure”
- Emotions: “I have a strong feeling right now”
- Behaviours: “sending an angry email”, “talk to friend about it”, “eat ice cream now think about it later”
Effects of creating a thought record?
People are amazed by the thoughts that pop into their head (automatic thoughts)
it helps them notice they are making overgeneralizations, jumping to conclusions, mind reading, assuming a negative outcome, discounting the positive
What is the cardinal question to cognitive therapy?
” What was just going through my mind?”
Idea: try to get closer to the truth
- Suffering will be decreased if you get closer to the way things actually are
- Need an accurate representation of what the breach is
- Maybe you did fail a test because you’re not good at a particular subject, its better to know that you’re not good at it and decide what to do next (better to decide between the options you do have)
What is a misconception about CBT?
That it isn’t about feelings.
It’s about feelings - feelings that have gotten out of hand - Too negative (low mood is too intense and too much of the time, same with shame, guilt and fear)
- We usually notice the emotions first - its about what was the thought that JUST went through the mind
Core beliefs
- deepest level of cognition
- they cut across many different situations (global), are held without questions and are sometimes old beliefs
- Often very short
Ex (negative): I’m unlovable, I’m incompetent, I’m worthless
Intermediate Beliefs
- usually longer in terms of the phrase
- also cuts across multiple situations (global)
- rules you follow, attitudes, assumptions, if/then statements
Ex: if I make a mistake it means I’m a bad person, if I make an interpersonal mistake it means I’ve failed profoundly
Rule examples: never express anger (rule), it’s mean to disagree with someone (rule)
- Holing these rules can change can how you interpret a situation that you’ve just experienced
- They form over time, coming out of experiences, we come up with them ourselves, sometimes taught to us, sometimes in movies, consistent with temperament
Automatic Beliefs
- pop into your head automatically in a situation
- come up in any particular one situation
Aaron Becks Cognitive Tirade:
Beliefs about the self, others and world
- Many of our false beliefs are centered around these three things
- “I’m bad”, “other people are bad”, “the world is bad”
What are core, intermediate, and automatic thoughts related to the “Jessica situation”?
Core:
- “i’m unlovable” (gloablly) - will change the automatic thoughts when percieving a rejection
- “I’m a failure”
Intermediate:
- “It’s unacceptable to make an interpersonal mistake”
- If I make an interpersonal mistake then that’s something really bad”
- cuts across situations but applies to this one
Automatic:
- “she doesn’t like me”
- “others will judge me”
can we figure out the way a person thinks, feels and behaves by only looking at one interaction?
no, we have the person record their thoughts over a few weeks and see if we can find repeating themes in the interactions that cut across the interactions
are there some consistent global and overly negative beliefs?
ex: “I’m a failure”
What is the order of events with beliefs and the situation?
- core and intermediate beliefs preceed a situation
- automatic thoughts come after a situation
- a reaction follows the automatic thoughts
Why are cognitive models complex?
anything can be a triggering situation:
- a discrete event
- a stream of thoughts
- a memory
- an image
- an emotion
- physiological experience
- etc…
Biased Information Processing
Once you already hold the belief that you are incompetent, for example, then your attentional system is selectively taking information that is already consistent with the belief, and reject everything else that would be positive
I got praise form my boss (+) -> but I didn’t deserve it (-) = incompetent
What kind of approach is used during a cognitive therapy session?
it is done with an attitude of collaboration (collaborative empiricism) - neither people know what the problem is but are trying to explore it together through discussion (what are the persons automatic thoughts, what are potential core beliefs, what are potential intermediate beliefs)
Behavioural experiments
- a way to modify beleifs
- They serve as a practical way to gather evidence and challenge thoughts in a real-world context, which can lead to more accurate and helpful beliefs
- through discussions, research (looking things up), going out into the world and doing something differently, texting someone you’re afraid to text, making eye contact
Behavioural activation
Idea that sometimes it’s important to think your way through a problem, but its also very important to notice how is the way the person is acting changing the way they’re experiencing a feeling or situation
- well researched intervention for depression
how is behavioural activation layed out:
there is a situation: thinking about doing laundry
automatic thoughts: “I’m too tired. I won’t enjoy it”
emotional reaction: dysphoria
behavioural reaction: stay in bed
BUT if you do the thing even if you don’t feel like it - your feelings with change quickly soon after
ex: - “I don’t want to do my laundry” but once you start doing the laundry you feel amazing
Idea of tire-pumping activities:
Every time you do behavioural activation you pump air into it, but its always leaking so doing things everyday that is tire pumping keeps you well
Cognitive intervention: credit list + gratitude list
Thoughts: “I’m a failure”, “I’m useless/defective”, “I never get anything done”
- Credit List: anything that you didn’t have to do but you did it anyway even if it’s very small that made you feel good - about today (ex: had breakfast, held door for someone)
Thoughts: “Nothing ever goes right for me”, “Nothing good is ever happening”
- Gratitude List: things that went well in the day but you didn’t have control over them
(ex: classmate said hi to me, delicious coffee)
Questions for Guided Discovery
As you’re discussing someone’s belief these are the questions your asking to help them explore and become critical for their own thinking
ex: what is the evidence that your thought is true? what is the evidence on the other side?; “what is an alternative way of viewing this situation?”; “if your friend were in this situation what advice would you give them?”
Reminders
writng down what you’ve thought through and write it down to remind you of what to do when you experience the situation again
“if I avoid going to the bookstore, remind myself that I probably could handle a job there and I could always quit if it didn’t work out”
cognitive distortions/thinking traps/ mental shortcuts
automatic ways of thinking that people hump to that ar very common
- jumping to conclusions
- mind reading
- fortune telling
- labelling: “I’m a failure”
- over-generalizing
- etc…
just noticing that a thought falls into one of these categories can change affect
positive data logs
comparing old core beleifs to new core beliefs and noticing the shift, or thinking about how you would react to a situation if your core belief was different
