The main principle of Baker's cognitive therapy is that the way visitors perceive and deal with the real world will affect their feelings and behaviors. Therefore, the goal of cognitive therapy is to reconstruct and adjust these distorted thinking, and then reconstruct the actual behavior of visitors and improve their emotional disorders. Consultants must follow the following eight principles:
First of all, cognitive therapy is based on the unique cognitive conceptualization of each visitor.
Second, a stable therapeutic relationship is necessary.
Third, cognitive therapy is goal-oriented.
Fourth, the treatment starts from the current situation.
Fifthly, cognitive therapy is a time-sensitive treatment.
Sixth, the therapy talk is structured and needs the active participation of counselors and visitors.
Seventh, visitors learn to recognize and respond to distorted ideas.
Eighth, cognitive therapy emphasizes psychological education and prevention of recurrence.
On the basis of observing the principle of cognitive therapy, psychological counselors use certain treatment methods to intervene with visitors. Commonly used cognitive therapy methods can be divided into three categories: behavioral methods, cognitive methods and emotional methods.
(A) behavior methods
1. Homework
Homework is to let visitors look for opportunities to use the cognitive principles they have learned in addition to treatment. For example, the consultant asked the visitors to record their thoughts and emotions in life with a self-help form for a week. Record the clarity of negativity on the right side of the table and the thoughts related to negative emotions on the left side of the table (as shown in the following table). In other words, the visitor should record what thoughts caused his negative emotions. In this way, the psychological counselor can understand the negative emotions and thoughts of the visitors in their lives, and can take certain measures to solve the problems of the visitors.
Show visitors' thoughts and corresponding emotional self-help forms.
Idea: I think ...
Emotion: I feel ...
2. Behavior experiment
Behavioral experiments can directly test the reliability of visitors' thinking or assumptions. If the treatment method is effective, behavior experiment will be an effective way to change the cognition and mood of visitors. Behavioral experiments are often combined with homework, including: the visitor expressed a negative prediction, and the counselor advised him to verify his thoughts or cognition within one week; The consultant decides when, where and how to carry out cognitive change experiments on visitors and puts forward suggestions for change; The counselor asked the visitors how they would respond if the experimental results confirmed their concerns, so that the counselor could prepare for further treatment in advance.
3. Role-playing
Role-playing in cognitive therapy is used to reveal the visitor's automatic thinking, develop his rational thinking and correct his core beliefs. Some visitors lack social skills, or although they are familiar with some form of communication, they lack application skills when they need to use it. You can practice the skills and methods you need in life through role-playing. Counselors should do some self-confidence exercises and role-playing with visitors to promote the development of social skills of visitors.
4. Graded exposure
During the treatment, visitors often feel uneasy and anxious because their current situation is far from the treatment goal. Psychological counselors should help visitors to make treatment goals and plans, and help them to carry out activities to relieve anxiety every day, and then subdivide the treatment goals into steps. One-step treatment will achieve certain results, accumulate in turn, and finally complete the treatment goal. The step-by-step process of treatment target is graded exposure, which can help visitors build up confidence, approach the treatment target step by step and realize the treatment effect.
Make a "pie chart"
Many times, people will look at events in an all-or-nothing way, that is, they will either completely deny or completely affirm. The best way to interfere with this way of thinking is to make a "pie chart". The way of pie chart requires visitors to divide different shares in the chart on the basis of careful consideration, and different shares represent their importance and responsibility in an event. Then ask the tourists to point out the reasons for the incident and the proportion of each reason in the picture. Finally, let them think about how much responsibility they bear in each incident.
6. Cost benefit analysis
The consultant asked the visitor to check the results of certain beliefs he held, both positive and negative. Once the result is presented to the visitor, he can choose to keep the original belief or replace it with a different belief. Cost-benefit analysis is to ask visitors to write what the costs and benefits of their existing beliefs are, to affirm positive ideas and to deny negative ones. You can ask visitors to draw a table and write down the advantages and disadvantages of the current belief on the left side of the table. When the disadvantages far outweigh the advantages, visitors will feel that the current belief is not good for them and make a decision to change their beliefs.
7. Practice of defense lawyers
The defense lawyer's practice is to let the visitor imagine that he has been taken to the trial bench and become a defense lawyer. The plaintiff is his automatic thinking. His task is to oppose the plaintiff's lawsuit, that is, to challenge his own ideas. Through the practice of defense lawyers, many visitors will find it much easier to imagine themselves as others' defense lawyers than their own. Visitors can put themselves in the role of asking for evidence, questioning evidence and challenging the plaintiff, that is, anything we expect lawyers to do. The practice of defense lawyers can make visitors challenge their automatic thinking and form new beliefs and ways of thinking.
Cognitive method
1. Guess this idea.
Sometimes the visitor's negative emotions are so strong that he can't think about the thoughts that accompany them. Guessing ideas means that the counselor puts forward some possible ideas to the visitor and lets him decide whether some of them are consistent with his own thoughts or emotions. Counselors and visitors try to speculate on potential ideas. If the visitor insists that he has no thoughts but only emotions, which hinders his recognition of thoughts, the counselor can guide him when his negative emotions are very strong, which will help the visitor guess his thoughts.
Understand the special meaning
Visitors with different automatic thinking will have different understanding of the meaning of words. Therefore, the consultant can't think that he knows the meaning of a word expressed by the visitor, but should thoroughly understand the special meaning of some words in a certain situation. Knowing the meaning expressed by the visitors can help the psychological counselors to know more about the thinking process of the visitors and help to carry out treatment.
3. Re-attribution method
The re-attribution method is that consultants help visitors to re-explore the causes of things, re-assign responsibilities to visitors, and reduce their responsibilities for adverse events. Because sometimes the event with bad results is not the responsibility of the visitor, but the visitor puts the responsibility on himself, and then blames himself, feels guilty and is depressed.
4. Vertical descent
Vertical descent method is an effective way to understand the potential thoughts of visitors. For visitors, negative thoughts are sometimes true, and the prediction of adverse events will bring worries or fears to visitors. Vertical decline is to explore the potential beliefs that trigger this negative emotion, and then weaken the thoughts of worry or fear. Counselors write visitors' thoughts on the top of the paper, and then draw a downward arrow to point to a series of thoughts or events hidden behind their thoughts, so as to obtain the potential meaning contained in these thoughts.
5. Two standards
These two standards ask visitors to think about what they will get if their current standards are applied to others. Guide visitors to think that they adopt one standard for themselves and another standard for others. Counselors can ask them the following questions: Why are they stricter with themselves than others? Why use different standards to evaluate yourself and others? These questions help visitors realize what is the most reasonable standard.
(3) Emotional method
1. Vent in words
Written venting allows visitors to freely write down troubled events to express their emotions, which can alleviate their negative emotions such as anxiety and depression. This is a way to express emotions freely, that is, to let visitors' negative emotions be vented. Although the negative emotions caused by annoying events may increase in a short time, after several days or weeks of treatment, the negative emotions and stress will decrease.
2. Identify emotional schema
Different visitors will have different thoughts or behaviors on negative emotions, that is, visitors will have different emotional schemas for different emotions. The key of this processing method is to let visitors identify various emotional schemas. Psychological counselors examine the different strategies of visitors to deal with different emotions, and take appropriate measures to help them according to their emotional schema.
3. Image reconstruction
Image reconstruction is to let visitors reconstruct events in a dramatic way and change the nature of events that initially caused anxiety and anxiety. Image reconstruction can activate the stronger and more powerful part of the visitor's self to counter the weak and failed part of the self. Image reconstruction can be used in conjunction with homework. Psychological counselors ask visitors to recall their past bad experiences and write them down in detail, and then reconstruct the images immediately. During the reconstruction, tourists became more confident, brave, independent and powerful. He can completely control himself and weaken the bad experience to achieve the therapeutic effect.
4. Emotional priming method
When tourists are anxious, they are more likely to overestimate the danger of certain events. Emotional elicitation method is to let visitors consider how emotions affect their thinking, that is, to let them consider how the causal relationship between emotions and thinking is produced. Emotional priming can help visitors learn how to create a special mood, thus correcting their emotional priming. If visitors are thinking with a negative emotion, then this negative emotion can be guided and corrected into a positive emotion, and their thinking will be restored under the positive emotion.
[edit]
The basic theory of cognitive therapy [3]
1. Cognition determines a person's mood and behavior.
Ellis believes that whether various stimulus events in the environment cause certain emotional and behavioral consequences depends on the individual's cognitive evaluation and belief system, and the individual's cognition is the fundamental reason for whether and how to respond. In fact, people with mental disorders such as neurosis may not have experienced more special experiences or stimuli than others, but they often use some irrational knowledge and beliefs that are not in harmony with reality to analyze and look at things, thus falling into the emotional disorder of "self". Therefore, cognitive therapy focuses on changing cognitive hands to eliminate or alleviate all kinds of negative emotions and bad behaviors. These irrational understandings and beliefs have several characteristics:
(1) absolutely required. It requires the perfection of things and people, and thinks that the logic of things' development is "necessity", "affirmation", "must" and "should", which lacks flexibility.
2 generalize by partiality. Generalization, the evaluation of events or people often grasps one, not as good as the rest, and generalizes the whole. If you do something wrong, you think you have accomplished nothing; If others can't do a thing well, they think they are useless and hostile.
It's terrible. I have always thought that the occurrence of an event will lead to extremely terrible or terrible results, but I can't do anything about it and fall into a painful emotional experience of anxiety or depression, pessimism and despair.
When studying depression, Baker also found that negative cognitive bias and self-defeating thinking mode are the main sources of depression, and these wrong habitual cognitive processes have become an automatic thinking. Common system reasoning errors that lead to cognitive distortion are:
(1) Subjective inference, one step ahead, thinking that you know what others are thinking; Perceptual reasoning always likes to use feelings rather than reason to lead the interpretation of reality.
(2) selective generalization, partial generalization, selective negative attention and only negative information.
③ Generalization, grasping one point is not as good as the rest.
(4) Underestimate the positive information and fail to see your own achievements and advantages.
(5) exaggeration and narrowing are not seeking truth from facts.
⑥ Personalization. Blame all the mistakes and failures on your own fault, ignore other people's responsibilities and environmental factors, and often take the initiative to take responsibility for other people's faults.
⑦ Labeling and mislabeling. Looking at a person's essence according to his shortcomings and previous mistakes always gives himself or others a negative evaluation as a whole.
8 extreme thinking, thinking and judging the essence of things or people in a way of all or nothing, either or not, black and white.
Pet-name ruby unfair comparison, always compare yourself with people who do better than yourself, leading to inferiority.
Attending regret tendency. Always pay attention to what should have been done better in the past, not the tendency to do better now.
Remy put forward the "center-edge" model of cognition. In his view, the wrong self-concept does not exist independently, but is expressed in clusters with specific sentence patterns. Some concepts are more basic and dominant than others, and each cluster of wrong concepts corresponds to some type of emotional disorder. The means of cognitive therapy is to gradually excavate and reveal the deep central misconception and correct it from the edge and surface misconception.
2. Schema determines the selective deviation and information forgetting in information processing.
After analyzing the cognitive characteristics of patients with depression, Baker believes that every case has the characteristics of schema, generalization and habitual thinking mode, and has obvious susceptibility. For example, depression schema reflects patients' concern about loss, failure, rejection and loss; Anxiety schema reflects patients' worries about threats and injuries; People who avoid schema will be reluctant to establish relationships with others and avoid challenging situations. Schema is a relatively stable internal psychological model established by people through life experience since childhood. According to these models, individuals process information such as perception, coding and memory of external things. As a relatively stable cognitive structure, schema may be positive and adaptive, or it may be a negative, unbalanced or biased information processing process. For example, the cognitive model formed by the early experience of patients with depression makes them tend to use negative evaluation and explanation too much, thus forming a susceptibility to depression. The biased distorted cognition and automatic thinking of information processing schema play a decisive internal role in the occurrence and development of depression.
[edit]
The technology of cognitive therapy [3]
Different cognitive therapists have put forward their own unique skills on how to change the unreasonable cognitive and schema processing process.
1. midwife debate technology
This is a reasonable emotional therapy and a way for psychologists to argue with patients about their unreasonable beliefs. It originated from the debate of the ancient Greek philosopher Socrates. The main point of its work is to let patients express their irrational views through questioning and qualitative methods, and then infer their irrational beliefs or ways of thinking, or debate or guide them according to the situation, until patients become illogical, voluntarily give up their original false beliefs and change their irrational ways of thinking, and learn to replace those irrational beliefs with reasonable ones.
2. Reasonable emotional imagination technology
By guiding patients to imagine themselves as uncomfortable situations and experience their excessive emotional response, and then by recognizing this inappropriate emotional response, they can change their exaggeration or excessive concern about emotional response and inspire patients to understand the relationship between concept and imagination. Imaginary fear is not equal to reality, and changing unreasonable cognition can eliminate the self-suggestion of negative emotional reaction.
3. Cognitive homework
That is, patients are required to carry out self-observation and self-analysis on their unreasonable beliefs after consulting home, so as to continue and consolidate the therapeutic effect of psychologists in the consulting room. The main form is similar to RET self-service table (self-service).
Form) and self-analysis report (rational
Self-analysis). The basic practice is to let patients write down the stimulating events that lead to negative emotions (a) and the results of their emotions and behaviors (c) according to the problems encountered in real life, and then find out the unreasonable beliefs and automatic thinking (b) related to them; Try to find some new reasonable beliefs (D) to replace the original B, look at event A according to new beliefs and ways of thinking, and see what changes may occur in emotion and behavior (E), that is, A-B-C-D-E treatment mode. Reading therapy is usually introduced to patients as a part of cognitive work.
4. Identify negative automatic thinking
Identifying the negative automatic thinking behind patients' bad emotions and reactions is the most important issue in cognitive therapy. So, how can we find out the negative automatic thinking? Psychologists have found that the wrong cognitive thinking mode is often manifested in some characteristic sentences, "What if?" People with anxiety patterns always ask themselves and answer themselves, which is an automatic thinking, and the result is that they are in a state of constant tension. If psychologists use the "vertical descent technique", it will help to explore the potential beliefs that cause fear of certain consequences and help to weaken this idea. Specifically, psychologists have been asking, "What will happen if that is true?" Such progressive questioning can dig out the unreasonable beliefs or potential worries at the bottom of patients, but the original consciousness is not clear.
5. Semantic technology.
When patients label themselves as "losers", psychologists should know what "failure" means to patients and how patients define failure. In fact, deep-seated misconceptions are often manifested in some abstract propositions related to self-concept, such as "I am a worthless person". Psychologists need to make a semantic analysis of the sentence pattern of "subject-one refers to one table" in patients' false self-concept to help patients analyze the wrong conclusions caused by improper expression of the subject (such as "I") and predicate (such as "a worthless person") in the sentence. In fact, the subject "I" is multifaceted. Specifically, if the abstract "I" is replaced by specific events and behaviors related to "I" and the predicate is replaced by words that can be evaluated according to standards, then we will find how illogical and meaningless the original sentence "I am a worthless person" is.
6. The concept of authenticity verification technology
In view of patients' negative thoughts, we can guide them to find real evidence for and against such thoughts, thus challenging the reliability of their thoughts. Specifically, choose a core belief that you want to evaluate (such as "I'm not likable"). ) and make a symmetrical two-column table. Write all "supporting evidence" on the left side of the form, and all "opposing evidence" on the right side of the form. Ask patients to spend a few weeks to record all the evidence that is inconsistent with negative core beliefs and the experience of confrontation, even if the evidence seems trivial, don't ignore it. Guide them to try to find even trivial experiences to prove that those beliefs are not 100% correct at all times. As time goes on, he may only find some small evidence at first, but later he found more and more. When translating those abstract beliefs into statements about evidence facts, we are often surprised to find that there are far more evidence items against false beliefs than supporting evidence.
7. Role-playing and communication
In order to correct negative thoughts, psychologists can alternately play the roles of positive and negative thoughts with patients. General psychologists play the role of positive or rational thinking, let patients play the role of negative automatic thinking, and then exchange roles, let patients try to refute and convince psychologists with rational thinking. Through several rounds of acting training, patients can be promoted to perceive their negative thoughts and learn to think rationally.
8. Encourage behaviors that change your mind.
The psychologist asked the patient, "If your idea is true, what can we do to make things better?" It is better to encourage patients to "do something" than "do nothing", encourage patients to formulate alternative viewpoints and action plans, and ask patients to record evidence supporting new beliefs from easy to difficult and from simple to complex. The working procedure is to reverse the original core belief into another new belief; Record subtle events and experiences that support new beliefs every day; The reliability of patients' new beliefs and practical experience was evaluated by emotional assessment scale; Comprehensive exercises to replace or balance the way of thinking.