Pg-Certificate CBT-2017 Dr.Bashir Ahmad (Course Director)

Cognitive Model of Emotional disorder Aaron T Beck 1979

Cognitive Model of Depression Cognitive model postulates three specific concepts to explain the psychological substrate of depression: 1.thinking errors (faulty information processing) 2. the cognitive triad 3.schemas.

Cognitive Model of Depression Depression is associated with shifts in information processing – (thinking errors) – resulting in holding negative view of self, world and future-- (The Cognitive Triad) Resulting in systematic bias leading to dysfunctional belief system- (schemas and automatic thoughts)

Cognitive Model of Depression Negative Automatic Thoughts (NATs) and depressive behaviours maintain depressed mood. When people learn to evaluate their thinking in a more realistic and adaptive way, they experience improvement in their emotional state and in their behaviour.

Cognitive Model of Depression Example, if you were depressed you might have an auto matic thought, an idea that just seemed to pop up in your mind “I can’t do anything right.” This in turn lead to a particular reaction: you might feel sad (emotion) and retreat to bed (behaviour)

Cognitive Model of Depression If you now examine the validity of this idea, you might conclude that you had overgeneralized and in fact, you actually do many things well. Looking at your experience from this new perspective would make you feel better and lead to more functional behaviour.

Cognitive Model of Depression For lasting improvement in patients’ mood and behaviour, cognitive therapists work at a deeper level of cognition. Basic beliefs about themselves, their world, and other people. Modification of their underlying dysfunctional beliefs produces more enduring change.

Cognitive Model of Depression For example, if you continually underestimate your abilities, you might have an underlying belief of incompetence. Modifying this general belief (i.e., seeing yourself in a more realistic light as having both strengths and weaknesses) can alter your perception of specific situations that you encounter daily. You will no longer have as many thoughts with the theme, “I can’t do anything right.” Instead, in specific situations where you make mistakes, you will probably think, “I’m not good at this specific task.”

Hot cross bun (Padesky & Mooney, 1990 ) Situation Failed job interview Cognitive I’m no good, never going to make it Physical Tired, insomnia, Mood Sad hopeless Developed in session 1 and 2 Behaviour Stay in bed, give up

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Cognitive Distortions/ Thinking Errors/ Automatic Thoughts Cognitive distortions lead to and maintain depression. During the course of therapy, these distortions are identified, modified and corrected. Once corrected patients feel less distressed and their mood is lifted.

Cognitive Distortions All-or-nothing thinking: (also called black-and-white, polarized, or dichotomous thinking): You view a situation in only two categories instead of on a continuum. Example: "If I'm not a total success, I'm a failure.”

Cognitive Distortions Catastrophizing You predict the future negatively without considering other, more likely outcomes. Example: "I'll be so upset I won't be able to function at all."

Cognitive Distortions Disqualifying or discounting the positive You unreasonably tell yourself that positive experiences, deeds, or qualities do not count. Example "I did that project well, but that doesn't mean I'm competent; I just got lucky.”

Cognitive Distortions Emotional reasoning You think something must be true because you "feel” it so strongly, ignoring or discounting evidence to the contrary. Example: "I know I do a lot of things well at work, but I still feel as if I'm a failure."

Cognitive Distortions Labeling You put a fixed, global label on yourself or others without considering that the evidence might more reasonably lead to a less disastrous conclusion. Examples: "I'm a loser. He's no good."

Cognitive Distortions Magnification/minimization When you evaluate yourself, another person, or a situation, you unreasonably magnify the negative and/or minimize the positive. Examples: "Getting a mediocre evaluation proves how inadequate I am. Getting high marks doesn't mean I'm smart."

Cognitive Distortions Mental filter (also called selective abstraction) You pay undue attention to one negative detail instead of seeing the whole picture. Example "Because I got one low rating on my evaluation [which also contained several high ratings] it means I'm doing a lousy job.”

Cognitive Distortions Mind reading You believe you know what others’ motivations are, or what they are thinking, failing to consider other, more likely possibilities. Example "He's thinking that I don't know nothing about this project."

Cognitive distortions Should" and "must” statements You have a precise, fixed idea of how you or others should behave and you overestimate how bad it is that these expectations are not met. Example: "It's terrible that I made a mistake, that mistake was disastrous, I should never make a mistake.”

Cognitive Distortions Tunnel vision You only see the negative aspects of a situation. Example: "My son's teacher can't do anything right. He's critical and insensitive and lousy at teaching."