Cognitive Approach to Abnormality "Everything can be taken from a man but one thing: the last of human freedoms to choose one's attitude in any given set of circumstances, to choose one's own way."  ~ Viktor Frankl

Assumptions of the causes of abnormality To understand behaviour we must understand thoughts – includes how people see themselves and the world around them. Abnormal behaviour is caused by faulty and irrational thought processes. So, for Ellis (1962) and Beck (1963) Irrational thinking  Psychological problems Examples of irrational thinking (aka ‘cognitive biases’) include: Magnification and Minimisation magnify failure and minimise achievement Selective abstraction bias towards focusing on negative aspects of life Generalisation using  isolated cases in making wide generalisations

‘Why so negative, dude?’ Schemata & Cognition Schemata = ‘ideas about the world & self’ Schemata develop on the basis of early experiences, and can be shaped by traumatic or unhappy experiences (shades of psychodynamics here!) Negative schemata –triggered by a life event- can lead to ‘negative automatic thoughts’ which can underpin the various cognitive biases.

Schemata in Action Beck used the term negative cognitive triad to refer to three main forms of negative thinking in depression; negative views about: Self 2) World 3) Future Ellis also incorporates the influence in schemata in his ABC model of mental disorders: A = Activating event B = Beliefs C = Consequence

Case Study: Depression A depressed woman thinks 'I can't face going into work today: I can't do it. Nothing will go right. I'll feel awful.' As a result of these thoughts - and of believing them - she rings in sick. By behaving like this, she won't have the chance to find out that her prediction was wrong. She might have found some things she could do, and at least some things that were OK. But by staying at home, brooding about her failure to go in, she may end up thinking: 'I've let everyone down. They will be angry with me. Why can't I do what everyone else does? I'm so weak and useless.' She will probably end up feeling worse, and have even more difficulty going in to work the next day. Thinking, behaving and feeling like this may start a downward spiral. This can apply to many different kinds of problems.

Therapies Often incorporates behavioural techniques Ellis’s Rational-Emotive Behavioural Therapy (REBT) Rational thinking changes emotions Beck’s Cognitive Therapy Change negative thoughts into constructive ones Recognise & correct errors in thinking

Assumptions about Treatment Abnormality is caused by faulty thinking; however the individual can gain control of their thoughts (and therefore behaviour) Thus, therapy aims to change the way the client thinks by actively challenging belief systems and breaking the automated –negative- thought processes Active involvement of client Only client knows thoughts Only client can change them Therapist merely assists

Cognitive Behavioural Therapy The cognitive part of the therapy involves identifying faulty or irrational thinking processes through questioning and getting the client to give examples of situations, what they would think and what they would do. The behaviour part of the therapy involves setting homework for client, giving them tasks that will help them challenge their own irrational beliefs. The idea is that the client identifies their own unhelpful beliefs and then proves them wrong, thus changing them (often in small steps!).

CBT Structure At the beginning client describes specific problems and to set goals they want to work towards. E.g. sleeping badly, not being able to socialise with friends, being unhappy at work. At start of sessions, main topics they want to work on is co-decided, and discus conclusions from the previous session. ‘Homework’ assignments between sessions is a vital part of the process. E.g. keeping a diary of any incidents that provoke feelings of anxiety or depression, so that they can examine thoughts surrounding the incident. Later, other assignment might consist of exercises to cope with problem situations of a particular kind.

Evaluation (AO2) +ve /-ve: Lays responsibility on the individual!(“depression is an indulgence of self-defeating thoughts” ~ Ellis). +ve /-ve: Doesn’t seek to ‘cure’, only help to adapt and cope. +ve: Proven to be effective in treating anxiety & depression and a range of other behavioural disorders such as OCD, phobias, anger management, eating disorders. +ve: Time/cost efficient (6-12 weekly sessions) -ve: Acknowledges complexity of cognition & role in disorders, but overlook biological factors