Cognitivism is a modern trend in psychology. Cognitive Behavioral Therapy: A Primary Treatment for Neurotic Disorders Case Study A

The work of Seligman, Rotter, and Bandura had a huge impact on behavioral psychotherapy. In the early 1970s, the aforementioned "cognitive turn" in behavioral psychotherapy was actively discussed in the professional literature. Scientists have tried to demonstrate the analogies already accumulated by practice between the two most important forms of psychotherapy: psychoanalysis and behavioral therapy. The reason for these publications was the following.

The practice of psychotherapy has clearly shown that behavior modification, carried out taking into account cognitive and emotional forms of behavior regulation, is more effective than purely behavioral training. It has been found that for some clients the essence of behavioral disorders is reduced solely to negative emotional disorders (fears, anxiety, shyness), disorders of self-verbalization or self-esteem. The accumulated empirical material clearly indicated that in some people a full-fledged behavioral repertoire is not realized in everyday life only due to emotional or cognitive blocking.

Summarizing the accumulated data, psychologists actively published works devoted to the analysis of common features and differences between these two forms of psychocorrection. In 1973, the American Psychiatric Society published the book "Behavior Therapy and Psychiatry", where the authors devoted a special chapter to the analysis of the established, in their opinion, "de facto" integration of psychoanalysis and behavioral psychotherapy.

Three years later, a book was published called Psychoanalysis and Behavior Therapy, in which an attempt was made to prove that the main ideas of psychoanalysis are in fact identical to the main ideas of behaviorism, that all the observations from which the theorists of psychoanalysis and behavioral psychology proceed are in one way or another connected with early the story of a life that flows unconsciously for the child, at a time when he does not yet understand what is happening to him. The early history of life in both theories is considered the basis of all subsequent achievements and shortcomings of development and socialization.

However, it is precisely this fact of "unity" of behavior therapy and psychoanalysis that has become the basis for a detailed critique of both approaches undertaken by supporters of the so-called "cognitive psychotherapy".

In American psychology, the term "cognitive psychotherapy" is most often associated with the names of Albert Ellis and Aaron Beck.

Both authors are psychoanalysts by education with a classical psychoanalytic education. With a short interval of time, Ellis in 1962, Beck in 1970, published works in which they very critically described their own, for them unsatisfactory, experience in the application of psychoanalysis.

Both came up with the rationale for the need for a significant expansion of psychoanalytic practice through the analysis and therapeutic processing of cognitive impairments. From their point of view, the classic trappings of psychoanalysis, such as the psychoanalytic couch and the method of free association, sometimes have a negative effect on the client, because they cause him to fixate on his negative thoughts and unpleasant experiences.

Analyzing the practice of behavior therapy, Beck came to the conclusion that any form of behavioral psychotherapy is only one form of cognitive therapy. Classical "orthodox" psychoanalysis, he gives a complete rejection, as, indeed, and Ellis. In the critique of psychoanalysis and behavior therapy, both of them chose very harsh, pointed formulations, trying to present their own point of view in a more contrasting way.

Ellis, for example, characterized the point of view of an orthodox psychoanalyst on the reason for the irrational belief that only those who earn a lot deserve respect: “So if you think that you have to earn a lot so that people respect you and you can respect yourself yourself, various psychoanalysts will explain to you that:

Your mom gave you enemas too often and you're therefore "anally fixed" and obsessed with money;

You unconsciously believe that a purse full of money represents your genitals, and therefore its fullness with money is actually a sign that you would like to change partners more often in bed;

Your father was strict with you, now you would like to earn his love, and you hope that money will contribute to this;

You unconsciously hate your father and want to hurt him with the fact that you will earn more than him;

You have too small a penis or breasts, and earning a lot of money, you want to compensate for this shortcoming;

Your unconscious mind identifies money with power, and in fact you are preoccupied with how to acquire more power” (A. Ellis, 1989, p. 54).

In reality, Ellis notes, the list is endless. All psychoanalytic interpretations are possible, but none of them is convincing. Even if these statements were true, how would knowing this help you get out of your preoccupation with money issues?

Relief and cure of cognitive impairment is achieved not by identifying early injuries, but by acquiring new knowledge in the process of therapeutic education. It is also necessary to train new patterns of behavior so that new beliefs can be implemented in reality. In the course of therapy, together with the patient, the psychologist tries to create an alternative way of thinking and acting, which should replace the suffering habits. Without such a new course of action, therapy will be insufficient and unsatisfactory for the patient.

The cognitive approach became an entirely new branch of psychotherapy because, unlike traditional methods such as psychoanalysis or client-centered psychotherapy, the therapist actively involved the patient in the treatment process.

Unlike psychoanalysis, the focus of cognitive psychotherapy is on what the patient thinks and feels during and after therapy sessions. Childhood experiences and interpretations of unconscious manifestations are of little value.

Unlike classical behavioral therapy, it focuses more on internal experiences rather than external behavior. The goal of behavioral psychotherapy is the modification of external behavior. The goal of cognitive therapy is to change ineffective ways of thinking. Behavioral training is used to consolidate the changes achieved at the cognitive level.

One way or another, many scientists and practitioners took part in the creation of a cognitive direction in behavioral therapy. At present, this approach is becoming more and more widely used, gaining more and more new supporters. In our presentation, we will focus on the classical theories of cognitive-behavioral psychotherapy, and we, of course, must begin with the presentation of Rational-Emotive Behavior Therapy (RET) by Albert Ellis. The fate of this approach is all the more remarkable because initially the author intended to develop a completely new (primarily different from psychoanalysis) approach and called it (in 1955) rational therapy. In subsequent publications, Ellis began to call his method rational-emotive therapy, but over time he realized that the essence of the method is more consistent with the name rational-emotive behavior therapy. It is under this name that the Ellis Institute in New York now exists.

Today, the correction of any psychological problems is carried out using a variety of techniques. One of the most progressive and effective is cognitive behavioral therapy (CBT). Let's see how this technique works, what it is and in what cases it is most effective.

The cognitive approach proceeds from the assumption that all psychological problems are caused by the thoughts and beliefs of the person himself.

Cognitive-behavioral psychotherapy is a direction that originates in the middle of the 20th century and today it is only being improved every day. The basis of CBT is the belief that it is human nature to make mistakes in the course of life. That is why any information can cause certain changes in the mental or behavioral activity of a person. The situation gives rise to thoughts, which in turn contribute to the development of certain feelings, and those already become the basis of behavior in a particular case. The behavior then creates a new situation and the cycle repeats.

A vivid example can be a situation in which a person is sure of his insolvency and impotence. In every difficult situation, he experiences these feelings, gets nervous and despairs, and, as a result, tries to avoid making a decision and cannot realize his desires. Often the cause of neurosis and other similar problems becomes an intrapersonal conflict. Cognitive-behavioral psychotherapy helps to identify the initial source of the current situation, depression and experiences of the patient, and then resolve the problem. The skill of changing one's negative behavior and stereotype of thinking becomes available to a person, which positively affects both the emotional state and the physical state.

Intrapersonal conflict is one of the most common causes of psychological problems.

CBT has several goals at once:

• stop and permanently get rid of the symptoms of a neuropsychiatric disorder;
• to achieve a minimum likelihood of recurrence of the disease;
• help improve the effectiveness of prescribed drugs;
• eliminate negative and erroneous stereotypes of thinking and behavior, attitudes;
• solve problems of interpersonal interaction.

Cognitive behavioral therapy is effective for a wide variety of disorders and psychological problems. But most often it is used if the patient needs quick help and short-term treatment.

For example, CBT is used for deviations in eating behavior, problems with drugs and alcohol, inability to restrain and live emotions, depression, increased anxiety, various phobias and fears.

Contraindications to the use of cognitive-behavioral psychotherapy can only be severe mental disorders that require the use of medications and other regulatory actions that seriously threaten the life and health of the patient, as well as his loved ones and others.

Experts cannot say exactly at what age cognitive-behavioral psychotherapy is used, since this parameter will be different depending on the situation and the methods of working with the patient selected by the doctor. Nevertheless, if necessary, such sessions and diagnostics are possible both in childhood and in adolescence.

The use of CBT for severe mental disorders is unacceptable; special drugs are used for this

The main principles of cognitive-behavioral psychotherapy are the following factors:

1. The person's awareness of the problem.
2. Formation of an alternative pattern of actions and actions.
3. Consolidation of new stereotypes of thinking and testing them in everyday life.

It is important to remember that both parties are responsible for the result of such therapy: the doctor and the patient. It is their well-coordinated work that will achieve the maximum effect and significantly improve a person's life, bring it to a new level.

Advantages of the technique

The main advantage of cognitive-behavioral psychotherapy can be considered a visible result that affects all areas of the patient's life. The specialist finds out exactly what attitudes and thoughts negatively affect the feelings, emotions and behavior of a person, helps to critically perceive and analyze them, and then learn how to replace negative stereotypes with positive ones.

Based on the skills developed, the patient creates a new way of thinking that corrects the response to specific situations and the patient's perception of them, changes behavior. Cognitive Behavioral Therapy helps to get rid of many problems that cause discomfort and suffering to the person himself and his loved ones. For example, in this way you can cope with alcohol and drug addiction, some phobias, fears, part with shyness and indecision. The duration of the course is most often not very long - about 3-4 months. Sometimes it may take much more time, but in each case this issue is resolved on an individual basis.

Cognitive-behavioral therapy helps to cope with anxieties and fears of a person

It is only important to remember that cognitive behavioral therapy has a positive effect only when the patient himself has decided to change and is ready to trust and work with a specialist. In other situations, as well as in especially severe mental illnesses, such as schizophrenia, this technique is not used.

Types of therapy

The methods of cognitive-behavioral psychotherapy depend on the specific situation and the patient's problem, and pursue a specific goal. The main thing for a specialist is to get to the bottom of the patient's problem, to teach a person positive thinking and ways of behaving in such a case. The most commonly used methods of cognitive-behavioral psychotherapy can be considered the following:

1. Cognitive psychotherapy, in which a person experiences insecurity and fear, perceives life as a series of failures. At the same time, the specialist helps the patient develop a positive attitude towards himself, help him accept himself with all his shortcomings, gain strength and hope.
2. reciprocal inhibition. All negative emotions and feelings are replaced by other more positive ones during the session. Therefore, they cease to have such a negative impact on human behavior and life. For example, fear and anger are replaced by relaxation.
3. Rational-emotive psychotherapy. At the same time, a specialist helps a person to realize the fact that all thoughts and actions must be coordinated with life realities. And unrealizable dreams are the path to depression and neurosis.
4. Self control. When working with this technique, the reaction and behavior of a person in certain situations is fixed. This method works with unmotivated outbursts of aggression and other inadequate reactions.
5. Stop tap technique and anxiety control. At the same time, the person himself says “Stop” to his negative thoughts and actions.
6. Relaxation. This technique is often used in combination with others to completely relax the patient, create a trusting relationship with a specialist, and more productive work.
7. Self instructions. This technique consists in the creation by the person himself of a number of tasks and their independent solution in a positive way.
8. Introspection. In this case, a diary can be kept, which will help in tracking the source of the problem and negative emotions.
9. Research and analysis of threatening consequences. A person with negative thoughts changes them to positive ones, based on the expected results of the development of the situation.
10. Method of finding advantages and disadvantages. The patient himself or together with a specialist analyzes the situation and his emotions in it, analyzes all the advantages and disadvantages, draws positive conclusions or looks for ways to solve the problem.
11. paradoxical intention. This technique was developed by the Austrian psychiatrist Viktor Frankl and consists in the fact that the patient is invited to live a frightening or problematic situation over and over again in his feelings and did the opposite. For example, if he is afraid to fall asleep, then the doctor advises not to try to do this, but to stay awake as much as possible. At the same time, after a while, a person stops experiencing negative emotions associated with sleep.

Some of these types of cognitive-behavioral psychotherapy can be done on their own or can be done as "homework" after a session with a specialist. And in working with other methods, one cannot do without the help and presence of a doctor.

Self-observation is considered one of the types of cognitive-behavioral psychotherapy

Techniques of Cognitive Behavioral Therapy

Cognitive-behavioral psychotherapy techniques can be varied. Here are the most commonly used ones:

• keeping a diary where the patient will write down his thoughts, emotions and situations preceding them, as well as everything exciting during the day;
• reframing, in which, by asking leading questions, the doctor helps to change the patient's stereotypes in a positive direction;
• examples from the literature, when the doctor tells and gives specific examples of literary characters and their actions in the current situation;
• empirical way, when a specialist offers a person several ways to try out certain solutions in life and leads him to positive thinking;
• role reversal, when a person is invited to stand "on the other side of the barricades" and feel like the one with whom he has a conflict situation;
• evoked emotions, such as anger, fear, laughter;
• positive imagination and analysis of the consequences of a particular choice of a person.

Psychotherapy by Aaron Beck

Aaron Beck- An American psychotherapist who examined and observed people suffering from neurotic depression, and concluded that depression and various neuroses develop in such people:

• having a negative view of everything that happens in the present, even if it can bring positive emotions;
• having a feeling of powerlessness to change something and hopelessness, when, when imagining the future, a person draws only negative events;
• suffering from low self-esteem and reduced self-esteem.

Aaron Beck used a variety of methods in his therapy. All of them were aimed at identifying a specific problem both on the part of the specialist and the patient, and then looking for a solution to these problems without correcting the specific qualities of a person.

Aaron Beck is an outstanding American psychotherapist, creator of cognitive psychotherapy.

In Beck's Cognitive Behavioral Therapy for personality disorders and other problems, the patient and therapist collaborate in an experimental test of the patient's negative judgments and stereotypes, and the session itself is a series of questions and answers to them. Each of the questions is aimed at promoting the patient to find out and realize the problem, to find ways to solve it. Also, a person begins to understand where his destructive behavior and mental messages lead, together with a doctor or independently collects the necessary information and checks it in practice. In a word, cognitive-behavioral psychotherapy according to Aaron Beck is a training or structured training that allows you to detect negative thoughts in time, find all the pros and cons, change the behavior pattern to one that will give positive results.

What happens during a session

Of great importance in the results of therapy is the choice of a suitable specialist. The doctor must have a diploma and documents permitting activity. Then a contract is concluded between the two parties, which specifies all the main points, including the details of the sessions, their duration and number, conditions and time of meetings.

Therapy session must be conducted by a licensed professional

Also in this document, the main goals of cognitive-behavioral therapy are prescribed, if possible, the desired result. The course of therapy itself can be short-term (15 sessions per hour) or longer (more than 40 sessions per hour). After the end of the diagnosis and getting to know the patient, the doctor draws up an individual plan of work with him and the timing of consultation meetings.

As you can see, the main task of a specialist in the cognitive-behavioral direction of psychotherapy is considered not only to observe the patient, to find out the origins of the problem, but also explaining one's opinion on the current situation to the person himself, helping him to understand and build new mental and behavioral stereotypes. To increase the effect of such psychotherapy and consolidate the result, the doctor can give the patient special exercises and "homework", use various techniques that can help the patient continue to act and develop in a positive direction independently.

Studying the world, we look at it through the prism of already acquired knowledge. But sometimes it may turn out that our own thoughts and feelings can distort what is happening and hurt us. Such stereotyped thoughts, cognitions, arise unconsciously, showing a reaction to what is happening. However, despite their unintentional appearance and seeming harmlessness, they prevent us from living in harmony with ourselves. These thoughts need to be dealt with through cognitive behavioral therapy.

History of therapy

Cognitive Behavioral Therapy (CBT), also called Cognitive Behavioral Therapy, originated in the 1950s and 1960s. The founders of cognitive behavioral therapy are A. Back, A. Ellis and D. Kelly. Scientists studied the perception of a person in various situations, his mental activity and further behavior. This was the innovation - the fusion of the principles and methods of cognitive psychology with behavioral ones. Behaviorism is a branch of psychology that specializes in the study of human and animal behavior. However, the discovery of CBT did not mean that such methods had never been used in psychology. Some psychotherapists have used the cognitive capabilities of their patients, thus diluting and supplementing behavioral psychotherapy in this way.

It is no coincidence that the cognitive-behavioral direction in psychotherapy began to develop in the United States. At that time, behavioral psychotherapy was popular in the United States - a positively minded concept that believes that a person can create himself, while in Europe, on the contrary, psychoanalysis, which was pessimistic in this regard, dominated. The direction of cognitive-behavioral psychotherapy was based on the fact that a person chooses behavior based on his own ideas about reality. A person perceives himself and other people based on his own type of thinking, which, in turn, is obtained through training. Thus, the wrong, pessimistic, negative thinking that a person has learned carries with it wrong and negative ideas about reality, which leads to inadequate and destructive behavior.

The therapy model

What is Cognitive Behavioral Therapy and what does it entail? The basis of cognitive behavioral therapy are elements of cognitive and behavioral therapy aimed at correcting the actions, thoughts and emotions of a person in problem situations. It can be expressed as a kind of formula: situation - thoughts - emotions - actions. In order to understand the current situation and understand your own actions, you need to find answers to questions - what did you think and feel when it happened. Indeed, in the end it turns out that the reaction is determined not so much by the current situation as by your own thoughts on this matter, which form your opinion. It is these thoughts, sometimes even unconscious ones, that lead to the appearance of problems - fears, anxieties and other painful sensations. It is in them that the key to unraveling many of the problems of people is located.

The main task of the psychotherapist is to identify erroneous, inadequate and inapplicable thinking that needs to be corrected or completely changed, instilling in the patient acceptable thoughts and behavior patterns. For this, therapy is carried out in three stages:

• logical analysis;
• empirical analysis;
• pragmatic analysis.

At the first stage, the psychotherapist helps the patient analyze the emerging thoughts and feelings, finds errors that need to be corrected or removed. The second stage is characterized by teaching the patient to accept the most objective model of reality and compare the perceived information with reality. At the third stage, the patient is offered new, adequate life attitudes, on the basis of which he needs to learn how to respond to events.

cognitive errors

Inadequate, painful and negatively directed thoughts are considered by the behavioral approach as cognitive errors. Such errors are quite typical and can occur in different people in different situations. These include, for example, arbitrary inferences. In this case, a person draws conclusions without evidence or even in the presence of facts that contradict these conclusions. There is also over-generalization - generalization based on several incidents, implying the allocation of general principles of action. However, what is abnormal here is that such overgeneralization is also applied in situations in which this should not be done. The next mistake is selective abstraction, in which certain information is selectively ignored, and information is also pulled out of context. Most often this happens with negative information to the detriment of positive.

Cognitive errors also include inadequate perception of the significance of an event. Within the framework of this error, both exaggeration and underestimation of significance can occur, which, in any case, does not correspond to reality. Such a deviation as personalization also does not bring anything positive. People who are prone to personalization regard other people's actions, words, or emotions as related when, in fact, they had nothing to do with them. Maximalism, which is also called black-and-white thinking, is also considered abnormal. With it, a person differentiates the things that have happened into completely black or completely white, which makes it difficult to see the essence of actions.

Basic principles of therapy

If you want to get rid of negative attitudes, you need to remember and understand some of the rules that CBT is based on. The most important thing is that your negative feelings are primarily caused by your assessment of what is happening around, as well as yourself and everyone around you. The significance of the situation that has occurred should not be exaggerated, you need to look inside yourself, in an effort to understand the processes that drive you. The assessment of reality is usually subjective, so in most situations it is possible to radically change the attitude from negative to positive.

It is important to be aware of this subjectivity even when you are sure of the truth and correctness of your conclusions. This frequent discrepancy between internal attitudes and reality disturbs your peace of mind, so it is better to try to get rid of them.

It is also very important for you to understand that all this - wrong thinking, inadequate attitudes - can be changed. The typical mindset you have developed can be corrected for small problems, and completely corrected for major problems.

Teaching new thinking is carried out with a psychotherapist in sessions and self-study, which subsequently ensures the patient's ability to adequately respond to emerging events.

Therapy Methods

The most important element of CBT in psychological counseling is teaching the patient to think correctly, that is, to critically evaluate what is happening, use the available facts (and search for them), understand the probability and analyze the collected data. This analysis is also called pilot verification. This check is done by the patient himself. For example, if it seems to a person that everyone constantly turns to look at him on the street, you just have to take it and count, but how many people will actually do it? This simple test can achieve serious results, but only if it is performed, and performed responsibly.

Therapy of mental disorders involves the use of psychotherapists and other techniques, such as reassessment techniques. When applied, the patient performs a check on the likelihood of this event occurring due to other causes. The fullest possible analysis of the many possible causes and their influence is carried out, which helps to soberly assess what happened as a whole. Depersonalization is used in cognitive behavioral therapy for those patients who feel constantly in the spotlight and suffer from it.

With the help of tasks, they understand that others are most often passionate about their affairs and thoughts, and not about the patient. An important direction is also the elimination of fears, for which conscious self-observation and decatastrophe are used. By such methods, the specialist achieves from the patient an understanding that all bad events end, that we tend to exaggerate their consequences. Another behavioral approach involves repeating the desired result in practice, its constant consolidation.

Treating neuroses with therapy

Cognitive Behavioral Therapy is used to treat a variety of diseases, the list of which is long and endless. In general, using its methods, they treat fears and phobias, neurosis, depression, psychological trauma, panic attacks and other psychosomatics.

There are a lot of methods of cognitive-behavioral therapy, and their choice depends on the individual and his thoughts. For example, there is a technique - reframing, in which the psychotherapist helps the patient get rid of the rigid framework into which he has driven himself. In order to better understand oneself, the patient may be offered to keep a kind of diary in which feelings and thoughts are recorded. Such a diary will also be useful for the doctor, as he will be able to choose a more suitable program in this way. A psychologist can teach his patient positive thinking, replacing the formed negative picture of the world. The behavioral approach has an interesting way - role reversal, in which the patient looks at the problem from the outside, as if it were happening to another person, and tries to give advice.

Behavioral therapy uses implosion therapy to treat phobias or panic attacks. This is the so-called immersion, when the patient is deliberately forced to remember what happened, as if to relive it.

Systematic desensitization is also used, which differs in that the patient is preliminarily taught relaxation techniques. Such procedures are aimed at the destruction of unpleasant and traumatic emotions.

Treatment for depression

Depression is a common mental disorder, one of the key symptoms of which is impaired thinking. Therefore, the need for the use of CBT in the treatment of depression is undeniable.

Three typical patterns have been found in the thinking of people suffering from depression:

• thoughts about the loss of loved ones, the destruction of love relationships, loss of self-esteem;
• negatively directed thoughts about oneself, the expected future, others;
• an uncompromising attitude towards oneself, the presentation of unreasonably rigid requirements and limits.

In solving the problems caused by such thoughts, behavioral psychotherapy should help. For example, stress inoculation techniques are used to treat depression. For this, the patient is taught to be aware of what is happening and intelligently deal with stress. The doctor teaches the patient, and then fixes the result with independent studies, the so-called homework.

But with the help of the reattribution technique, one can show the patient the inconsistency of his negative thoughts and judgments and give new logical attitudes. Used to treat depression and such methods of CBT as a stop technique, in which the patient learns to stop negative thoughts. At the moment when a person begins to return to such thoughts, it is necessary to build a conditional barrier for the negative, which will not allow them. Having brought the technique to automatism, you can be sure that such thoughts will no longer bother you.

Psychology has today a wide interest among ordinary people. However, the real techniques and exercises are carried out by specialists who understand what they use all the methods for. One of the areas of work with a client is cognitive psychotherapy.

Specialists of cognitive psychotherapy consider a person as an individual personality that shapes his life depending on what he pays attention to, how he looks at the world, how he interprets certain events. The world is the same for all people, but what people themselves think about it may differ in different opinions.

In order to know why certain events, sensations, experiences occur to a person, it is necessary to deal with his ideas, attitude, views and reasoning. This is what cognitive psychologists do.

Cognitive psychotherapy helps a person deal with their personal problems. These can be individual experiences or situations: problems in the family or at work, self-doubt, low self-esteem, etc. It is used to eliminate stressful experiences as a result of disasters, violence, wars. It can be used both individually and when working with families.

What is cognitive psychotherapy?

In psychology, many techniques are used on how to help a client. One of these areas is cognitive psychotherapy. What it is? This is a purposeful, structured, directive, short-term conversation aimed at transforming the inner "I" of a person, which is manifested in the sensation of these transformations and new behaviors.

That is why one can often come across such a name as cognitive behavioral therapy, where a person not only considers his situation, studies its components, puts forward new ideas for changing himself, but also practices new actions that will support new qualities and characteristics that he develops himself.

Cognitive Behavioral Therapy performs many useful functions that help healthy people transform their own lives:

1. First, a person is taught a realistic perception of the events that happen to him. Many problems are taken from the fact that a person distorts the interpretation of events happening to him. Together with the psychotherapist, the person reinterprets what happened, now being able to see where the distortion occurs. Along with the development of adequate behavior, there is a transformation of actions that become consistent with situations.
2. Second, you can change your future. It depends solely on the decisions and actions that a person makes. By changing your behavior, you can change your entire future.
3. Thirdly, the development of new models of behavior. Here the psychotherapist not only transforms the personality, but also supports it in these transformations.
4. Fourth, fixing the result. For a positive outcome to exist, you need to be able to maintain and maintain it.

Cognitive psychotherapy uses many methods, exercises and techniques that are applied at different stages. They are ideally combined with other directions in psychotherapy, supplementing or replacing them. Thus, the therapist can use several directions at the same time, if this helps in achieving the goal.

Beck's Cognitive Psychotherapy

One of the directions in psychotherapy is called cognitive therapy, the founder of which was Aaron Beck. It was he who created the idea, which is the main one in all cognitive psychotherapy - the problems that arise in a person's life are the wrong worldview and attitudes.

Various events happen in the life of each individual. Much depends on how a person perceives the promises of external circumstances. The thoughts that arise are of a certain nature, provoking the corresponding emotions and, as a result, the actions that a person performs.

Aaron Beck did not consider the world to be bad, but people's views of the world as negative and wrong. It is they who form the emotions that others experience, and the actions that are then performed. It is actions that affect how events unfold further in the life of each person.

Mental pathology, according to Beck, occurs when a person distorts external circumstances in his own mind. An example would be working with people who have suffered from depression. Aaron Beck found that all depressed individuals had the following thoughts: inadequacy, hopelessness, and defeatism. Thus, Beck brought out the idea that a depressive state occurs in those who comprehend the world through 3 categories:

1. Hopelessness, when a person sees his future exclusively in gloomy colors.
2. Negative view, when the individual perceives the current circumstances exclusively from a negative point of view, although for some people they may cause pleasure.
3. Reduced self-esteem, when a person perceives himself as helpless, worthless, insolvent.

Mechanisms that help in correcting cognitive attitudes are self-control, role-playing games, homework, modeling, etc.

Aaron Beck worked with Freeman mostly on people with personality disorders. They were convinced that every disorder is the result of certain beliefs and strategies. If you identify thoughts, patterns, patterns and actions that automatically appear in your head in people with a specific personality disorder, then you can correct them by transforming your personality. This can be done by re-experiencing traumatic situations or by using the imagination.

In psychotherapeutic practice, Beck and Freeman considered important a friendly atmosphere between the client and the specialist. The client should have no resistance to what the therapist is doing.

The ultimate goal of cognitive psychotherapy is to identify destructive thoughts and transform the personality by eliminating them. What is important is not what the client thinks, but how he thinks, reasons, what mental patterns he uses. They should be transformed.

Methods of cognitive psychotherapy

Since a person’s problems are the result of his incorrect perception of what is happening, inferences and automatic thoughts, the validity of which he does not even think about, the methods of cognitive psychotherapy are:

• Imagination.
• Fight negative thoughts.
• Secondary experience of childhood traumatic situations.
• Finding alternative strategies for perceiving the problem.

Much depends on the emotional experience that the person has experienced. Cognitive therapy helps in forgetting or learning new things. Thus, each client is invited to transform old patterns of behavior and develop new ones. It uses not only a theoretical approach, when a person studies the situation, but also a behavioral one, when the practice of committing new actions is encouraged.

The psychotherapist directs all his efforts to identify and change the negative interpretations of the situation that the client uses. So, in a depressed state, people often talk about how good it was in the past and what they can no longer experience in the present. The psychotherapist suggests finding other examples from life when such ideas did not work, remembering all the victories over one's own depression.

Thus, the main technique is to recognize negative thoughts and modify them into others that help in solving problems.

Using the method of finding alternative ways of acting in a stressful situation, the emphasis is on the fact that a person is an ordinary and imperfect being. You don't have to win to solve a problem. You can just try your hand at solving a problem that seems problematic, accept a challenge, not be afraid to act, try. This will bring more results than the desire to win the first time.

Cognitive Psychotherapy Exercises

The way a person thinks affects how he feels, how he treats himself and others, what decisions he makes and actions he performs. People perceive the same situation differently. If only one facet stands out, then this significantly impoverishes the life of a person who cannot be flexible in his thinking and actions. This is why cognitive psychotherapy exercises become effective.

There are a large number of them. All of them can look like homework, when a person reinforces in real life new skills acquired and developed in sessions with a psychotherapist.

All people from childhood are taught to unambiguous thinking. For example, "If I can't do anything, then I'm a failure." In fact, such thinking limits the behavior of a person who is now not even going to attempt to refute it.

Exercise "Fifth column".

• In the first column on a piece of paper, write down the situation that is problematic for you.
• In the second column, write down the feelings and emotions that you have in this situation.
• In the third column, write down the “automatic thoughts” that often flash through your mind in this situation.
• In the fourth column, write down the beliefs that trigger these "automatic thoughts" in you. What attitudes are you guided by, because of what you think this way?
• In the fifth column, write down the thoughts, beliefs, attitudes, positive statements that refute the ideas from the fourth column.

After identifying automatic thoughts, it is proposed to perform various exercises where a person will be able to change his attitudes by performing other actions, and not those that he did before. Then it is proposed to perform these actions in real conditions in order to see what result will be achieved.

Cognitive Psychotherapy Techniques

When using cognitive therapy, three techniques are actually used: Beck's cognitive psychotherapy, Ellis's rational-emotive concept, and Glasser's realistic concept. The client mentally argues, performs exercises, experiments, fixes models at the level of behavior.

Cognitive psychotherapy aims to teach the client to:

• Identification of negative automatic thoughts.
• Finding the connection between affects, knowledge and actions.
• Finding arguments "for" and "against" automatic thoughts.
• Learning to identify negative thoughts and attitudes that lead to wrong behavior and negative experiences.

For the most part, people expect a negative outcome of events. That is why he has fears, panic attacks, negative emotions, which make him not act, run away, fence off. Cognitive psychotherapy helps in identifying attitudes and understanding how they affect the behavior and life of the person himself. In all his misfortunes, the individual is guilty himself, which he does not notice and continues to live unhappily.

Outcome

Even a healthy person can use the services of a cognitive psychotherapist. Absolutely all people have some kind of personal problems with which he cannot cope on his own. The result of unresolved problems is depression, dissatisfaction with life, dissatisfaction with oneself.

If there is a desire to get rid of an unhappy life and negative experiences, then you can use the techniques, methods and exercises of cognitive psychotherapy, which transforms people's lives, changing it.

Cognitiveness (cognition) is a person's ability to process and perceive information. In psychology, the term is widely used to explain psychological processes.

In psychology

Cognitiveness in psychology is interpreted as an act of cognition. Specialists under this term mean such processes as memory, attention, perception and making conscious decisions. Emotions do not belong to cognitive states, as they arise uncontrollably and originate from the subconscious.

There is a separate direction in applied psychology, known as the school of cognitivism. Its representatives consider human behavior through its cognitive processes. They believe that a person acts in a certain way, based on the peculiarities of thinking. Cognitiveness in this context is considered an acquired property that has nothing to do with genetic or gender characteristics.

There is even a theory of cognitive correspondence, which was formed in the 50s of the last century. It describes the cognitive structure of the personality in terms of balance. After all, the main motivation of a mature individual is the preservation of integrity and the achievement of internal balance.

Understanding cognition has spawned a separate section. Cognitive psychology studies the processes of cognition and is directly related to the study of memory, completeness of perception of information, imagination, speed of thinking.

cognitive processes

Cognitiveness has not only philosophical, but also applied significance. As already mentioned, this section of psychology substantively studies the cognitive abilities of a person. They can be equally developed in all individuals, or vary depending on genetic characteristics, upbringing or individual personality traits.

Cognitive abilities are a manifestation of the higher functions of the brain. These include: orientation in time, personality and space, learning ability, memory, type of thinking, speech, and many others. Psychologists and neurologists first of all turn their attention to the degree of development or impairment of these particular functions.

Cognitive functions are primarily associated with the ability to recognize and process information, and also characterize the functioning of the brain. Scientists distinguish two main processes:

• gnosis - the ability to recognize and perceive information;
• praxis is the transfer of information and the performance of purposeful actions based on this information.

If even one of these processes is disturbed, then we can talk about the occurrence of cognitive impairment.

Possible reasons

Cognitive impairment, like any pathological process in the body, does not occur out of the blue. Most often, there are neurodegenerative diseases, pathologies of cerebral vessels, infectious processes, injuries, malignant neoplasms, hereditary and systemic diseases.

Atherosclerotic changes in blood vessels and arterial hypertension can be considered one of the most common factors in the occurrence of cognitive impairment. Violation of the trophism of brain tissues often leads to structural changes or even death of nerve cells. Such processes are especially dangerous in the places of connections between the cerebral cortex and subcortical structures.

Separately, we should talk about Alzheimer's disease. Cognitive impairment in this pathology is the leading symptom and significantly reduces the quality of life of the patient and his relatives. The main manifestation is dementia, impaired short-term and long-term memory and recognition.

Classification

There are many classifications of cognitive impairments. According to the severity and reversibility of the process, there are:

Timely diagnosis and therapy

Cognitive impairment in the early stages is very difficult to suspect. At first, a person is only concerned about weakness, fatigue, a slight decrease in some functions, or a change in mood. Very rarely, such complaints are cause for concern. Seek medical advice already at later stages of the disease.

First of all, if a loss or decrease in cognitive functions is suspected, it is necessary to carefully collect an anamnesis. After all, these symptoms cannot appear without the main cause, to eliminate which the main therapeutic measures will be directed. When collecting an anamnesis, it is necessary to ask about the presence of chronic diseases and the constant intake of any drugs. After all, many drugs, penetrating the blood-brain barrier, can affect brain cells.

Diagnosis of disorders consists in considering the subjective complaints of the patient himself and his close circle (relatives, roommates), direct assessment of the neurological status and functional examination methods. There are special tests that can accurately determine not only cognitive impairment, but also their severity. Such screening scales help detect pathologies such as stroke, vascular or senile dementia, and others. Too complex tests should not be used for diagnosis. Their data will not be objective, since the complication of tasks will primarily indicate intellectual baggage, and not possible violations.

It is also important to assess the emotional sphere. Often in patients with depression there is a violation of memory and concentration. It is also necessary to pay close attention to this, since screening neuropsychological tests do not always fully reveal the state of the psyche.