Understanding Assumptions in Cognitive Therapy
1. Introduction to Cognitive Therapy
• Cognitive therapy focuses on theory building.
• It involves exploring and identifying negative thoughts, feelings, and assumptions.
• The goal is to weigh evidence that confirms or disconfirms beliefs.
2. Identifying Rigid Beliefs
• Some beliefs are harder to shift and are more rigid.
• These beliefs often lead to repetitive behavioural patterns or coping mechanisms.
3. Understanding Assumptions
• Assumptions can also be referred to as core beliefs or schemas.
• They can be conditional or unconditional.
4. Examples of Conditional Assumptions
• Conditional assumptions are based on specific conditions:
o "If I am not loved, then I am worthless."
o "To be happy, I must own a big house."
o "I must please others, or they will leave me."
5. Exploring the Impact of Assumptions
• Conditional beliefs can lead to various emotional responses:
o Feeling sad or angry based on the belief of needing to be perfect.
6. Using the Downward Arrowing Technique
• This technique helps uncover deeper beliefs:
o Ask the patient, "If this were true, what would be so bad about this?"
o Continue asking until the patient cannot answer, revealing core beliefs.
7. Reformulating Conditional Beliefs
• Explore healthier guidelines to replace rigid rules.
• Discuss self-fulfilling prophecies and the importance of behaviour change.
8. Understanding Self-Worth
• Help patients see degrees of good and bad instead of extremes.
• Use the "big eye, little eye" technique to illustrate this concept.
9. Setting Up Behavioural Experiments
• Behavioural experiments test cognitive hypotheses:
o Define the purpose and ensure a no-lose outcome.
o Clarify how the experiment will be conducted.
10. Importance of Formulation
• Formulations help patients understand the context of their thoughts.
• Trace critical incidents back to rules and beliefs.
11. Working on Core Beliefs
• Help patients understand core beliefs as ideas, not truths.
• Identify how these beliefs are maintained by schemas and behaviours.
12. Developing New Beliefs
• Encourage patients to recognise their strengths and positive experiences.
• Use positive data logs to track accomplishments.
13. Conclusion and Further Reading
• Techniques to modify core beliefs are numerous.
• Recommended reading: Beck's "Cognitive Therapy for Depression" and Judith Beck's works.