Cognitive therapy is a type of talk-based psychotherapy that explores the connections between our thoughts, feelings and behaviors. Pioneered in the middle of the 20th century, cognitive therapy uses a process called cognition to identify unhelpful and problematic behaviors, emotional responses or thought patterns, and then helps individuals to change these behaviors. Cognitive therapy is almost always practiced in conjunction with behavior therapy, which trains a patient’s behavioral response, and is therefore often referred to as cognitive behavioral therapy.
The cognitive model dictates that our perception of an event is more relevant to the way we process it than the experience itself. Cognitive therapy hinges on that association between thoughts and feelings. One important part of CT is the concept of automatic thoughts, or involuntary ideas that pop into our minds which assist us in making sense of a situation. You might have heard these referred to before as internal dialogue. For people who struggle with depression and anxiety, this dialogue is pessimistic.
For example, you might catch a chance glance from a co-worker that results in a negative automatic thought based on the dysfunctional assumption that you’re being rejected: “She’s staring at me again. Why does she hate me?” What was no more than a casual glance has been interpreted as judgment thanks to a negative automatic thought.
Dr. Aaron Beck’s research into automatic thoughts in the 1960s revealed that depressed patients had three ideological roadblocks to perceiving a situation, all of them harmful to that patient’s well-being: negative thoughts about the future, about the world in general, and about themselves. Many of these dysfunctional beliefs are formed in childhood and become fixed as we age. CT creates an environment in which patients can identify and evaluate any negative underlying thoughts, channeling them into more positive assumptions that allow them to function better.
While cognitive therapy has been proven to successfully treat a wide range of disorders and conditions, it is most commonly used to the umbrella category of emotional challenges. Depression is among the most common conditions treated by the use of cognitive therapy, but a wide range of other disorders are treatable through CT as well. These include the following:
- Social phobia
- Bipolar disorder
- Personality disorder
- Panic disorder
- Post-traumatic stress disorder
- Sexual dysfunction
- Substance abuse
- Obsessive compulsive disorder
- Irritable bowel syndrome
- Body disorders like bulimia, anorexia and obesity
- Specific anxieties, like health anxiety, and generalized anxiety disorder
- Chronic fatigue syndrome
- Chronic pain
Cognitive behavioral therapy is goal- and action-oriented and often works well in the short term. Usually, clients will attend one hour-long session a week over a period that generally extends to no more than a year. In treatment, a therapist will help a patient to identify troubling situations, gain an awareness of his or her emotional response, recognize specific negative tendencies and misinterpretations in thinking, and use this information to change thought patterns.
CT is sometimes used in tandem with medication such as antidepressants, and with other therapies such as Gestalt therapy, motivational interviewing, exposure therapy, and dialectical behavior therapy, to name a few.