An Essay on Cognitive Behavioural Therapy

In this article I will outline a critique of cognitive therapy (CT), a therapeutic approach most famously associated with the psychologist Aaron Beck (see Beck, 1967). Firstly, the philosophical underpinnings of the approach will be discussed such as the focus on conscious verses unconscious thought processes, as well as the mechanisms of dysfunctional thought such as the cognitive triad, negative self-schemas, and errors in logic. Next, typical features of how the approach is applied therapeutically are discussed as well as some important strengths and weaknesses outlined in the literature. Finally, I discuss how I utilize the cognitive approach in my own practice with clients.

Cognitive Therapy: Philosophical Principals

In the decades that followed Freud’s work (see Freud, 1915; Ellenberger, 2008), the rise of behaviourism and the subsequent ‘cognitive revolution’ eventually led to the development of cognitive therapy (Javel, 1999; Wedding, 1995). Beck, the founder of the approach, had indeed once applied Freudian principals in his earlier therapeutic work. However, while conducting Freudian free association techniques, Beck observed that thoughts were not as unconscious as described by Freud (Oatley, 2008). For Beck, it was largely the conscious negative thought patterns that were the root cause of psychological dysfunction.

According to Beck (1967) psychological dysfunction, and particularly depression, are caused by three main mechanisms. These are:

- The cognitive Triad (of negative automatic thinking).

- Negative self-schemas.

- Errors in Logic (i.e. faulty information processing).

The Cognitive triad: Generally, CT focuses directly on beliefs about helplessness and unloveability (Beck, 1995). According to beck, people who suffer from depression tend to generate negative thoughts about themselves, the world, and the future – a cognitive triad. These thoughts come seemingly spontaneously to the person and such spontaneous thoughts Beck felt were particularly important to therapeutic practice: “There is a whole level of mentation going on that isn't being tapped through our analytic methods” (Beck, 1997, p. 277). Spontaneous negative thoughts may arise in light of a specific stimulus and lead to a related emotional reaction. For instance, a person’s partner may forget about their anniversary. This may prompt a negative interpretation of the world (They really don’t care about me), themselves (Why would anyone love me), and feelings of helplessness (Nothing I ever do in relationships works). Each of these three negative assumptions may strengthen the others, leading to a downward spiral of negative thinking.

Negative self-schemas: Beck described the tendency for sufferers of depression to hold particularly negative or pessimistic views about themselves. These beliefs may have manifested as a result of traumatic childhood experiences (e.g., bullying, parental rejection/neglect). Often, the negative self-schema is upheld even in the face of abundant contradictory evidence. This highlights the illogical conclusions that can be drawn when an individual holds core beliefs that go unchallenged (Beck, 1967). However, by gradually uncovering the automatics thoughts of clients, underlying assumptions which influence how related events are perceived can be unearthed. The goal here is to challenge these core beliefs and change them if possible (Beck, 1976).

Errors in logic: An important feature of CT is that it identifies classifiable errors in reasoning typically found in clients seeking therapy (Beck, 1967). These include:

Arbitrary interference, whereby a largely irrelevant piece of information is assigned deeper implications (e.g., The weather in this country is awful and my life is depressing).

Selective abstraction, whereby a single piece of a story is illogically chosen as causal (e.g., I forgot to buy the right birthday cake and I’ve ruined my friends’ birthday).