Cognitive Psychotherapy

Cognitive-Behavioural Psychotherapy

This kind of psychological therapy helps through your thoughts ("cognitions") and actions "behaviours"). It is particularly effective in reducing anxiety, and also useful with depression. Relationship problems are not central to this approach.

Behaviour Therapy

The first use of this therapy was for phobias. People with a specific fear tend to avoid the thing they fear. For example a fear of spiders can be controlled by not going into old buildings. A fear of medical procedures can be controlled by not going to hospital. This keeps the anxiety down, but means that the sufferer cannot go to these places. Joseph Wolpe showed that systematic desensitisation can allow the phobic person to approach the object in graded steps. The anxiety is manageable at every step, so the sufferer does not need to run away.

Behaviour therapy will help with obsessions, generalised anxiety, agoraphobia, tics and blushing, and many other conditions.

Cognitive Therapy

Aaron Beck developed this approach while working with patients with who were depressed. He noticed that people who are depressed tend to have unhelpful patterns of thinking. Automatic Negative Thoughts (ANTs) can be

Catastrophic - "things are as bad as they could possibly be"
My fault - "it's raining - I should never have got out of bed"
Out of control - "the whole of society's gone this way"

In cognitive therapy you would confront unhelpful thoughts. This would relieve depression and allow you to think coping thoughts. Then you regain the energy to deal with problems.

Monitoring

Troublesome internal sensations - stomach in a knot, heart pounding, trembling - may occur in particular situations. It is helpful to recognise the connections between the inside and the outside. Sometimes it helps to keep a diary.

Skill practice

Many problems can be reduced by combining skilled behaviour and coping thoughts. Therapy of this kind usually involves practising a skill such as:

Progressive Muscle Relaxation: anxiety can be reduced by practising this technique
Assertion: "saying Yes" and "saying No" need to be rehearsed.Body language, such as height and voice, need practice and feedback.

Homework

The skills learned in the clinic need to be practised at home. After a couple of weeks of practice at home, it is usually possible to try the same skills in more difficult situations.

Research

This therapy grew out of scientific psychology, so it has been well researched. It has been shown that phobic and generalised anxiety usually improve with a course of psychotherapy. Improvement is quicker than would occur with help from friends only.