Cognitive-behavioral therapy is a treatment that helps patients become aware of feelings and thoughts that influence their behavior. It is usually used to treat a wide range of diseases, including addiction, phobia, anxiety and depression. Behavioral therapy, the training of which is becoming very popular today, mainly does not last long and is primarily aimed at helping people with a specific problem. During treatment, clients learn to change and identify disturbing or destructive patterns of thinking that negatively affect their behavior.
The origins
How did cognitive or rational behavioral therapy come about? What adherents of the popular psychoanalysis forced to turn to the study of various models of cognition and human behavior?
Wilhelm Wundt, who founded the first official laboratory for psychological research at the University of Leipzig in 1879, is considered the founder of experimental psychology. But it is worth noting that what was then considered experimental psychology is very far from today's experimental psychology. In addition, it is known that current psychotherapy owes its appearance to the works of Sigmund Freud, known throughout the world.
However, few know that applied and experimental psychology found fertile ground for their development in the United States. In fact, after the arrival of Sigmund Freud here in 1911, psychoanalysis managed to surprise even prominent psychiatric specialists. Yes, so that after a few years, about 95% of the country's psychiatrists were trained in ways of working in psychoanalysis.
This monopoly in the USA on psychotherapy continued until the 1970s, while it lingered in the core circles of the Old World for another 10 years. It is worth noting that the crisis of psychoanalysis - in terms of its ability to respond to various changes in the requirements of society after the Second World War, as well as the ability to "treat" it - began in the 1950s. At this time, alternative varieties of psychotherapy were born . The main role was played among them, of course, by cognitive-behavioral therapy. Few people dared to do exercises on their own.
Arising immediately in different parts of the world, thanks to the contribution of psychoanalysts, dissatisfied with their instruments of intervention and analysis, rational-emotional-behavioral therapy soon spread throughout Europe. For a short time, she has established herself as a treatment method that can provide an effective solution to various problems of clients.
Fifty years have passed since the publication of the work of J. B. Watson on the topic of behaviorism and the use of behavioral therapy, only after this time she took her place among the working areas of psychotherapy. But its further evolution took place at an accelerated pace. There was a simple reason for this: like other techniques that were based on scientific thought, cognitive-behavioral therapy, the exercises of which are given in the article below, remained open for changes, integrated and assimilated with other techniques.
She incorporated the results of studies that were conducted in psychology, as well as in other scientific fields. This has led to the emergence of new forms of intervention and analysis.
This 1st generation therapy, characterized by a radical shift from the well-known psychodynamic therapy, was soon followed by a set of “innovations”. They have already taken into account previously forgotten cognitive aspects. This fusion of cognitive and behavioral therapy is the next generation behavioral therapy, also known as cognitive behavioral therapy. She is being taught at the present time.
Its development is still ongoing, there are ever new methods of treatment that belong to the therapy of the 3rd generation.
Cognitive Behavioral Therapy: The Basics
The basic concept assumes that our feelings and thoughts play a major role in shaping human behavior. So, a person who thinks too much about accidents on the landing strip, air crashes and other air crashes, can avoid the movement of various air transport. It is worth noting that the goal of this therapy is to teach patients that they cannot control every aspect of the world around them, while they can take control of their own interpretation of this world, as well as their interaction with it.
Recently, cognitive-behavioral therapy is independently used more and more often. This type of treatment generally does not take much time, due to which it is considered more accessible than other types of therapy. Its effectiveness has been empirically proven: experts have established that it enables patients to cope with inappropriate behavior in its various manifestations.
Types of therapy
Representatives of the British Association of Cognitive and Behavioral Therapists note that this is a series of treatment methods based on principles and concepts based on models of human behavior and emotions. They include a huge range of approaches to getting rid of emotional disorders, as well as the possibility of self-help.
The following types are regularly used by specialists:
- cognitive therapy;
- emotional-rational-behavioral therapy;
- multimodal therapy.
Behavioral Therapies
They are used in cognitive learning. The main method is behavioral rational emotional therapy. Initially establish irrational thoughts of a person, then find out the reasons for the irrational belief system, after which there is an approach to the goal.
As a rule, general training methods are ways to solve problems. The main method is biofeedback training, which is mainly used to get rid of the effects of stress. In this case, a hardware study of the general state of muscle relaxation occurs, and feedback is also optically or acoustically. Feedback muscle relaxation is positively reinforced, and then leads to complacency.
Cognitive-behavioral therapy: methods of learning and assimilation
In behavioral therapy, the postulate of upbringing is systematically used, according to which you can teach and also learn the correct behavior. Modeling is one of the most important processes. Assimilation methods focus mainly on operant conditioning, after which people build their desired behavior. A very important method is imitation learning.
A pattern is systematically imitated in substitution learning - to a person or symbol. In other words, inheritance can be encouraged by complicity, symbolically or implicitly.
Behavioral therapy is actively used when working with children. Exercises in this case contain reinforcing immediate incentives, such as sweets. For adults, a system of privileges, as well as rewards, serves this purpose. Prompting (the support of a therapist setting an example) is gradually decreasing with success.
Weaning Methods
The Odyssey in Homer's Odyssey, on the advice of the Circe (sorceress), orders herself to be tied to the mast of the ship in order not to be subjected to the singing of seducing sirens. He covered his companions with wax. With explicit avoidance, behavioral therapy weakens the effect, with some changes being made that increase the chance of success. For example, an aversive irritant, for example, the smell causing vomiting, is added to negative behavior, alcohol abuse.
Cognitive-behavioral therapy exercises have a variety of different. So, with the help of an apparatus designed to treat enuresis, it is possible to get rid of nighttime urinary incontinence - the patient's awakening mechanism immediately works when the first drops of urine appear.
Repair methods
Remedies must combat inappropriate behavior. It is worth noting that one of the main methods is a systematic desensitization to decompose the fear reaction using 3 steps: training deep muscle relaxation, compiling a complete list of fears, as well as alternating irritations and relaxing fears from the list in increasing order.
Confrontation Methods
These methods use accelerated contacts with the initial stimuli of fear regarding peripheral or central phobias in various mental disorders. The main method is flooding (assault with various stimuli using solid techniques). At the same time, the client is subjected to direct or intense mental influence of various stimuli of fear.
Therapy Components
Often people experience feelings or thoughts that only strengthen them in the wrong opinion. These beliefs and opinions lead to problematic behavior that can affect all kinds of areas of life, including romantic relationships, family, study, and work. For example, a person who suffers from low self-esteem can have negative thoughts about himself, his abilities or appearance. Because of this, a person will begin to avoid situations of interaction with people or abandon career opportunities.
To correct this, behavioral therapy is used. To combat such destructive thoughts and negative behavior, the therapist begins by helping the client to establish problematic beliefs. This stage, also known as “functional analysis,” is important for understanding how situations, feelings, and thoughts can contribute to inappropriate behavior. This process can cause difficulties, especially for clients struggling with a tendency to excessive introspection, although as a result it can lead to conclusions and self-knowledge, which are considered an essential part of the healing process.
Cognitive-behavioral therapy includes the second part. She focuses on the actual behavior that contributes to the development of the problem. A person begins to practice and learn new skills, which can then be applied in real situations. So, a person who suffers from drug addiction is able to master the skills to overcome this craving and can avoid social situations that could potentially cause a relapse, as well as cope with all of them.
CBT in most cases is a smooth process that helps a person take new steps to change their behavior. So, a sociophobe can start with a simple imagination of himself in a certain social situation that causes him concern. Then he can try to talk with friends, acquaintances and family members. The process with regular movement towards the goal does not seem so complicated, while the goals themselves are absolutely achievable.
Use of CBT
This therapy is used to treat people who suffer from a wide range of diseases - phobias, anxiety, addiction and depression. CBT is considered one of the most studied types of therapy - in part because treatment focuses on specific problems and its results are relatively easy to measure.
This therapy is best suited for clients who are prone to introspection. For CBT to be truly effective, a person must be ready for it, he needs to want to spend effort and time analyzing his own feelings and thoughts. Introspection like this can be difficult, and it’s a great way to learn a lot more about the effect of an internal state on behavior.
Cognitive-behavioral therapy is also great for people who need quick treatment, which does not involve the use of certain medications. So, one of the advantages of cognitive-behavioral therapy is that it helps clients develop skills that can be useful today and later.
Self confidence development
It is worth mentioning right away that self-confidence arises from various qualities: the ability to express the needs, feelings and thoughts, in addition, to perceive the needs and feelings of other people, the ability to say no; in addition, the ability to start, end and continue conversations, while speaking freely before the public, etc.
This training is aimed at overcoming possible social fears, as well as difficulties in contacts. Similar effects are also used for hyperactivity and aggressiveness, to activate clients who have been treated by psychiatrists for a long time, and for mental retardation.
This training primarily has two goals: the formation of social skills and the elimination of social phobias. At the same time, many methods are used, for example, behavioral exercises and role-playing games, training in everyday situations, operant technicians, model training, group therapy, video techniques, self-control methods, etc. Therefore, in this training, in most cases we are talking about a program with using all kinds of methods in a certain sequence.
Behavioral therapy for children is also used. The special forms of this training were created for kids with difficulties in contacts and social phobias. Peterman and Peterman proposed a therapeutic compact program, which, together with group and individual training, also includes counseling for the parents of these children.
Criticism of CBT
Some patients at the beginning of treatment report that, regardless of the rather simple awareness of the irrationality of some thoughts, only one awareness of the process of getting rid of this does not make it easy. It should be noted that behavioral therapy involves the identification of these patterns of thinking, and it also aims to help get rid of these thoughts using a huge number of strategies. They can include role-playing games, journaling, methods of distraction and relaxation.
Now consider some exercises that you can perform on your own at home.
Jacobson Progressive Muscular Relaxation
The lesson is held sitting. You need to lean your head against the wall, put your hands on the armrests. First, you should call yourself tension in all the muscles sequentially, while this should occur on inspiration. We inspire a feeling of warmth. At the same time, relaxation is accompanied by a very quick and fairly sharp exhalation. Muscle tension takes about 5 seconds, and relaxation takes about 30 seconds. In addition, each exercise needs to be done 2 times. This method is perfect for children.
- The muscles of the hands. Stretch your arms forward, spread your fingers in different directions. It is necessary to try to reach the wall with your fingers.
- Brushes. Clench your fists as much as possible. Imagine squeezing water out of a compressible icicle.
- Shoulders. Try to reach your earlobes with your shoulders.
- Feet. Toes reach the middle of the lower leg.
- Stomach. Make your stomach stone, as if reflecting a blow.
- Hips, Shins. Toes are fixed, heels rise.
- Average 1/3 of the face. Wrinkle your nose, squint your eyes.
- Upper 1/3 of the face. Wrinkle your forehead, a surprised face.
- Lower 1/3 of the face. Lips folded "proboscis."
- Lower 1/3 of the face. Take the corners of the mouth to the ears.
Self-instruction
We all say something to ourselves. We give ourselves instructions, orders, information for a specific solution to problems or instructions. In this case, a person can begin with verbalization, which over time will be part of the entire behavioral repertoire. People are taught such direct instructions. Moreover, in some cases, they become the “counter-instructions” of aggression, fear, and other behavioral disorders. In this case, self-instructions with approximate formulas are applied according to the steps below.
1. Preparing for the stressor.
- “This is easy to do. Remember the humor. "
- “I can create a plan to handle this.”
2. Response to provocations.
- “As long as I keep calm, I am in full control of the whole situation.”
- “In this situation, anxiety will not help me. I am absolutely sure of myself. ”
3. Reflection of experience.
- If the conflict is insoluble: “Forget about the difficulties. To think about them is only to destroy oneself. ”
- If the conflict is resolved or it turned out to cope with the situation: "It was not as scary as I expected."