Session Four: Background Information
Introduction to Cognitive Behavioural Therapy. 1
Cognitive Behavioural therapy (CBT) is useful in treating stress. It holds the general principle that events contribute to the way we feel and act, but do not cause these reactions, which are mainly determined by our views of these events. Thus, stress is seen to originate in irrational beliefs. The stress reaction is seen as being induced by an unconscious process of information processing that occurs outside of awareness, but CBT works on the premise that these unconscious processes can be made conscious.
CBT is based on the idea that there are two kinds of beliefs, rational and irrational. In CBT rational beliefs are those that are flexible, consistent with reality, logical and which promote the person’s psychological well-being and aid pursuit of personally meaningful goals. Irrational beliefs are seen as illogical, rigid, inconsistent with reality, and as interfering with the personal, psychological wellbeing and pursuit of personally meaningful goals.
Irrational beliefs are at the core of unhealthy negative emotions. Once negative emotions are experienced, a person will tend to think in negative ways about the experience, this will influence behaviour, and the person will tend to act in self-defeating and goal-impeding ways.
CBT teaches people how to dispute these irrational beliefs, asking questions such as
“Why must I get a new job?”
“Where is the evidence that I won’t be able to bear it if I don’t get a new job?”
“Is it true that I am worthless if I don’t get a new job?”
CBT also uses reframing, showing individuals how to find good things in some of the bad things that happen to them and helps them be aware of the disadvantages of harmful feelings and behaviours.
In order to bring irrational thoughts to light, CBT uses the ABCDE procedure, which is a basic procedure for helping people to identify their automatic thoughts by training them to observe the sequence of external events and their reactions to them. The individual may report a number of circumstances where he or she felt unaccountably upset or stressed and assumed that the feelings of distress were due to the circumstances or events preceding them. However, usually, there is a gap between the stimulus and the emotional response. The emotional upset becomes understandable if the person can recollect the thoughts that occurred during the gap. The ABC procedure is explained in CBT as follows.
A is the activating stimulus
These can be events or inferences about events.
B appears to be a blank in the person’s mind.
However, B stands for the evaluative beliefs about A.
C is the inappropriate emotional response which can lead also to the physical response of a stress related illness
D stands for disputing the person’s irrational beliefs
E stands for the effects of disputing, encouraging the person to develop more rational beliefs.
The process of CBT argues that people are only aware of what happens at A and C, and believe C to be a consequence of A, when C is actually mediated by the thoughts and beliefs at B, where unrealistic inner rules generate negative feelings.
There are two types of C, emotional and behavioural i.e., people do not just respond emotionally to the events in their world; they also try, if necessary to do something about them.
The ABC procedure is introduced in this session with the Stress Thought Log, which aims to capture the most common irrational beliefs and thoughts specific to each individual. (Form S4.b).