p.1
Part I
COGNITIVE BEHAVIOURAL THEORY
p.3
1
Eliciting meaning
āAt the very heart of the C[B]T model is the view that the human mind is not a passive receptacle of environmental and biological influences and sensations, but rather that individuals are actively involved in constructing their realityā (Clark, 1995: 156). In order to understand a personās emotional response to particular life events, itās important to discover the meaning they attach to these events: their subjective construction of reality. For example, a person whose partner has left them believes they cannot be happy or cope on their own and becomes depressed; another person whose partner has departed feels relieved as they believe they have been freed from a āstifling relationshipā; a third person feels guilty as they view their bad behaviour as the reason for their partnerās departure ā the same event for each person, but not the same emotional reaction to it as each reaction is mediated by the personās view of the event. In order to change the way we feel about events we need to change the way we think about them. Meaning isnāt static but changes over time, that is, your viewpoint alters.
This conceptual cornerstone of cognitive behavioural therapy (CBT) derives from ancient Stoic philosophers such as Epictetus and Marcus Aurelius and their views on mental control. That is to say, our thoughts and beliefs are within our control whereas many things that happen to us in life are outside of our control; therefore, we can choose how we respond to events. Events themselves do not cause or dictate our reactions, for example, losing your job in a recession is outside of your control but losing your self-respect as well is a judgement you have made about being jobless (for a fascinating discussion on the links between Stoic philosophy and CBT, see Robertson [2010]. Iāve met executives who proudly showed me their copies of Marcus Aureliusās Meditations and Epictetusās Handbook which they said taught them how to develop the inner stability to cope with the unrelenting pressures of the workplace).
p.4
Modern CBT doesnāt argue that a personās emotional problems are simply created in their head but that the impact of adverse events (e.g. being burgled) can be greatly exacerbated by the personās unhelpful thoughts and beliefs that interfere with their ability to cope constructively with such events (e.g. āI can never ever feel safe again in my own home no matter how many locks I put on the doors and windowsā). Clients are helped to develop adaptive viewpoints in order to tackle their problems (e.g. āIf I keep things in perspective, I know that the increased security measures will help to keep me safe in my home and my mind, but I realize and accept, without liking it, that there can be no guarantee I wonāt be burgled againā).
Developing an alternative viewpoint underscores the CBT principle that there is always more than one way of seeing things, no matter how unpleasant these things are. Even in the unspeakable horrors of Auschwitz, Viktor Frankl, a famous psychiatrist, observed that āeverything can be taken from a man but one thing: the last of the human freedoms ā to choose oneās attitude in any given set of circumstances, to choose oneās own wayā (1946/1985: 86). Coutu (2003) states that Franklās theory is the basis for much of the resilience coaching in the business world.
p.5
2
Distorted information processing
Cognitive theory is based on an information-processing model āwhich posits that during psychological distress a personās thinking becomes more rigid and distorted, judgements become overgeneralized and absolute, and the personās basic beliefs about the self and the world become fixedā (Weishaar, 1996: 188). In a calmer frame of mind, the person is likely to check their impressions and appraisals of events in order to obtain clear and accurate information. However, everyone engages in distorted information professing such as jumping to conclusions or mind-reading (see below) but these distortions āonly become a problem when the bias is chronic or too extremeā (Kennerley et al., 2017: 193).
When emotionally upset the person will usually distort incoming information by introducing a consistently negative bias into their thinking, for example, they are upset when not invited to a friendās party because they interpret the lack of an invitation to mean that they are an unlikeable person. Instead of ascertaining the reasons for not being invited, or keeping an open mind about it, the person dwells on their supposed unlikeability, lowering their mood in the process.
Distorted thinking underlies psychological problems. These distortions usually stem from deeper negative beliefs that are activated during emotional distress, for instance, a person experiencing depression after the break-up of their relationship insists āIāll always be aloneā (fortune-telling) because they believe they are unattractive (core belief). Common information-processing errors or biases found in emotional distress include the following.
p.6
ā¢ All or nothing thinking: situations and individuals are viewed in either/or terms, e.g. āEither youāre a success or failure in life. Itās as simple as thatā.
ā¢ Emotional reasoning: believing that feelings are facts, e.g. āI feel repulsive, so it must be trueā. āI feel repulsiveā is actually a belief (āI believe Iām repulsiveā), not a feeling, and therefore is subject to examination like any other belief.
ā¢ Jumping to conclusions: judgements are rushed rather than considered, e.g. a client says 15 minutes into the first session: āThis isnāt going to work as I donāt feel any betterā.
ā¢ Mind-reading: discerning the thoughts of others without any accompanying evidence to support such claims, e.g. āMy boss didnāt smile at me this morning, so that means sheās unhappy with my workā (she praised their work previously without smiling at them).
ā¢ Labelling: attaching global negative labels to oneself, others or the world, e.g. āI didnāt understand what he said, unlike others in the group, so this must mean Iām stupidā (theyāre also mind-reading in assuming that everyone else in the group understood what was said).
Teaching clients how to identify and correct these errors or biases in their thinking facilitates the return of information processing that is more evidence-based and balanced (non-absolute). In the example above, the person discovers that their friend had invited them but āmy mother forgot to pass on the message. If I hadnāt got so upset, then I wouldnāt have jumped to conclusionsā. If they hadnāt been invited and it was expected that they would be, then they need to contact their friend to find out why they have been excluded from the invitation list. Even if their friend deliberately excluded them, this does not mean they are an unlikeable person, but a person not immune to their friendships ending and having to learn to adapt to this unwelcome reality.
p.7
3
Levels of thought
There are three levels to consider.
1. Negative automatic thoughts (NATs) are situation-specific and involuntarily āpop intoā a personās mind when they are experiencing psychological difficulties. They appear plausible to them and are difficult to turn off. NATs often lie outside of immediate awareness but can be quickly brought to the clientās attention by asking, āWhat was going through your mind at that moment when you got to the meeting late?ā (Clientās reply: āIām always late. Iām undisciplined, sloppy. My colleagues will look down on meā). NATs can be triggered by external and/or internal events (e.g. pounding heart: āIām having a heart attack. Oh God! Iām going to dieā).
NATs can also occur as images, for example, a person sees himself ādying of embarrassmentā if he makes a faux pas as best man at his friendās wedding. Clients are usually more aware of how they feel than of the thoughts that prompted the feeling. In coaching as in therapy, NATs are usually the starting point for investigation. The alternative thoughts to NATs are not PATs (positive automatic thoughts) as they can be equally distorted (e.g. āOnce the problem is gone, it wonāt reoccurā), but thoughts based on reason and evidence that remove cognitive distortions from the personās view of events.
2. Underlying assumptions (e.g. āIf I impress others, then I should get ahead in lifeā) and rules (e.g. āI should not let people downā) guide behaviour and set standards. These assumptions and rules are often unarticulated and can be difficult for clients to detect, unlike NATs. Underlying assumptions are usually identified by their āif . . . thenā or āunless . . . thenā construction, and rules are usually expressed in āmustā and āshouldā statements. These assumptions and rules are the means by which individuals hope to avoid coming āface-to-faceā with their negative core beliefs (e.g. āIām incompetentā). The ātruthā of these core beliefs is not usually questioned and, therefore, assumptions and rules serve to maintain and strengthen them.
p.8
Trouble looms for the person when their behaviour is not what it should be, standards are not met or rules are violated ā ātroubleā is the activation of the negative core belief from its dormant state. Beck et al. (1985) suggest that unhelpful assumptions often focus on three major issues: acceptance (e.g. āIām nothing unless Iām lovedā); competence (e.g. āI am what I accomplishā); and control (e.g. āI canāt ask for helpā). Worries about not being seen to be in control of oneself or events, acting incompetently or losing the respect/approval of colleagues are common themes in coaching. Assumptions and rules are cross-situational and are also known as intermediate beliefs because they lie between NATs and core beliefs (J. S. Beck, 2011).
3. Core beliefs are the deepest level of thought. Negative core beliefs are overgeneralized and unconditional (e.g. āIām hopelessā). They are usually formed through earlier learning experiences and lie dormant until activated by relevant life events. For example, the person believes theyāre worthless without a partner: theyāre anxious when the present relationship goes through turbulent times (āIs this the end?ā) and depressed if it does end thereby confirming their core belief. Once activated, negative core beliefs process information in a biased way that confirms them and disconfirms contradictory information (e.g. āI canāt learn to live on my own for a while and be more independent. I must find someone elseā). Core beliefs can be about the self (e.g. āIām unloveableā), others (e.g. āI canāt trust anyoneā), and/or the world (e.g. āEverything is against meā). Once the distress has passed (e.g. theyāre relieved when they find a new partner), negative core beliefs become deactivated or return to their latent state and a more positive outlook is re-established.
p.9
Core beliefs are usually the targets of change in longstanding problems. Core beliefs can be modified indirectly by targeting NATs as they are situation-specific expressions of core beliefs. This indirect targeting also helps to reactivate quiescent positive core beliefs (āIām likeableā) which became inactive due to the dominance of the negative beliefs. Dobson and Dobson (2009) suggest that itās quite likely that negative core beliefs change gradually without directly modifying them if clients continue to think and act differently over the longer term. In coaching, negative core beliefs are targeted for change if required; for example, a highly successful executive takes little pleasure in their achievements ābecause, at bottom, Iām a fraudā and wants to stop seeing themself in this way.
How do these three levels interact? A person feels depressed when they fail to get a first in their university exams. Their dormant core belief, āIām a failureā, is activated by their inability to live up to their rigid rule that they must meet the high expectations placed on them by others and their mind is flooded with NATs: āI canāt show my face at university. Run away and hide. The whole university is laughing at me. Iāve lost the respect of my friends.ā
p.10
4
Thoughts, feelings, behaviour, physiology and the situation are interconnected
In the cognitive model, uncovering the meaning (thoughts and beliefs) that people attach to events is crucial for understanding their emotional and behavioural reactions to events. However, cognition in cognitive behavioural therapy (CBT) is not viewed in isolation from other response systems within the person but recognizes its interaction with behaviour, physiology and emotions. These systems interact within the wider context of a personās environment such as having noisy neighbours or living in a high crime area. Each one of these elements is capable of influencing the others in an interactive cycle. Seeing the linkages between these five areas of a personās experience can...