Fundamentals of Cognitive Therapy

It has long been established that Cognitive Therapy is an effective treatment for a variety of recognized disorders and a helpful model that is useful for general mental health. Dr. Lisa Feldman Barrett is a distinguished psychologist and neuroscientist whose groundbreaking research has significantly advanced our understanding of emotional response. Her work challenges traditional views on emotional experiences and highlights the crucial role that cognitive processes play in shaping our feelings. Feldman-Barrett’s theory of constructed emotions states that emotions are not hardwired but are instead constructed from our brain’s predictions and automatic expectations about ourselves and the world around us. This perspective underscores how our cognitive framework influences our emotional experiences.

Expectations are powerful mental frameworks shaping our perception of the world. According to Feldman-Barrett’s research, our brain continuously makes predictions about what will happen next based on a combination of cognitive biases and past experiences. When reality deviates from these expectations, it can trigger a range of emotional responses.

Demands are simply more intense expectations that significantly intensify the effect on our emotional experience. These demands stem from personal, social, or cultural pressures that impose specific standards or requirements. They create a framework of “shoulds” that can be difficult to meet and often lead to heightened stress and dissatisfaction. For example, if you have an internal demand to be perfect in every aspect of
your life, falling short can lead to intense feelings of failure and frustration. This constant pressure can distort your perception of your abilities and achievements, leading to negative emotional states.

SECONDARY DISTURBANCE OR META-COGNITIVE RESPONSE

Secondary disturbance refers to the additional layer of emotional turmoil that arises from our reactions to our initial emotional experiences. It’s essentially a second-order emotional response to our primary emotions, which complicates and intensifies our distress. For example: Primary Emotion: You feel anxious about an upcoming presentation. Secondary Disturbance: You then worry about your anxiety itself, thinking, “My anxiety is out of control,” or “What if my anxiety prevents me from performing well?” This secondary worry adds an additional layer of stress and can exacerbate the original anxiety. We get anxious about being anxious and depressed about being sad. Mindfulness helps clients accept their primary emotions without adding further judgment or criticism.

The concept of “shoulds” refers to the rigid standards we set for ourselves or others. These internal rules often dictate how we believe things ought to be, rather than how they are. When these expectations are unmet, they trigger a host of negative emotions, including anger, guilt, and sadness.

Feldman-Barrett’s research indicates that “shoulds” are cognitive beliefs rather than objective realities. Expectations, demands, and “shoulds” are linked to biases that influence how we process information and make judgments. Biases play a role in in escalating and perpetuating emotional distress by focusing our attention to information supporting distressing interpretations while ignoring  contradictory information.

Addressing expectations, demands, and “shoulds” is transformative in cognitive therapy. Therapists help clients recognize and challenge these cognitive biases, reframe unrealistic expectations, and develop more flexible and adaptive thinking patterns.

Identify and Challenge Expectations:

Therapy assists in identifying unrealistic expectations and their impact on emotions. By challenging expectations and replacing them with more realistic ones, clients can reduce emotional distress.

Address Demands and “Shoulds”:

Cognitive therapists work with clients to explore and deconstruct demanding “shoulds.” This process involves reframing rigid standards into more achievable and compassionate goals.

GETTING THE MOST FROM COGNITIVE THERAPY

Reframe Cognitive Biases:

Therapists help clients recognize and address cognitive biases. Techniques such as thought records can aid in shifting from negative, biased thinking to more balanced and objective perspectives.

Set Realistic Goals:

Set achievable and realistic goals for yourself and others. Change “shoulds” to “preferences” in your thought processes. Focus on progress rather than perfection to reduce stress and
enhance motivation.

Accept Emotional Distress:

Accepting our primary emotional experience and allowing ourselves to experience that emotion, accomplishes at least three things. First acceptance of an unpleasant emotional sensation can prevent the secondary disturbance that so commonly escalates an emotional response into distress and perpetuates discomfort. Secondly it allows the demanding cognitive belief that initially triggered the emotion to be evaluated by our more rational cognitive processes, often opening the mind to reframing that principle to a healthier, less internally demanding approach. Third it counters our intrinsic low tolerance to any discomfort. Low discomfort tolerance is a major contributor to depression and anxiety. Practicing emotional stoicism can build both resilience and immunity to future extreme emotional distress. Research into emotions and cognitive processes offers invaluable insights into how our mental frameworks shape our emotional experiences. By understanding the impact of expectations, demands, and “shoulds,” we can better navigate our emotional lives and make meaningful changes through cognitive therapy.

Cognitive Therapy (CT) teaches people to become their own therapists. The positive benefits of CT persist long after therapy ends. For many common mental health problems CT is more effective than medication with more lasting effects.

SMARTER THERAPY: Thoughts, Beliefs & Behavior Integrated

1. Thoughts and beliefs cause stress. “Men are disturbed not by things but by their view of things”: Epictetus, 1st century
2. Beliefs are more difficult to change than thoughts. Cognitive therapy involves more than ‘thinking positively’.
3. Fake it till you make it. We assume our outlook will change, then we will act differently. Try the reverse!

Incorporating regular fitness into your routine is a powerful tool for enhancing mental health. It provides a holistic approach to managing stress, anxiety, depression, and other mental health challenges while promoting overall well-being and quality of life.

A Publication of the Centre for Cognitive Therapy. Written by Dr. Arthur Blouin.