Sunday, August 23, 2015

Cognitive Behavioural Therapy

B.F. Skinner developed the 'behavioural therapy', essentially programming animals with reward mechanisms.  It wasn't original but he systematized it and popularized it and made this ancient 'training' and 'educating' mechanism scientific so that it could be 'programmed'.  Rats and maizes and all that sort of stuff was shown to be made up of little building blocks.  Many clinical applications followed.
Pavlov's dogs, 'conditioned' by being giving meat on the sound of a bell, salivated thereafter when they heard the bell.  
Cognitive Behavioural Therapy followed showing that 'cognitions' programed behaviour.  No surprise. If I think I'm going to fail at a task and say to myself, "you're a failure, you're a failure", I'm more likely to fail.  Like the 'little engine who can'  subjects in experiments were told to change their 'self talk' and surprise surprise the outcome was scientifically significantly altered.
Insight therapy for example, psychoanalysis, delved into the past to see what was causing present day limitations, whereas Cognitive Behavioural Therapy focussed principally on the present.
It is in fact an "educational" form of therapy and lends itself to group instruction, reproduction and work book materials.
Feeling Good was the 1980 classic in the new "Mood Therapy" written by Burns who was a student of the greatest Cognitive Behaviour Therapist of the day, Dr. Beck. His "Beck Depression Scale" remains today as a standard Cognitive Behavioural Therapy tool.
Patients, or clients, like students, are encouraged to record their 'thinking', what are they 'actively thinking about a problem .
eg.  "No one likes me."
Then the person is encouraged to write the 'cognitive error'  ie this is a Generalization.  Whenever a person thinks "no one likes me" they are indeed encouraged to respond to their inner Cognitive errors 'that is a 'Generalization", some people don't like me, some people do."
Psychology , a relative new kid on the block, tends to forever 'rename' things and claim them.  It's a very 'plagiaristic pseudoscience' at this level.
The original "cognitive errors' or 'cognitive disonance'  or 'negative programming' was best described years ago in philosophy under the heading, "Fallacies".
Most of the cognitive errors which are popularly called with 'neat memorable psychology labels' were rigorously defined and given the proper labels of 'illogical' thinking.  Indeed Cognitive Behavoural Therapy in it's own way attempts to encourage 'logical thinking'.
Much of the understanding and communications used in teaching Cognitive Behavioural Therapy were originally developped in Theology and Philosophy and now are renamed and over taken by psychology.

Michael LaBoisiere, (42 Fallacies)  a French philosopher has, to my mind, made the Fallacies most understandable.  Listening to patients for decades I've noted the 'illogical' thinking and the 'emotionally reasoning' and simply ticked off the 'fallacies' the patients use much as Laboissiere describes.  Burns has in his classic popularizing book Feeling Good listed a few of these cognitive errors like 'catastrophising' , "the world is going to end".
The fallacie of catastrophising is taking a single event and assuming that one event represents the whole and because it's a negative event assuming that the future will be negative.
Affirmations are 'thought blocking' techniques that go back thousands of years in pastoral care and theological literature.
Patients are advised to say "All shall be well" rather than "I"m going to die, I'm going to die."  Since the panic thought leads the body to accelerated heart rate hyperventialiation and blacking out it's fairly maladaptive.  So by 'blocking' the negative thought with the affirmation 'all shall be well' one breaks up the negative behavioural program by changing cognition. 

The term 'emotional reasoning' can be understood by considering the statement 'It feels good so it is good."  Translate this to "it looks good so it is good" and you have a person who would pick up a 'red' coloured insect without realizing that 'red' is often the symbol for deadly.

Ad hominen means 'against the man'.  The cognitive distortion would be to say, "I can't believe what John told me about physics because John isn't married".  Commonly people have this kind of bizarre thinking.

Generalizations are fallacious and cognitive distortions can occur.  Eg.  My mother told me I could  trust her brother but he sexually abused me, therefore everything my mother says is false."  This isn't true and therefore based on this one 'event' patient generalizes that what their mother told them about the existence of gravity is also false.  Not true.

Alot of the problems with distorted thinking can be found in the media presentation of stories, marketting and advertising.  Clinton was not a poor president because he had sex with Monica.  However, since he had a contractual relationship with his wife called marriage and a duty to his children as father and as a president he had a responsibility to follow contracts and a duty to the country. When questioned by Star as to whether or not he had sexual relations with Monica he could reasonably have answered "I didn't commit adultery".  Biblically, technically, oral sex is not mentioned and adultery laws most clearly are related to knowing who the father is in patriarchal societies.  However when he answered he 'did not have sexual relationships with Monica", he either 'lied under oath' thereby forfeiting his responsibility to the american people or he didn't know that what he was doing was deemed 'sexual' whereby he'd be a complete idiot and not worthy or safe to be President.  The media coverage of this pivotal moment in history was however mostly at the level of a lot of rather stupid media coverage, crass and sexual.  We can't have good media with so many perverted mental midgets being allowed to speak on tv. However the vast majority who watch mainstream media aren't themselves that swift. Most media is marketed to the majority who are under the college level.  Hence the stupidity of mainstream media and the continuation of the insaniety for which CBT is needed to address.

Eg.  I loved him so I killed myself.

Love does not beget suicide, only narcissism begets this kind of adolescent suicidal behaviour.  Yet Hollywood continues to celebrate it's suicides and continues to support the cognitive disorder that love is destructive when theoretically at least love is considered love because it's life enhancing.

Schizophrenia per se is often associated with flipping the pronowns which we call 'projection'.  In cognitive behaviour therapy we encourage people to use "I " statement.  "I don't like you" rather than "You don't like me".

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