Cognitive Behavior Therapy - Essay Example

Cognitive Behavior Therapy Cognitive Behavior Therapy views human nature as full of innate potentials and flaws. suffering from psychological problems are assumed to focus more on their flaws that pull them down than on their potentials that may spur them up to success. The basic premise of Cognitive Behavior Therapy is the clients’ erratic or exaggerated beliefs that it is their fault why they came to such a dreadful state. The goal of therapy is to help the client realize that reorganizing the way they view situations will call for a corresponding reorganization in behavior – sort of marrying the concepts of “mind over matter” and “self-fulfilling prophecy”. As an example, a recovering alcoholic will think that he has mustered enough discipline over alcohol. (mind over matter), hence, he strives to be strong and sober enough to resist a drink offered to him at a party (self-fulfilling prophecy). The focus of Cognitive Behavior Therapy is more on thinking and acting more than just expressing feelings, which was more of the concentration of other kinds of therapies. It deals with the client’s present and not his past, although it acknowledges that his irrational thinking might have come from past negative experiences. The duration of the therapy process is usually short, as it immediately cuts to the core and does away with useless preliminaries. The therapist uses a variety of therapeutic strategies depending on what he decides will work on his particular client. He also delegates responsibility to his client by expecting him to do homework outside the therapy sessions. Homework is aimed at positive behavior that brings about emotional and attitudinal change. Ellis’ Rational Emotive Behavior Therapy (REBT) is considered to be the forerunner of Cognitive Behavior therapies. Its basic hypothesis is that our emotions stem mainly from our beliefs, evaluations, interpretations and reactions to life situations. Ellis believes that we have an inborn tendency towards growth and actualization but we often sabotage our movement toward growth due to self-defeating patterns we have learned. Through therapeutic processes, the client learns skills to isolate and dispute their irrational views which were mostly self-constructed and maintained by self-indoctrination. REBT helps clients replace such irrational views with rational and constructive ones, thus resulting in more productive change in behavior and reactions to situations. Although Ellis believes that therapists maintain unconditional regard for the client, he also warns against giving too much warmth to the point of coddling, as it encourages clients’ dependence for approval from the therapist. Maturity is expected of the client as great faith is placed on him that he can change his irrational ways of thinking. Another proponent of Cognitive therapy is Aaron Beck who agrees that much of our psychological problems are caused by “cognitive distortions” due to our acknowledged human fallibility. Therapists engage in Socratic dialogues with the clients, throwing questions that encourage introspection with the goal of the client arriving at his own conclusions. Still another alternative to REBT is Donald Meichenbaum’s Cognitive Behavior Modification. It features client’s self-verbalizations that involve a heightened sensitivity to his thoughts, feelings, actions, physiological reactions and ways of reacting to others. Clients are also taught more effective coping skills practiced in real-life situations. He may be considered his own coach because his self-talk reminds him of how he should restructure his thinking and behavior. Meichenbaum also puts emphasis on stress management which can be very helpful to clients when faced with stressful situations not unlike those that caused their flawed thinking. Personally, I can summarize Cognitive Behavior Therapy as the consideration of one’s perspective in life. One’s viewpoint of facts, ideas or situations colors everything one does, says and thinks. For me, perspective in life highly depends on one’s relationship to God. If one looks at life from God’s perspective, he can be assured that everything can work out for the good. As an illustration, remember Peter’s story (Matthew 14: 25-32) when he walked on the water while he focused on Jesus and when he was distracted by the wind, he lost his concentration and fell on the water. That can be applied to our own lives. If we keep our perspective focused on God, we think and do good things. It gives us peace of mind and leaves us stress-free. The moment we lose that heavenly perspective and swap it for a more worldly one, we begin to sink – just like Peter. No matter which particular Cognitive Behavior Therapy we use for our clients – Ellis’, Beck’s or Meichenbaum’s, it is essential to straighten out “crooked” perspectives and help replace them with “straight” and Godly ones. They must be reminded that although flawed, all of us were created in God’s image and likeness. Having that as our clients’ base perspective, and built upon by a supportive therapist’s faith in their capacity to rise up from their self-derogatory thinking, then clients are empowered to take action…. to take the journey to true healing. Reality Therapy Reality therapy is the kind of therapy that makes clients accountable for whatever state of life he is presently in. It is a product of the choices he has made, and so, makes him in control of his own thinking, feeling and behavior. It is premised on Choice theory that advocates that we are born with five genetically encoded needs – survival, love and belonging, power or achievement, freedom or independence, and fun. If one need is not satisfied, it becomes a source of instability, and reality therapists teach clients to identify and satisfy that need. Total behavior is made up of four inseparable but distinct components – acting, thinking, feeling and physiology. Clients are asked to evaluate each component and the quality of each as it functions in their practical lives. This self-assessment will eventually help the client make effective choices. The most important component in our quality life is the important people in our lives that we want to connect with. Clients who come to therapy are usually those who have unsatisfactory relationships in their perceived quality world and hope to repair these dysfunctional relationships. It is the goal of therapy to help clients make the right choices through intensive reflection and introspection guided by realistic questions. Such questions are like bitter pills to swallow, as they force the clients to confront reality and deal with it. Reality therapists are direct, frank and open about their opinions without being intimidating to their clients. The art of balancing confrontation and unconditional acceptance is to be mastered to ensure success. Taking the basic points of Reality therapy into consideration, let us try to apply it to a fictitious depressed client whom we shall call Sheila, who is experiencing a falling out with her best friend and business partner. Sheila has shared a very close friendship with Linda. Both ladies put up a flower shop which became hugely successful. After three years, Linda had to take a leave from the business because of her problematic family issues, which left Sheila in charge. Sheila run the shop very well and established happy relationships with satisfied customers. When Linda came back after three months, she felt slighted that customers seemed to prefer Sheila over her, and resented Sheila for it. She became sarcastic and self-righteous, making her very difficult to live with. Sheila tried her best to understand Linda, as she is aware that she is still reeling from her family problems. She felt guilty at being so successful in her management of the business to the “detriment” of her friend’s self-esteem. To save their friendship, Sheila kept on apologizing about little things, and allowed to be manipulated by Linda. During therapy, Sheila has identified that her needs for love, achievement and freedom were affected in her relationship with Linda. She desperately wanted to keep her love; her achievement at her successful business management was questioned; and she has lost her freedom to decide on business matters by herself because she kept on considering her business partner’s feelings. Her self-assessment of her behavior components are as follows: she acts very subservient towards Linda in an effort to win back the quality of friendship they shared; she thinks Linda is insecure, over-reactive and irrational and needs to realize that she is being hurtful herself; she feels inauthentic in the way she deals with Linda as she is overly cautious with her words and actions to avoid being misjudged; and when she is with Linda, her body is tensed, she finds her throat dry all the time and she feels “butterflies in her stomach”, and all these physiological responses disappear the moment they part ways. The hard questions that she confronts are: “Would you choose to stick to her friendship or prefer to lose it?”, “What do you get from maintaining this friendship?” , “How is this affecting your business, your sense of achievement?”, “What is is you want that you don’t seem to be getting from this friendship?”, “What do you think stops you from making the changes you would like?” In confronting these hard questions, she realizes that she indeed wants to keep Linda’s friendship, but accepts that it may not be possible to regain the closeness unless Linda herself chooses it to be that way. However, she realizes that she needs to take the business aspect of their relationship out of the way, as it is the source of friction between them. She decides that once and for all she needs to express her real feelings to Linda about their sticky situation, and announce her decision either to leave the business and start a new one on her own, or to go on to a totally different career path and leave the business to Linda. Whichever she decides, she will assure Linda of her friendship, and if Linda rejects it, Sheila just needs to accept it and move on with her life. If everything turns out well, Sheila satisfies her need for love (either Linda’s or her own love for self), achievement (by choosing her own career path) and freedom (to make her own choices for her own life without considering a “partner”). A biblical inspiration that came to me with regards to Reality therapy is the character of Job. His reality was filled with suffering, trials and tribulations, but he chose to stick with his great faith in God. He unceasingly loved and praised the Lord, knowing that he will be vindicated. He made the right choice, as indeed, the Lord made him prosperous again, and gave him blessings he never thought he could have. Even in his lowest moment, he did not consider his needs, except for that of pleasing God. Although his psychological health seemed questionable because of his behavior, his words reflect otherwise. “To worry yourself to death with resentment would be a foolish, senseless thing to do.” Job 5:2 (TEV) Job did not seem to need Reality therapy or any kind of therapy for that matter, as in spite of all the terrible things that has happened in his life, he maintained a healthy positive view of life. Read More