Origins of Cognitive Therapy

Origins of Cognitive Therapy

Cognitive Therapy was originated by Aaron Beck and, separately, Albert Ellis. Ellis later developed Rational Emotive Behavioural Therapy, which has very similar themes and approaches to Beck’s CT. CBT was later developed from these ideas.

Beck was a psychoanalyst who employed the free association technique before realizing that his clients had another stream of thought running parallel to it.  These were unreported and usually self-critical and always affected the clients’ emotions. Beck trained his clients to report these negative automatic thoughts and from this he developed Cognitive Therapy, which believed that cognitions, or thoughts, determined emotions and behaviour. It is therefore, not so much the events themselves that cause depression but the interpretation of events that lead to negative emotional reactions and dysfunctional behaviours. The way someone thinks about an event can cause dysfunction. Beck (1976) believed that disordered thinking maintains emotional disorders, such as depression. Beck later applied his theories to anxiety and it has later been developed to treat people suffering from many forms of mental and emotional problems e.g. schizophrenia, eating disorders and chronic fatigue syndrome amongst others.

During childhood a person develops core beliefs and assumptions about life. These are stable and become stored as memories; they are called ‘schemas’. Beliefs, or core constructs, are unconditional ‘truths’ such as ‘I’m not good enough’. Assumptions are conditional and judgmental and often contain ‘if…then’ ideas e.g. ‘if I feel angry then I’m a bad person’. Negative automatic thoughts (NATs) spring from schemas (see diagram)

When schemas are activated by events, they influence how information is processed and help shape the interpretation of events, which then affect behaviour. Because they spring from schemas, the thoughts and behaviours seem logical to the person, despite seeming irrational to others.

People with emotional disorders such as depression and anxiety have schemas that are more rigid and have particular characteristics in the content of their schemas and NATs (Wells, 1997). Those with anxiety have assumptions and beliefs about danger. The different types of anxiety disorders, e.g. panic, social phobia etc, will have different emphases. (See under later descriptions for more details). Those with depression often have ‘themes of loss and self-devaluation’ (Wells, 1997).

Beck believed that there were several factors involved in people being more likely to developing psychological problems:

• Genes
• Childhood experiences
• Learned behaviour

Stress and trauma can then activated the unhealthy schemas, which are then maintained by cognitive distortions and biases and the person thinks and behaves in ways that keep these problems going.