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Cognitive Behavioral Therapy

cognitive behavioral therapy

Cognitive Behavioral Therapy: RET-Why it Works with Many People

There are many theories of Psychology. It is a discipline that involves subjective reasoning on the part of both the practitioner and the patient, so it only requires a solid approach and a well-trained psychologist or therapist to implement it. However, it is important for therapists to employ a technique that has proven results. Cognitive behavioral therapy is a proven method for helping people deal with issues such as anxiety and depression, as well as trauma focused therapy which helps them work through crises.

WHAT IS COGNITIVE BEHAVIOR THERAPY?

Cognitive behavior therapy was first implemented and developed by Albert Ellis, who is considered the Father of RET (rational emotive therapy), the practical application component of cognitive behavior therapy. Cognitive behavior therapy involves combining two important theories of Psychology: Behaviorism and Cognitive therapies, into one theory which houses the best of both disciplines.

To fully understand this approach, it helps to understand the two disciplines which it was derived from:

BEHAVIORISM

B.F. Skinner developed one of the first theories of Applied Psychology which was based on rat psychology. Rat psychology deals with the science of learning, and is grounded in scientific methods to establish a baseline of behaviors. In addition, research is centered on changes over time and multiple trials, whereby experimental psychology techniques are applied and results are compared to previous results, to gain data on learning processes and results.

Behaviorists believe that an individual is motivated by only two things: punishment and reward. They believe that people (and rats) will do anything for a reward, and strive to avoid punishment at all costs. They do not believe it is important to think about WHY people do things, but rather to focus on the factor that is present at the time the action or behavior occurred.

This scientific approach to behavior among rats and other lab animals in a controlled environment yields a lot of important information which helps us predict human behavior and some therapists employ the techniques of Behaviorism alone. However, many theorists felt the Behaviorist approach, in isolation, did not match the holistic approach required with many patients, and lacked a personal perspective that other techniques offered. In addition, they are disturbed by the fact that the Behavioral perspective did nothing to address the reasons for behaviors, nor did it attempt to explain them. So they were motivated to find other methods to complement this.

COGNITIVE THERAPY

Cognitive therapy, unlike Behavioral therapy, involves the process of delving deeper into the WHY of behaviors and the resulting factors. It takes the approach that people, (unlike lab rats), have the capacity for higher order thinking, which is involved in thinking processes which allow one to analyze the reasons as to why they do things. Many therapists use cognitive therapy to help patients think through decisions they are debating with themselves, or they use it for anxiety disorders or other maladies which require a cognitive approach. But this alone is still somewhat lacking. Some therapists prefer to combine the two theories into one theory. The approach of cognitive behavioral therapy is most attributed to Albert Ellis. He further evolved his techniques into a theory known as RET (rational emotive therapy) which takes a step-by-step approach to issues. It is described below.

R.E.T. (DEFINED)

Rational emotive therapy or R.E.T. involves a number of processes which all focus on disputing the false belief systems an individual harbors in their mind which motivate them to exhibit behaviors which are not getting them what they want in life and relationships. The theory goes on the idea that thinking precedes behavior, and that the reasons people do things are as important as the fact that they do them. Albert Ellis, whose name is now synonymous with this theory (which is a combination of both Behavioral and Cognitive principles), involves a process of rationalizing with the patient to get into the thinking patterns and get them to see that they are basing their assumptions on faulty logic.

EXAMPLES OF COGNITIVE BEHAVIORAL THERAPY

For example, if someone says, “I am stupid in Math,” or “I can never keep a job,” the RET therapist may ask them to tell them of a time when they performed well in math or kept a job for more than a year. The person can usually think of such instances easily, but they see them as the exception. The skilled cognitive behavioral therapist will point out to them that they are using generalization to make statements such as these, and that they are not based in reality. This is called “disputing the belief,” and focuses the therapy on restoring the confidence in their abilities or disputing the irrational belief and replacing it with rational ones.

EXERCISES IN COGNITIVE BEHAVIORAL THERAPY

Another technique often used in RET and Cognitive Behavioral therapy involves the use of taking on challenges which one may have a fear or anxiety about and making it appear less intimidating. Albert Ellis, in his audiotapes about this technique, suggest that, to get over a fear, you should do it everywhere to desensitize yourself to the fear of it. For example, if you are afraid of being embarrassed on a bus, he instructs you to call out something loudly like, “42nd Street!!” for all to hear as the bus comes to a stop. Or if someone is afraid of elevators, they should ride every elevator in town until they have lost the fear of it. So this type of therapy involves not only disputing the faulty or erroneous beliefs present, but also over exposure to those things which hold people back and keep them being able to truly enjoy life and take risks.

FOR DEPRESSION

This technique is often used for depression as well. In this case, it would be pointed out to the patient that their depression is a result of thinking that is faulty and that you are a result of what you “think.” Therefore, depression is treated like an unwanted visitor which can be easily eliminated by merely changing the thinking involved in depression and replacing it with more rational belief systems. For example, if you are depressed because someone doesn’t like you for a potential romantic partner, he advises people to think of all the reasons why it is good that it didn’t work out. He gives absurd examples such as “you won’t have 12 ugly children,” etc. Ellis is known for his use of humor, as well as RET techniques to help people change their thinking and learn to move forward with their life.

FOR INSOMNIA

Taking the example of insomnia used with cognitive behavioral therapy, again, the therapist would delve into the thinking processes and beliefs of the patient to discover what he or she is “thinking” that keeps them awake at night. They would encourage patients with this problem to define what is disturbing their ability to fall asleep at night, and learn to change their thinking to a more peaceful perspective, so that they can leave their worries at the door.

RET & CBT

RET & Cognitive Behavior Therapy are often used interchangeably in therapy circles, but there are other types of therapy which may fit under the CBT model. However, RET is the most commonly used technique of CBT and therefore, it is the accepted model for CBT applications in practice. CBT though, can encompass the “reality therapies” as well, which take a pragmatic approach to looking at the reality of the patient and addressing the issues that are most likely to result in positive outcomes. William Glasser, who still practices reality therapy in his institute in the north, adheres to the principles of Cognitive Behavioral Therapy as well and it is closely related to CBT and is considered a complementary therapy. Some even see them as the same thing.

SUMMARY

In summary, cognitive behavioral therapy helps people in many cases, due to its “thought precedes action” approach and in the way it seeks to find the reality of a person and plan a strategy based upon this reality. CBT theorists argue that it does no good to delve into the problems of one’s past (as we see in a Psychodynamic approach), or to use the “Stages” approach of theorists like Erikson, who claimed that everyone met certain ways of thinking at different ages, based on the way they viewed their world (Psychosocial Aspects of Development, Erikson; “Stages”).

They argued that people are not rats (like the Behaviorist views the world), and that they have a need to rationalize through the thinking processes and analyze the outcome of events, so that they will not repeat their mistakes. They further believed that with a select number of analytical thinking tools at their arsenal, they could empower patients to drop the faulty logic that was the real reason for their behavioral problems, depressions, and anxiety issues, and take charge of their thought processes, and thus control their behaviors as well.

Proponents for the CBT model claim that there have been many people helped with these tenets of the cognitive behavioral model, because it delves into the thought processes which produce both the emotions and the behaviors that someone is wanting to control. Therefore, it frees them to make their own choices based on what is practical and right for them, and within their own reality, so that they can move past the things that hold them back.

Proponents against the CBT model argue that an eclectic approach is better, because RET does not work for everyone and that it limits the therapeutic process to the thinking process only and does not get into the emotional components which are a result of past wrongs, which it is important for people to deal with.

No matter what your personal or professional beliefs on this technique, it does work for many people, especially those who tend to over generalize about their life or relationships, catastrophize about what happens, and focus too much on the way things do not work out, often blaming themselves for their predicament.

RET and CBT guide the patient into seeing the world the way it IS…not the way the patient views the world, and leads them to their own reality. It empowers them to reach for new goals that they previously did not believe they were able to obtain. It acts as a method to help them analyze their lives, but in a practical way, with positive hopes for the future, rather than the grim, bleak view that the Freudian approach takes.

It is a practical approach to behavior that allows people to explore their potential, through the help of a kind guide, rather than a Psychoanalytic approach which begs the question, “Tell me about your mother.”

CBT helps many people to make sense of the chaos and achieve a kind of understanding they could not achieve by any of the other methods. But therapists should use RET and CBT only with people they truly believe it will benefit, based on their knowledge of the patient and their problems.

“The unexamined life is not worth living.” -Aristotle

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