About Cognitive Psychotherapy

By Michael Herkov, Ph.D

Cognitive therapy is based on the theory that much of how we feel is determined by what we think. Disorders, such as depression, are believed to be the result of faulty thoughts and beliefs. By correcting these inaccurate beliefs, the person’s perception of events and emotional state improve.
Research on depression has shown that people with depression often have inaccurate beliefs about themselves, their situation and the world. A list of common cognitive errors and real life examples is listed below:

• Personalization — relating negative events to oneself when there is no basis.
  Example — When walking down the hallway at work, John says hello to the company CEO. The CEO does not respond and keeps walking. John interprets this as the CEO’s lack of respect for him. He gets demoralized and feels rejected. However, the CEO’s behavior may have nothing to do with John. He may have been preoccupied about an upcoming meeting, or had a fight with his wife that morning. If John considered that the CEO’s behavior may not be related to him personally, he is likely to avoid this negative mood.
• Dichotomous Thinking — seeing things as black and white, all or none. This is usually detected when a person can generate only two choices in a situation. Example — Mary is having a problem at work with one of her supervisors who she believes is treating her badly. She convinces herself that she has only two options: tell her boss off or quit. She is unable to consider a host of other possibilities such as talking to her boss in a constructive way, seeking guidance from a higher supervisor, contacting employee relations, etc.
• Selective Abstraction — focusing only on certain aspects of a situation, usually the most negative. Example — During a staff meeting at work, Susan presents a proposal for solving a problem. Her solution is listened to with great interest and many of her ideas are applauded. However, at one point her supervisor points out that her budget for the project appears to be grossly inadequate. Susan ignores the positive feedback she has received and focuses on this one comment. She interprets it as a lack of support from her boss and a humiliation in front of the group.
• Magnification-Minimization — distorting the importance of particular events. Example — Robert is a college student who wants to go to medical school. He knows that his college grade point average will be used by schools during the admission process. He receives a D in a class on American History. He becomes demoralized thinking now that his lifelong dream to be a physician is no longer possible.

Cognitive therapists work with the person to challenge thinking errors like those listed above. By pointing out alternative ways of viewing a situation, the person’s view of life, and ultimately their mood will improve. Research has shown that cognitive therapy can be as effective as medication in the long-term treatment of depression.