February 2001
By Jeff Wailes

What is Cognitive Therapy?

Cognitive therapy is a way of helping people to cope with stress & emotional problems. The idea behind it is quite simple - the way we think about things affects how we feel emotionally. For example, if you wave to a friend & they don’t wave back to you, the way you think about your friend will affect how you feel about the situation. If you think your friend is avoiding you, you might feel sad or angry. On the other hand if you think they just didn’t notice you, you might think it funny. So, our feelings are not just automatic reactions to events, they are shaped by the internally generated interpretations that we have. So, it is not the events of life to which we respond but rather it is the mental representation we create of those events.

How Does it Work?

Cognitive therapy is a way of talking about the connections between how we think, how we feel & how we behave. It particularly concentrates on ideas that are unrealistic. These often undermine our self-confidence & make us feel stressed, depressed or anxious. Looking at these can help us work out different ways of thinking & behaving that in turn will help us cope better. Cognitive therapy also helps us to look at our “rules for living”. These are strong beliefs about how we should live our lives which we develop while we are growing up. They are based both on what we learn from other people & on our own experiences. Although they shape our lives, most of the time we don’t give them much thought. They may be realistic or unrealistic, helpful or unhelpful. For example, someone may grow up with the belief that “I cannot be happy unless I am successful in everything I do”. This belief is unrealistic - the reality of life is that we all fail sometimes. By demanding the impossible this idea is likely to produce feelings of depression. Cognitive therapy can help us not only to be aware of the “rules” we use but also to develop more helpful ones. Cognitive therapy looks at “here & now” issues rather than things from the past. It helps people to learn new methods of coping & problem solving which they can use for the rest of their lives.

What Does a Course of Therapy Involve?

Most courses of cognitive therapy last from 8 to 12 sessions each lasting about 50 minutes. In the first few sessions, the client & the therapist decide which problems seem to be the most important. Clients take an active part & carry out “homework” between sessions. They will often be asked to keep a diary of their thoughts, feelings & behaviours in the situations that they find particularly stressful. They then discuss these in detail with the therapist, asking themselves whether or not their ways of thinking are realistic or not. They can then learn to change these ways of thinking to use more helpful ones. The later sessions may often concentrate on the clients “rules for living”. It can be quite a surprise to find out how these ideas come about in the first place. Through discussing them, the client can develop new & more flexible rules, which may prevent problems from developing in the future.

Who Can it Help?

Cognitive therapy particularly suits people who want to be actively involved in dealing with their problems. Research has shown that it is particularly helpful for people who suffer from anxiety or depression. It can be successfully used with people who are taking anti-depressant drugs & may also be used to treat panic attacks & eating disorders such as bulimia. It can also be helpful for people who have been through traumatic experiences or who are trying to come to terms with a long-term physical illness, or grief.