Cognitive restructuring
Cognitive restructuring is a therapeutic technique primarily used in the treatment of mental health conditions such as depression, anxiety, obsessive-compulsive disorder, and eating disorders. It forms a crucial part of cognitive behavior therapy (CBT), which emphasizes the importance of altering negative thought patterns that contribute to these disorders. Developed in the mid-20th century by psychologists like Albert Ellis and Aaron T. Beck, cognitive restructuring focuses on helping individuals recognize cognitive distortions—unrealistic and negative thought patterns—that lead to self-defeating behaviors and heightened emotional distress.
The process involves several steps, including identifying negative thoughts, evaluating their accuracy, and correcting them based on evidence. For instance, someone receiving a low test score may spiral into self-criticism and pessimistic predictions about their future, whereas cognitive restructuring encourages a more balanced perspective by challenging those automatic thoughts. This method not only promotes more realistic thinking but also fosters healthier responses to challenges. While cognitive restructuring can be practiced independently, it is often more effective when guided by a trained therapist, as they can provide support and insight through the process of change. Overall, cognitive restructuring aims to empower individuals to replace harmful thought patterns with more constructive ones, ultimately enhancing emotional well-being.
On this Page
Subject Terms
Cognitive restructuring
Cognitive restructuring is a technique used in the mental health field to treat conditions such as depression, anxiety, obsessive-compulsive disorder, and eating disorders. It is a key technique in the psychological treatment method known as cognitive behavior therapy. The aim of cognitive restructuring is to change the thought processes that lead to these conditions. Cognitive restructuring techniques are usually taught during a course of therapy with a psychological professional such as a counselor or psychiatrist.
Background
The cognitive behavior therapy treatment method has its roots in the 1950s. It grew out of the work of American psychologist Albert Ellis and American psychiatrist Aaron T. Beck. Instead of taking a psychoanalytical approach, in which the therapist works with the patient to find the origin of the disorder, Ellis and Beck addressed thought processes. Their cognitive approach focused on changing the thoughts and behaviors that were creating unhealthy conditions such as depression and excessive anxiety and leading to self-sabotaging behaviors such as procrastination, addictions, and eating disorders.
Ellis began using his rational emotive and cognitive behavior therapy in 1955. Instead of using the psychoanalytical approach of examining a patient's past to search for the cause of anxiety, depression, or other problems, Ellis started in the present. He developed a method called "disputing," in which the patient is guided to challenge his or her thoughts to determine how accurate the thoughts are and correct those that are invalid. This became known as a cognitive approach.
A few years later in the 1960s, Beck was conducting studies on the effectiveness of psychoanalysis in dealing with depression. After discovering that it was only minimally effective, Beck also adopted a cognitive approach. Beck noticed that many patients with depression and other mental health conditions had a tendency to automatically fall into negative thought patterns when they encountered difficulties. He developed methods to help people identify, challenge, and change these thought processes. This led patients to more realistic thoughts about their situation and healthier responses. The technique pioneered by Ellis and Beck became known as cognitive behavior therapy.
Overview
Cognitive restructuring is a key element in cognitive behavior therapy. The technique restructures, or changes and reorganizes, what people know or think they know. People with depression, anxiety, or other mental health concerns often see only the negative aspects about their situations. They also tend to assume the most negative outcomes for any situation they are facing. This can lead to self-defeating attitudes and behaviors.
For instance, two people each get a low grade on an important test. The person who has an anxiety disorder will tend to automatically think the worst of the situation. That person will often berate himself for being unintelligent or lax in his study habits, and may become convinced that he will now get a low grade in the class. He may even think this low grade is a predictor of more low grades in other classes that will make it impossible for him to get into his preferred college and get a good job. All of this adds an additional element of anxiety and stress to his condition, and could eventually lead him to experience depression. Thoughts like this, which do not match up to the reality of the situation, are called cognitive distortions.
The person who does not have an anxiety disorder, on the other hand, might be upset momentarily but will generally look for ways to learn from the situation. He might ask the teacher to explain something he got wrong and study more the next time. He is also unlikely to assume one bad test is going to end his chances at future good grades, getting into a good school, or getting a good job.
The person with the anxiety disorder can use cognitive restructuring techniques to develop a thought process more like his classmate without the disorder. The multistep process guides the person to recognize the negative thought processes, determine the validity of those thoughts, test the validity, evaluate the results of that testing, and correct the thoughts as needed. None of the steps are difficult, but because they involve changing thought processes that may have been in place for a long time, they can be challenging to implement.
For instance, the person who got the bad test grade might recognize that his problem is that he tends to make sweeping negative predictions based on a single incident. The first step to address this would be to become aware that he is prone to this form of cognitive distortion. The therapist might suggest he spend the time between visits noting how often this occurs. The next step would be to determine how accurate the negative thoughts are. The person who fears one bad test will lead to more might note how he does on other tests and quizzes that week. He might also look back and see what his test performance has been in the past. Listing all of these instances will enable him to see how often his assumption that he will always do poorly is correct. By noting his performance as he does more tests, he will be able to test the accuracy of his "prediction" that he will get more low grades in the future.
Together, these methods of testing the accuracy of the thoughts he had after receiving the grade will help him evaluate the thought that he will always do poorly and not be able to achieve future success. Over time, seeing how often these distorted thoughts are incorrect helps the person develop new ways of thinking and reacting to challenging circumstances. The therapist will also often recommend other techniques to help deal with the situation while working through the cognitive process, such as meditation, and treating oneself with the same level of kindness and compassion that would be shared with a friend. For instance, it is unlikely that someone whose friend got a bad grade on a test would say to that friend, "You are stupid and you did not study enough. Now you will always get bad grades, and you have ruined your entire future!" However, that is the type of thing someone experiencing a cognitive distortion might say to himself. Cognitive restructuring aims to help correct that.
While the technique can be used independently, experts say it is more effective if the person works through distorted thoughts with a trained therapist. It takes some practice to develop the objectivity needed to correctly recognize and name the negative thoughts. It can also take practice to determine the best ways to test and analyze the validity of those thoughts.
Bibliography
Boyes, Alice. "Cognitive Restructuring." Psychology Today, 21 Jan. 2013, www.psychologytoday.com/blog/in-practice/201301/cognitive-restructuring. Accessed 2 Mar. 2018.
"Cognitive Restructuring." University of Chicago, wellness.uchicago.edu/page/cognitive-restructuring. Accessed 2 Mar. 2018.
"Examples of Cognitive Restructuring." Concordia University, www.concordia.ca/students/health/topics/stress-management/examples-of-cognitiverestructuring.html. Accessed 2 Mar. 2018.
Herbert, James D., and Evan M. Forman. "The Evolution of Cognitive Behavior Therapy." Acceptance and Mindfulness in Cognitive Behavior Therapy: Understanding and Applying the New Therapies. John Wiley and Sons, 2011, pp. 3–25.
"History of Cognitive Behavior Therapy." Beck Institute, beckinstitute.org/about-beck/our-history/history-of-cognitive-therapy/. Accessed 2 Mar. 2018.
Mills, Harry et al. "Cognitive Restructuring." MentalHelp.net, 30 June 2009, www.mentalhelp.net/articles/cognitive-restructuring-info/. Accessed 2 Mar. 2018.
"Rational Emotive and Cognitive-Behavior Therapy." Albert Ellis Institute, albertellis.org/rebt-cbt-therapy/. Accessed 2 Mar. 2018.
Rodriguez, Diana. "Cognitive Restructuring: Change Your Thoughts, Change Your Attitude." Everyday Health,22 Dec. 2009, www.everydayhealth.com/emotional-health/understanding/cognitive-restructuring.aspx. Accessed 2 Mar. 2018.