We already know that the treatment of depression requires both pharmacotherapy and psychotherapy. Compared with pharmacotherapy, psychotherapy is more complex and has many schools. Such as behavioral therapy, Morita therapy, exposure therapy, psychoanalysis, systematic desensitization, relaxation training, and so on.

Cognitive therapy is one of the most widely used schools of psychotherapy theory in the world. As early as the 50s of the 20th century, the American clinical psychologist Albe

t Ellis founded rational emotion therapy; Thereafter, Aa

o

Beck founded cognitive therapy in 1960.

Thinking determines emotions, and emotions originate from thoughts

Cognition is the way people see the world; At a deeper level, it is a person's mentality and beliefs. The theoretical basis of cognitive therapy can be summed up in one sentence: thinking determines emotions, and emotions originate from thoughts. That is, any kind of emotion is the result of the interaction between external environmental stimuli, physiological changes of the body and the response of the human body to external stimuli, and the cognitive process plays a decisive role.

All human emotions come from cognition and thinking. Emotions follow the mind, and so do they. What kind of cognition there is, what kind of emotions will there be. When the mood is depressed, the mind is overshadowed by a sense of negativity that cannot be shaken off. If negative thinking is ingrained and forms a conditioned reflex, it becomes habitual thinking. Cognition, feeling, and behavior will interact to form a closed loop that is constantly circulating.

The essence of cognitive therapy is to learn to replace unhealthy ways of thinking with healthy ones. Let you distinguish between what your painful feelings are due to facts and what is due to misjudgment of the mind. That is, it is very likely that your feelings are not real, but are the result of your distorted, illogical, and unrealistic thinking.

The above is the principle level. If defined at the operational level, cognitive therapy is to alleviate undesirable emotions and behaviors by modifying an individual's cognitive evaluation and thinking patterns. It is an intervention model that requires active patient participation to guide patients to identify, monitor, and eliminate false thoughts, beliefs, and self-explanations associated with current stimuli, providing a new and more adaptive "cognitive-behavioral" model. The ultimate goal is for patients to be their own therapists.

Change your mindset

How much does a person's perception of things affect him? The answer is: too big to imagine. No matter what perception you take, it is subtly affecting you and your life.

Almost all people with depression believe that he is the most unlucky and powerless person in the world; He was caught up in some thorny and terrible problem from which he could not extricate himself; His negativity is reasonable and inevitable.

In fact, about 2,000 years ago, the Greek philosopher Epictus said that people's troubles do not come from practical problems, but from the way they look at them. You may feel unhappy, and perhaps you can find specific reasons for your unhappiness: unhappy family, lack of love in childhood, chaotic living environment, poverty, ...... There must be some truth to these thoughts, after all, the world cannot be happy, and life will always encounter various setbacks and even devastating disasters. It is true that people's genes and painful childhood experiences can affect their thinking and emotions, and the external environment and cold interpersonal relationships can also disturb people's minds - but none of this is the main reason.

Cognition determines emotions, and emotions determine emotions. The results of brain science research have also shown that emotions can arouse the excitement of the right brain, and cognition can arouse the excitement of the left brain. Emotions have a dynamic effect on people's cognition and activities. Positive emotions are the internal driving force of people's cognition and activities, while negative emotions are resistance.

With this in mind, cognitive therapy aims to help us change our mindset and even our own basic values and beliefs. Not only will your emotions be adjusted, but your horizons will be broader, and you will even be more motivated to work. The changes it brings to you are huge and long-lasting.

Dr. David Antonuccio and Dr. William Denton of the University of Nevada, USA, and Dr. Gooland de Nelskai of Cleveland Medical Center have been researching cognitive therapies for many years. They co-authored an article titled "Psychotherapy vs. Pharmacotherapy for Depression Treatment: Challenging Conventional Wisdom and Telling the Truth." Using the data they have obtained over a long period of time, the article has come to some conclusions that are very different from traditional beliefs: genetic influence accounts for only 16% of the causes of depression; Newer psychotherapies – especially cognitive therapies – are no less effective than pharmacotherapy, and for some patients, it appears to work better; Patients with depression treated with psychotherapy were more likely to maintain their response after recovery, and the recurrence rate was much lower than that of patients treated with pure medication; Psychotherapy can treat not only mild depression but also severe depression.

These conclusions, while not yet fully verifiable, are still encouraging. After all, relying on drugs to change the imbalance of chemical elements in the brain is using a destructive force, and cognitive therapy allows people to see the possibility of healing with inner strength.

Modern medicine has been able to roughly see that depression may be caused by an imbalance of brain chemicals. Recent research suggests that cognitive therapy may actually be able to alter brain chemistry. Some scientists in the United States recently used positron emission tomography to observe whether there were any changes in the metabolism of the brains of the two groups before and after treatment. One group received only cognitive therapy (no medication) and the other group received only antidepressant medication (no psychotherapy).

The result of the experiment was that after the patients in the drug treatment group got better, the researchers found that the chemicals in their brains changed. This is to be expected. Surprisingly, the patients in the cognitive therapy group also experienced changes in brain chemistry after successful recovery, and there was no significant difference from the medication group. The experiment led researchers to believe that cognitive therapy might actually be able to alter the chemicals and structure of the human brain to cure patients.

How to adjust cognition

A.T. Beck, the main representative of cognitive therapy, has systematically introduced the principles and methods of cognitive therapy. According to him, the cognitive structure of an individual is divided into automatic thinking (thoughts that quickly emerge in the brain induced by a certain situation); cognitive distortion (including arbitrary inferences, selective generalizations, over-generalizations, full or none, etc.); dysfunctional assumptions (attitudes, beliefs, or codes of conduct held by individuals about things); schema (relatively persistent and stable cognitive structures acquired in early development).

Baker believes that the occurrence of affective disorders is closely related to the schema formed by the patient's early experience, which exists in the patient's subconscious and is not easily detected. Once an adverse life event occurs, a large number of negative automatic thoughts will emerge in the brain, rising to the level of consciousness, which will lead to the occurrence of bad emotions and behaviors.

Accordingly, Baker believes that the cognitive behavioral treatment of depressed patients should mainly focus on the negative thinking that leads to depression, so as to modify cognitive evaluation at different levels, develop rational thinking at the level of consciousness, strengthen positive behavior patterns, and improve undesirable adaptive behaviors. In this way, the cognitive, behavioral, emotional, and physiological levels form a benign interaction, so that the emotional and behavioral patterns spiral upwards to the positive and rational levels, so as to achieve the purpose of treatment.

When it comes to specific steps, the first step is to know yourself. Clients can be instructed to self-monitor their daily activities, quantitatively assess their sense of pleasure and achievement, and then develop a step-by-step task plan to activate their withdrawal behaviors. These behavioral activation strategies have been found to be highly effective in alleviating depression and create opportunities for patients to identify and modify negative perceptions.

The second step is to look inwardly. The occurrence of depression is closely related to the individual's recent stressful life events, and the therapist should discuss, evaluate, and identify the client's wrong coping strategies through discussion, evaluation, and identification. On this basis, patients are instructed on how to express and vent negative emotions in a positive way, rethink, plan and examine, and establish a positive coping model.

The third step is to learn problem-solving skills. Patients with depression often lack sufficient skills to solve problems with a rigid model, so it is necessary to improve patients' adaptability and explore the best way to solve the problem through pros and cons analysis, cost-benefit analysis and other methods.

People with depression will always have a lot of relationship problems to deal with. The effective intervention of behavioral technology can help to improve their basic social skills, increase interpersonal social support and intimacy experience, and reduce the tendency of social withdrawal.

In conclusion, an important part of CBT is to identify negative automatic thoughts, challenge cognitive distortions, develop new positive thought patterns, perform cognitive reconstruction, and improve the patient's self-control over emotional responses.

In the past 30 years, a large number of clinical practice and empirical studies have been carried out on cognitive behavioral therapy for depression at home and abroad, and it has been found that the efficacy of cognitive therapy for patients with mild to moderate depression is basically the same as that of antidepressants, and the recurrence rate is low. It has been reported that the efficacy of cognitive therapy can last for 8 to 14 years. At present, the clinical treatment guidelines for depression formulated in Western countries have listed it as a first-line treatment.

Of course, cognitive therapy is a very individualized therapy, which requires the therapist and the patient to form a "one-to-one" treatment plan, and it is difficult to develop a standardized model, and it is difficult to predict when the treatment will be effective and when it can be ended. At present, psychology's understanding of the mechanism of cognitive therapy is still limited. These are things that need to be explored further in the future.

Cognition determines emotions, and emotions determine emotions. Emotions have a dynamic effect on people's cognition and activities. Positive emotions are the internal driving force of people's cognition and activities, while negative emotions are the resistance.