Topic 6: Automatic Thoughts & Core Beliefs {by 10/17}

[Automatic Thoughts] – Watch MDD-12: Automatic Thoughts – Negative Automatic Thought Record.  Answer the following: (1) How is the client’s response to the outcome (emotionally and cognitively) helpful to understanding his distress? (2) What would be effective Socratic techniques to modify his negative automatic thought?

 

[Core Beliefs] – There are three readings due this week (J. Beck – 2 Chapters; Volungis – 1 Chapter).  (1) What are core beliefs?  (2) What are the therapeutic gains that come from modifying core beliefs?  Your original post should be posted by the beginning of class 10/17.  Have your two replies posted no later than 10/19.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

30 Comments (+add yours?)

  1. Zacharie Duvarney
    Oct 15, 2019 @ 08:46:02

    1. How is the client’s response to the outcome (emotionally and cognitively) helpful in understanding his distress?

    In the assigned video, Mark discusses an event where he asked a coworker out to lunch. The coworker stated he could not go to lunch with Mark, which resulted in Mark experiencing several negative thoughts and feelings. Mark has been struggling to socialize and tends to internalize failed attempts at socializing. Therefore, the information that can be gleaned from this therapy session is useful in understanding Mark’s distress cognitively and emotionally.
    When asked what thoughts went through his head after having his lunch invitation declined, Mark stated he thought to himself “Jeff doesn’t want to spend time with me”. Negative automatic thoughts derive from core beliefs. Thus, Mark’s negative automatic thought “Jeff doesn’t want to spend time with me” likely stems from his core belief of “I am unlikeable”. Conceptualizing Mark’s distress in this manner seems accurate given his repeated failures at socializing and subsequent internalizing. Therefore, by identifying this automatic thought, we can determine that Mark may have negative core beliefs related to feelings of unlikability.
    When asked about the emotional intensity and believability of his negative automatic thought, Mark stated that he experienced strong feelings of guilt and sadness. Furthermore, Mark’s belief of his negative automatic thought was strong. Therefore, the therapist should conclude that this negative automatic thought is worth focusing on, given the strong emotional and cognitive connotations.
    As aforementioned, Mark internalized the failed attempt at socializing with his coworker. The therapist accurately labels this as a cognitive distortion, specifically that of “personalization”. Personalization is the belief that others are behaving negatively because of you, without considering more plausible explanations for their behavior (Beck, 2011).
    Having identified Mark’s negative automatic thought (“Jeff doesn’t want to hang out with me”), the core belief that likely created this thought (“I am unlikeable”), and the associated cognitive distortion (personalization), the therapist can now employ appropriate and effective therapeutic interventions. These 3 factors (negative automatic thought, core belief, and cognitive distortion) are at the crux of CBT theory, meaning the information provided in this therapy session is essential in understanding Mark’s depression both emotionally and cognitively.

    2. What would be effective Socratic techniques to modify his negative automatic thought?

    There are multiple Socratic techniques that can be effectively employed to modify Mark’s negative automatic thought. Given that Mark falls victim to the cognitive distortion of personalization, one effective technique may be to help Mark separate himself from the negative automatic thought. This typically entails asking the client what they would tell a significant other if they were in the same position as them (Volungis, 2019). By separating himself from the thought, Mark should hopefully view the situation from an objective standpoint and arrive at an alternative explanation for why his coworker declined his lunch invitation. Volungis (2019) suggests using the client’s own words (verbatim description of the event and automatic thought) when employing this technique, as this will make the exercise more impactful for the client.
    Another Socratic technique that could be particularly potent given the situation is shifting Mark’s attributional bias. Attributions are the meanings that people assign to everyday events (Beck, 2011; Volungis, 2019). There are three dichotomous categories of attributions: personal (internal vs. external), permanent (stable vs. unstable), and pervasive (general vs. specific) (Volunis, 2019).
    Personal attribution refers to how much the person attributes events to themselves (internal) or the environment (external) (Volungis, 2019). In Mark’s case, he believes his failure to socialize is predominantly internal. This internalization causes Mark distress, meaning shifting this bias toward external explanations (e.g. Jeff couldn’t go to lunch because he was truly too busy) may help alleviate some of Mark’s negative feelings.
    Permanent attributions reflect how much the person believes events are stable (events will always be the same) or unstable (events can change) (Volungis, 2019). Through interpretation of Mark’s therapy sessions, one could reasonably conclude that Mark has a stable interpretation of his failure to socialize. In other words, Mark likely expects that anytime he attempts to socialize, he will fail. Unfortunately, Mark’s recent attempts at socializing have likely reinforced this interpretation. Therefore, the therapist should endeavor to shift this bias toward an unstable interpretation. If the therapist can convince Mark that his situation is liable to change, then Mark will be more motivated to continue his pursuit of increased social activity.
    Pervasive attribution refers to how consistent the individual interprets events to be. Specifically, whether events are general (e.g. the event will happen everywhere and every time) or specific (the event was unique or atypical) (Volungis, 2019). Mark’s feelings of unlikability seem to be general, in that he always expects to be rejected by others. Thus, it would be advantageous for Mark to foster an interpretation of social rejection that is not global. Essentially, Mark should learn that his failed attempts at socializing are unique, and that he will not always be rejected when he attempts to socialize.
    All in all, separating oneself from automatic thoughts and shifting attributional biases seem to be most applicable to Mark’s circumstances.

    3. What are core beliefs?

    Core beliefs are the most central ideas about the self (Beck, 2011). They are considered to be absolute truth. According to Beck (2011), negative core beliefs fall in to three broad categories: helplessness, worthlessness, and unlovability. Core beliefs are developed over the life span, resulting from interactions between personality traits, genetic predispositions, and environmental transactions (especially with significant others). Individuals typically form logical and realistic core beliefs. When the individual constructs negative core beliefs, they are typically developed on faulty logic, leading to the development of cognitive distortions. Cognitive distortions are disillusioned views about the cognitive triad (self, future, world).

    4. What are the therapeutic gains from modifying core beliefs?

    The modification of core beliefs is essential for many clients to achieve long-term therapeutic gains (Volungis, 2019). Considering that core beliefs dictate most of our automatic thoughts and subsequent behaviors, it is imperative that clients replace their maladaptive core beliefs with adaptive ones.
    Maladaptive core beliefs are typically developed through faulty appraisals of life events and environmental stimuli (Beck, 2011). Thus, maladaptive core beliefs are rooted in illogical thinking. This illogical style of appraisal leads the client to develop cognitive distortions, which result in maladaptive behaviors. Therefore, core beliefs are the central cause of client distress.
    In order to promote substantial long term-improvement in the client, negative core beliefs must be modified. While engaging in behavioral interventions (e.g. behavioral activation) can provide immediate alleviation from distress, it does not typically persist long term. One of the primary goals of CBT is for clients to “become their own therapist”. In order to avoid maladaptive behaviors and distress, clients need to understand their functioning on an intellectual level. By realizing that their core beliefs are rooted in faulty logic, clients can alter these beliefs, allowing them to perceive reality from a more objective standpoint. Consequently, clients will be able to construct realistic appraisals of life events and select coping mechanism and behaviors that are contextually appropriate and useful. This will lead to a drastically improved quality of life.
    In summary, the modification of core beliefs brings about long term therapeutic gains because core beliefs are often the root of client distress. While behavior modifications can help clients cope in the short term, core belief modification must take place for clients to solve their problems independently.

    Reply

    • Katrina Piangerelli
      Oct 16, 2019 @ 20:11:58

      Zach, you gave a very detailed description and analysis for each of these questions. I think that we share a lot of the same thoughts regarding these topics. I really like the way that you analyzed Mark’s therapy session and described the way in which he was struggling with being unlikable. You also went into detail about the Socratic techniques that would most benefit Mark in this particular situation such as helping Mark separate himself from the negative automatic thoughts, shifting Mark’s attributional bias, and then going into detail about the different types of attributions that may have an affect on Mark. When describing the therapeutic gains from modifying core beliefs, you mention the client becoming his or her own therapist. This is something that we have stressed throughout the semester as being an essential part of CBT. I think that you did a good job of describing how core beliefs can be shifted and the process that should take place in order to shift these thoughts.

      Reply

    • Tricia Flores
      Oct 16, 2019 @ 20:31:24

      Zacharie-
      Your discussion of cognitive distortions as a disillusioned view of the cognitive triad brought to mind how psychoeducation about cognitive distortions assists in working with adolescents. I have learned the hard way that pointing out a cognitive distortion while a person is making it may not be the best approach all the time. Interactions with my son come to mind. I’ve found that generally pointing out the problem in the moment helps and then later reviewing the specific cognitive distortion has worked best.

      Reply

  2. Katrina Piangerelli
    Oct 16, 2019 @ 20:11:31

    (1) How is the client’s response to the outcome (emotionally and cognitively) helpful to understanding his distress?

    Mark’s response to the outcome is helpful in understanding his distress because it helps the therapist understand what he is feeling. When Mark’s coworker did not want to get lunch with him, Mark described feeling bad, sad, and guilty about the outcome. This response helps the therapist to understand where Mark is coming from, as well as how he processes his distress currently. This ties back into Mark’s core belief of feeling as though he is unlikeable or hard to like, and that people do not want to spend time with him. It is important for a therapist to understand these thoughts and his subsequent reaction in order to help Mark learn ways to cope with these feelings. It also gives us insight into his core beliefs being something that the therapist should focus on with Mark. The strong emotional reaction that Mark has during this session also shows the effect that this event has had on Mark. Mark seems to be processing this event and shows through facial expressions, body language, and his description of what happened that this event really hurt him. This is then labeled as a cognitive distortion, more specifically personalization, which is the belief that another person’s negative behavior is because of you, rather than considering any other explanations for this behavior. Mark’s response to the outcome, both emotionally and cognitively, is very important during this therapy session and gives insight to the therapist as they begin to work with Mark on his cognitive distortions, negative automatic thoughts, and core beliefs.

    (2) What would be effective Socratic techniques to modify his negative automatic thought?

    One effective Socratic technique to use with Mark would be to explore possible alternative explanations. This technique helps the client to consider other possible reasons that the event associated with their negative automatic thoughts and emotions might have occurred. In the case of Mark, this would be his coworker saying that he can’t go out to lunch. During this Mark may begin to recognize that there are other possible explanations aside from Mark being unlikable or his coworker not wanting to spend time with him. This will help Mark to learn experientially that there may be other ways to perceive events like this one. It may also be helpful for Mark to explore alternative thoughts, emotions, and behavior/consequence of his negative automatic thoughts and the actions that follow them.

    Another Socratic technique that may be beneficial for Mark is assess the impact of believing the negative automatic thought. This would be done by asking Mark what the outcome was of believing his negative automatic thought. When he responds saying that he felt hurt, sad, and guilty, the therapist could then ask what the outcome would be if he didn’t believe this negative automatic thought, and instead replaced it with another. This could help Mark recognize that taking an alternative perspective could change his emotions and behaviors.

    [Core Beliefs] – There are three readings due this week (J. Beck – 2 Chapters; Volungis – 1 Chapter).

    (1) What are core beliefs?

    Core beliefs are rigid, global, and overgeneralized beliefs are all-or-nothing statements that people make about themselves, others, and the world. Core beliefs that are negative can lead to concrete maladaptive patterns in thinking. These pervasive thoughts are often presented as negative automatic thoughts in the “external,” but are negative core beliefs “internally.” Core beliefs are global sources that form the foundation of negative automatic thoughts, and are often ingrained in the person. They are also templates that often provide the rules for a person’s information processing. There are three categories of negative core beliefs, including helplessness, worthlessness, and unlovability. Core beliefs typically develop during childhood and throughout adolescence, and can be biased and self-perpetuating. Negative core beliefs can be replaced by core beliefs that are accurate and adaptive. However, presenting distress often causes a person to overlook positive core beliefs.

    (2) What are the therapeutic gains that come from modifying core beliefs?

    There are many therapeutic gains that come from modifying negative core beliefs. Maladaptive or negative core beliefs tend to develop due to false appraisals of different events and environmental stimuli, which then trigger these automatic thoughts. One benefit to modifying these beliefs is that it helps clients to change the ways in which they view themselves, interact with others, and perceive the world. Another gain is helping the client to relieve distress by reducing their negative automatic thoughts and replacing these with adaptive and accurate thoughts. This will also help with the client’s ability to cope with future stressors, due to an improved ability to recognize and modify negative automatic thoughts independently. Utilizing positive core beliefs is another gain when modifying core beliefs, because it helps the client use these positive core beliefs to modify negative ones. Recognizing the role that the interaction between core beliefs and automatic thoughts have on the way they view themselves, others, and the world may help a client to understand how they react and how this influences them. Another gain would be having the psychoeducation to help the client to understand what is going on when they have negative automatic thoughts and how to properly manage these thoughts independently.
    The goal of CBT is to help the client achieve long-term stability in his or her mental health disorder through coping strategies. One behavior intervention that may be useful is behavioral activation, which can help the client in the moment, with immediate distress. In order to alleviate long-term distress, the automatic negative thoughts the client is experiencing need to be recognized and evaluated by the client in order to help in understanding his or her own thoughts. Once clients are able to recognize their negative automatic thoughts as being false and maladaptive, they are then able to work on changing these beliefs with the help of a therapist.

    Reply

    • Tricia Flores
      Oct 16, 2019 @ 20:26:12

      Katrina-
      I appreciated the idea of utilizing positive core beliefs in treatment. These could be used to address the maladaptive core beliefs. I agree that positive core beliefs can be overlooked during times of distress. I see the benefit of identifying positive core beliefs alongside negative core beliefs and utilizing them when changing automatic thoughts to ones that are more positive. One example I can think of in regards to this is my belief that people are inherently good. When faced with a bad driver sometimes my initial thought is annoyance or anger at what appears to be a callous disregard of others. When this thought comes to my head I try to replace it with empathy for what might be a difficult situation the person could be facing. This focus on my belief of goodness assists me in addressing temporary feelings of anger so that they do not become over-reaching unhappiness and short-temper.

      Reply

    • Zacharie Duvarney
      Oct 17, 2019 @ 10:42:23

      Katrina,

      In your response to the question about Socratic techniques, you discussed techniques that I did not talk about in my response. It was informative to see other techniques applied to this case that I hadn’t considered.

      Regarding your response about core beliefs, I’m glad you mentioned that people have positive core beliefs, and that these beliefs are often overlooked in the therapy process. It is important that we not only attempt to compensate for our clients’ weaknesses but also that we reinforce their strengths.

      Well done!

      Reply

    • Olivia Corfey
      Oct 17, 2019 @ 13:27:22

      Katrina,
      Your post was insightful and informative. I appreciate your thought about how it is important for a therapist to understand the response to outcomes in order to see how Mark copes with certain situations. These revealed coping strategies give insight into the pattern of maladaptive behaviors, strong negative emotions, and negative automatic thoughts. As to your thoughts about Socratic technique, I would agree that it would be beneficial for Mark to assess the impact of believing his negative automatic thoughts. I had not thought of the benefits of using this technique with Mark. However, I can see now how it would show the negative effects of believing these skewed thoughts. Overall your post was well written and gave several different points to think about. Thank you!

      Reply

  3. Tricia Flores
    Oct 16, 2019 @ 20:18:30

    How is the client’s response to the outcome (emotionally and cognitively) helpful in understanding his distress?

    Mark learns about negative automatic thought records in MDD-12. The therapist utilizes the previously discussed situation of Mark being turned down by his coworker for lunch as an experience to learn about evaluating his negative automatic thoughts. It was a good example for the lesson because it was recent, elicited strong emotions, and was an illustrative example of Mark’s core belief of being unlikeable and his internalization of failed social attempts. During the experience that was discussed Mark had several negative thoughts and a strong emotional response. Prior to asking Jeff if he wanted to have lunch, Mark identified that he thought “Jeff doesn’t want to spend time with me.” This stems back to his core belief of being unlikeable. Mark identified the distress he experienced has strong and the believability as high. The strong emotional reaction, Mark’s report that it is believable, and the repeated instances of similar negative automatic thoughts means that it is a good negative automatic thought to focus on.
    The therapist further discussed the concept of cognitive distortions and identified it as personalization. Personalization is when other people’s behavior is due to them without consideration for a more plausible explanation.
    These three parts, negative automatic thought, core belief, and associated cognitive distortion are the underlying CBT ideas. Mark has now been introduced to all three parts and for effective treatment will learn how to do this independently, eventually learning how to identify, modify, and change cognitions and behavior.

    What would be effective Socratic techniques to modify his negative automatic thought?

    Shifting attributional bias and separation are both Socratic techniques that can be utilized to modify Mark’s negative automatic thoughts. Shifting attributional bias means changing the inappropriately attributed meaning of events. The three categories of attribution are personal, permanent, and pervasive. Personal can be internal or external, permanent can be stable or unstable, and pervasive is either general or specific. In personal it means if the attribution is due to themselves, internal, or others, external. Mark has internalized his social rejections. By moving the focus to a slightly more external focus Mark will be able to identify when situations are not due to himself, but other factors outside of his control.
    Permanent attributions is a determination of change. Stable means they will stay the same and unstable means events can. Mark sees his situation as fairly permanent. He does not expect it to change. Having positive responses to his social requests will hopefully result in Mark moving toward an unstable permanent attribution. Another possibility, without initial change, is the therapist having Mark buy into the idea of non-permanence. Lastly, pervasive attribution refers to consistency. In general the person sees events as across situations and times, specific means it is not across all events. Mark feels unlikeable in general in social situations, though not for all people, he hasn’t stated that he believes that his family or girlfriend view him as unlikeable.
    Another Socratic technique that could be utilized is separation. This was briefly used earlier when the question was raised about how his girlfriend reacted to the cancelation of dinner plans. Mark stated that she was not bothered by it. This helped Mark separate himself from the perceived social rejection and see it from a less internalized point of view. Utilizing the client’s own words is a useful way to employee separation. A client may view his interpretation differently when asked what advice he would give to a friend in a similar situation. He may not have the same cognitive distortion if viewing the situation from an outsider’s perspective. Utilizing the same words the client did would assist in helping the client connect that he perceives his own experiences differently than how he may perceive them as an outsider.

    What are core beliefs?

    Core beliefs are considered absolute truth and the central ideas about the self. They are developed over ones lifetime and come from interactions between genetic predispositions, personality traits, and environmental transactions. Negative core beliefs can be considered under three categories: unlovability, worthlessness, and helplessness. While typical core beliefs are logical and realistic, negative core beliefs come from poor logic and result in cognitive distortions.

    What are the therapeutic gains from modifying core beliefs?

    While some therapies focus on behavior modification, this does not get to the underlying issues of negative faulty core beliefs. Behavior modification changes the short-term, while modifying faulty core beliefs results in clients solving their own future problems by changing the root cause of client distress.
    Core beliefs result in automatic thoughts, which causes behavior. Maladative core beliefs come from misinterpretation of life events and environmental stimuli. The illogical thinking that results in cognitive distortions and maladaptive behaviors.
    Clients can work backwards, identifying behaviors, determining negative automatic thoughts, and ultimately identifying maladaptive core beliefs. Utilization of Socratic techniques psychoeducation to understand how one’s mind works results in a deeper understanding of the self. The end result is the person being empowered to make meaningful changes independently, demystifying patterns of thoughts, emotions, and actions that one may not feel in control of.

    Reply

    • Adam Rene
      Oct 17, 2019 @ 11:46:13

      Tricia –

      Thank you for your post. There were a few aspects of your post that I wanted to note. First, I appreciate that you noted where Mark is currently in treatment through identifying what Dr. V has introduced to him at this point regarding the CBT process. I too agree that Mark has been introduced to the major tenets of CBT and thus can engage more in the process. Second, I appreciated your discussion in core beliefs regarding short-term and long-term relief. This was a result that I came to as well.

      Reply

    • Kelsey Finnegan
      Oct 19, 2019 @ 19:35:25

      Tricia,

      You provided a strong explanation for why Mark’s automatic thought was a good one to choose. I agree that the recency of the event, and the high level of emotional distress and believability make it a good choice to focus on in therapy.

      Also, I particularly appreciated the point you made about how simply modifying behaviors is not effective in the long term because it does not take into account the underlying issues that occur as a result of negative core beliefs.

      Reply

  4. Paola Gutierrez
    Oct 16, 2019 @ 21:41:32

    1. How is the client’s response to the outcome (emotionally and cognitively) helpful to understanding his distress?

    Mark’s experience with asking Jeff out to lunch was a strong example for the automatic thought record because it was a recent event and brought out Mark’s emotions. His response to the outcome, though, was to isolate and ruminate, which he reported feeling “bad, sad, and guilty” about. I think processing not only the event itself but the outcome of Mark’s automatic thought(s), associated emotions, and subsequent behaviors is important because they seem to contribute to his current distress about the event. The fact that he isolated himself and ruminated about the event most likely exacerbated the emotional distress he experienced as a result of Jeff’s rejection of his invitation to lunch. Furthermore, Mark’s believability of the automatic thought and the emotions experienced was also ranked high, which indicates that this is an automatic thought worth modifying. The event even tapped into Mark’s core belief of unlikability, indicating that this is a core belief that should be evaluated and modified later in treatment.

    Mark also tends to personalize failed social attempts, concluding that others do not like him or value him if they decline an invitation or cancel plans. Some cognitive distortions were identified, such as personalization, which is when one internalizes events/reactions from others and make it about the individual without consideration of alternative explanations. Mark also tends to jump to conclusions. Mark’s body posture, facial expressions, tone, and the manner in which he described the event indicated that the event and his cognitive/emotional/behavioral responses were a significant factor in his distress and could benefit from different cognitive techniques for modifying the automatic thought (and core belief).

    2. Socratic techniques to modify automatic thoughts?

    A Socratic technique that should generally always be used when evaluating/modifying automatic thoughts is to examine the evidence. Mark could examine the evidence for/evidence against his automatic thought that “Jeff doesn’t want to spend time with me.” For example, while there may be occasions that support the automatic thought, there will likely be events that discredit the automatic thought.

    Another Socratic technique is to consider possible alternative explanations. Perhaps in doing so, Mark’s automatic thought will lessen from an extreme to a more neutral, realistic one. For example, Jeff may have truly been busy, or perhaps he was stressed from an earlier interaction with his supervisor or a significant other. Modifying the negative thought this way may result in a lesser degree of distress, and may even change any possible behavioral outcomes (such as avoiding Jeff at work or no longer inviting him out for lunch).

    A third Socratic technique that could be used to modify Mark’s automatic thought is to separate the self from negative automatic thought. Something similar to this has been done before, in relation to Mark’s canceled dinner plans with friends. His negative automatic thought was “they don’t value me” whereas his girlfriend Melissa’s response was “we’ll get them next time.” This question sort of separated Mark from his automatic thought by looking at how others perceived the event. Since Mark has a significant other (Melissa) that he cares about, this technique might be a particularly powerful one to use with Mark.

    3. What are core beliefs?

    Core beliefs are fundamental understandings of the self, others, and the world, developed in early childhood through interactions/relationships with others (such as parents, teachers, peers) and life experiences. As such, core beliefs are deeply ingrained, pervasive, and are rigid and overgeneralized. Core beliefs tend to lie at the extremes of a spectrum, generally on the negative side during periods of distress. For example, an individual might have a core belief of “I’m a complete failure.” This belief obviously demonstrates one extreme on a continuum of success/worth/competence. Additionally, core beliefs can be positive or negative, with negative core beliefs activated in particular during periods of distress. Beck notes that individuals with personality disorders often have constantly activated core beliefs, with more negative core beliefs and fewer and weaker positive ones. Core beliefs often have an element of truth to them, possibly serving the individual at one point in time but are either presently invalid or valid to some degree. Core beliefs are distinguished by categories, which fall under helplessness, worthlessness, and unlovability umbrellas. Individuals can have one or more core beliefs, with a lens directed at either the self, world, or others. Core beliefs are often hinted at through automatic thoughts, or, in some cases, stated outright. A therapist can hypothesize about possible core beliefs a client has through common, prominent themes in automatic thoughts. Core beliefs can be modified to represent more realistic and adaptive core beliefs that alleviate client distress. Lastly, positive core beliefs, which are often overlooked in treatment, provide substance for changing core beliefs and are thus strengths in the modification of core beliefs.

    4. Therapeutic Gains from Modifying Core Beliefs?

    The purpose of changing negative core beliefs is not to move from one extremely negative core belief to an extremely positive core belief, but to adopt a more accurate core belief that recognizes both positive and negative, which more closely represents reality. For example, an individual who has a core belief that “No one likes me” might be modified to “Even though not everyone likes me, some people do like me.” Before modifying core beliefs, however, a client must understand how core beliefs work and how they develop. Having some understanding of how these beliefs develop (influences of early life experiences) and how they contribute to present distress is likely validating for clients to a degree. In other words, clients have a better idea of what factors play a role in their distress, and that may feel reassuring for some clients. The most important benefit of modifying negative core beliefs is that changing these beliefs will likely result in distress reduction for most clients, by influencing the frequency and severity of negative automatic thoughts. Furthermore, modifying core beliefs can be seen as a “preventative measure” for future stressors. In the event of stress, clients will be less likely to fall back on old negative core beliefs and rather utilize more adaptive coping skills based on positive or more accurate core beliefs. Modified negative core beliefs are therefore helpful not only during the course of treatment but can still help clients after treatment is completed particularly with recognizing and changing negative automatic thoughts.

    Reply

    • Zacharie Duvarney
      Oct 17, 2019 @ 10:48:12

      Paola,

      In regards to your response about modifying core beliefs, I am glad you mentioned how core beliefs typically present as overly-positive or overly-negative. Therefore, it is not our goal to shift overly-negative core beliefs to overly-positive ones, but rather to ground these beliefs in reality (which likely exists in the middle of the continuum). In other words, we aren’t trying to imbue people with unrealistic positive expectations, we are assisting them in seeing the cognitive triad from an objective standpoint.

      You were very insightful in mentioning this aspect of core beliefs in your response.

      Reply

    • Bianca Thomas
      Oct 17, 2019 @ 12:58:22

      Paola, I absolutely agree with you that Mark’s isolation and rumination contributed and even exacerbated his automatic thoughts and even the believability he had about those thoughts, and that the score he assigned to those thoughts prove worthy and necessary of modification. I like that you chose to use the Socratic technique of removing himself from the situation, and how his girlfriend’s response to the situation could have been very beneficial in seeing how another person’s response may be suitable for him to believe, as opposed to his negative thought of “they don’t value me.”

      Reply

  5. Adam Rene
    Oct 17, 2019 @ 11:25:09

    [Automatic Thoughts]

    1. After personally completing my own negative automatic thought record, I hadn’t considered how important the outcome of the behavior is when examining automatic thoughts. I noted that since my thought occurred automatically my behavior, and thus the outcome, seemed to feel automatic as well. When I took time to reflect on the situation I noted how upset I was that this thought ruined what was a really happy evening and determined my attitude until I went to sleep that night. For Mark, I felt that I could see the disappointment and hurt in his facial expression as he reviewed his own response to this situation – I feel that Mark wants to change and approach these situations more adaptively. By examining the outcome of his actions I believe he’s starting to see how these automatic thoughts (and core beliefs) are dictating how he appraises his relationships with others.

    2. Socratic techniques I would use to help Mark modify his negative automatic thought would be questions regarding evidence for thoughts, worst/best/realistic scenarios, alternative explanations, other people or related factors. I chose the technique regarding evidence as I believe it will be more and more important for Mark to discern the evidence from his own emotional reaction or his tendency to ‘fill in the gaps’ when he begins to personalize a situation. I chose the technique regarding worst/best/realistic scenarios in particular for this automatic thought because Mark did go out to lunch, but chose to do something he purposefully didn’t enjoy because of the emotions experienced from his automatic thought. To me, this was part of a ‘worse’ case scenario and I feel it would be important to explore the ‘best’ and land at a ‘realistic’ scenario for Mark regarding the Jeff lunch situation. I chose the other people or related factors technique as it would be important for Mark to get into the habit of viewing situations from the other person’s perspective and understand if there were other people or factors that could’ve influenced that situation – such as Jeff being on a time crunch for work or having just gotten into a fight with a boss or a significant other.

    [Core Beliefs]

    1. Core beliefs, as Dr. V has in his lecture, are the templates that provide the rules for how we process information. Core beliefs are rigid and are overgeneralized – we apply them to everything we experience and how we think the world works. Core beliefs develop when we are young and are the result of several factors which range from interactions with others to biological/genetic vulnerabilities. These factors are reciprocal, which we have learned to be a constant cycle of interactions without a discernable understanding of which one influences the other or where the influence began in the first place. Core beliefs don’t necessarily all have to be bad, but it is the negative ones that really shine bright when we’re experiencing distress.

    2. Modifying negative automatic thoughts are great, but only for the short-term. By addressing the negative automatic thought I recorded for class I will be happier and more adaptive when I approach that particular situation again. Modifying core beliefs, though, is essential for long-term relief and mastery over the effects of our thoughts. Modifying a core belief, as described by Dr. V, acts as an ‘immunization’ from future negative automatic thoughts. If we can help modify and change that ‘template,’ we can modify the perception itself rather than the fleeting thoughts. If I were to work to modify the core belief I have that is tied to this automatic thought, I would’ve approached the situation that upset me more adaptively. As a CBT therapist, the better you understand your client’s core beliefs the more effective your case formulation will be. With a better case formulation comes better interventions and thus more effective therapy.

    Reply

    • Paola Gutierrez
      Oct 17, 2019 @ 11:56:20

      Adam — I appreciated how you emphasized that modifying automatic thoughts is more helpful for short-term therapeutic gains and distress reduction, but that modifying core beliefs offers therapeutic gains in the long-term. I hadn’t included that in my own response, but thinking about it helps to understand why it’s important to modify core beliefs. A CBT therapist could hypothetically stop at automatic thoughts, but without a change in core beliefs, modifying automatic thoughts will only go so far in maintaining therapeutic gains.

      Overall, a well-thought-out post!

      Reply

    • Bianca Thomas
      Oct 17, 2019 @ 12:54:03

      Adam, I really liked how you reflected on your own experience in the outcome of your own automatic thought and related that to Mark’s situation. I agree with your statement that it seems as though Mark really does want to change and become more adaptive in how he approaches situations. I also agree with your choices of Socratic techniques, using the evidence for the thought.

      Reply

    • Anthony Mastrocola
      Oct 18, 2019 @ 12:30:13

      Hi Adam,

      You made a really interesting point in your first response that particularly grabbed my attention. You noted how immediate the relation can be between automatic thoughts and behaviors. This connection does not acknowledge emotions as much. This is an interesting take that I really enjoyed thinking about, because as a class we have been discussing how effective emotions can be in identifying automatic thoughts. Sometimes thoughts can be so strong that they can elicit behaviors without maybe an easily identifiable emotional component. I personally catch myself first considering emotional responses to automatic thoughts before I consider behavioral responses. Sometimes behavioral responses can be more distressing than emotional responses.

      Reply

    • Katrina Piangerelli
      Oct 19, 2019 @ 12:34:26

      Adam, I really like the way that you refer to your own experience regarding the negative automatic thought record. I think that this allows you to relate more to Mark and the therapy session that we watched. It seems like we shared some of the same insights, with both of us recognizing how hurt Mark was in the way that he reacted during the video with his facial expressions and body language. The Socratic techniques that you refer to do seem as though they would be beneficial for Mark. The two that I chose to focus on were alternative explanations and the impact of believing the negative automatic thought. I think that the evidence for thoughts and scenarios would also be a good addition for Mark. For the question regarding the benefits of modifying negative automatic thoughts, you explained the process really well and also gave great insight into how this would be beneficial for the client. I think your focus on having the therapist focus on a client’s core beliefs is very beneficial for the client.

      Reply

  6. Anthony Mastrocola
    Oct 17, 2019 @ 11:45:46

    (1) How is the client’s response to the outcome (emotionally and cognitively) helpful to understanding his distress?

    Mark originally attempted to ask his coworker out to lunch. Unfortunately, Mark’s coworker declined, leaving Mark in a state of distress. There were some emotions and thoughts that Mark identified as responses to the declined invitation. Mark shared immediate feelings of loneliness and isolation as he ate by himself in the McDonald’s parking lot. He also felt sad and guilty for going to lunch by himself, especially at McDonald’s, a place not particularly desirable compared to the sub shop he intended to go to. Mark commonly ruminates about his negative thoughts and emotions, which results in intensified and prolonged distress. The identified thoughts and emotions that acted as immediate responses to the environment elicited a reoccurring cognitive distortion and core belief; both of which are helpful in understanding the pattern of his distress. Personalization is a cognitive distortion Mark typically utilizes when distressed. When events do not meet Mark’s expectations, he takes it personal. In this case, the declined invitation elicited Mark’s core belief of being unlikeable. Similar to the scenario where Mark’s friend cancelled dinner plans, Mark has a pattern of questioning if people value either their friendship or interactions with Mark. The belief is that people do not want to spend time with him. This core belief is reinforced whenever Mark attempts to make plans with others and they decline. Identifying and understanding this core belief is helpful for the therapist in better understanding the client’s thought processes.

    (2) What would be effective Socratic techniques to modify his negative automatic thought?

    Mark experiences some negative thoughts that elicit intense emotions of guilt, sadness, and loneliness. Stemming from a core belief of being unlikeable, Mark experiences negative thoughts about no one wanting to spend time with him, or wanting to be his friend. Affected by the cognitive distortion of personalization, Mark is impulsive in disregarding evidence, and abruptly attributing declined invitations as attacks on his value as a person. Mark has already exemplified his ability to examine the validity of his negative thoughts and weigh out other possible explanations. I think examining the evidence and determining if the automatic thoughts are invalid would be an effective Socratic technique for Mark to modify his negative automatic thoughts. This Socratic technique would pair well with the other technique of exploring other explanations Mark’s negative thoughts about his coworker not liking him is a conclusion that he jumped to that is likely invalid. With little evidence, Mark rated his believability in this thought as an 8/9 out of 10. With high believability, Mark’s emotional responses are understandable and valid. With help from the therapist, Mark would likely benefit from carefully examining the evidence, along with all of the possible explanations as to why people either cancel or decline plans with him. Another Socratic technique that would apply well to Mark’s case is shifting attributional biases. In the case of the failed dinner plans, it may be helpful for Mark to consider the possibility of his friend’s girlfriend/wife being sick and forcing the cancelled plans. In the lunch scenario, perhaps the boss assigned Mark’s coworker a large amount of work to be finished before the weekend, forcing the coworker to work through lunch. All 3 of these Socratic techniques force Mark to slow down, consider all explanations, and avoid the impulsivity that triggers his automatic thoughts.

    (1) What are core beliefs? 

    Core beliefs serve as the foundation for thoughts. Core beliefs are formed early in childhood and adolescence, and consistently shape depending on new experiences. All people have positive and negative core beliefs. Negative core beliefs have greater impact and are easier to identify during times of distress. Although rigid in nature, all people have the power to modify their core beliefs to be more accurate and adaptive, rather than inflexible, invalid, and hindering. Negative automatic thoughts are largely influenced by core beliefs that have been in place for years, and possibly have been reinforced by past experiences. Core beliefs are biased, emphasizing information that confirm the belief, and disregards any contrary evidence. If a therapist is able to identify their client’s core belief(s), then he or she will better understand the client’s thought processes. There are three categories of core beliefs, all of which explain and influence negative automatic thoughts. The three categories of core beliefs are helplessness, worthlessness, and unlovability/unlikeability.

    (2) What are the therapeutic gains that come from modifying core beliefs?

    Negative core beliefs influence the way in which individuals perceive and interpret information provided by the environment. Perceptions may be inaccurate and distorted by biased core beliefs, resulting in frequent and intense distress. Clinicians work to modify core beliefs to be more accurate and adaptive. If successful, distress would diminish, allowing clients to live a more fulfilling life. Clients that are able to understand the nature of core beliefs, as well as how to identify and modify core beliefs can use these skills after termination in the future. Clients that have already gone through this process are better prepared to identify and modify core beliefs before they fully develop and cause a large amount of distress. Lastly, modifying core beliefs allows the client to view themselves, others, and the overall environment more accurately. Negative, distorted core beliefs can cloud perception, due to bias. Through a more accurate and adaptive modification process, clients can perceive themselves, others, and the environment more accurately.

    Reply

    • Adam Rene
      Oct 17, 2019 @ 11:51:15

      Anthony –

      Thank you for your post. In particular, I wanted to comment on your statement regarding Mark’s impulsivity in disregarding evidence to his automatic thought. I thought this was really well put and for me, crafted this visual of him throwing away proof that his thought doesn’t have much (if any) utility and focusing in on what he thinks to be true – the core belief of being ‘unlikeable.’ Mark certainly seems to put up his blinders when these situations occur and flocks to what is most comfortable for him, which seems to be this belief that he is not liked by others.

      Reply

    • Paola Gutierrez
      Oct 17, 2019 @ 12:01:37

      Anthony — I appreciate how you connected the Socratic techniques you would use to modify Mark’s negative automatic thoughts to some of the cognitive distortions he has. For example, personalization would pair well with examining alternative explanations or shifting the self from the thought. Same applies for jumping to conclusions. The automatic thoughts are, by nature, impulsive in that they pop in and out, leaving an emotional weight. So yes, as you described, the techniques to modify automatic thoughts will allow him to stop and examine other (more adaptive) possibilities, which will hopefully then result in more adaptive emotional/behavioral responses and outcomes.

      Reply

    • Olivia Corfey
      Oct 17, 2019 @ 13:19:17

      Anthony,
      We share similar ideas about Mark’s cognitions, core beliefs, and the importance of gaining further understanding in a therapeutic standpoint. Your thought about using a Socratic technique of examining the evidence and determining if the automatic thoughts are valid or invalid would help the client as well as counselor to gain more information upon Mark’s distress. As Mark has made multiple attempts at making social engagements that have been canceled or declined. Exploring whether Mark’s thoughts have some validity is important in helping Mark engage in social interactions adaptively. I also agree on your point about how core beliefs can cloud perception due to bias. Negative core beliefs make seeing situations or events through an adaptive or realistic lens difficult.

      Reply

  7. Bianca Thomas
    Oct 17, 2019 @ 12:49:59

    Automatic Thoughts
    1. Mark described his thoughts as his friend not wanting to spend time with him and that the friend had no time for him, and the believability of this thought as an 8 or a 9, and his emotions as feelings hurt and rejected, with his believability of these emotions as an 8 or even a 9. He admitted that he was personalizing the situation and even mind-reading what his friend was thinking in the situation as well. Mark described that he felt lonely and isolated and that even though he still got lunch he did not feel good about himself or the situation, and he kept ruminating on the situation while he was eating by himself. This is very helpful in understanding Mark’s distress because it is evident that Mark tends to have a habit of isolating himself when he feels in distress; he withdraws himself from others and during that period of withdrawal he ruminates on the situation, eventually blaming himself (personalization) and tends to mind-read, assuming the individual does not like him or does not want to be friends with him. Mark has a history of doing these behaviors in relation to other situations where distress have occurred, such as when his friends cancelled dinner last minute, and Mark withdrew to his bedroom and played videogames.

    2. Effective Socratic techniques to help modify his negative automatic thought could include examining the evidence for the automatic thought, in which Mark would look for details within the situation to determine evidence for and against the automatic thought to decide whether the automatic thought is largely valid or invalid. Another technique applicable in this situation could be to decatastrophize the negative outcomes of the situation, by asking him questions such as “what is the worst that could happen,” “if it did happen, what effect would this have on you and how would you cope with it,” and then asking him to consider the worst, best and most realistic case scenario and his believability of each. A third possible Socratic technique applicable for this includes exploring alternative explanations in which Mark would consider what other alternatives there are to describe what happened in the situation, and the corresponding thoughts, emotions and behaviors that would go along with that alternative explanation. I think this would be highly beneficial for Mark by helping him depersonalize situations that he perceives having a negative outcome.

    Core Beliefs
    1. Core beliefs are all-or-nothing statements that are typically very rigid, global, and overgeneralized views about the self, others, and how the world “works.” These beliefs fall under three different categories, feelings of helplessness (i.e., ineffectiveness in getting things done, protecting oneself and achievement), feelings of worthlessness (e.g., bad, unworthy, or dangerous to other people), and feelings of unlovability (defective in character as so to preclude gaining the sustained love and caring of others). Examples of helplessness involve statements such as “I am helpless,” “I fail at everything I try,” “I am stuck.” Examples of worthlessness include “I am greatly flawed,” “I shouldn’t be allowed to live.” And examples of unlovability include “I am unlovable,” “I am unlikeable,” “I will never be cared for,” “I will always be alone.”

    2. Core beliefs provide the “prototypes” for how people understand information and how they take in that information from the environment. They also determine how individual cognitively process information, and behaviorally respond to the environment. Aiding clients with their negative core beliefs can help them change the way they view themselves, how they interact with other people and how they perceive their world. Modifying these beliefs can reduce or eliminate client’s overall distress by reducing the frequency or intensity of the negative automatic thoughts, and works as a sort of “immunization” by teaching clients to resist future stressors through their improved ability to recognize and modify their own negative automatic thoughts.

    Reply

    • Kara Rene
      Oct 17, 2019 @ 14:36:37

      Bianca,

      We had very similar ideas about what Socratic techniques would be useful for helping Mark examine his automatic thoughts! I agree that examining alternative explanations would help Mark to depersonalize his thoughts about the situation, and that decatastrophizing would be helpful in helping him to scale back his reactions.

      I enjoyed your description of core beliefs serve as “prototypes” for how people understand information. It is so encouraging that CBT can help clients examine and modify their core beliefs to help them become more adaptive overall!

      Reply

  8. Olivia Corfey
    Oct 17, 2019 @ 13:05:29

    (1) How is the client’s response to the outcome (emotionally and cognitively) helpful to understanding his distress?
    The negative automatic thought records help the counselor have a deeper understanding of the client’s distress. This is due to how the client responds to a thought and the emotional and cognitive components surrounding this reaction. A negative automatic thought record investigates the outcome behavior and thought, in doing so, the counselor is also able a repetitive pattern of outcomes. It is also insightful for the counselor to understand how Mark’s responses to the outcomes perpetuate into additional negative automatic thoughts, creating a cycle of consistent distress. The negative automatic thoughts record may also help the counselor to see if the client is able to identify and cognitively think through this identified thought.

    (2) What would be effective Socratic techniques to modify his negative automatic thought?
    There are many Socratic techniques that may be used to modify negative automatic thoughts. In the case of Mark, due to the perpetuation of internalization and personalization it may be beneficial to examine the evidence with Mark. This entails asking questions such as “What is the evidence that supports your thought?” and “What is the evidence against your thought?”. This technique may be useful in order to have Mark question the believability of his thought. These questions aid in realistically thinking though the event, rather than filling in holes of ambiguity. Another technique that may be helpful in the case of Mark is to explore possible alternative explanations. Mark has the tendency to jump to negative conclusions, often involving personalizing the event. By exploring possible alternative explanations, Mark may be able to see alternative possibilities that may have lead to the event or situation. This technique may help Mark to become socialized to externalizing more often.

    (1) What are core beliefs?
    Core beliefs are concrete statements that are overgeneralized and sculpture one’s view of oneself, others, and the world. There are three types of core beliefs: helplessness, worthlessness, unlovability. One core belief may even fit into all three categories of core beliefs. Negative core beliefs are typically biased. Therefore, these core beliefs only see what validates the negative belief and ignores contradictory evidence. These negative beliefs are self-perpetuating in nature. Therefore, the beliefs feed into negative automatic thoughts, maladaptive behaviors, negative emotions, and cognitive distortions. However, negative core beliefs have the potential for identification and modification. The negative belief would be replaced with a realistic and more adaptive core belief. There is potential for positive core beliefs to be used in order to modify negative core beliefs.

    (2) What are the therapeutic gains that come from modifying core beliefs?
    As core beliefs act as a lens on how we view ourselves, others, and the world, it is essential to identify and modify negative core beliefs. Modifying negative core beliefs for more adaptive and accurate core beliefs can have positive outcomes for the individual. Helping the individual view themselves, others, and the world in a more positive or accurate manner will help in reducing distress. Negative core beliefs perpetuate negative automatic thoughts, by reducing or modifying negative core beliefs, negative automatic thoughts will be reduced of modified. This may creates a domino effect with the individual. Reducing or modifying negative core beliefs and heightening positive core beliefs will reduce maladaptive behaviors, negative emotions, cognitive distortions, and negative automatic thoughts. Due to the power of core beliefs, it is essential for the therapeutic process to identify and modify negative core beliefs that are causing the individual distress.

    Reply

    • Kara Rene
      Oct 17, 2019 @ 14:41:53

      Olivia,

      You raise a good point about how examining a client’s response to an outcome helps the therapist gain insight not only into the client’s behaviors, but also whether the client’s environment is creating a pattern that impacts the client. We have talked in class about whether Mark engages in behaviors that make him less enjoyable to be around, and how if he does, this may be part of why he is continuing to report friends turning down his offers to get together or canceling plans. This could provide the therapist with valuable insight into how the client’s behaviors may be impacting their environment in a way that makes it less rewarding.

      I agree that helping Mark examine alternative explanations would be very helpful. He does have a tendency to internalize negative outcomes, so I liked your point that practicing this technique may help him begin to externalize negative outcomes more often.

      Reply

    • Anthony Mastrocola
      Oct 18, 2019 @ 12:22:03

      Hi Olivia,

      You highlighted an important aspect of identifying and modifying core beliefs. Individuals who experience distress pay extra attention to their negative core beliefs, while not particularly acknowledging their positive core beliefs. Through identification and modification of negative core beliefs, distress will decrease and the individual will function more adaptively.

      Reply

  9. Kara Rene
    Oct 17, 2019 @ 14:29:58

    Automatic Thoughts
    1. When Mark’s coworker turns down his offer to go to lunch together, Mark decides to go out by himself, but not to the restaurant he wanted to go to. While he eats by himself, Mark feels hurt and thinks about his coworker’s rejection of his offer. This reaction offers valuable information about how Mark tends to respond when circumstances do not go as he hopes they will. Mark’s reaction highlights his tendencies to isolate himself and to ruminate on negative automatic thoughts. Both patterns significantly contribute to his distress because they do not help him cope with the negative emotions he is feeling as a result of his negative automatic thoughts. Understanding this pattern gives the therapist the opportunity to help Mark understand how his reactions contribute to his distress and how changing his behavior can help him better cope with disappointing circumstances.
    2. Working with Mark to examine the evidence for his automatic thought would be a helpful technique to use to start. Based on Mark’s past behavior, it is likely that he will be able to come up with a fair amount of evidence supporting his automatic thought, so he may need some help with coming up with evidence against his automatic thought. This process may also give the therapist some valuable information about whether Mark’s behavior patterns are eliciting negative responses from his friends and coworkers. Additionally, Mark has a tendency to “fill in the gaps” of the information he receives with his own, often negative, perceptions. For this reason, I think that exploring possible alternative explanations would be particularly helpful for him. Shifting attributional biases would be a helpful technique to use in tandem with exploring possible alternative explanations.

    Core Beliefs
    1. Core beliefs are rigid and overgeneralized beliefs about oneself, others, and how the world should work. They are the template that individuals use to process all information. Core beliefs are typically formed in early childhood and are based upon life experiences from that period. Interactions with significant individuals in one’s life, significant events, and biological vulnerability all play a role in the core beliefs an individual develops. Maladaptive core beliefs tend to fall into three general categories: helplessness, worthlessness, and unlovability. Core beliefs dictate the way an individual sees themselves and the world around them and shape the nature of the automatic thoughts individuals have.
    2. Since automatic thoughts spring from core beliefs, and in turn impact how an individual acts and feels, modifying core beliefs to be more adaptive is an important part of CBT. Modifying negative core beliefs will help to reduce the number and believability of negative automatic thoughts a person experiences. This reduction will serve to reduce the amount of distress the client is experiencing. Modifying core beliefs is important not only for immediate symptom relief, but also for long-term symptom belief. By working at the root (core beliefs) of a person’s negative automatic thoughts, the CBT therapist can increase the likelihood that the client will be able to maintain positive gains after therapy is over, because the way their view themselves and the world around them has been modified to be more adaptive.

    Reply

    • Kelsey Finnegan
      Oct 19, 2019 @ 19:50:09

      Kara, I agree that Mark’s tendency to isolate himself and ruminate when he feels socially rejected is a maladaptive pattern that significantly contributes to his distress. I also think exploration of alternative explanations would be an effective Socratic technique to use with Mark because of his strong tendency to fill in the gaps with his assumption that his friends don’t want to spend time with him.

      Reply

  10. Kelsey Finnegan
    Oct 17, 2019 @ 15:11:31

    Automatic Thoughts:
    1. The MDD-12 video effectively demonstrates how automatic thought records can help clarify the origins of a client’s distress. When Jeff declined Mark’s invitation to lunch, Mark’s automatic thought was “Jeff doesn’t want to spend time with me.” As a result, Mark feels rejected and sad. These thoughts and feelings influenced his behavioral response, which was to get lunch from McDonalds and eat it alone in his car instead of going inside to the sub shop. Mark reports sitting in the car feeling sad, bad, and guilty about the outcome, which reveals that he is processing his distress via rumination. Ultimately, this event further reinforced Mark’s core belief that he is unlikable. This process also revealed that Mark has a tendency to personalize social rejection, which contributes to his core belief that he is unlikeable.
    2. Several Socratic techniques could be effectively implemented to modify Mark’s negative automatic thought that Jeff doesn’t want to spend time with him. For example, it would be beneficial to “examine the evidence” with Mark by asking him what possible evidence exists that supports his thought and what evidence exists that suggests his thought might not be true. It would also be helpful to discuss alternative explanations for Jeff’s refusal to go to lunch with him. Perhaps, Jeff just received bad news from home, or perhaps he is feeling stressed or sick. There are infinite possible reasons why Jeff was unable to go to lunch with Mark, so it will be useful to explore these with Mark. Hopefully this will help decrease the believability of Mark’s negative automatic thought.

    Core Beliefs
    1. Core beliefs are mental rules for how we process information. These rules are typically global, rigid, and overgeneralized views about the self, others, and the world. Core beliefs tend to be all-or-nothing statements that develop during childhood and adolescence. Generally, core beliefs fall under three categories: helplessness, worthlessness, and unlovability. These beliefs are negatively biased, which means individuals have a tendency to focus on evidence that supports these beliefs, and ignore or dismiss evidence that refutes them. However, the nature of core beliefs also allows for modification, and is possible to replace negative core beliefs with more accurate and adaptive ones.
    2. One important goal of CBT is to modify negative core beliefs. By helping clients change these beliefs, we can also alter the way they view themselves, others, and the world around them. This will help eliminate the client’s overall level of distress because it will reduce the frequency and intensity of their negative automatic thoughts. Typically, clients also have many positive core beliefs, but they do not spend as much time focusing on them. Therefore, it proves useful to identify these positive core beliefs and utilize and expand upon them in therapy. As a result, negative core beliefs will be balanced by the positive ones, which will loosen their hold over the client.

    Reply

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Adam M. Volungis, PhD, LMHC

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