The different types of cognitive therapies

Cognitive therapy can come under several different names: Rational Emotive Behavioral Therapy (REBT), Cognitive Behavioral Therapy (CBT), or just plain old Cognitive Therapy (CT). All are essentially the same thing with slightly different spins and techniques focused around the same principles. (The different disciplines have more to do with the legacy of the particular psychologists who founded the practice and called it their own particular thing than it does with any important distinction between these different methods.)

What is cognitive therapy?

Cognitive therapy in its many different forms involves helping a person (adult or child) reframe a negative experience in a healthier way while adopting perspectives that will eliminate emotional suffering. At this point in time, cognitive therapy is the only type of psychotherapy with a good, consistent track record for accomplishing results, and the only method with strong science behind it. It involves the type of therapeutic principles we base most of the information in our books on. Cognitive behavioral therapy involves the same basic concepts, only revolves more around changing behavioral patterns in our lives.

How does cognitive therapy work?

Cognitive therapy works so well because most of the pain we feel is not actually a direct result of our experiences. Rather, most of our mental anguish arises out of flawed perspectives and irrational beliefs about the world. By repairing these flawed perspectives and irrational beliefs, we can greatly reduce, and even eliminate, the pain we feel over past events.

Cognitive therapy works because of a simple and well-established fact: Humans do not think rationally. In fact, we’re horrible at reasoning when it comes to our personal lives. We blow events out of proportion. We adopt irrational expectations about how the world should work, and then torture ourselves when the outside world fails to conform to these flawed expectations. We let our emotions think or reason for us, even though our emotional thoughts by their very nature are always a gross distortion of reality. We assign malicious intentions to the actions of others that often aren’t there. When we don’t know everything about a given situation, we fill in the blanks with our own thoughts – thoughts that often involve catastrophic beliefs or inaccurate assumptions. Quirks in our upbringing cause us to interpret the world at large in a certain way that is neither valid nor beneficial, but based on past experiences with a select few people. We inflate the significance of all sorts of experiences in our lives with negative meaning that exists only because we create it in our mind, and we drive ourselves crazy with rigid goals that have nothing to do with our happiness. We absorb flawed information and ideals from the world around us, then adopt these beliefs as truth.

After a while our minds become a tangled web of irrational, unhealthy and unrealistic beliefs which cause conflict with one another and against life itself. We no longer see the events in our lives through a rational, uncorrupted lens; rather, every experience is distorted by this vast sea of mental baggage, and it is this mental baggage, far more than the experiences themselves, which cause most of our suffering. So when we experience negative events that cause us emotional pain, there is a tremendous amount of room to diminish this suffering merely by learning to see the situation through a more accurate, undistorted lens.

Cognitive therapy works from the understanding that mental turmoil is not so much a problem of our experiences, but a problem of flawed belief systems and the way we approach those experiences. Life can still be painful at times – no therapy can ever eliminate all pain. Cognitive therapy involves eroding all the nonsense that amplifies our painful experiences and keeps us dwelling on them long after they are over. A funny thing happens when people start to erode these mental traps: the vast majority of mental anguish melts away. People still do hurtful things from time to time, but those experiences become far less painful and far more manageable.

The Pro’s and Cons of Cognitive Therapy

The benefits of cognitive therapy

1. It’s effective, scientifically based, and has actually been proven to bring about results in randomized studies.

2. The goal is to help the patient overcome the event or fix negative patterns, which can happen in a few sessions or a few months. It’s not usually an extended or drawn out form of therapy, unless you’d like it to be.

3. Although a therapist may touch upon the past or bring up a patient’s childhood if he or she notices unhealthy thought patterns that are rooted in a patient’s history, there is generally no need to air-out unrelated dirty laundry from the past. A therapist is not going to pry into painful past events or attempt to “uncover” childhood trauma. The focus is on the present, not blaming problems on childhood traumas. So it may be a more comfortable form of therapy for those who have a difficult time talking about personal issues.

4. Because CBT involves learning about your own thought processes and gaining the ability to recognize flawed patterns of thinking, it’s as much about social education and emotional intelligence as it is interaction with the therapist. This brings two benefits. First, therapy will benefit patients in all aspects of their life, and its usefulness extends well beyond the issue at hand. Second, because its focus is on social and emotional education, it’s something patients can also self-educate themselves with, through personal reading and study. You can rely on the therapist in helping you through personal problems while supplementing their services with self-study to continue your emotional growth.

5. Cognitive therapy is the only type of therapy we can universally recommend for children and teens.

6. Cognitive therapy principles can generally be incorporated into any method, from play therapy to group therapy or family sessions.

The possible disadvantages of cognitive therapy

1. It can sometimes be difficult for overly sensitive patients, and will be disappointing for those looking to blame all their problems on their parents or the world at large. Cognitive therapy avoids the traps of blame, anger, hatred and judgment, while promoting the idea of personal responsibility over one’s own feelings and actions. Therefore it often causes friction against the defense mechanisms that some people have spent a lifetime building up. Cognitive therapy is for people who want to overcome adversity and be happy and mentally healthy, not for those who want to stay miserable while keeping their illusionary defenses. If you’re looking for a sympathetic shoulder to cry on and tell you how wrongly the world has treated you, then cognitive therapy is probably not the right fit.

2. Some cognitive therapists have cheapened the process in their attempts to provide quick fixes, and in some areas, the discipline has been streamlined too much and turned into a cookie-cutter approach to resolving problems. As beneficial as it can be, and as quickly as it can often work, you also tend to get out of it the work you put into it. Flawed patterns of thinking generally don’t change overnight. Yet some clinics have popped up trying to serve up CBT like you would order a Big Mac from McDonald’s. Be cautious about these one-size-fits-all, quick-fix approaches.

3. In studies, cognitive therapy routinely outperforms SSRI antidepressants such as Zoloft or Prozac in combating depression. Cognitive therapy routinely outperforms powerful pain medications in treating chronic pain. It has studies showing it often works better than traditional medical therapies on things like irritable bowel syndrome or sleep disturbances. In fact, throughout the research, CBT often works a little too well. Its success has had the unfortunate side-effect of causing some practitioners to overstate its benefits or apply it to medical conditions for which there is not consistent research backing its effectiveness. So be cautious about fantastical claims.

4. Children eight and younger may not have the verbal skills or cognitive processing ability to benefit from CBT, at least not without other accommodations made for their age.