Cognitive Therapy

There are truths you have to grow into.

- H.G. Wells

Few of us have been taught how to think, and we tend to follow the thinking patterns that emerged when we were children. Alas, some of these primitive cognitive tendencies lead us to believe things that are not only untrue, but evoke self-sabotaging emotional states [This is a good time to review some classic Thinking Errors and note which ones you recognize in yourself.]

The Core Beliefs of Cognitive Therapists

Our first task as a cognitive therapy collaborators is to look at your thoughts and beliefs from the perspective of a kindly, rational observer, so you can identify the irrational thoughts and beliefs that elicit self-sabotaging emotional states. Identifying these pathogenic cognitive events is the key to escaping the recurrent self-defeating pattern of a mood disorder. Cognitive therapy does not seek to make you happy or feel safe when you are not; it seeks to free you from thinking errors that evoke negative emotional states that are so costly to you and to those around you.

Our reactions to the things that happen are determined by what we believe they mean about ourselves, other people, our future, etc. The telephone rings in the middle of the night, but there is no one on the line. Bernie reacts to this event with anger, but Barry reacts to the same event with fear. In this example the same Antecedent event produced a different Consequent emotion in these two individuals? The Antecedent event was filtered through a different Belief system and thereby resulted in a different Consequent emotion.

Certain beliefs are special: They not only have the power to transform a neutral event into powerful emotional reactions, but once elicited, these emotional reactions distort state-dependent phenomena in ways that produce outcomes that confirm the original belief. Once established a Self-Confirmatory Belief can last a lifetime. Mood Disorders that result from these beliefs are hard to change, because they are continually validated by real world events. For example, consider the effect of Barry's belief that he is socially awkward:

Barry's Self-Confirmatory Bias

Barry, a clever but socially anxious engineer, can be very funny but is inarticulate in social settings in which he feels like a loser. The appraisals: “I’m a loser,” or “I am a witty guy” exist only in Barry’s mind and not in the objective world. Nevertheless, his subjective reality influences how he behaves in the objective world.  Whether he reacts to the snide insult at the office party with a witty come back or with a humiliating silence depends to a large extent on his subjective reality at the time. His retort is more likely to be clever if he is in a confident trance than if he is in his “loser” trance. He wants to bring on the clever version of himself and enjoy a social victory for a change, but he expects to be intimidated as usual. Observers who know Barry have their predictions, but these are just the creative fictions of their minds.  Only the actions Barry performs become part of objective reality; the other expectations and possibilities will fade into oblivion.

There is a battle between the creative fictions that will determine Barry's trance at the critical moment. On one side is his intention to be the cool and clever Barry, on the other is his expectation that he will be tongue tied.  The winner of the battle will determine which version of Barry gets to be part objective reality.  The expectations have the advantage—both Barry and his audience believe them to be true. From our dispassionate perspective we can see they are both creative fictions, which are neither true nor false until Barry performs and actualizes one of them. 

Barry’s limitation does not come from outside of him, nor is it due to a slow wit.  He is handicapped by his own self-sabotaging suggestion.  In contrast to injuries that tend to heal with time, the source of Barry’s misery is Barry and so the passage of time offers no respite. Barry’s acceptance of the premise that he is socially incompetent continually recreates the conditions that confirm his worst fears.     

Another example of the power of a self-confirmatory bias on an individual's entire biography is the fact that Bernie, who believes that everyone is trying to screw him so he better screw them first, is surrounded by people who are, in fact, trying to screw him. If you knew Bernie, you'd be trying to screw him too.

Both Barry and Bernie have influenced their subjective and objective worlds unintentionally. In each case the self-fulfilling prophesy resulted from "acting as if" the pathogenic premise was true. The consequence of accepting the suggestion is that state-dependent phenomena such as perception, motivation, and response tendencies are biased in ways that bring about unwanted outcomes.

The Consequences of Bernie's Expectations

Bernie reported: “During a chaotic situation at an airport ticket counter someone kicked me in the back of the leg. When I turned around to confront the ass hole I saw a handicapped girl in a wheelchair, which had evidently rolled, out of control, down a ramp and into me. She was terrified by the rage on my face. I felt terrible.”

Bernie still cringes over this memory several years after the incident took place.

The facts that Barry often behaves incompetently is social situations, and that Bernie is continually surrounded by people who are trying to screw him confirms each of the pathogenic beliefs that cause them to act counter to their own interests.

Once you appreciate that your beliefs determine how you react to the things that happen, and that these beliefs may be completely nonsensical [see Cognitive Distortion Mechanisms], you can begin to move beyond the mentality of childhood. The Thought Record is a powerful Cognitive Therapy tool that will help you unravel the knots of your neurotic trap.

Meta-Cognitive Tool: The A-B-C Thought Record

To identify the automatic thoughts and pathogenic core beliefs that cause you to feel and act in ways that are counter to your interests, print out the A-B-C Thought Record.

We will use this tool to deconstruct the particular structure of your neurotic trap. A good place to begin is a recent situation in which your emotional reaction was excessive, considering the circumstance.


Use the first column [labeled Antecedent event] to describe the situation that triggered the emotional reaction that you are to name in the third column [labeled Consequent emotion]. You need only name the emotion  — e.g., anger, fear, frustration, and rate its intensity from 1 [very low] to 10 [strongest emotion I've ever experienced].

Now for our detective work to discover the automatic thoughts and ultimately the core belief that turns the antecedent condition into the consequent emotion in your subjective world. To do this research, we will ask several questions, but we are not looking for the logical or "right" answer, but the answer you would have given when you were in the midst of the situation.

Complete the top portion of the middle column to identify the automatic thoughts implicated in the sequence of external and internal events that produces the unwanted emotional reaction.   [you may have to ask some several times to uncover all the auto thoughts and images]:

  • What was going through my mind just before feeling this way?
  • What does it say about me?
  • What does this mean about my life, my future?
  • What am I afraid could happen?
  • What does it mean about how this person (or other people in general} think about me?
  • What does it mean about this other person (or other people in general)?
  • What images or memories does this situation trigger?

Use the bottom portion of the middle column to see if you can deduce the pathogenic core belief that lies at the heart of this neurotic trap. One strategy is to review the list of automatic thoughts and see if one stands out as the crux of this issue. Another approach is to seek the foundation for the automatic thoughts is continue following up the answer to the questions above by asking yourself questions such as: "if this thought is true, what does that mean about, me, the other, or the future?"


Complete this form by composing your hypothesis of the core belief that forms the heart of your neurotic trap.

Being rational and competent in my office is easier than being rational and competent during an emotional crises. Awakening from Doing Mode to Being Mode can free you from the frustrating emotional reactivity that denies you access to your Cognitive Processing System at the very moments when you need it most.

Characteristics of Depression and Anxiety

  • Depression is generally associated with slowing down, while anxiety is generally associated with speeding up [e.g., pounding heart, sweating].
  • Depressed individuals may lack the energy of motivation to do things they should do, while anxious individuals avoid doing things they should do.
  • The cognitive events of depressed individuals tend to be negative, hopeless, and self-critical, while those of anxious individuals tend to focus on threats, worries and catastrophic imagery.
  • Both depression and anxiety are maintained by ruminative thinking patterns. The focus of the former is the past, the focus of the latter is the future.
  • thoughts -> mood which filters input in self confirmatory way. The stronger the mood, the more potent the filter.


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