Abnormal Psychology

130 CHAPTER 4

their emotional state, the outcome. For example, a rational response to Yoshi’s

automatic thought about being selfi sh might be that it is acceptable to express a

strong preference sometimes, that it doesn’t necessarily indicate selfi shness, and

that he is often very fl exible.

As shown in Figure 4.4, when a patient challenges the logic and truth of an

automatic thought and then develops a rational response, it is likely that the new

emotional state will be rated as less distressing. Sometimes, however, it is diffi cult

to challenge automatic thoughts; a patient may be so accustomed to the “truth” of

the automatic thought that he or she cannot perceive the thought as irrational or

distorted. This would be the case if Leon were unable to see why his belief that

other people will laugh at him is irrational.

The process of reorganizing how a person interprets situations and events,

which relies on dysfunctional or irrational automatic thoughts with more rational

ones, is called cognitive restructuring. The therapist helps the patient to consider the

accuracy of automatic thoughts or habitual ways of interpreting himself or herself

and the world and then to develop more realistic thoughts or interpretations.

Methods of Cognitive-Behavior Therapy

CBT relies in part on the methods developed by Ellis and Beck but also uses a variety of

additional ones. For example, CBT therapists may also employ psychoeducation,

which is the process of educating patients about research findings and therapy

procedures relevant to their situation. The therapist may provide such information

during a therapy session, may suggest a book or Web site that has relevant informa-

tion, or may give the patient reading materials to take home. This new knowledge

helps patients to develop a less distorted, more realistic understanding of their prob-

lems and to formulate more appropriate treatment goals (Cuijpers, 1998; Miklowitz

et al., 2003; Rice & Moller, 2006).

Cognitive restructuring
The process of reorganizing how a person
interprets situations and events, which
relies on replacing dysfunctional or irrational
automatic thoughts with more rational ones.

Psychoeducation
The process of educating patients about
research fi ndings and therapy procedures
relevant to their situation.

Table 4.4 • Five Common Cognitive Distortions

Cognitive Distortion Defi nition Example

Dichotomous Thinking

(also called black-and-

white thinking)

Maintaining only extremes of

an idea, as in thinking that if

you are not perfect, you are

worthless

“I’m trying to stop drinking

and I had a beer; I blew it, so

I might as well have fi ve or six

more.”

Mental Filtering Directing attention to the

negative qualities of something

while overlooking—or fi ltering

out—its positive qualities

Noticing only what you weren’t

able to accomplish on a

given day, not what you did

accomplish

Mind Reading Believing that you can tell what

other people are thinking,

particularly what they think

about you

Thinking that other people

are aware of what a failure

you are and that they can tell

that you are incompetent and

detestable

Catastrophic

Exaggeration

Thinking that the worst possible

circumstance will come to pass

and that you won’t be able to

handle it

Fearing that people will see

who you “really” are (unworthy,

incompetent, unlovable) and

you’ll never be able to show

your face again

Control Beliefs Believing that unless you

keep your life tightly under

control, things will spin totally

out of control and you will be

permanently helpless

Feeling certain that if you lose

something, bad things will

happen, which you won’t be

able to prevent or repair