Seminars in the Psychotherapies by Jane Naismith & Sandra Grant

Author:Jane Naismith & Sandra Grant [Jane Naismith & Grant Sandra]
Language: eng
Format: epub
Publisher: RCPsych Publications
Published: 2007-03-15T00:00:00+00:00

Cognitive psychology

Teasdale (1993) states that ‘the development of cognitive therapy for depression has proceeded largely in isolation from basic cognitive science’ and draws attention to a number of problems in the conceptualisations involved in Beck’s cognitive therapy. Cognitive therapy works within a narrow definition of cognition and the emphasis is on the modification of consciously experienced thoughts and images, whereas in cognitive psychology it is assumed that the majority of cognitive processing is not experienced as consciously accessible thoughts or images.

Teasdale further challenges the basic assumption made in Beck’s cognitive therapy for depression, that certain types of cognition lead to emotional reactions, and points out that sometimes cognition appears to be a consequence of the emotional state. Patterns of negative thinking in depressed patients largely disappear when their mood improves following treatments not directly related to modification of cognitions, such as antidepressant medication.

It is suggested that there may be a reciprocal relationship between cognition and emotion. Some negative thoughts are antecedents to emotional states, which in turn increase the likelihood of those same cognitions. Further concerns expressed by Teasdale are that there has been a failure to demonstrate the persistence of dysfunctional attitudes in vulnerable people after their depression has remitted, that many patients experience emotional reactions without being able to identify proportionate negative thoughts, that rational argument is frequently ineffective in changing the emotions and that cognitive therapy is too often ineffective.

Teasdale & Barnard (1993) have developed a comprehensive theoretical framework that accommodates the knowledge of cognitive science and clinical cognitive theory, the interacting cognitive subsystems framework. This complex scheme proposes the existence of nine types of information, each representing a different aspect of experience. They propose that there are mental codes relating to two levels of meaning. The propositional code represents specific meaning and the implicational code represents generic and holistic levels of meaning. These codes are said to be directly linked to emotion and the implicational code is most important in emotional experiences. It is suggested that the central goal of therapy should be to replace implicational code patterns related to depressive schematic models with alternative patterns related to more adaptive higher level meanings.

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