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Project: CBT Lecture 4
I have the 24-lecture series from The Teaching Company on Cognitive-Behavioral Therapy. I'll take notes here, for the amusement and interest of anyone who is curious.
The entry about Lecture 3
Lecture 4: what I learned
Third-Wave Cognitive Behavioral Therapy
This course is mostly about Second Wave but here we will place the "waves" in context and explore a bit of what "third wave" is.
First wave = did he call this "traditional psychodynamics?" = before CBT
- Freud etc, symbolism, deeper meanings to everything
Second wave = cognitive model = CBT
- Event causes us to feel? Work makes me stressed, my daughter made me angry? There's a middle step here, cognitions and specifically what the previous lecture called automatic thoughts
- Habits of mind
- - Example: personalization -
- - Example: maximization (making a mountain out of a molehill)
- - Example: minimization (devaluing a compliment)
- - Example: selective filter (selective recall)
- - Example: all or none thinking (you're either an astounding success or you're nothing)
- - Example: mind-reading (we are imagining what our conversation partner REALLY means or feels)
- - Example: fortune telling (predicting what will happen in the future)
- Beliefs, causing the above automatic thoughts
- - If I don't get an A on that test, then I'm a failure
- - If I assert myself, then people will reject me
- - I'm unlovable
- - People don't care about each other
Homework: Ask yourself what are your preferred or most common habits of mind?
Homework: What are your rules? What are your core beliefs about yourself, the world, and others? Can you boil them down to lovability and achievement, as some famous dudes or other have suggested they all boil down?
Homework: DAS dysfunctional attitude scale (attitudes about ourselves etc), ATQ automatic thoughts questionnaire
"ABCD" exercise:
- A = activating event
- B = beliefs and thoughts
- C = consequences eg emotions and behaviors
- D = dispute: if you don't like those consequences, try reworking the earlier steps
- - We aren't trying to make the beliefs "false" just work on how to make them more helpful
- - We can rework behaviors as well, eg "I should find a babysitter I trust more, so I can be less worried"
Thoughts are neither true nor false, but are helpful or hurtful. We may never know how accurate they are but we can tell when they have unwanted consequences.
So that's all second wave.
Third wave = after CBT? newer and more improved CBT?
- One type of this is Acceptance and Commitment Therapy aka "ACT"
- A key skill is decentering or de-fusion
- Another type is Mindfulness Based Cognitive Therapy aka MBCT
"ACT"
- Focus on the PROCESS of cognition, not just the content. How much attention do we pay to it?
- Bus analogy: You are driving a bus (through life, hopefully in the direction of your goals and values) and people (thoughts) get on and off it. Some are positive and supportive, some are neutral, some are negative and disruptive. You can stop the bus and argue with those negative people, you can divert the bus so they'll shut up, or are you going to drive where you wanted to go?
- Psychological suffering is caused by experiential avoidance: if we're afraid of something we won't do it and this deprives us of the opportunity for learning and growth
- Psychological suffering is also caused by cognitive entanglement: we ruminate in circles and tell ourselves not to think about a white elephant until all we are thinking about is a white elephant
- Many of our core problems are due to fear, or (as an acronym) FEAR:
- - F fusion with your thoughts (instead of seeing thoughts as things that come and go but are not us)
- - E evaluation of your experience, or mis-evaluation
- - A avoidance of your experience
- - R reason for your behavior, coming up with excuses
- Contrast to ABCD in second wave, where we write down thoughts and dispute them. Here we accept them as things that come and go, and we let go of them.
ACT is equal to CBT in therapeutic efficacy
ACT is shown to be useful for a ton of things eg chronic pain, tinnitus, work stress, drug abuse...
Decentering or De-fusion
- We are different from our thoughts and our emotions
- We can choose to pay attention to them or to just let the storm blow through
- Recognizing that we aren't entangled with them and can avoid getting swept up in them is a learnable skill
- This skill is often called mindfulness
- Building this can be via meditation eg concentrating on the breath, relaxation / somatic quieting, and "a healthy dose of acceptance"
MBCT Mindfulness Based Cognitive Therapy
- Buddhist meditation meets cognitive therapy
- You can't exactly wrestle with your thoughts and accept / let go at the same time, but you can decide which skill to apply at which time
- This one looks good in restrospective studies too
The entry about Lecture 3
Lecture 4: what I learned
Third-Wave Cognitive Behavioral Therapy
This course is mostly about Second Wave but here we will place the "waves" in context and explore a bit of what "third wave" is.
First wave = did he call this "traditional psychodynamics?" = before CBT
- Freud etc, symbolism, deeper meanings to everything
Second wave = cognitive model = CBT
- Event causes us to feel? Work makes me stressed, my daughter made me angry? There's a middle step here, cognitions and specifically what the previous lecture called automatic thoughts
- Habits of mind
- - Example: personalization -
- - Example: maximization (making a mountain out of a molehill)
- - Example: minimization (devaluing a compliment)
- - Example: selective filter (selective recall)
- - Example: all or none thinking (you're either an astounding success or you're nothing)
- - Example: mind-reading (we are imagining what our conversation partner REALLY means or feels)
- - Example: fortune telling (predicting what will happen in the future)
- Beliefs, causing the above automatic thoughts
- - If I don't get an A on that test, then I'm a failure
- - If I assert myself, then people will reject me
- - I'm unlovable
- - People don't care about each other
Homework: Ask yourself what are your preferred or most common habits of mind?
Homework: What are your rules? What are your core beliefs about yourself, the world, and others? Can you boil them down to lovability and achievement, as some famous dudes or other have suggested they all boil down?
Homework: DAS dysfunctional attitude scale (attitudes about ourselves etc), ATQ automatic thoughts questionnaire
"ABCD" exercise:
- A = activating event
- B = beliefs and thoughts
- C = consequences eg emotions and behaviors
- D = dispute: if you don't like those consequences, try reworking the earlier steps
- - We aren't trying to make the beliefs "false" just work on how to make them more helpful
- - We can rework behaviors as well, eg "I should find a babysitter I trust more, so I can be less worried"
Thoughts are neither true nor false, but are helpful or hurtful. We may never know how accurate they are but we can tell when they have unwanted consequences.
So that's all second wave.
Third wave = after CBT? newer and more improved CBT?
- One type of this is Acceptance and Commitment Therapy aka "ACT"
- A key skill is decentering or de-fusion
- Another type is Mindfulness Based Cognitive Therapy aka MBCT
"ACT"
- Focus on the PROCESS of cognition, not just the content. How much attention do we pay to it?
- Bus analogy: You are driving a bus (through life, hopefully in the direction of your goals and values) and people (thoughts) get on and off it. Some are positive and supportive, some are neutral, some are negative and disruptive. You can stop the bus and argue with those negative people, you can divert the bus so they'll shut up, or are you going to drive where you wanted to go?
- Psychological suffering is caused by experiential avoidance: if we're afraid of something we won't do it and this deprives us of the opportunity for learning and growth
- Psychological suffering is also caused by cognitive entanglement: we ruminate in circles and tell ourselves not to think about a white elephant until all we are thinking about is a white elephant
- Many of our core problems are due to fear, or (as an acronym) FEAR:
- - F fusion with your thoughts (instead of seeing thoughts as things that come and go but are not us)
- - E evaluation of your experience, or mis-evaluation
- - A avoidance of your experience
- - R reason for your behavior, coming up with excuses
- Contrast to ABCD in second wave, where we write down thoughts and dispute them. Here we accept them as things that come and go, and we let go of them.
ACT is equal to CBT in therapeutic efficacy
ACT is shown to be useful for a ton of things eg chronic pain, tinnitus, work stress, drug abuse...
Decentering or De-fusion
- We are different from our thoughts and our emotions
- We can choose to pay attention to them or to just let the storm blow through
- Recognizing that we aren't entangled with them and can avoid getting swept up in them is a learnable skill
- This skill is often called mindfulness
- Building this can be via meditation eg concentrating on the breath, relaxation / somatic quieting, and "a healthy dose of acceptance"
MBCT Mindfulness Based Cognitive Therapy
- Buddhist meditation meets cognitive therapy
- You can't exactly wrestle with your thoughts and accept / let go at the same time, but you can decide which skill to apply at which time
- This one looks good in restrospective studies too