What is special about the method of cognitive behavioral psychotherapy? Cognitive behavioral therapy: the main method of treating neurotic disorders.

People's experiences often include themes of hopelessness, a gloomy perception of the world, and dissatisfaction with oneself. Cognitive psychotherapy helps to identify established stereotypes by working with thinking and replacing “automatic” negative thoughts with positive ones. The patient is an active participant in the therapy process.

Cognitive therapy - what is it?

Aaron Beck, an American psychotherapist, one of the founders of the movement in 1954, studying depression within the framework of psychoanalysis, did not receive any encouraging reliable results. This is how a new direction of psychotherapeutic help for panic attacks, depression, various dependencies. Cognitive therapy is a short-term method aimed at recognizing negative thought patterns that lead a person to suffering and replacing them with constructive thoughts. The client learns new perceptions, begins to believe in himself and think positively.

Methods of cognitive psychotherapy

The psychotherapist initially negotiates and establishes a collaborative relationship with the patient. A list of target problems is formed in the order of importance of elaboration for the patient, and automatic negative thoughts are identified. Cognitive behavioral therapy methods that produce positive changes at a fairly deep level include:

• struggle with negative thoughts (“this is pointless”, “this is useless”, “nothing good will come of this”, “I don’t deserve to be happy”);
• alternative paths perception of the problem;
• rethinking or living through a traumatic experience from the past, which affects the present and does not allow the patient to adequately assess reality.

Cognitive psychotherapy techniques

The psychotherapist encourages the patient to actively participate fully in therapy. The therapist’s goal is to convey to the client that he is unhappy with his old beliefs; there is an alternative to start thinking in a new way, to take responsibility for his thoughts, state, and behavior. Homework is required. Cognitive therapy for personality disorders contains a number of techniques:

1. Tracking and recording negative thoughts and attitudes when you need to do something important action. The patient writes down on paper in order of priority the thoughts that come to him while making a decision.
2. Journaling. During the day, the thoughts that arise most often in the patient are recorded. A diary helps you track thoughts that affect your well-being.
3. Testing negative attitudes in action. If the patient claims that “he is not capable of anything,” the therapist encourages him to first take small successful actions, then complicates the tasks.
4. Catharsis. A technique for experiencing emotions from a state. If the patient is sad or in self-disagreement, the therapist suggests expressing sadness, for example, by crying.
5. Imagination. The patient is afraid or unsure of his abilities to take action. The therapist encourages you to imagine and try.
6. Three Column Method. The patient writes in the columns: situation-negative thought-corrective (positive) thought. The technique is useful for learning the skill of replacing a negative thought with a positive one.
7. Recording the day's events. The patient may believe that people are aggressive towards him. The therapist suggests keeping a list of observations, where to put “+” “-”, throughout the day with each interaction with people.

Cognitive therapy - exercises

Lasting results and success in therapy are ensured by the consolidation of new constructive attitudes and thoughts. The client completes homework and exercises that the therapist will prescribe: relaxation, tracking pleasant events, learning new behavior and self-change skills. Cognitive psychotherapy and self-confidence exercises are necessary for patients with high anxiety and depression from dissatisfaction with themselves. In the process of developing the desired “image of oneself,” a person tries on and tries different behavior options.

Cognitive therapy for social phobia

Fear and high, unreasonable anxiety prevent a person from performing his or her duties normally. social functions. Social phobia is a fairly common disorder. Cognitive psychotherapy for social phobia helps to identify the “benefits” of such thinking. Exercises are selected for the patient’s specific problems: fear of leaving the house, and so on.

Cognitive therapy for addictions

Alcoholism and drug addiction are diseases caused by a genetic factor; sometimes it is a pattern of behavior of people who do not know how to solve problems and see stress relief in the use of psychoactive substances without solving the problems themselves. Cognitive behavioral psychotherapy for addictions is aimed at identifying triggers (situations, people, thoughts) that trigger the mechanism of use. Cognitive therapy successfully helps a person cope with bad habits through awareness of thoughts, working through situations and changing behavior.

Cognitive behavioral therapy - the best books

People cannot always turn to a specialist for help. Techniques and methods of well-known psychotherapists can help you independently move towards solving some problems, but they will not replace the psychotherapist himself. Cognitive behavioral therapy books:

1. “Cognitive therapy for depression” A. Beck, Arthur Freeman.
2. “Cognitive psychotherapy for personality disorders” A. Beck.
3. “Psychotraining according to the Albert Ellis method” A. Ellis.
4. “The practice of rational-emotional behavioral psychotherapy» A. Ellis.
5. “Methods of behavioral therapy” V. Meyer, E. Chesser.
6. “Guide to cognitive behavioral therapy” by S. Kharitonov.

PHOTO Getty Images

Anxiety and depression, disorders eating behavior and phobias, problems in couples and communication - the list of questions that cognitive behavioral therapy undertakes to answer continues to grow from year to year. Does this mean that psychology has found a universal “key to all doors”, a cure for all diseases? Or are the advantages of this type of therapy somewhat exaggerated? Let's try to figure it out.

Put your psyche back in place

In the beginning there was behaviorism. This is the name of the science of behavior (hence the second name of cognitive behavioral therapy - cognitive behavioral therapy, or CBT for short). The first to raise the banner of behaviorism was the American psychologist John Watson at the beginning of the twentieth century. His theory was a response to the European fascination with Freudian psychoanalysis. The birth of psychoanalysis coincided with a period of pessimism, decadent moods and expectations of the end of the world. This was also reflected in the teachings of Freud, who argued that the source of our main problems is outside the mind - in the unconscious, and therefore it is extremely difficult to cope with them. The American approach, on the contrary, assumed some simplification, healthy practicality and optimism. John Watson believed that we need to focus on human behavior, on how we react to external stimuli. And - work to improve these very reactions. However, this approach was successful not only in America. One of the fathers of behaviorism is the Russian physiologist Ivan Petrovich Pavlov, who received the Nobel Prize for his research and studied reflexes until 1936.

Between the external stimulus and the reaction to it there is a very important authority - in fact, the person himself who reacts. More precisely, his consciousness

It soon became clear that in its desire for simplicity, behaviorism threw out the baby with the bathwater - essentially, reducing a person to a set of reactions and putting the psyche as such out of the picture. And scientific thought moved in the opposite direction. In the 1950–1960s, psychologists Albert Ellis and Aaron Beck “returned the psyche to its place,” rightly pointing out that between an external stimulus and the reaction to it there is a very important authority - in fact, the person himself who reacts.

More precisely, his consciousness. If psychoanalysis places the origins of the main problems in the unconscious, inaccessible to us, then Beck and Ellis suggested that we are talking about incorrect “cognitions” - errors of consciousness. Finding them, although not easy, is much easier than penetrating the dark depths of the unconscious. The work of Aaron Beck and Albert Ellis is considered today the foundation of cognitive behavioral therapy.

Errors of consciousness

Errors of consciousness can be different. One simple example is the tendency to view any event as having something to do with you personally. Let’s say your boss was gloomy today and greeted you through gritted teeth. “He hates me and is probably about to fire me” is a fairly typical reaction in this case. But it’s not necessarily true. We do not take into account circumstances that we simply do not know about. What if the boss’s child is sick? What if he quarreled with his wife? Or have you just been criticized at a meeting with shareholders? However, one cannot, of course, exclude the possibility that the boss really has something against you. But even in this case, repeating “What a horror, everything is lost” is also a mistake of consciousness. It is much more productive to ask yourself whether you can change something in the situation and what benefits might come from leaving your current job.

One of the errors of consciousness is the tendency to perceive all events as relevant to us personally.

This example clearly illustrates the “scope” of CBT, which does not seek to understand the mystery that was happening behind the door of our parents’ bedroom, but helps to understand a specific situation. And this approach turned out to be very effective: “No other type of psychotherapy has such a scientific evidence base,” emphasizes psychotherapist Yakov Kochetkov. He is referring to a study by psychologist Stefan G. Hofmann that supported the effectiveness of CBT methods. 1: A large-scale analysis of 269 articles, each of which in turn reviewed hundreds of publications.

“Cognitive-behavioral psychotherapy and psychoanalysis are traditionally considered the two main areas of modern psychotherapy. Thus, in Germany, in order to obtain a state certificate as a psychotherapist with the right to pay through insurance companies, you must have basic training in one of them. Gestalt therapy, psychodrama, systemic family psychotherapy, despite their popularity, are still recognized only as types of additional specialization,” note psychologists Alla Kholmogorova and Natalya Garanyan 2. In almost all developed countries, psychotherapeutic assistance and cognitive behavioral psychotherapy are almost synonymous for insurers. For insurance companies, the main arguments are scientifically proven effectiveness, a wide range of applications and a relatively short duration of therapy.

Related to the last circumstance funny story. Aaron Beck said that when he started practicing CBT, he almost went broke. Traditionally, psychotherapy lasted a long time, but after just a few sessions, many clients told Aaron Beck that their problems had been successfully resolved, and therefore they saw no point in further work. A psychotherapist's earnings have dropped sharply.

Questions for David Clark, cognitive psychotherapist

You are considered one of the pioneers of cognitive behavioral therapy. What path did she take?

I think we were able to improve a lot. We have improved the system for measuring the effectiveness of therapy and were able to understand which components are most important. It was possible to expand the scope of CBT – after all, it was initially considered only as a method of working with depression.

This therapy is attractive to authorities and insurance companies economically – a relatively short course brings a noticeable effect. What are the benefits for clients?

Exactly the same! It quickly gives positive results, allowing you to avoid spending money on going to a therapist for many years. Imagine, 5-6 sessions in many cases are enough for a noticeable effect. Moreover, often the most significant changes occur at the beginning of therapeutic work. This applies, for example, to depression, in some cases - anxiety disorders. This does not mean that the work is already done, but the patient begins to experience relief in a very short term, and this is extremely important. In general, CBT is a very focused therapy. She does not set the goal of improving the condition in general; she works with the specific problems of a particular client, be it stress, depression or something else.

How to choose a therapist who works using the CBT method?

Find someone who has completed a certified, internationally recognized training program. Moreover, one that provides supervision: the work of a therapist with an experienced colleague. You can't become a therapist by just reading a book and deciding you're ready. Our research shows that supervised therapists are much more successful. Russian colleagues who began to practice CBT had to regularly travel to the West, because they could not undergo supervision in Russia. But now the best of them are ready to become supervisors themselves and help spread our method.

Method of use

The duration of the CBT course may vary. “It is used both short-term (15-20 sessions in the treatment of anxiety disorders) and long-term (1-2 years in the case of personality disorders),” point out Alla Kholmogorova and Natalya Garanyan. But on average this is significantly less than, for example, a course of classical psychoanalysis. Which can be perceived not only as a plus, but also as a minus.

CBT is often accused of being superficial, likening it to a painkiller pill that relieves symptoms without addressing the causes of the disease. “Modern cognitive therapy begins with working with symptoms,” explains Yakov Kochetkov. – But working with deep-seated beliefs also plays a big role. We just don't think it's necessary to work with them for many years. The usual course is 15-20 meetings, not two weeks. And about half of the course is working with symptoms, and half is working with causes. In addition, working with symptoms also affects deep-seated beliefs.”

The exposure method consists of controlled exposure of the client to the very factors that are the source of problems

This work, by the way, includes not only conversations with a therapist, but also the exposure method. It consists in the controlled influence on the client of the very factors that serve as the source of problems. For example, if a person has a fear of heights, then during the course of therapy he will have to climb onto the balcony of a high-rise building more than once. First - together with a therapist, and then independently, and each time to a higher floor.

Another myth stems, apparently, from the very name of therapy: since it works with consciousness, then the therapist is a rational coach who does not show empathy and is not able to understand what concerns personal relationships. This is not true. Cognitive therapy for couples, for example, in Germany is recognized as so effective that it has the status of a state program.

In the treatment of phobias, exposure to heights is used: in reality or using computer simulation PHOTO Getty Images

Many methods in one

“CBT is not universal, it does not displace or replace other methods of psychotherapy,” says Yakov Kochetkov. “Rather, it successfully builds on the findings of other methods, each time testing their effectiveness through scientific research.”

CBT is not one, but many therapies. And today there are CBT methods for almost every disorder. For example, schema therapy was invented for personality disorders. “CBT is now successfully used in cases of psychosis and bipolar disorders,” continues Yakov Kochetkov. – There are ideas borrowed from psychodynamic therapy

. And recently, the authoritative journal The Lancet published an article about the use of CBT for patients with schizophrenia who refused to take medications. And even in this case, this method gives good results.” All this does not mean that CBT has finally established itself as “psychotherapy No. 1”. She has many critics. However, if required quick relief

in a specific situation, then 9 out of 10 experts in Western countries would recommend contacting a cognitive behavioral psychotherapist.

1 S. Hofmann et al. "The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses." Online publication in the journal Cognitive Therapy and Research dated 07/31/2012.

2 A. Kholmogorova, N. Garanyan “Cognitive-behavioral psychotherapy” (in the collection “Main directions of modern psychotherapy”, Cogito Center, 2000).

The article will be of interest to CBT specialists, as well as specialists in other areas. This is a full-fledged article about CBT in which I shared my theoretical and practical findings. The article provides step-by-step examples from practice that clearly demonstrate the effectiveness of cognitive psychology.

Cognitive behavioral therapy (CBT) is a form of psychotherapy that combines cognitive and behavioral therapy techniques. It is problem oriented and results oriented.

The main task of CBT is to find the patient’s automatic thoughts of “cognition” (which traumatize his psyche and lead to a decrease in quality of life) and direct efforts to replace them with more positive, life-affirming and constructive ones. The task facing the therapist is to identify these negative cognitions, since the person himself treats them as “ordinary” and “self-evident” thoughts and therefore accepts them as “should” and “true.”

Initially, CBT was used exclusively as an individual form of consultation, but now it is used in both family and group therapy (problems of fathers and children, married couples, etc.).

A consultation with a cognitive behavioral psychologist is an equal, mutually interested dialogue between a cognitive psychologist and a patient, where both take an active part. The therapist asks such questions, by answering which the patient will be able to understand the meaning of his negative beliefs and realize their further emotional and behavioral consequences, and then independently decide whether to continue to support them or modify them.

The main difference between CBT is that a cognitive psychotherapist “brings to light” a person’s deeply hidden beliefs, experimentally identifies distorted beliefs or phobias and tests them for rationality and adequacy. The psychologist does not force the patient to accept the “correct” point of view, listen to “wise” advice, and he does not find the “only correct” solution to the problem.

Step by step, by asking the necessary questions, he extracts useful information about the nature of these destructive cognitions and allows the patient to draw his own conclusions.

The main concept of CBT is to teach a person to independently correct his erroneous processing of information and find the right path to resolving his own psychological problems.

Goals of Cognitive Behavioral Psychotherapy

Goal 2. Teach the patient to control his negative automatic thoughts.

Goal 3. Teach the patient to independently find the connection between cognitions and their further behavior.

Goal 4. So that in the future a person can independently analyze and correctly process the information that appears.

Goal 5. In the process of therapy, a person learns to independently make a decision to replace dysfunctional destructive automatic thoughts with realistic, life-affirming ones.

CBT is not the only tool in the fight against psychological disorders, but it is one of the most effective and efficient.

Strategies for conducting consultations in CBT

Strategy 1. Empiricism of cooperation

Collaborative empiricism is a partnership process between the patient and the psychologist, as a result of which the patient's automatic thoughts are identified and they are either reinforced or refuted by various hypotheses. The meaning of empirical cooperation is as follows: hypotheses are put forward, various evidence of the usefulness and adequacy of cognitions is considered, logical analysis is carried out and conclusions are drawn, on the basis of which alternative thoughts are sought.

Strategy 2. Socratic dialogue

Socratic dialogue is a conversation in the form of questions and answers that allows you to:

• identify the problem;

• find a logical explanation for thoughts and images;

• understand the meaning of current events and how the patient perceives them;

• rate events that support cognition;

• assess the patient's behavior.

The essence of guided discovery comes down to the following: using cognitive techniques and behavioral experiments, the psychologist helps the patient clarify problematic behavior, find logical errors and develop new experiences. The patient develops the ability to correctly process information, think adaptively and respond adequately to what is happening. Thus, after consultation, the patient copes with the problems independently.

Cognitive therapy techniques

Step 1: Identifying Automatic Thoughts

Negative destructive cognitions are thoughts that constantly “spin in the head”, do not allow you to adequately respond to what is happening, are emotionally exhausting, cause physical discomfort, destroy a person’s life and knock him out of society.

“Filling the Void” Technique

To identify (identify) cognitions, the cognitive technique “Filling the Void” is widely used. The psychologist divides the past event that caused the negative experience into the following points:

A – event;

B – unconscious automatic thoughts “emptiness”;

C – inadequate reaction and further behavior.

The essence this method consists in the fact that, with the help of a psychologist, the patient fills the “emptiness” between the event that occurred and the inadequate reaction to it, which he cannot explain to himself and which becomes a “bridge” between points A and C.

Case study: The man experienced incomprehensible anxiety and shame in a large company and always tried to either sit unnoticed in the corner or quietly leave. I divided this event into points: A - you need to go to general meeting; B – unexplained automatic thoughts; S – feeling of shame.

It was necessary to identify cognitions and thereby fill the void. After questions asked and the responses received, it turned out that the man’s cognitions are “doubts about his appearance, ability to carry on a conversation and insufficient sense of humor.” The man was always afraid of being ridiculed and looking stupid, and therefore after such meetings he felt humiliated.

Thus, after a constructive dialogue-questioning, the psychologist was able to identify negative cognitions in the patient; they discovered an illogical sequence, contradictions and other erroneous thoughts that “poisoned” the patient’s life.

Step 2. Correcting automatic thoughts

“Decatastrophizing”, “Reframing”, “Decentralization” and “Reattribution”.

Quite often, people are afraid of looking ridiculous and funny in the eyes of their friends, colleagues, classmates, fellow students, etc. However existing problem"look ridiculous" goes further and extends to strangers, i.e. a person is afraid of being ridiculed by salespeople, fellow travelers on the bus, or passers-by.

Constant fear forces a person to avoid people and lock himself in a room for a long time. Such people withdraw from society and become unsociable loners so that negative criticism does not damage their personality.

The essence of decatastrophizing is to show the patient that his logical conclusions are incorrect. The psychologist, having received an answer to his first question from the patient, asks the next one in the form of “What if...”. By answering the following similar questions, the patient realizes the absurdity of his cognitions and sees real actual events and consequences. The patient becomes prepared for possible “bad and unpleasant” consequences, but no longer experiences them so critically.

An example from the practice of A. Beck:

Patient. I have to speak to my group tomorrow and I'm scared to death.

Therapist. What are you afraid of?

Patient. I think I'll look stupid.

Therapist. Let's assume you really will look stupid. What's bad about it?

Patient. I won't survive this.

Therapist. But listen, suppose they laugh at you. Are you really going to die from this?

Patient. Of course not.

Therapist. Suppose they decide that you are the worst speaker that ever existed... Will that ruin your future career?

Patient. No... But it's good to be a good speaker.

Therapist. Of course not bad. But if you fail, will your parents or wife really disown you?

Patient. No... they will be sympathetic.

Therapist. So what's the worst thing about this?

Patient. I'll feel bad.

Therapist. How long will you continue to feel bad?

Patient. A day or two.

Therapist. And then?

Patient. Then everything will be in order.

Therapist. You are afraid that your destiny is at stake.

Patient. Right. I feel like my entire future is at stake.

Therapist. So, somewhere along the way, your thinking fails... and you tend to view any failure as if it were the end of the world... You need to actually label your failures as failures to achieve a goal, rather than as a terrible disaster, and begin to challenge your false premises.

At the next consultation, the patient said that he spoke in front of an audience and his speech (as he expected) was awkward and upset. After all, the day before he was very worried about its result. The therapist continued questioning the patient, paying special attention to how he imagines failure and what he associates with it.

Therapist. How are you feeling now?

Patient. I'm feeling better... but I've been broken for a few days.

Therapist. What do you think now about your opinion that awkward speech is a disaster?

Patient. Of course, this is not a disaster. It's unpleasant, but I'll get through it.

This moment of consultation is the main part of the “Decatastrophization” technique, in which the psychologist works with his patient in such a way that the patient begins to change his idea of ​​the problem as an imminent catastrophe.

After some time, the man spoke again to the public, but anxious thoughts this time it was much less and he delivered the speech more calmly with less discomfort. Coming to the next consultation, the patient agreed that he attached too much importance to the reactions of people around him.

Patient. During the last performance I felt much better... I think it's a matter of experience.

Therapist. Have you had any glimmer of awareness that most of the time it doesn't really matter what people think of you?

Patient. If I'm going to become a doctor, I need to make a good impression on my patients.

Therapist. Whether you are a bad doctor or a good one depends on how well you diagnose and treat your patients, not on how well you perform in public.

Patient. Okay... I know that my patients are doing well, and I think that's what matters.

The next consultation was aimed at looking more closely at all of these maladaptive automatic thoughts that cause such fear and discomfort. As a result, the patient said the following phrase:

“I now see how ridiculous it is to worry about the reactions of complete strangers. I'll never see them again. So, what difference does it make what they think of me?”

For the sake of this positive replacement, the cognitive technique “Decatastrophization” was developed.

Technique 2: Reframing

Reframing comes to the rescue in cases where the patient is sure that the problem is beyond his control. A psychologist helps you reframe negative automatic thoughts. It is quite difficult to make a thought “correct” and therefore the psychologist must ensure that the patient’s new thought is specific and clearly defined in terms of his further behavior.

Case study: A sick, lonely man came in, who was sure that no one needed him. After the consultation, he was able to reformulate his cognitions into more positive ones: “I should be more social” and “I should be the first to tell my relatives that I need help.” Having done this in practice, the pensioner called and said that the problem disappeared by itself, since his sister began to look after him, who did not even know about the deplorable state of his health.

Technique 3. Decentralization

Decentralization is a technique that frees the patient from the belief that he is the center of events happening around him. This cognitive technique is used for anxiety, depression and paranoid states, when a person’s thinking is distorted and he tends to personalize even what has nothing to do with him.

Case study: The patient was sure that at work everyone was watching how she carried out instructions, so she experienced constant anxiety, discomfort and felt disgusting. I suggested that she conduct a behavioral experiment, or rather: tomorrow, at work, not to focus on her emotions, but to observe her employees.

Arriving at the consultation, the woman said that everyone was busy with their own business, some were writing, and some were surfing the Internet. She herself came to the conclusion that everyone was busy with their own affairs and she could be calm that no one was watching her.

Technique 4. Reattribution

Reattribution applies if:

• the patient blames himself for “all the misfortunes” and unfortunate events that happen. He identifies himself with misfortune and is sure that it is he who brings them and that he is the “source of all troubles.” This phenomenon is called “Personalization” and it has nothing to do with real facts and evidence, a person simply says to himself: “I am the cause of all misfortunes and that’s all, what else can you think about?”;

• if the patient is sure that the source of all troubles is one specific person, and if it weren’t for “he”, then everything would be fine, but since “he” is nearby, then don’t expect anything good;

• if the patient is sure that the basis of his unhappiness is some single factor (unlucky number, day of the week, spring, wearing the wrong T-shirt, etc.)

Treatment of an anxious patient during consultation with a cognitive psychologist

In order to clearly demonstrate the work of a cognitive psychologist and the effectiveness behavioral techniques Let us give an example of treatment of an anxious patient, which took place over 3 consultations.

Consultation No. 1

Stage 1. Introduction and familiarization with the problem

Institute student before exams, important meetings And sports competitions had difficulty falling asleep at night and woke up frequently; during the day he stuttered, felt trembling in his body and nervousness, was dizzy and had a constant feeling of anxiety.

The young man said that he grew up in a family where his father told him from childhood that he needed to be “the best and the first in everything.” Their family encouraged competition, and since he was the first child, they expected him to win in school and sports, so that he could be a “role model” for his younger brothers. The main words of instruction were: “Never allow anyone to be better than you.”

Today the guy has no friends, since he mistakes all his fellow students for competitors, and he has no girlfriend. Trying to attract attention to himself, he tried to seem “cooler” and “more respectable” by inventing fables and stories about non-existent exploits. He could not feel calm and confident in the company of the guys and was constantly afraid that the deception would be revealed and he would become a laughing stock.

Consultations

The patient's questioning began with the therapist identifying his negative automatic thoughts and their impact on behavior, and how these cognitions could drive him into a depressed state.

Therapist. What situations upset you the most?

Patient. When I fail in sports. Especially in swimming. And also when I make mistakes, even when playing cards with the guys in the room. I get very upset if a girl rejects me.

Therapist. What thoughts run through your head when, say, you fail at something in swimming?

Patient. I think that people pay less attention to me if I'm not at my best, not a winner.

Therapist. What if you make mistakes when playing cards?

Patient. Then I doubt my intellectual abilities.

Therapist. What if a girl rejects you?

Patient. This means that I am ordinary... I am losing value as a person.

Therapist. Don't you see the connection between these thoughts?

Patient. Yes, I think my mood depends on what other people think of me. But this is so important. I don't want to be lonely.

Therapist. What does it mean to you to be single?

Patient. This means that there is something wrong with me, that I am a failure.

At this point, the questioning temporarily stops. The psychologist begins, together with the patient, to build a hypothesis that his value as a person and his personal self are determined by strangers. The patient completely agrees. Then they write on a piece of paper the goals that the patient wants to achieve as a result of the consultation:

• Reduce anxiety levels;

• Improve the quality of night sleep;

• Learn to interact with other people;

• Become morally independent from your parents.

In the morning he goes to the exam without sleep, begins to worry and begins to experience all the above-described symptoms of neurosis. Then the psychologist asked to answer one question: “What is the benefit of constantly thinking about the exam, day and night?”, to which the patient replied:

Patient. Well, if I don't think about the exam, I might forget something. If I constantly think, I will be better prepared.

Therapist. Have you ever been in a situation where you were “underprepared”?

Patient. Not in the exam, but I once took part in a big swimming competition and was with friends the night before and wasn't thinking. I returned home, went to bed, and in the morning I got up and went swimming.

Therapist. So how did it turn out?

Patient. Wonderful! I was in shape and swam pretty well.

Therapist. Based on this experience, do you think there is reason to worry less about your performance?

Patient. Yes, probably. It didn't hurt me that I didn't worry. In fact, my anxiety only makes me sad.

As can be seen from the final phrase, the patient independently, through logical inference, came to a reasonable explanation and abandoned the “mental chewing gum” about the exam. Next step became a refusal of maladaptive behavior. The psychologist suggested using progressive relaxation to reduce anxiety and taught how to do it. The following dialogue-question followed:

Therapist. You mentioned that when you worry about exams, you experience anxiety. Now try to imagine that you are lying in bed the night before an exam.

Patient. Okay, I'm ready.

Therapist. Imagine thinking about an exam and deciding that you didn't prepare enough.

Patient. Yes, I did.

Therapist. What do you feel?

Patient. I feel nervous. My heart starts pounding. I think I need to get up and exercise some more.

Therapist. Fine. When you think you are unprepared, you become anxious and want to get up. Now imagine lying in bed the night before an exam and thinking about how well you prepared and knew the material.

Patient. Fine. Now I feel confident.

Therapist. Here! See how your thoughts influence your feelings of anxiety?

The psychologist suggested that the young man write down his cognitions and recognize distortions. He had to write down in a notebook all the thoughts that visited him before an important event, when he became nervous and could not sleep peacefully at night.

Consultation No. 2

The consultation began with a discussion of homework. Here are some interesting thoughts the student wrote down and brought to the next consultation:

• “Now I’ll think about the exam again”;

• “No, now thoughts about the exam no longer matter. I'm prepared";

• “I left time in reserve, so I have it. Sleep is not so important to worry about. You need to get up and read everything again”;

• “I need to sleep now! I need eight hours of sleep! Otherwise I will be exhausted again.” And he imagined himself floating in the sea and fell asleep.

Result of the first consultation: the first 2 goals were achieved (reduce anxiety levels and improve the quality of night sleep).

Stage 2. Research part

Therapist. If someone ignores you, could there be other reasons than that you are a loser?

Patient. No. If I can't convince them that I'm important, I won't be able to attract them.

Therapist. How do you convince them of this?

Patient. To tell the truth, I exaggerate my successes. I lie about my grades in class or say I won a competition.

Therapist. And how does it work?

Patient. Not very good actually. I am embarrassed and they are embarrassed by my stories. Sometimes they don't pay much attention, sometimes they leave me after I say too much about myself.

Therapist. So in some cases they reject you when you attract their attention to you?

Patient. Yes.

Therapist. Does it have anything to do with whether you're a winner or a loser?

Patient. No, they don't even know who I am inside. They just turn away because I talk too much.

Therapist. It turns out that people react to your speaking style.

Patient. Yes.

The psychologist stops the questioning when he sees that the patient is beginning to contradict himself and needs to point this out, so the third part of the consultation begins.

Stage 3. Corrective action

The conversation started with “I’m insignificant, I won’t be able to attract”, and ended with “people react to the style of conversation.” Thus, the therapist shows that the problem of inferiority has smoothly turned into a problem of social inability to communicate. In addition, it became obvious that for the young man the most pressing and painful topic seems to be the topic of “loser” and this is his main belief: “No one needs or is interested in losers.”

Here the roots were clearly visible from childhood and constant parental teaching: “Be the best.” After a couple more questions, it became clear that the student considers all his successes solely due to his merits parenting, not his personal ones. This infuriated him and deprived him of confidence in his abilities. It became clear that these negative cognitions needed to be replaced or modified.

Stage 4. Ending the conversation ( homework)

It was necessary to focus on social interaction with other people and understand what was wrong with his conversations and why he ended up alone. Therefore, the next homework assignment was this: in conversations, ask more questions about the affairs and health of the interlocutor, restrain yourself if you want to embellish your successes, talk less about yourself and listen more about the problems of others.

Consultation No. 3 (final)

Stage 1. Discussion of homework

The young man said that after all the tasks were completed, the conversation with his classmates went in a completely different direction. He was very surprised how other people sincerely admit their mistakes and are indignant at their mistakes. That many people simply laugh at mistakes and openly admit their shortcomings.

Such a small “discovery” helped the patient understand that there is no need to divide people into “successful” and “losers”, that everyone has their own “cons” and “pros” and this does not make people “better” or “worse”, they they are just the way they are and that makes them interesting.

Result of the second consultation: achievement of the 3rd goal “Learn to interact with other people.”

Stage 2. Research part

It remains to complete point 4: “Become morally independent of your parents.” And we began a questioning dialogue:

Therapist: How does your behavior affect your parents?

Patient: If my parents look good, then it says something about me, and if I look good, then it honors them.

Therapist: List the characteristics that distinguish you from your parents.

The final stage

The result of the third consultation: the patient realized that he was very different from his parents, that they were very different, and he said a key phrase, which was the result of all our joint work:

"Understanding that my parents and I - different people, brings me to the realization that I can stop lying."

The final result: the patient freed himself from standards and became less shy, learned to cope with depression and worries on his own, and made friends. Most importantly, he learned to set moderate, realistic goals for himself and found interests that had nothing to do with achievement.

In conclusion, I would like to note that cognitive-behavioral psychotherapy is an opportunity to replace deep-rooted dysfunctional beliefs with functional ones, irrational thoughts with rational ones, rigid cognitive-behavioral connections with more flexible ones, and teach a person to independently process information adequately.

Depression, anxiety, phobias and others mental disorders quite difficult to cure traditional methods forever.

Drug treatment only relieves symptoms, not allowing a person to become completely mentally healthy. Psychoanalysis may be effective, but it will take years (from 5 to 10) to obtain a sustainable result.

Cognitive-behavioral direction in therapy is young, but really working for healing with a form of psychotherapy. It allows people to a short time(up to 1 year) get rid of despondency and stress by replacing destructive patterns of thinking and behavior with constructive ones.

What is human cognitive development? Find out about this from ours.

Concept

Cognitive methods in psychotherapy work with the patient's thinking model.

The goal of cognitive therapy is awareness and correction of destructive patterns (mental schemes).

The result of treatment is a complete or partial (at the request of the patient) personal and social adaptation of a person.

People faced with unusual or painful events in different periods life, often react negatively, creating tension in the body and brain centers responsible for receiving and processing information. At the same time, hormones are released into the blood, causing suffering and mental pain.

In the future, such a thinking pattern is reinforced by repetition of situations, which leads to. A person ceases to live in peace with himself and the world around him, creating your own hell.

Cognitive therapy teaches you to react more calmly and relaxed to inevitable changes in life, turning them into a positive direction with creative and calm thoughts.

Advantage of the method- work in the present tense, without focusing on:

• events in the past;
• the influence of parents and other close people;
• feelings of guilt and regret about lost opportunities.

Cognitive therapy allows take fate into your own hands, freeing yourself from harmful addictions and unwanted influence of others.

For successful treatment It is advisable to combine this method with behavioral, that is, behavioral.

What is cognitive therapy and how does it work? Find out about it in the video:

Cognitive-behavioral approach

Cognitive behavioral therapy works with the patient in a comprehensive manner, combining the creation of constructive mental attitudes with new behaviors and habits.

This means that every new mental attitude must be supported by specific action.

This approach also allows us to identify destructive patterns of behavior, replacing them with healthy or safe for the body.

Cognitive, behavioral and combination therapy can be used either under the supervision of a specialist or independently. But still, at the very beginning of the journey, it is advisable to consult with a professional to develop the right treatment strategy.

Areas of application

The cognitive approach can be applied to all people who feel unhappy, unsuccessful, unattractive, unsure of themselves etc.

An attack of self-torture can happen to anyone. Cognitive therapy in this case can reveal the thinking pattern that served as the trigger for creating bad mood, replacing it with a healthy one.

This approach is also used for the treatment of the following mental disorders:

Cognitive therapy can remove difficulties in relationships with family and friends, as well as teach how to establish and maintain new connections, including with the opposite sex.

What does cognitive science study? find out right now.

Aaron Beck's opinion

American psychotherapist Aaron Temkin Beck (Professor of Psychiatry at the University of Pennsylvania) is the author of cognitive psychotherapy. He specializes in the treatment of depressive conditions, including with suicidal tendencies.

The basis of the approach of A.T. Beck took the term (the process of processing information by consciousness).

The decisive factor in cognitive therapy is the correct processing of information, as a result of which an adequate behavioral program is consolidated in a person.

Patient undergoing treatment according to Beck must change the way I look at myself, your life situation and tasks. In this case, you need to go through three stages:

• admit your right to make mistakes;
• abandon erroneous ideas and worldviews;
• correct thought patterns (replace inadequate ones with adequate ones).

A.T. Beck believes that only correcting faulty thinking patterns can create life with more high level self-realization.

The creator of cognitive therapy himself effectively applied its techniques to himself when, after successfully curing patients, his income level significantly decreased.

The patients recovered quickly without relapses, getting back to health and happy life , which adversely affected the doctor’s bank account.

After analyzing thinking and correcting it, the situation changed for the better. Cognitive therapy suddenly became fashionable, and its creator was asked to write a series of books for a wide range of users.

Aaron Beck: goals and objectives of cognitive psychotherapy. Practical examples in this video:

Cognitive behavioral psychotherapy

After this work, methods, techniques and exercises of cognitive behavioral therapy are used that cause positive changes in a person's life.

Methods

Methods in psychotherapy are ways to achieve a goal.

In the cognitive behavioral approach these include:

1. Removing (erasing) thoughts that destroy fate(“I won’t succeed”, “I’m a loser”, etc.).
2. Creating an adequate worldview(“I’ll do it. If it doesn’t work out, it’s not the end of the world,” etc.).

When creating new thought forms it is necessary look at problems realistically. This means that they may not resolve as planned. This fact should also be calmly accepted in advance.

1. Reviewing painful past experiences and assessing the adequacy of their perception.
2. Consolidating new thought forms with actions (practice of communicating with people for a sociopath, nutritious nutrition for an anorexic, etc.).

The methods of this type of therapy are used to solve real problems in the present time. An excursion into the past is necessary only to create an adequate assessment of the situation in order to creation healthy model thinking and behavior.

You can read more about the methods of cognitive behavioral therapy in the book by E. Chesser, V. Meyer, “Methods of Behavioral Therapy.”

Technicians

A distinctive feature of cognitive behavioral therapy is the need active patient participation in your healing.

The patient must understand that his suffering is created by incorrect thoughts and behavioral reactions. It is possible to become happy by replacing them with adequate thought forms. To do this you need to do next row technician.

You can learn about what the cognitive sphere of personality is from ours.

Diary

This technique will allow you to track the most frequently repeated phrases that create problems in your life.

1. Identifying and recording destructive thoughts when solving any problem or task.
2. Checking a destructive attitude with a specific action.

For example, if the patient claims that “he won’t succeed,” then he should do what he can and write it down in a diary. Next day recommended perform a more complex action.

Why keep a diary? Find out from the video:

Catharsis

In this case, the patient needs to allow himself to express feelings that he previously forbade himself, considering them bad or unworthy.

For example, cry, express aggression(in relation to a pillow, mattress), etc.

Visualization

Imagine that the problem has already been solved and remember emotions, which appeared at the same time.

The techniques of the described approach are discussed in detail in the books:

1. Judith Beck, Cognitive Therapy. Complete Guide"
2. Ryan McMullin "Cognitive Therapy Workshop"

Methods of cognitive behavioral psychotherapy:

Cognitive dissonance - what is it in simple words? is on our website.

Exercises to do on your own

To correct your thinking, behavior and solve problems that seem insoluble, you don’t have to immediately turn to a professional. You can try the following exercises first:

The exercises are discussed in great detail in the book. S. Kharitonova"Manual of Cognitive Behavioral Therapy."

Also, when treating depression and other mental disorders, it is advisable to master several relaxation exercises, using auto-training techniques and breathing exercises.

additional literature

Cognitive behavioral therapy - young and very interesting approach not only for the treatment of mental disorders, but also for creating a happy life at any age, regardless of the level of well-being and social success. For more in-depth study or self-study, the following books are recommended:

Cognitive behavioral therapy is based on worldview correction, which is a series of beliefs (thoughts). For successful treatment, it is important to recognize the incorrectness of the formed thinking model and replace it with a more adequate one.

The foundation of cognitive behavioral therapy (CBT) was laid by the eminent psychologist Albert Ellis and psychotherapist Aaron Beck. Originating in the sixties of the last century, this technique is recognized in academic communities as one of the most effective methods psychotherapeutic treatment.

Cognitive behavioral therapy is a universal method of helping people suffering from various disorders of the neurotic and mental levels. The authority of this concept is added by the overriding principle of the methodology - unconditional acceptance of personality characteristics, a positive attitude towards each person while maintaining healthy criticism of the subject’s negative actions.

Cognitive behavioral therapy methods have helped thousands of people who suffered from various complexes, depression, and irrational fears. The popularity of this technique explains the combination of obvious advantages of CBT:

• guarantee of achieving high results and complete solution existing problem;
• long-term, often lifelong persistence of the resulting effect;
• short course of therapy;
• understandability of the exercises for the average citizen;
• simplicity of tasks;
• the ability to perform exercises recommended by a doctor independently in the comfort of your own home;
• a wide range of techniques, the ability to be used to overcome various psychological problems;
• no side effects;
• non-traumatic and safe;
• using the body's hidden resources to solve a problem.

Cognitive behavioral therapy has shown high results in the treatment of various disorders of the neurotic and psychotic level. CBT methods are used in the treatment of affective and anxiety disorders, neurosis obsessive states, problems in the intimate sphere, abnormalities in eating behavior. CBT techniques bring excellent results in the treatment of alcoholism, drug addiction, gambling addiction, and psychological addictions.

general information

One of the features of cognitive behavioral therapy is the division and systematization of all personal emotions into two broad groups:

• productive, also called rational or functional;
• unproductive, called irrational or dysfunctional.

The group of unproductive emotions includes the destructive experiences of an individual, which, according to the concept of CBT, are a consequence of a person’s irrational (illogical) beliefs and beliefs - “irrational beliefs”. According to proponents of cognitive behavioral therapy, all unproductive emotions and the associated dysfunctional pattern of individual behavior are not a reflection or result of the subject’s personal experience. All irrational components of thinking and the unconstructive behavior associated with them are a consequence of a person’s incorrect, distorted interpretation of his real experience. According to the authors of the methodology, the real culprit of all psycho-emotional disorders is the distorted and destructive belief system present in the individual, which was formed as a result of the individual’s incorrect beliefs.

The foundation of cognitive behavioral therapy is based on these ideas, the main concept of which is as follows: the emotions, feelings and behavior patterns of the subject are determined not by the situation itself in which he finds himself, but by how he perceives the current situation. The main strategy of CBT is based on these considerations - to identify and identify dysfunctional experiences and stereotypes, and then replace them with rational, useful, realistic feelings, taking full control of your train of thought.

By changing your personal attitude towards some factor or phenomenon, replacing a rigid, rigid, unconstructive life strategy with flexible thinking, a person will gain an effective worldview.

Emerging functional emotions will improve the psycho-emotional state of the individual and ensure excellent well-being under any life circumstances. On this basis it was formulated conceptual model of cognitive behavioral therapy, presented in an easy-to-understand ABC formula, where:

• A (activating event) – a certain event occurring in reality that is a stimulus for the subject;
• B (belief) – a system of personal beliefs of an individual, a cognitive construct that reflects the process of a person’s perception of an event in the form of emerging thoughts, formed ideas, formed beliefs;
• C (emotional consequences) – final results, emotional and behavioral consequences.

Cognitive-behavioral therapy is focused on identifying and subsequently transforming distorted components of thinking, which ensures the formation of a functional behavioral strategy for the individual.

Treatment process

The treatment process using cognitive behavioral therapy techniques is a short-term course, including from 10 to 20 sessions. Most patients see a therapist no more than twice a week. After the face-to-face meeting, clients are given a little “homework,” which includes performing specially selected exercises and additional familiarization with educational literature.

CBT treatment involves the use of two groups of techniques: behavioral and cognitive.

Let's take a closer look at cognitive techniques. They are aimed at identifying and correcting dysfunctional thoughts, beliefs, and ideas. It should be noted that irrational emotions interfere with a person’s normal functioning, change a person’s thinking, and force them to make and follow illogical decisions. Affective, unproductive feelings that go off scale in amplitude lead to the individual seeing reality in a distorted light. Dysfunctional emotions deprive a person of control over himself and force him to commit reckless acts.

Cognitive techniques are conventionally divided into several groups.

Group one

The goal of the first group of techniques is to track and understand your own thoughts. The following methods are most often used for this.

Recording your own thoughts

The patient receives the task: to express on a piece of paper the thoughts that arise before and during the performance of any action. In this case, it is necessary to record thoughts strictly in the order of their priority. This step will indicate the significance of certain motives of a person when making a decision.

Keeping a Thought Journal

The client is advised to briefly, concisely and accurately record all thoughts that arise in a diary over several days. This action will allow you to find out what a person thinks about most often, how much time he spends thinking about these thoughts, how much certain ideas bother him.

Distance from dysfunctional thoughts

The essence of the exercise is that a person must develop an objective attitude towards his own thoughts. In order to become an impartial "observer", he needs to distance himself from the ideas that arise. Detachment from your own thoughts involves three components:

• awareness and acceptance of the fact that a non-constructive thought arises automatically, an understanding that the idea that is now overwhelming was formed earlier under certain circumstances, or that it is not one’s own product of thinking, but is imposed from the outside by outsiders;
• awareness and acceptance that stereotypical thoughts are dysfunctional and interfere with normal adaptation to existing conditions;
• doubt about the truth of the emerging non-adaptive idea, since such a stereotypical construct contradicts the existing situation and does not correspond in its essence to the emerging requirements of reality.

Group two

The task of the second group of techniques is to challenge existing dysfunctional thoughts. To do this, the patient is asked to perform the following exercises.

Exploring the pros and cons of stereotypical thoughts

A person studies his own maladaptive thoughts and writes down on paper the arguments for and against. The patient is then advised to re-read his notes daily. With regular practice, the “correct” arguments will become firmly established in the human mind over time, and the “wrong” ones will be eliminated from thinking.

Weighing the advantages and disadvantages

This exercise is not about analyzing your own unconstructive thoughts, but about studying existing solution options. For example, a woman compares what is more important to her: maintaining her own safety by not having contact with people of the opposite sex, or allowing some risk into her life in order to ultimately create a strong family.

Experiment

This exercise requires that a person experimentally and through personal experience comprehend the result of demonstrating this or that emotion. For example, if the subject does not know how society reacts to the manifestation of his anger, he is allowed to express his emotion in full force, directing it towards the therapist.

Return to the past

The essence of this step is a frank conversation with impartial witnesses of events that happened in the past that left a mark on the human psyche. This technique is especially effective for disorders mental sphere, in which memories are distorted. This exercise is relevant for those who have misconceptions that are the result of an incorrect interpretation of the motives driving other people.

This step involves presenting to the patient arguments drawn from scientific literature, official statistical data, and the doctor’s personal experience. For example, if a patient is afraid of air travel, the therapist points him to objective international reports, according to which the number of accidents when using airplanes is significantly lower in comparison with accidents that occur on other types of transport.

Socratic method (Socratic dialogue)

The doctor’s task is to identify and point out to the client logical errors and obvious contradictions in his reasoning. For example, if a patient is convinced that he is destined to die from a spider bite, but at the same time claims that he has been bitten by this insect before, the doctor points out the contradiction between anticipation and the real facts of personal history.

Changing your mind - re-evaluating the facts

The purpose of this exercise is to change a person’s existing point of view on current situation by testing whether alternative causes of the same event would have had the same effect. For example, the client is asked to reflect and discuss whether this or that person could have treated him in a similar way if she had been guided by other motives.

Reducing the significance of results - decatastrophizing

This technique involves developing the patient’s maladaptive thoughts to a global scale for subsequent devaluation of its consequences. For example, to a person who is terrified of leaving his own home, the doctor asks questions: “In your opinion, what will happen to you if you go outside?”, “How strongly and for how long will negative feelings overcome you?”, “What will happen then? Are you going to have a seizure? Will you pass away? Will people die? Will the planet end its existence? A person understands that his fears in a global sense are not worth attention. Awareness of the time and space framework helps eliminate fear of the imagined consequences of a disturbing event.

Softening the intensity of emotions

The essence of this technique is to conduct an emotional reassessment of a traumatic event. For example, the injured person is asked to summarize the situation by saying to himself the following: “It’s a pity that such a fact happened in my life. However, I won't allow

this event will control my present and ruin my future. I'm putting trauma behind me." That is, the destructive emotions that arise in a person lose the power of affect: resentment, anger and hatred are transformed into softer and more functional experiences.

Role reversal

This technique involves an exchange of roles between the doctor and the client. The patient is given the task of convincing the therapist that his thoughts and beliefs are maladaptive in nature. Thus, the patient himself becomes convinced of the dysfunctionality of his judgments.

Postponing ideas

This exercise is suitable for those patients who cannot give up their unrealizable dreams, unrealistic desires and unrealistic goals, but thinking about them makes him feel uncomfortable. The client is asked to postpone the implementation of his ideas for long term, while specifying a specific date for their implementation, for example, the occurrence of a certain event. Anticipation of this event eliminates psychological discomfort, thereby making a person’s dream more achievable.

Making an action plan for the future

The client, together with the doctor, develops an adequate, realistic program of action for the future, which stipulates specific conditions, defines the person’s actions, and sets step-by-step deadlines for completing tasks. For example, the therapist and the patient stipulate that when some critical situation occurs, the client will follow a certain sequence of actions. And until the onset of a catastrophic event, he will not exhaust himself with anxious experiences at all.

Group three

The third group of techniques is focused on activating the sphere of the individual’s imagination. It has been established that in anxious people the predominant position in their thinking is not occupied by “automatic” thoughts, but by obsessive, frightening images and exhausting destructive ideas. Based on this, therapists have developed special techniques, acting on the correction of the imagination area.

Termination method

When the client has an obsessive negative image, he is recommended to say a conditional laconic command in a loud and firm voice, for example: “Stop!” Such an indication stops the effect of the negative image.

Repetition method

This technique involves repeated repetition by the patient of attitudes characteristic of a productive way of thinking. Thus, over time, the formed negative stereotype is eliminated.

Using metaphors

To activate the patient’s imagination, the doctor uses appropriate metaphorical statements, instructive parables, and quotes from poetry. This approach makes the explanation more colorful and understandable.

Modification of images

The method of modifying imagination involves the active work of the client, aimed at gradually replacing destructive images with ideas of a neutral color, and then with positive constructs.

Positive imagination

This technique involves replacing a negative image with positive ideas, which has a pronounced relaxing effect.

Constructive imagination

The desensitization technique consists in the fact that a person ranks the probability of the occurrence of an expected catastrophic situation, that is, he establishes and orders the expected future events by significance. This step leads to the fact that the negative forecast loses its global significance and ceases to be perceived as inevitable. For example, the patient is asked to rank the probability fatal outcome when meeting an object of fear.

Group four

Techniques from this group are aimed at increasing the effectiveness of the treatment process and minimizing the resistance provided by the client.

Purposeful repetition

The essence of this technique is persistent repeated testing of a variety of positive instructions in personal practice. For example, after re-evaluating one’s own thoughts during psychotherapeutic sessions, the patient is given the task: to independently re-evaluate the ideas and experiences that arise in everyday life. This step will ensure sustainable consolidation of the positive skills acquired during therapy.

Identifying hidden motives for destructive behavior

This technique is appropriate in situations where a person continues to think and act in an illogical way, despite the fact that all the “correct” arguments have been presented, he agrees with them and fully accepts them.

As noted on classicalhypnosis.ru hypnotherapist Gennady Ivanov, in this case, the task of therapy is to find the hidden motives of his destructive behavior and establish alternative motives for the person’s dysfunctional actions.

Other areas of psychotherapy refer to this exercise as seeking secondary gain.