Within the cognitive current, it is maintained that most of the discomfort that a person suffers is due more to their way of seeing and interpreting reality rather than the problem itself.
One of the therapies that takes this into account is metacognitive therapy which not only focuses on the patient’s dysfunctional thoughts, but also on how they perceive them, that is, it takes into account their metacognition.
Throughout this article we will go into more depth about metacognitive therapy, in addition to explaining in more detail the idea behind the concept of metacognition and what disorders it is used for.
What is metacognitive therapy?
Traditionally, cognitive therapies have maintained that alterations or biases in thinking are the cause of the patient’s psychological distress, rather than the situation itself. The discomfort comes from the way reality is interpreted, not from reality itself.
Metacognitive therapy, which was developed by Adrian Wells, is in accordance with the fundamental premise of cognitive therapies, giving importance to cognitive factors in the appearance and maintenance of psychological disorders That is why this is among the therapies of this type.
However, a key point of metacognitive therapy is its focus of attention. This type of therapy tries to understand why there are people who, when faced with an adverse situation, are able to not worry while others, faced with the same situation, manifest depressive and anxious symptoms.
According to the Wells theory, What would be behind the maintenance of this discomfort are the person’s metacognitions , that is, the way you see your own thinking. These metacognitions would be responsible for whether the individual has healthy or pathological control of his or her mind.
Based on this, the objective of metacognitive therapy is to eliminate modes of thinking that lead to dysfunctional beliefs. That is, the aim is to change the person’s inflexible way of seeing stimuli that, within their mentality, are considered threatening. By changing this way of seeing and interpreting things, the person stops being trapped by the situation and acquires a greater degree of well-being by knowing how to deal with problems.
What is meant by metacognition?
On many occasions, the discomfort experienced in a certain situation is not due to the situation itself, but to the way in which it is interpreted. This means that The same situation can be seen in very different ways depending on the person In this way, it is understood that there are people who, when faced with an adverse situation, know how to deal with it and do not worry too much while others suffer to such an extent that they become paralyzed.
Within the cognitive current, therapy aims to identify, question and change those automatic thoughts that, activated in a certain situation, are the true source of the person’s discomfort. By questioning the strength of these dysfunctional thoughts, the negative emotions associated with these harmful beliefs will decrease.
However, in order to carry out this, it is necessary to make the person aware of their own thoughts That is, think about what you are thinking and how you think about it. According to Wells, the term ‘metacognition’ refers to a wide range of interrelated factors made up of all cognitive processes that are involved in the interpretation, monitoring and control of one’s own cognition.
Metacognition is an aspect that has been closely related to the theory of mind This concept can be subdivided into several components, mainly being the knowledge, experiences and strategies that the person has to deal with the situations that arise. Metacognition is made up of beliefs and theories about our own way of thinking.
Within the metacognitive therapy model, a distinction is made between explicit or declarative beliefs, and implicit or procedural beliefs.
1. Explicit beliefs
Explicit beliefs can be expressed verbally, and They refer to specific thoughts of patients that cause them discomfort
An example of this type of belief would be ‘I have bad thoughts, which makes me a bad person’, ‘worrying could cause me to have a heart attack’, ‘what I have thought is a sign that something is not right.’
Explicit metacognitive knowledge can be shown in the form of positive or negative beliefs Positive explicit beliefs are those that the patient believes are advantageous, such as ‘if I worry, I will be prepared for when things are worse’, ‘focusing on the threat will help me know what to do’.
On the other hand, the negative refer to negative evaluations of sensations and thoughts related to perceived danger They are formulated in terms of uncontrollability, meaning, importance and dangerousness of thoughts.
Some examples of negative metacognitive beliefs would be “I do not have control over my thoughts”, “if I think violently it means I am going to commit some aggression”…
2. Implicit beliefs
Implicit beliefs refer to those rules or programs that guide a person’s thinking such as paying attention to a particular stimulus, ruminating on particular memories, or the way in which one judges other people.
How and for what disorders is it used?
Metacognitive therapy has been shown to be effective and efficient in terms of improving patients’ well-being. This has been observed empirically in research, for example the case of Normann and Morina (2018) who saw how this type of therapy improved the mental health of patients. However, it should be noted that It is especially useful for anxiety disorders and depression
In fact, in the clinical setting it has been seen how effective it is with multiple anxiety problems. Some of them are social anxiety, generalized anxiety disorder, obsessive compulsive disorder, post-traumatic stress disorder. However, when this model was formulated, the goal was for it to be used transdiagnostically, that is, for multiple psychological disorders of any type.
Normally the therapy takes place between 8 and 12 sessions. The therapist discusses with the patient the adjustment of his way of interpreting his own cognition , that is, thoughts, past experiences and applied strategies. Once it has been possible to see what is causing the discomfort, the therapy focuses on promoting in the patient more adaptive thinking styles appropriate to the situations that they had previously associated with problems.
Cognitive attention syndrome
The metacognition of people who suffer from psychological disorders, according to Wells, gives rise to a particular way of responding to internal experience, that is, their thoughts and emotions. This makes these negative feelings chronic and the person continues to suffer This pattern of thinking has been called Cognitive Attentional Syndrome (ACS), which would be composed of the following three aspects:
This syndrome is of vital importance to understand the metacognitive therapy model. This is especially understandable in those people who suffer from an anxiety disorder: your attention is fixed on a threat , which causes them great concern and, trying to get rid of this negative emotionality, they carry out coping strategies that, in the long run, make them think even more about this problem. So, they end up having thoughts like “what if this happens?”2, “I should worry about this not getting worse”…