It will surprise many, but our lives are not defined by our experiences, but by how we interpret them. Our thinking greatly influences how we perceive our reality and, in turn, affects our way of relating to the world.
For example, if we make a mistake we can interpret it as being useless, or if someone disagrees with something we have said, it means that they don’t like us. This can affect our self-esteem and distort reality worryingly.
Cognitive restructuring techniques focus on changing this pathological thinking pattern to make the person change their way of seeing reality and choose to face it in a more appropriate, optimal and efficient way.
Each of us understands the world through mental representations and subjective images, that is, we perceive the world based on our beliefs and expectations. What happens to us, no matter how apparently neutral it may be, we always give it some type of subjective meaning. This makes our life, our feelings and our well-being depend, to a large extent, on our cognitions.
Cognitive restructuring is a methodology used to identify and correct dysfunctional patterns of thinking. Its main purpose is to change the way experiences are interpreted, modifying irrational thoughts that cause us discomfort, and replacing them with others that will improve the patient’s mood.
People with dysfunctional thinking patterns have subjective evaluations that cause them discomfort, especially if they decrease their level of self-esteem and self-efficacy. For example, a person who has failed an exam and has these types of thoughts may believe that he is not worth studying instead of understanding that he needed to study more.
In cognitive restructuring work on these dysfunctional patterns of thinking , causing the person to question their pessimistic belief system and have a better way of relating to the world. It is about changing her thinking and behavior so that he can enjoy life, or at least reduce the symptoms linked to his low self-esteem.
1. Down arrow
The downward arrow technique aims to identify the basic belief that underlies the dysfunctional thinking. To do this, the therapist begins to ask a series of questions with the intention of expand the knowledge we have about the origin and maintenance of dysfunctional thinking and how it affects the psychological problem that has brought the patient to consultation.
Among the questions that the therapist asks the patient we can find the following:
He constantly asks the patient questions so that he can give all the answers he deems appropriate, until the moment arrives when he is unable to answer any more.
The downward arrow technique is one of the most basic in the treatment of most psychological disorders and allows the modification of the patient’s thinking patterns. Seeing that he has no more answers for what he fears, he considers the veracity of his excuses and fears
It is through this technique that part of the main objective of cognitive restructuring is achieved, which is to make the patient let go of irrational and limiting beliefs, to adopt more functional ones. Beliefs, attitudes and points of view are modified with the intention that the person begins to interpret experiences differently, and sets more realistic and appropriate objectives and expectations.
2. Socratic dialogue
Socrates (470-399 BC) was a Greek philosopher in whose philosophy there was, as the most important notion, questioning everything to explore more complex ideas This same way of thinking has reached current psychology, and is known as Socratic dialogue. Through this technique, the patient’s belief system is questioned, although the cognitive distortion that it manifests must first be detected.
The questions posed through Socratic dialogue are, in some ways, similar to those of the downward arrow. However, the realism of your patterns of thinking or worrying is directly questioned here. Among some of the questions that we can find we have:
3. Paradoxical intention
Paradoxical intention is a cognitive-behavioral technique in which The patient is asked to do exactly the opposite of what he would never have thought he would do It consists of giving you a series of guidelines and indications that, far from seeming to solve your problem, what seems to be achieved is to enhance your problem.
For example, one of the problems in which paradoxical intention is most used is with insomnia. The patient has probably tried to do everything to fall asleep, such as meditating, going to sleep earlier, avoiding caffeine, among others.
When you go to therapy, you expect the therapist to give you those same instructions or start therapy with a very obvious methodology to solve your sleep problems. However, with the paradoxical intention, not only will the therapist not give you instructions to get to sleep, but he will tell you not to sleep, to do everything possible to avoid falling asleep.
This, at first, will shock the patient, given that it is a clearly uninstinctive alternative. The patient had been struggling to sleep for some time and now he is being told to do the opposite. This is beneficial, since the patient will go from making an effort every day to try to sleep, presenting anticipatory anxiety due to the fear of not achieving it, to a situation that he can control, which is not falling asleep.
Since the perspective is just the opposite, the cycle is broken from trying to sleep and not getting it, moving to one in which the external cause that prevented him from sleeping, previously unknown, is now the demand of his therapist. Basically, the patient can control not sleeping, and when he tries not to sleep, unconsciously, he will end up falling asleep.
Whatever the psychological problem for which this technique is used, the truth is that it implies a change in the way of thinking. We go from trying each and every option aimed at solving the problem in an obvious way to one that is not so instinctive seeing that even what seems to enhance your problem serves to solve it.
4. Role play
In cognitive therapy, we work on emotions, behaviors and beliefs that are not functional for the patient. An attempt is made to change the way of thinking with the intention of incorporating positive changes in the patient’s thinking and behavior. One of the ways to achieve all this is through “role-playing.”
Through role-playing and role-playing, significant changes can occur in the patient’s mind, in addition to increase emotional control and empathy An example of the use of role playing is the staging of an interview that the patient will face in the future, and which is causing him a lot of anxiety because he asks questions such as:
By simulating an interview in consultation, the patient has the opportunity to practice. In addition, he will be able to see if all the fears that she believes may appear in a real interview occur, even if it is in a controlled situation. Emulating this scenario can be of great help, since it allows you to work on your emotions and thoughts, discovering that it is not a big deal.
You can see if you are actually getting nervous or if you are having trouble formulating questions and answers during the interview. Also You can see how your physiological response occurs or if some of your fears are fulfilled what he had told the therapist. At the same time, you can discover what you are doing wrong and see how to work on it, with the professional help of the therapist.
You may be interested: “Cognitive Behavioral Therapy: what is it and what principles is it based on?”
Generally, the patient’s cognitive distortions are nothing more than an exaggerated view of reality, a fearful way of interpreting it. The technique of What would happen if…? is very useful, since it consists of asking the patient that same question, or ask you what you think is the worst thing that could happen in a certain situation
The idea is that, even in the worst case scenario, there are things that are acceptable and that are most likely not life or death things.
6. Judge thoughts
This technique consists of have the patient act as a defense attorney, prosecutor and judge at the same time , defending, attacking and judging their own distortions. He will first act as a defense attorney, trying to provide objective evidence of his thoughts, never opinions or interpretations. Then he will act as a prosecutor, also attacking them with evidence. Finally you will be the judge, and will assess whether the time has come to get rid of that way of thinking.
This technique is very useful because The patient is subjected to a rigorous process of criticizing his way of thinking, but from different perspectives You have to give convincing evidence of why you have this way of thinking, and you have to refute it at the same time. It’s basically comparable to the typical “pros vs. cons”, only from a therapeutic perspective and addressing it in the most objective way possible.
Kahn, J.S. Kehle, T.J.; Jenson, W.R., & Clark, E. (1990). Comparison of cognitive-behavioral, relaxation, and self-modeling interventions for depression among middle-school students. School Psychology Review, 19, 196-211.
McNamee, S., & Gergen, K.J. (1996). Therapy as social construction. Barcelona: Paidós.
Olivares, J. and Méndez, FX (2008). Behavior Modification Techniques. Madrid: New Library.
Vila, J. & Fernández, MC (2004). Psychological treatments. The experimental perspective. Madrid: Pyramid.
Taylor S. (1996) Meta-analysis of cognitive behavioral treatments for social phobia. Journal of Behavior Therapy Exp Psychiatry 27:1-9.
López, A & García-Grau, E. (2010). The technique of cognitive restructuring.
