Cognitive therapy addresses the thoughts and beliefs that a person develops early in life that color the ways he feels and behaves. For various, often complicated reasons, some people develop negative core beliefs about themselves and their world that distort their interpretations of events and their expectations. Cognitive theories suggest that when people are helped to examine and correct their thinking (how they interpret events, what they expect from the world, how they talk to themselves) their moods and behavior naturally improve. In most cases, cognitive therapy is short-term. Typically, a course of cognitive therapy lasts three to six months, with therapy sessions once a week. It focuses on the present and tends to be problem- or symptom-specific. The therapist takes an active role, guiding the patient towards more accurate and realistic thinking, questioning the patient's explanations and teaching more effective coping strategies. During therapy sessions, the therapist directs the patient's attention to the automatic thoughts that seem to produce feelings of anxiety or depression. Facing a new task, a person may automatically think, "Why try? I'll only mess up." After a disappointment, he might think, "As always, I'm nothing but a loser." The patient is helped to recognize how he exaggerates the sense of threat, anticipates disaster, overgeneralizes from negative experiences and ignores things that go well. He is encouraged to examine how realistic these thoughts are and to consider alternative interpretations and outcomes. So, for instance, someone who has panic attacks would be encouraged to see that his physical symptoms (palpitations, hyperventilation, dizziness) are not actually a prelude to a heart attack. Unlike a psychodynamic psychotherapist, who may help a demoralized patient understand the origins of the feelings and defeatist thoughts that underlie his demoralization, cognitive therapists teach him to identify and label his negative thoughts, recognize their erroneous nature and devise a plan to assess things more positively and deal with them more realistically. In essence, cognitive therapy is a self-help approach that provides specific ways of thinking as tools that a person can apply on his own whenever he finds himself slipping into old patterns of thought and behavior. Last Updated: 12/16/2002
The Johns Hopkins University 1996-2003. All rights reserved. This information is not intended to provide advice on personal medical matters, nor is it intended to be a substitute for consultation. | 
