Cognitive Therapy and Hypnotherapy: A Cognitive-Developmental Approach
Dowd, E. Thomas, Journal of Evidence-Based Psychotherapies
This article describes the cognitive developmental model of psychotherapy and applies it to cognitive hypnotherapy. First I trace the development of this model from the original and relatively ahistorical cognitive therapy model. I then describe the movement towards an emphasis on the assessment and modification of cognitive structures, known as tacit knowledge. In this model the mind is seen as an active, organizing and constructing system which constructs its own reality, rather than serving as a repository of acquired information. I describe the central features of this tacit knowledge and how it is acquired. I then apply it to memory processes and modification because it can be important in psychology to gradually change some client memories. I then address the assessment and modification of core cognitive schemas (tacit knowledge) within cognitive therapy. Finally I provide examples of the application of these techniques in cognitive hypnotherapy.
Keywords: Cognitive therapy, cognitive hypnotherapy, tacit knowledge structures, cognitive unconscious
Cognitive therapy, although relatively new, has undergone significant theoretical and conceptual development in its brief history. Originally developed independently in various iterations of style and content by Aaron Beck, Albert Ellis, and Donald Meichenbaum as a method of identifying and changing distorted and maladaptive thinking patterns that were thought to underlie psychological disorders, it has evolved into a highly flexible collection of treatment procedures. These approaches share four underlying assumptions. First, they assumed that psychological disorders were associated with a group of negative thoughts regarding one's abilities, behavior, or self-worth. These negative cognitions, while not always present, were latent and would be activated under stress-producing situations (the diathesis-stress model). Second, they were assumed to be relatively non-historical in nature. It was considered more important what individuals thought or said to themselves now, rather than what occurred in the past. Likewise little attention was paid to why these negative cognitions were present; it was enough to concentrate on modifying them at this time. Ellis is the primary exponent of this present-oriented therapy. Third, despite the procedural differences, there was an underlying emphasis on counteracting the negative cognitions and replacing them with more positive cognitions. Fourth, there was an assumption that the negative cognitions were directly accessible to consciousness, although usually requiring some assistance from the therapist. The concept of inaccessible cognitions was discarded as too psychoanalytic and psychodynamic.
Levels of cognitive activity
Elsewhere (Dowd, 2000) I discuss three levels of cognitive activity. Cognitive products are the self-statements, the automatic thoughts, the internal dialogue that cognitive psychotherapy theoreticians have described. They have been independently identified by Ellis (Ellis & Dryden, 1997), A.T. Beck (A.T. Beck, Rush, Shaw, & Emery, 1979), and Meichenbaum (1977). It is what individuals think. In its earlier formulation, cognitive products were the cognitive phenomena that were addressed in therapy. The assumption was that if these self- statements were changed, better and more adaptive psychological and behavioral health would result. The client would think better and as a result behave better and feel better. In essence, behavior and emotional change were thought to follow cognitive change.
Cognitive processes are the cognitive distortions that have been identified by Beck and Ellis, although the irrational beliefs of Ellis seem to incorporate both cognitive content and cognitive processes. It is how individuals think. Ellis (Ellis & Dryden, 1997) has identified two fundamental types of human disturbances; making absolutist demands on themselves, others, and the world (ego disturbance) and low frustration tolerance (discomfort disturbance), that is, making demands that comfortable and comfortable life conditions must exist. …