Depression can be devastating. There is a way out and we can help.
Depression can cause you to lose interest in activities that once were pleasurable. You can experience a loss of appetite or it can cause you to over eat, it can bring problems with concentrating or cause a ‘racing head’ that wont ‘switch off’, remembering details or making decisions become almost impossible, you often doubt your short term memory to help you perform what were once the simplest of tasks.
Depression can bring insomnia, excessive sleeping, fatigue, loss of energy, lack of interest in sex, it can bring aches and pains or digestive problems, all to a such a degree they become the norm. You can often feel it will never change. You often just want to sleep.
If you want to change how you feel we can help you explore the problem, agree a solution, make a plan look at it and see it through.
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The CBT model
Below is a brief explanation of Cognitive Behavioural Therapy. The following is a basic interpretation of how a CBT therapist begins to understand a clients thinking process in order to help to change it from unhelpful to helpful thinking.
Negative Automatic Thoughts (NAT)
First we shall look at ‘Negative Automatic Thoughts’ (NAT’s). NAT’s are thoughts at the automatic level and intrude into a clients conscious mind often involuntarily and negatively distort their perceptions and memories, leading to emotional and behavioural disturbances. It might manifest as an image. A NAT might, for example, be a negative prediction that ‘I will fail the test’.
Dysfunctional Assumption (Inference or Evaluation)
Dysfunctional Assumptions are at the second or intermediate conscious level, which are conditional propositions, for example ‘If I fail at something, then I am a failure’.
Negative Core Belief
At the third or deepest and less consciously accessible level are negative ‘core beliefs’ which are unconditional and accepted as truths about the self, the world and the future, such as ‘I am a failure’.
These dysfunctional assumptions and core beliefs are components of cognitive schemas often established early in life which are activated by certain internal or external triggers, like a ‘key in a lock’. Once activated the schemas can lead to the cognitive distortions, and self-maintaining vicious cycles can then ensue. So in the above example the exam will trigger a schema that contains the core belief ‘I am a failure’ with the dysfunctional assumption ‘If I fail I will be a failure’ giving rise to NAT’s such as ‘I will fail the test’.
Another model proposes that emotional disturbances are the Consequence (C) of Beliefs (B) about the Adverse Events (A).
A = Something Happens
B = My belief about what has just happened (though Inference or Propositions)
C = How I feel and behave as a result of my belief about what has just happened
In this second model there are two types of Belief; Inferences which are ‘if’, then propositions which could be ‘true’ or ‘false’, and Evaluations, which are good-bad judgements. Ellis asserts that it is only certain specific rigid and extreme evaluations that can generate emotional disturbances.
Integrating the two models
In brief, NAT’s can be thoughts or images, they can be Dysfunctional Assumptions or Core Beliefs in the first model, or can be Inferences or Evaluations in the second model. Dysfunctional Assumptions can be Inferences or Evaluations.
These Dysfunctional Assumptions and Core Beliefs are components of Cognitive Schemas often established early in life which are activated by certain internal or external triggers.
At all times it is important to be clear whether the NAT or dysfunctional assumption is an inference or an evaluation.
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