06/21/2024

Persa Korfiati, Psychologist

Cognitive-behavioural therapy is one of the most popular and current forms of psychotherapy, firstly, due to its short duration compared to psychoanalytic or humanitarian psychotherapy, and secondly for its ability to handle a diverse number of problems. Sometimes cognitive-behavioural therapy requires only a few interviews, but usually 20 to 30 meetings are needed, in four to six months. The length of the treatment depends on the severity and the number of the patient’s issues.

Cognitive-behavioural therapy is focused on the patient's realization that he/she perceives and suffers the unfortunate events of his/her existence, in a distorted way. It is a psychological technique that aims to eliminate or shade the patient’s anxious or / and depressive feelings, allowing him/she to reflect upon the source of the thoughts that accompany these feelings, and to replace those thoughts with positive ones.

In more detail, cognitive therapy is based on the hypothesis that some of the negative feelings are created by a delusional state of the individual, or a distorted perception regarding the information received, highlighting their negative aspects and maintaining them in a self damaging internal monologue. A. T. Beck, an American doctor, who was influenced by the psychoanalytic movement, supports that the depressed patient has a wrong and a pessimistic view of himself/herself, of the world and of the future. In order to resolve the issue of the cognitive impairment of the individual, the therapist must somehow transform what the person says about himself/herself, and thus lead him/her to maintain more realistic thoughts. Of course in order to proceed with the therapeutic process the therapist uses behavioural methods, which suggest some exercises to the patient (eg to write down certain actions and the emotions that accompany them) to achieve the cognitive reorganization. This is cognitive-behavioural therapy, focusing on the cognitive procedure that the therapist is trying to process.

According to DSM-IV, the classification of mental illnesses according to the American Psychiatric Association, eating disorders consist of two syndromes. Anorexia and bulimia nervosa. The person's behavior is very different to the general population, in anything related to food consumption. For example, someone is likely to present anorexia in conjunction with depression. In behavioural theory, anorexia is a result of accustomed negative behaviors. Therefore, if food related co-dependencies change, a person’s relationship with food can improve. Furthermore, according to the behavioural approach, bulimia is also a result of accustomed negative co-dependencies of the person’s environment.

The term "Behavior modification" was used by Ulman and Krasner and includes all the processes and techniques used in the behavioural treatment, such as desensitization, reinforcement, etc., which aims to alternate (modify) undesirable behaviors. These techniques are mainly based on cognitive theories of emotions and stress. The use of these techniques aims in leading the person to new estimations and interpretations of his/her behaviour within the conditions of his/her environment. Through them, the person is led to a new pragmatic (realistic) estimation of reality and pushed to change his/her painful situation and to improve his/her self-esteem.

It is important to mention that bulimia is often accompanied by feelings of depression, guilt and self-devaluation. When a bulimic person feels hungry, the feeling does not reflect a need of the body but of the mind. The person doesn’t need to feed but needs to satisfy a "hunger" without knowing its real source. Modern studies, both in the theory of learning and reflexes, as well as in psychoanalysis, note that the notion of food is associated with the mother figure and tenderness. So unconsciously, the bulimic seeks to satisfy, eating in a symbolic way, an unsatisfied need for affection. So bulimia generally indicates some neurotic situation and is often combined with psychogenic (neurotic) anorexia.

Treatment of anorexia nervosa refers to a medical, psychodynamical and behavioural context, namely through therapy that emphasize to the individual or to systemic framework, where the emphasis is place on the relationship dynamics within the family.

Below is a brief analytical description of the basic components of Cognitive-behavioural therapy.

Reason: The patient's difficulties are due to disordered and antisocial behaviours acquired during the era of insuficient learning. The patient is disturbed because he/she retains false beliefs. The latter leads to unrealistic expectations of himself/herself, of others or of the world, so he/she experiences failure and hardship (cognitive approach).

Therapeutic process: Anything obtained during the era of insufficient learning, can be reverted by applying the principles of learning (behavioural approach). These false beliefs can be abandoned or converted, and thus creating more positive or realistic beliefs (cognitive approach).

Therapeutic Techniques: Behavioural / systematic decrease of sensitivity, strengthening the Ego, techniques that will influence ethical and / or mental behaviour of the individual. Cognitive / repositioning of irrational beliefs, evolutionary analysis of cognitive structures.

Therapist Attitude: Active and guiding, but in a partnership, where the patient chooses which behaviour to change and the therapist selects and teaches the patient the way to change.

Characteristics of patient: Any socio-economic class and ethnic group. The patient should be encouraged to transform and be ready to cooperate within the proposed activities. Verbal skills are less important for behavioural psychotherapies but in cognitive psychotherapy the verbal and cognitive skills are necessary.

Finally it should be emphasized that no psychotherapy can be successful without the personal request of the individual and his/her personal motivation for treatment.

Persa Korfiati
Psychologist

REFERENCES
(1) Les Bases de la Psychothérapie - Olivier CHAMBON Michel MARIE - CARDINE. Edition DUNOD - Paris 2003.
(2) Grand Dictionnaire de la Psychologie - Edition LAROUSSE - Paris 2000.
(3) Dictionary of Psychology - Nikos G. Papadopoulos-Version Contemporary Publishing, Athens 2005.
(4) Article: Sharf, Richard S. "Psychotherapy." Microsoft ® Encarta ® 2006 [DVD]. Redmond, WA: Microsoft Corporation, 2005.
(5) Nikos Takis Klin.Psych. iatronet 1999-2006 - www.iatronet.gr.