Health

Getting A Grip: What is cognitive therapy?

As human beings, we are always thinking. We tell ourselves a story about how the world works, about our own place in it, about right and wrong, about the significance of our personal experiences and observations.

A cognitive therapist may ask you what is going on in your life, but what we really want to know is what you are telling yourself about your situation. And, ultimately, we want to teach you how to observe your own thoughts, challenge those that are irrational and come into a more balanced view of yourself and the world.

We are very attached to our stories. Even the tragedies hold personal meanings for us, and we are loathe to give up our beliefs without a fight. That is why a cognitive therapist enlists the client’s aid.

I assign homework so clients may experience for themselves how their thoughts determine their feelings and actions. First, I ask them to describe a painful or difficult situation without any “flourishes.” I want them to write down exactly what happened, where it happened, when it happened and who was involved. Notice I don’t ask “how” or “why” it happened. Those are thoughts and beliefs, rather than facts. In the next session, I may ask him to tell me how he feels about the situation. He may respond with “angry” or “sad” or “confused.” I ask which of those is the strongest feeling, and he will pick one. His next homework assignment will be to write down all the thoughts, ideas and beliefs he has about the situation, and then see whether he can discover himself which thought is tied most closely to his strongest emotion.

For example, a man’s life had been turned on its head because his church had rejected him for being homosexual and his closest friends had all died of AIDs. He also believed his family had turned against him, and as proof, showed me a letter his sister had written. The letter, as far as I could see, was the kind of innocuous, friendly letter an older sister writes to her younger brother.

“You see?” he demanded when I had finished.

“I don’t see anything negative about this letter,” I told him. “It doesn’t seem at all like the hateful, self-righteous letter you described.”

“You have to read between the lines!” he shouted.

“Ah,” I said, “that is the problem.” Because, of course, between the lines were where his thoughts, imagination and beliefs about his sister’s opinion of him lay.

It is by writing out these thoughts that the weakness in our arguments against ourselves is revealed: We discover things such as “This should not have happened,” and “They should have believed me,” and other nonsense, which adds up to beliefs such as “The world should be fair.” Oh, if only it were. But, alas, the world is not fair. Neither is the world unfair. It simply is the way it is. Facing the reality of things as they are, we come up with a more balanced thought, such as, “I wish this had not happened, but it did, and there were consequences I have to take care of.”

I think the prime mover in any kind of therapy is the relationship between the therapist and the client. The relationship ideally should be one of collaboration, not coercion. For me, personally, this approach through cognitive therapy is a good fit. I have great faith in the individual’s ability to change, to make peace within him or herself through self-observation, to stand outside himself and to engage his higher processes to serve his own best interests.

One of my clients, who had been working with me awhile and had come to the end of our time together, asked me for some advice “in a nutshell” that she could take away with her in case she encountered problems in the future.

“First,” I told her, “Don’t believe everything you think. And, secondly, don’t take anything personally.”

• Gale Harris is a licensed clinical social worker who has worked at several agencies in McHenry County and currently runs a private practice out of her Woodstock home. She also is the host of “Get a Grip” on Harvard Community Radio. Contact her at tpgaleh@yahoo.com or visit www.galeharrislcsw.com.

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