Nama : Ratna Sari Fauzia
Npm : 10509841
Kelas : 3PA03
Tugas Psikoterapi
Automatic Thoughts
the standard cognitive model of beck and colleagues (1979)
describes negative thinking in depression at three levels : negative automatic
thoughts, thinking errors or biases and underlying beliefs or assumptions.
firstly, many of the spontaneous or automatic thoughts of people with
depression are manifestly negative. such negativity focuses on the self, the
world and the future: the negative cognitive triad. people suffering from acute
depression tend to see themselves as defective or inadequate, and see the world
as presenting them only with insuperable obstacles and difficulties. they see
such problems persisting indefinitely into the future and are pessimistic to
the point of hopelessness and perhaps suicidal wishes. when these negative
automatic thoughts come to mind, they tringger feelings of misery and despair
or exacerbate an existing low mood
state. negative emotions or low mood can prime these negative thoughts, making
them more likely to come to mind and more believable when they do. as low mood
primes the negative thoughts, which then further exacerbate low mood, a vicious
circle is set up whereby the person's mood can spiral downwards. this can also
lead to procrastination and inacitivity, which further feed into the vicious
circle, as illustrated in figure.
Cognitive Biases
The negative content of thinking manifest in these negative
automatic thoughts results in part from certain biases or distortions in the
processing of informations. These biases include all-or-nothing or ‘black and
white’ thinking, personalization and jumping to conclusion. Dichotomous or
‘black and white’ thinking is central, whereby the person sets unrealistically
high standards for their own performance. If these standards are not met,
negative judgements ensue. negative biases may also be in the form of arbitrary
inferences, where the depressed person jumps to the most negative conclusion
about a situation in the absence of any evidence. patients often predict quite
catastrophic outcomes are never conceived or are dismissed as highly unlikely.
this way of thinking is particularly characteristic of depressed patients who
present with significants anxiety symptoms. For example, this processing bias
could readily be identified with one patiens, Elizabeth, from the early strages of therapy
and was a target for intervention. if something did not meet elizabeth's exacting high standards it was
dismissed as substandard and of no value. elizabeth
saw no shades of grey, so that even an adequate outcome was seen as not making
the grade. black and white thinking can lead to a mental filter, such that
positive or neutral aspects of a situation are ignored, whereas negative
aspects are selectively focused on and dwelt on at length. having such high
standards served to focus elizabeth
continually on her shortcomings. her expectation of failing to meet her
standards accounted in large part for the avoidance and procrastination that
had pervaded her life since the onset of her depression. elizabeth's thinking biases are evident in
the following discussion that took place while reviewing one of her homework
assignments
Dysfunctional assumptions
the third level of negative thinking is that of longstanding
cognitive structures that predate the onset of the episode of depression and
whose activation results in cognitive biases and automatic thoughts. in cases
od acute depression, conditional beliefs or assumptions are thought to confer
the cognitive aspect of vulnerability. these conditional beliefs typically set
out the conditions that must be satisfied for the person to adopt a sense of
worth, fulfilment or happiness.
in the cognitive model of depression, these conditional
beliefs are thought to develop in many cases through early life experiences.
where parents have been excessively critical, the child may internalise the
implicit rule that being valued only comes from perfect performance, as was the
case for elizabeth.
this assumption may become latent or silent during parts of adults life where
any endeavours are met with a reasonable degree of success. thus, prior to
becoming depressed, elizabeth
had, by unrelenting hard work, managed to live up to the excesses of her
conditional belief. however, any notable failures activate the latent
assumption and the person becomes sensitised to any signs of falling short of
their perfectionistic standard.
Sumber : cognitive therapy for chronic and persistent
depression karangan Richard G. Moore dan Anne Garland tahun 2003 penerbit West Sussey,England.
