Many people have the false impression that psychotherapy always involves years of tedious exploration of…
Changing Negative Thinking in People With Depression
Millions of Americans struggle daily with the symptoms of major depression or one of several other conditions that the American Psychiatric Association classifies as a depressive disorder. One of the biggest factors in a depressive episode or ongoing depression symptoms is the presence of “down” or negative thought patterns. Depressed people can potentially overcome their symptoms with the help of a form of psychotherapy called cognitive behavioral therapy (CBT), which addresses the connection between negative thinking and damaging behaviors that stem from such thinking. According to the results of a study published in 2010 in the journal Behavior Research and Therapy, it’s initially much more important to use CBT to change negative thinking in depressed individuals, rather than attempting to change depression-related behaviors.
Negativity and Depression
Generally speaking, negative thoughts are heavily intertwined with negative emotional states. These states earn their designation as “negative” because they typically do such things as reduce your ability to respond effectively to the changes that happen in everyday life, diminish your sense of mental well-being, and decrease your ability to view yourself accurately in relation to your surroundings or other people. In most cases, the average person experiences enough “positive” emotional states to counteract or limit the effects of negativity. However, some people develop habits of negativity that significantly increase their life risks for developing depression or some other significant mental health issue. Emotional states that can contribute to a pattern of negativity include hostility, frustration, guilt, sadness, anger, and shame.
Cognitive Behavioral Therapy Basics
Cognitive behavioral therapy is the common name for a group of psychotherapeutic techniques that help people learn how to change the ways they habitually think and behave when they find themselves in situations that produce high levels of stress. In all of these techniques, patients learn how to view their seemingly unapproachable, ingrained stress reactions as a series of smaller problems that they can come to grips with one by one. For a given stressful situation, specific individual aspects of a problematic reaction typically include negative thoughts, negative emotional states, unpleasant bodily sensations that stem from negative thoughts and emotions, and involvement in dysfunctional behaviors that are consciously or unconsciously designed to reduce exposure to the source of stress.
While the specific methods used during CBT vary according to a therapist’s techniques, the overall outline of the therapy is generally the same. Over a series of weekly sessions, a patient meets with his or her therapist and learns how to examine the thoughts, emotions, physical sensations and behaviors that come together to produce a damaging stress response. After identifying these factors, the therapist teaches the patient how to develop new thought patterns, emotions, physical sensations and behaviors that gradually take the place of the old responses and produce a significantly increased sense of mental and physical equilibrium. The National Institute of Mental Health considers CBT to be a beneficial part of an effective plan for treating depression.
Changing Thinking First
In the study published in Behavior Research and Therapy, a multi-institution research team examined the effectiveness of different CBT techniques for treating the symptoms of major depression in 60 people with a preexisting depression diagnosis. The patients were divided into groups of 10; each individual group received cognitive behavioral therapy from a single therapist. Some of the therapists participating in the study focused on changing depression-related thinking before changing depression-related behaviors, while others focused on changing depression-related behaviors before changing depression-related thinking.
Several weeks into treatment, the authors of the study assessed the usefulness of these different approaches to CBT. The assessment was done at that time because previous evidence indicates that the typical depression patient sees his or her greatest treatment benefits from the initial weeks of therapy involvement. After reviewing their findings, the authors concluded that therapists who initially use CBT to change depression-related negative thinking witness clear declines in their patients’ symptom levels. However, therapists who initially use CBT to change depression-related behaviors do not witness any substantial declines in their patients’ symptom levels. Since cognitive behavioral therapy has a limited window for producing results, these findings strongly indicate that therapists should focus on changing negative thinking, not negative behaviors.
The authors of the study in Behavior Research and Therapy also examined other factors that increase the usefulness of cognitive behavioral therapy as a depression treatment. They concluded that patients receive even greater benefits from CBT when they get the chance to work actively with their therapists and devise plans of action that apply specifically to their individual circumstances.