Cognitive Behavioral Therapy

Cognitive Triad Of Depression

By  | 

Aaron Beck and his colleagues, who have used CBT to reliably treat depression and relieve many of its symptoms, discovered three patterns of maladaptive thinking that are common in people who are depressed or susceptible to becoming depressed.

The Self

This person usually has low self-esteem and a generally unfavorable impression of his abilities and intelligence. He will set unreasonably high expectations that are impossible to live up to for long and that invariably lead to disappointment. He usually sees himself as morally deficient, worthless, or flawed. Evidence to the contrary is glossed over or flat out denied. As you can see this type of person is his own worst critic. Self-fulfillment and a feeling of efficacy are basically unattainable.

Present Reality

Just as he has a negative concept about himself, the depressive usually has a negative concept about his interactions with others, his accomplishments, his job performance, and the world in general. When things go well he will attribute this fortuitous happening to forces outside himself, believe he got lucky, and generally lack the belief that they can keep up. He is always waiting for the other shoe to drop. When things do go badly he will attribute them to his own deficits and mistakes, and as proof of his worthlessness.

He views most of his interactions with others through this same lens. For example, after a conversation with a coworker about an important upcoming project, an outside observer might not view anything in the conversation as out of the ordinary. There may have been some tension or conflict, but there was also cooperation and collaboration. However, the depressive will leave the encounter focusing on what he believes went wrong, ignore the positives, and view the entire encounter in a negative light.

Future Expectations

As you can probably guess, he is usually not hopeful about the future improving. He believes that his present suffering will continue indefinitely. He does not feel equipped to deal with challenges or new experiences. He feels trapped and that there is no reason for optimism. Most healthy, happy people bounce back rather quickly from conflict or setbacks and believe that ‘tomorrow is a new day’. The depressive views current suffering as proof of future suffering and a self-fulfilling prophecy is created.

Conclusion

This cognitive triad of beliefs is a ticking time bomb for depression. The good news if you feel that you fit the descriptions given here is that outcomes for depression using CBT have been rigorously studied and are generally very favorable. Since most of these issues are errors in perception, therapy that focuses on creating a more accurate picture of life, emphasizing the positives, and learning skills to deal with setbacks in a healthy way usually effects significant change. Many people suffer unnecessarily, and while changing perception is only one piece of the puzzle, it is an important first step in helping people find relief and start to enjoy life.