My family doctor has advised me to learn about cognitive therapy for
help with my depression and anxiety. Even after years of therapy for
abuse I suffered as a child, I still have very low self esteem. I haven't
been able to work for months, now. If you could explain cognitive therapy
to me, I would appreciate it.
Congratulations on your effective steps in finding help for your depression
and anxiety. Your family physician has given you some useful direction
here. Depression with anxiety are labels for a set of symptoms that
often occur in response to traumatic incidents in life. Of course, such
symptoms often strike us "out of the blue" too. But with your issues,
cognitive therapy can be very helpful.
Research studying depression has tended to explore the ways we think,
the ways we behave, and the the brain's biochemistry. The mental health
researchers identified with cognitive therapy think that all of these
topics are related. Their experience indicates that therapy focused
on depressive thinking can influence behavior and mood in overcoming
depression and anxiety.
A cognitive therapist approaches your depression and anxiety as a co-investigator
with you; as a scientific ally. Rather than spending years exploring
your history, a cognitive therapist will assist you in learning just
how current patterns of thinking create an atmosphere for depressive
symptoms. Such therapists often refer to those symptoms as "disturbances."
By clearly labeling the thinking connected to such disturbances, an
action plan is created, using any number of useful strategies. The course
of therapy is usually brief.
In your situation, for instance, years of abuse experienced as a child
may have left you with very deeply held beliefs about yourself. You
had to be tough and resourceful to survive, yet these thoughts are not
positive. How could they be! These ideas often are self accusing, full
of shame, alienation; wounding thoughts of failure, incompetence, and
Cognitive therapists work with you to label, understand, dispute, and
extinguish such thoughts, in a compassionate, empathic, caring partnership.
They encourage you to become an expert in your self management of disturbing
cognition's. They help you learn to be in control.
There is no blame attached to having these thoughts, by the way. You
did not create them. What better way to deal with the pain an outsider
created in your life than learn how to effectively command, dispute,
and move them from your life.
Dr. David Burns, now at Stanford University, has written about cognitive
therapy in his book "Feeling Good" and its Handbook. I recommend this
book wholeheartedly. It is based upon scientific evidence, is readable,
and offers clear guidelines for self help from a cognitive therapy perspective.
The Center for Cognitive
Therapy at the University of Pennsylvania maintains a "home page"
on the internet that offers specific information about their technique
(it was developed there primarily, by Dr. Aaron Beck).
To find a trained cognitive therapist in your area, you might call
your local or state psychology association. Your physician may know
of someone using these techniques, or be able to consult with a mental
health professional who would know.
Finally, you can trust that cognitive therapy is effective. In clinical
studies, cognitive therapy is at least as effective in the treatment
of typical depression as are the major antidepressant medications. It
is especially useful for depression resulting from abusive experiences
in childhood. So good luck in your journey to help with your pain.
Dr. Kenneth Dutro is a licensed psychologist in
California. He is a member of the faculty at Humboldt State University, Arcata,
California. He has been faculty member of a medical school, and worked for years
as a psychologist in university-affiliated teaching hospitals.