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Psychological Explanations: Part II

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C.E. Zupanick, Psy.D. and Mark Dombeck, Ph.D.

As is evident from the examples in the previous section, a major cause of individual differences in reaction to stressors are the individual differences in the way people appraise that particular event (Lazarus and Folkman, 1984). Their cognitive appraisals will in turn affect whether or not they experience anxiety.

Cognitive Beliefs:

So far we have discussed two psychological variables that influence whether or not someone is likely to experience anxiety: perceived control and cognitive appraisals. But these two variables are actually a reflection of a person's beliefs about themselves and the world around them. The relationship between a person's individual, unique beliefs about an event, and their responses to that event, is very similar to the theory behind Rational Emotive Behavioral Therapy, a particular type of cognitive therapy. According to Ellis (1997), the specific stressors in a person's environment do not directly cause their emotional reaction, or maladaptive behavioral choices. Instead, maladaptive responses are the result of a person's unique beliefs, not only about the event itself, but also beliefs about his/her ability to cope with, and/or tolerate negative events.

Interestingly, our beliefs about a particular situation, and our beliefs about our ability to cope with it, are not necessarily haphazard. Instead, our understanding of a particular situation is often influenced by underlying attitudes and "core beliefs" about ourselves, and the world around us. Core beliefs refer to organizing principles we use to understand and interpret the events in our environment. According to Aaron T. Beck, the one of the principal founders of cognitive therapy, each of us come to form strongly held, core beliefs about ourselves, others, and the world around us. Although these core beliefs fundamentally influence our appraisal of an event, we are often unaware of these beliefs, and do not realize their impact on our everyday lives. Unfortunately, these core beliefs may not always represent an accurate portrayal of the situation at hand, and may in fact cause us to experience undue emotional distress. Cognitive therapy seeks to bring these core beliefs in awareness, and to challenge the accuracy of those beliefs. For more information about cognitive theory and associated therapies please refer to that section.

Cognitive Distortions:

As a general rule, our beliefs are usually not evaluated in terms of their objective validity. The common expression, "You're entitled to your beliefs" reflects this acceptance. However, some beliefs can lead to distorted thoughts, which in turn may lead to distressing emotions and maladaptive behavior. According to Beck and Emery (1985), individuals (particularly those that suffer from anxiety disorders) are prone to make certain types of cognitive "errors" in their appraisals across various situations in their lives. These thinking errors are often called cognitive distortions. While there are many different types of cognitive distortions that may affect anxiety, there are two types of cognitive distortions that are commonly associated with anxiety: 1) the overestimation of threat and 2) the underestimation of one's ability to cope with the threat. The overestimation of threat commonly refers to the beliefs an individual holds about the perceived probability, or certainty, of an event's occurrence. This type of cognitive distortion is often called "fortune-telling" (e.g., "I will get lost when I am driving"). A related cognitive distortion refers to catastrophic prediction, which is a heightened or exaggerated sense of perceived harm, and is sometimes called "catastrophizing" (e.g., "It will horrible if I get lost," or "I will be in grave danger").

Subsequently, it is not hard to imagine that if someone already overestimates the danger of a situation, they will most likely underestimate their ability to cope with it. Indeed, similar to the concepts of primary and secondary appraisal discussed above, the cognitive distortion of overestimation of threat, often leads to the second distortion of underestimating one's ability to cope with the threat ("I will never be able to find my way home" or "I will be helpless and I can't tolerate that"). Unfortunately, the combination of these cognitive distortions will most likely result in the individual experiencing a disproportionate amount of anxiety relative to the actual situation, while at the same time increasing the odds of engaging in maladaptive behaviors (i.e., avoidance). The avoidance of challenging or stressful situations blocks the development of the coping skills (e.g., problem solving skills such as asking for directions, using a map, etc.). Because avoidance prevents any opportunity to refute the distorted belief it has the effect of strengthening cognitive distortions. For instance, if I believe "I will get lost" and therefore avoid traveling on my own, I will never have the opportunity not to get lost. For more information about cognitive distortions, review the Cognitive Theory and Therapy Section.

The importance of psychological vulnerabilities

Taken together, our beliefs (including perceived control, cognitive appraisals, and cognitive distortions) affect the way we experience, and respond to, a potentially threatening situation. In general, the greater the gap between our estimation of threat, and our estimated abilities, the greater the likelihood we will experience anxiety. Because these beliefs have such a powerful influence, cognitive therapy seeks to create an awareness of these cognitions, and to challenge the veracity of them. Interestingly, in clinical practice we often see individuals who, despite their initial belief about their inability to cope with a situation, are often quite good at problem-solving solutions to threatening situations. In addition, when coached to challenge their cognitive distortions, they are able to accurately reevaluate the probability of catastrophic outcomes.

It is important to understand the significant impact of thoughts and beliefs on current behavior in order to understand a fundamental premise of anxiety disorder treatment: It is possible to treat anxiety symptoms in the present, regardless of prior experiences, or strongly held beliefs and assumptions that were formed in the past.. The idea of focusing on the "here-and-now" is one of the main tenets underlying the many useful techniques of cognitive-behavioral therapy (CBT)- often considered the "gold standard" of treatment for anxiety disorders. Simply stated, CBT is based on the premise that people's dysfunctional thinking patterns, as well as their maladaptive behavioral patterns, contribute to the development and maintenance of an array of difficulties, ranging from daily stress, to full-blown psychological disorders. Consequently, the main goal of CBT is help individuals change problematic beliefs and thinking patterns, as well as to engage in more adaptive behaviors in order to relieve a person's symptoms, and to restore their quality of life. In a sense, by treating the symptoms in the present, the therapist and therapy participant are chipping away at the psychological vulnerability that was formed in the past.

 

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute

Authors Statement: Established in 1979, the Bio Behavioral Institute is a psychological and psychiatric clinic dedicated to the treatment and research of anxiety and mood disorders. Based in Long Island, NY, USA, the institute serves both a local and international clientele. Our staff have over 40 years of experience treating anxiety and mood disorders and have been at the forefront of scientifically supported treatments for anxiety disorders for many years. We offer a variety of programs provided by a multidisciplinary team of professionals. For more information, please visit us online at www.biobehavioralinstitute.com or view Bio Behavioral Institute and author biographical information on this website.