Cognitive Behavior Management A Synopsis

STIMULI

 The world is filled with stimuli – some arouse the individual and some do not. The basis for arousal is novelty. If something provides new information [the difference that makes a difference], it needs to be examined. Arousal is simply the use of voluntary attention – consciousness – needed to determine how the new information is to be incorporated into the mind. Mind can be thought of as the sum product of the activities of the brain. The brain has two hemispheres that have different, although sometime overlapping functions. Both hemispheres do cognitive operations, but the right brain does not use words, so the concept thought includes quirks or somatic instincts, associations, hunches that are as idiosyncratic as ideas or concepts. Some stimuli are habituated to the central nervous system related to the left hemisphere and are responded to as though they were in the autonomic nervous system – automatically as needed. Stimuli can be either external or internal. These are also habituated and we do not consciously arouse to our breathing, until something novel causes us to attend.

SENSATION

Stimuli enter the individual system through sensations – which have been called qualia or submodalities. The sensory modalities are visual, audio, kinetic, olfactory and gustatory. Each has submodalities, for example, for vision we have color, movement, brightness, etc. These factors are all that the individual receives. On a somatic level or right hemisphere, these factors are organized and categorized.

PERCEPTION

However, these somatic experiences must be left-hemisphere or cognitively organized and interpreted to give the stimulus meaning. This interpretation is based on memories and comparisons of prior experiences. Thus an organized sensation of a chill down the spine could be interpreted as fear or a draft.

GENERALIZATION

Patterns of interpretations are formed over time creating a cognitive architecture – or mental structures called schema. There are many conventional cognitive schemata (networks of thoughts and quirks brought together about a subject) on such things as restaurants, ballgames, etc. These structures are both stable and flexible – while you cannot step into the same river twice, the river continues to exist as a unique and identifiable entity even though the water is constantly moving – so it is with a schema, new thoughts and concepts are constantly being considered and through assimilation and accommodation the schema changes – but unless a trauma occurs the general shape of the schema continues. Trauma, like an earthquake, can change the shape of the river/schema. And just as we have merged our concepts about schema and rivers, a ballgame motif can be brought into a restaurant schema to make a ‘sports bar’. Cognitive blends of this type, which might be considered for our purposes here, an extended analogy, are what moves meaning forward. Many of these generalizations, particularly those of the first three years of life, are made by intuitive, not logical means, since children before the age of three generally are not using the ‘left brain’ logical/language. Because of this the generalization may therefore be ineffable or unsayable. When major negative generalizations are made, the individual may ‘feel’ negative things that they don’t understand and cannot truly explain. They just ‘feel’ that way.

COGNITIVE STRUCTURE

The major cognitive structures that concern human services are not the conventional schemata, but the personal schema about SELF and OTHERS. These two are in constant appraisal and comparison; that in specific cases lead to attributions of cause, judgements about disposition, and predictions [expectations] for the future. EXPECTATIONS are also a major schema because our beliefs about ourselves in comparison to others is critical to our expectations about what will happen in the future and our role in it. One might think of expectations as the lintel that lies across the other two pillars making a doorway. This doorway is symbolically the access to the total person – for s/he is what s/he thinks. [see below]

SELF-FULFILLING PROPHECIES

Our expectations about what will happen in the future are so powerful that we tend to behave in a manner that makes it likely it will happen. Therefore, if you believe that you will fail, or you believe you will succeed, you are probably right. Each of us creates our own future in large part by what we believe will happen. This can be very problematic when you believe that you are likely to fail – for surely you will. It is also problematic when the significant people around you believe you will fail – for they will ‘make it so’. It is true that the child will need to interpret this stimulus, but it is estimated that ninety-three [93%] of the message is conveyed by nonverbal information, and even infants are quite adept at picking up these cues. Thus, the messages sent to children by significant adults have profound potential for good or evil, and yet we spend very little time concerning ourselves with these messages.

SUBJECT/OBJECT

Because human beings can predict what might happen in the future, we can project ourselves into a future scene. This cognitive talent allows us to see ourselves as a subject of some future scenario – ‘subject’ meaning here the ‘major actor’ or master of our soul, ‘hero’, or, conversely as the object of the scenario – meaning here that someone else is in charge and we are only responding to what happens to us – a subordinate or ‘victim’ of the power of others. People who usually refer to themselves as the ‘object’ of a scenario -”It’s his/her fault!” – often see themselves in a ‘victim’ role -> which can, if the belief is powerful enough, lead to feelings of helplessness, hopelessness and worthlessness. This is the ‘big three’ of negative thinking and often occurs in very young children who have been invalidated, neglected and/or abused from the generalizations made around attachment, and therefore create very difficult problems in living. Obviously, if you believe and refer to yourself as the actor [hero], you are de facto not helpless, and therefore avoid thoughts about hopelessness and feelings of worthlessness. There is, of course, the possibility that you will see yourself both as the victim of circumstance and as the cause of those circumstances; ergo, seeing yourself as worthless although effective at destruction. A further concern has been identified in that as the subject, we have certain biases toward our actions and against the actions of others. As the object, we use those biases against ourselves as in the case of seeing yourself as both victim and cause.

COGNITIVE PROCESSES

How we ‘see’ or refer to ourselves happens every second of wakefulness. Beginning meditators discover very quickly that the mind is always active and that stopping it is difficult. At all times, we are thinking about what is happening, comparing this experiences to other experiences [e.g., this is the best apple I every had!] and comparing ourselves to other people [I wish I had apples as often as John! He is so lucky! He doesn't deserve it. But maybe something is wrong with me.] These chains of thought include automatic thoughts about self and others that occur so quickly and so often that, like blinking and breathing, we don’t notice them, at least not until someone points it out. Like the river, they are different each time we ‘tune in’, but they are clearly consistently the same as well. We perform several processes in an instant [it is not clear that the instantaneous processes can be separated out in these categories - some theorists group them differently]:

Appraisal: We are constantly making cognitive appraisals by checking with our stored memories and comparing the present experience to past experiences – and the role of others and ourselves.

Attribution: Attribution is the process of drawing causal inferences upon which to make judgements about other people – why did that happen? We make personality judgements in order to explain otherwise confusing behavior. Attribution is a three-step process through which we perceive others as causal agents

• Perception of the Action (I saw that!)

• Judgement of Intention (You meant to do that!)

• Attribution of disposition (You’re a jerk!)

Disposition: Judgements are usually made by personal constructs. Because constructs represent some form of judgement or evaluation, by definition they are scalar: that is, the concept good can only exist in contrast to another concept like bad, the concept gentle can only exist as a contrast to a concept like harsh. Any evaluation we make could reasonably be answered with the question ‘Compared with what?’ Personal constructs for any domain can be uncovered through a repertory interview and once identified, the construct can be ‘laddered’ for more detail and ultimately changed.

Prediction: Based on the prior factors, we predict what will come next.

COGNITIVE ERRORS

There are several kinds of cognitive errors that occur in our automatic thinking. These include, but are not limited to:

1. Filtering: The person focuses on the negative details while ignoring all the positive aspects of a situation.

2. Polarized Thinking: Things are black or white, good or bad. The person has to be perfect or s/he’s a failure. There’s no middle ground, no room for mistakes.

3. Overgeneralization: The person reaches a general conclusion based on a single incident or piece of evidence. S/he exaggerates the frequency of problems and uses negative global labels.

4. Mind Reading: Without them saying, the person knows what people are feeling and why they act the way they do. In particular, s/he has certain knowledge of how people think and feel about him/her.

5. Catastrophizing: The person expects, even visualizes disaster. S/he notices or hears about a problem and start asking, “What if?” What if tragedy strikes? What if it happens to me?

6. Magnifying: The person exaggerates the degree or intensity of a problem. S/he turns up the volume on anything bad, making it loud, large, and overwhelming.

7. Personalization: The person assumes that everything people do or say is some kind of reaction to them. S/he also compares him/herself to others, trying to determine who is smarter, more competent, better looking, and so on.

8. Shoulds: The person has a list of ironclad rules about how s/he and other people should act. People who break the rules anger him/her, and s/he feels guilty when s/he violates the rules.

9. Externalizing: The person explains the cause of success and/or failure as external forces such as task difficulty or luck over which s/he has no control, instead of to his/her own effort. “It’s his fault! She doesn’t like me!”

10. Prophesizing: The person has negative and relatively stable expectancy or generalized beliefs about a lack of self competence in achievement situations. “I’m going to fail this test. Nobody is going to talk to me.” Prophesizes negative outcomes.

These are not unlike the fallacies of thinking in philosophy or logic. They are the kinds of thinking errors that people generally make. The consequences of these errors here, however, are far more malevolent than simply losing an argument or debate. One of the major problems is the consistency of our automatic thoughts, which are representations of our beliefs about ourselves and other people. As we say these things to ourselves over and over again, we network neurons in the brain. This is not quite ‘hardwiring’, but it can get close. People who make consistent negative connotations about themselves and others tend to be notoriously rigid. They have trouble considering other meanings for what occurred. Overcoming these negative neural networks will require creative and alternative thinking and that will require a formal and public analysis of the person’s thoughts.

However, we have another kind of error that must be overcome as well and that is personal bias. There are certain human biases that occur in everyone. Primarily, we are biased toward ourselves [when this does not occur, it is a maladaptive phenomenon]. The most obvious bias is the confirmation bias – the tendency to confirm what we already believe to be true. Sometimes our beliefs are so strong that we cannot even perceive contrary information. This was demonstrated in a simple experiment reported by Thomas Kuhn in The History of Scientific Revolution. It was concerned with a display of playing card in which some of the cards were made accurately, but with different colors. So a four of spade, for example, was red. Because of the expectation, based on memories of prior experiences, most people did not perceive the differences and some could not even when they had the cards in front of them.

As Dr. Farkas says, “Don’t believe everything you think!”. The Buddhists spend years trying to overcome such biases and to think clearly, so don’t expect that you are going to teach your clients how to change their thoughts overnight. Yet, startling changes can occur, if we are able to reframe the context so that a new meaning arises. Language and concepts are quite fluid and the appropriate use of words and concepts can have long lasting effects.

Complex equivalence is a linguistic term used to describe words such as ‘love’. What does that word mean? It certainly doesn’t mean the same thing to you at five as it does at fifty. Nor does it mean the same when you are referring to your father or your spouse. How about the love of your job? Love has some attributes, but the meaning comes from the context and from the ‘inner logic’ of the individual person. A teenager was sent to the principal’s office because of behavior difficulties. After the discussion, which the principal felt was very productive, s/he was dismissed by the principal with the statement – “Have a good day.”. Imagine the surprise by the principal when s/he blew up, accused the principal of being sarcastic and challenged the appropriateness of the statement. Compare [speculate] the ‘inner logic’ of the teenager and the principal.

CHANGE

What does all of this mean? First, it means that the fundamental assumption about why people behave the way they do is:

People are the sum total of their thoughts

It means that the theory of change is:

People will only change when they change the way they think.

So if you want to be helpful, how do you get a person to change the way they think. Can we persuade them to think differently? Well, perhaps, but remember the ‘inner logic’ and the perception of what you expect. Unless you understand the other person’s ‘inner logic’ it is difficult to make a persuasive argument and to have the other person even understand it. It would seem better to have them challenge their own thoughts. But here we have the confirmation bias issue. This bias is a little like finding your lost keys. Where are your keys? – the last place you look. You certainly wouldn’t continue to look if you found them. In a like manner, if I want to confirm my belief that the world is flat, I may search and search for confirmation, ignoring all contrary evidence, until I find the ‘flat earth’ web site, and then I stop looking – I have found the evidence [other people’s beliefs] I need to support my belief.

It is also true that some of the thoughts may, in part or whole, be true. I may, in fact, be slow in processing information and it would be unfair, inappropriate and potentially damaging for me to say – “I am as smart as everyone else!”. But is being smart the most important thing in life? How about being the nicest, or the most honest, or the best friend – do these qualify?

There are two major technologies to changing thoughts. The first, pioneered by Aaron Beck and Albert Ellis is concerned with left-brain logic and language. It is essentially a five-step process.

Awareness: The person is helped to become aware of his/her automatic thoughts – note that these thoughts are connected to the core schema about self, others and expectations, and although only the ‘tip of the iceberg’, give significant clues about these core values. Note also, that not only are automatic thoughts nonconscious, but most of our core beliefs about self and others are as well. With the right tools, most of the ‘iceberg’ can be brought to consciousness, although this is not necessary in most cases.

Attention: Usually through a thought journal, the person is encouraged to attend to these automatic thoughts

Analysis: Following a formaland public process the person is helped to identify cognitive errors in his/her thinking

Alternatives: When a thought is distorted and distressing to the client, s/he is encouraged to seek alternative meanings for the thought. No s/he really isn’t ‘the fattest person in the world”, but yes s/he could lose some weight. No, it is not impossible to lose weight, only difficult. And yes, the power is within him/her based on the effort s/he is willing to expend. And, by the way, s/he may choose not to expend the effort and find a more balanced and rational way to describe his/her body image: yes, I am heavy, but I carry it well, and I am comfortable with it.

Adaptation: We noted that consistently saying something to yourself or thinking about something over and over creates a neural pathway in the brain. By repeating as a mantra the italicized sentence above, the person can create a semi- hardwired pathway. In and of itself, this does not unwire the old pathway. However, when give the option of two thoughts, we will tend to think the one that is most gratifying and satisfying and to ignore those that are distressing. Over time, even very established networks disappear.

We call this process Cognitive Process Change, because it changes the cognitive processes that occur in self-talk. As such, it does affect core beliefs, but does not attempt to directly access or change them. Strategies to make such changes to core beliefs are generally of the same type, but with increased intensity. In addition, this technology, Cognitive Restructuring, uses much more imagery and unanswerable questions for we must help the person bring to consciousness that which they cannot even say. A child who suffered abuse and neglect and has acquired ‘feelings’ of helplessness, hopelessness and worthlessness, may need to ‘relive’ the experiences so that s/he can reinterpret the meaning. Instead of ‘blaming’ herself or even her parents, s/he may be able to perceive the event objectively as a very difficult experiences from which s/he can learn. This is a very different place – s/he is now the subject [hero] – “That which does not kill me makes me strong” [Nietzsche] – no longer the victim.

There is also evidence that people can change the way they think simply by changing the emotional content of the experience. Usually, this is done by observing the experience from different ‘positions’ [first, second or third person] and dissociating from the emotional content. However, there is some evidence that simply changing the submodalities or qualia [coding of the sensory input], one can change the emotion. A simple Swish – visualizes a picture of something – notes the qualia [brightness, distance, color, etc. and then changes it suddenly several times. Now when the person thinks of the experience, they have coded the memories differently and therefore feel differently about it – giving it a different meaning.

SUMMARY

Note that the client decides what is distressing and what needs to be changed. Cognitive change is ALWAYS self-change. The helper becomes a person who enables the client to address these issues and helps them maintain an objective balance, but the client must decide. 

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