In my last post I discussed some considerations that one might take into account as they discern whether they are ready to take psychotropic medication. As a follow-up to that post I want to explore some practical, non-medication related suggestions for coping with anxiety and depression, as well as discuss 10 common thought errors/distortions that cause many of us difficulty. In order to do this, however, It is necessary to provide some background on the various ways psychological disturbances are conceptualized.
While, there are a number of different ways that psychologists conceptualize mental illness (and we will discuss many of these as time goes on), one common way is to frame psychological disorders as a cluster of distressing and problematic thoughts (cognitions), actions (behaviors), and emotions. This approach is commonly called the cognitive-behavior model because of its particular focus on thoughts and actions.
ABC’s of the Cognitive-Behavioral Model
Simply put, the cognitive-behavioral model states that our emotions and behaviors are caused by our thoughts/beliefs. Thoughts cause feelings and actions. Our trusty old childhood ABC’s provide an easy way to understand the cognitive-behavioral model.
Activating Event/Situation– This is any stimulus or event that functions as a trigger for an emotional or behavioral response.
Belief System– These are the thoughts or patterns of thoughts that we tell ourselves when A happens.
Consequence- The consequence is the emotional or behavioral result of the thoughts/beliefs.
With any event or stimulus that we encounter we have beliefs or thoughts about the event/stimulus. Our beliefs and thoughts about the event/stimulus cause feelings to arise (e.g. anxiety, sadness, anger) or can give rise to behaviors (e.g. yelling, leaving the situation, getting quiet, crying). The subsequent emotion and/or behavior can then become an event or stimulus. That is, a person may have certain thoughts or beliefs about feeling sad, angry, or aroused (e.g. “This is bad” or “I shouldn’t feel this way”) that can give rise further emotions or behaviors.
Example from Scripture
An example may help illustrate the point. What follows here is pure speculation for the sake of showing how the cognitive-behavioral model might be applied. Let’s take Peter at the court of the high priest after Christ is apprehended. Here, Christ is being questioned and some of the bystanders recognize Peter as one of Christ’s disciples. So, the initial activating event is the vocal accusation by the three onlookers that Peter is one of His followers. What might some of Peter’s thoughts/beliefs be about this accusation? Perhaps Peter may have thought, “Ut-oh, I don’t want to draw attention to myself,” “this situation is getting out of control,” or “they’ll kill me!” The consequence of these thoughts may have been emotions like fear and anxiety, which then become a new activating event. That is, these fears and anxieties may have caused Peter to think to himself, “This anxiety is terrible. I have to get out of this feeling,” “I need to distance myself from Jesus,” or “Run!” Such thoughts then caused Peter to deny Christ three times.
Now, the behavioral consequence of denying Christ certainly becomes another activating event. Peter definitely had thoughts and beliefs about his denial of Christ that caused feelings likely of sadness, regret, and remorse. Ultimately, Peter’s thoughts/beliefs about these feelings led him back to Christ on the beach repeating, “Lord, you know I love you” three times to repent for each his denials. Both Peter and Judas deny Christ, but Peter repents, while Judas hangs himself. Why? According to the cognitive-behavioral model Judas’s beliefs and thoughts about denying Christ (his behavior) led to feelings of despair and hopelessness for which he thought there was no remedy expect suicide.
Of course, this entire cycle often occurs very quickly and automatically for many of us—with our feelings rapidly arising from an event without our awareness of the interposed thoughts. Likewise our behaviors usually proceed quickly on the heels of a feeling without the recognition that thoughts and beliefs about those feelings exist between emotions and actions.It’s important to note as well that our cognitions occur on different levels ranging from explicit, conscious thoughts to more implicit, automatic (almost unrecognized) thoughts (we’ll talk more about these in the next post). It can take practice to recognize these automatic thoughts and the emotional and behavior consequences they cause.
That is an overview of the cognitive-behavioral model of psychological distress. Cognitive-behavioral therapy (CBT) uses this foundation as a starting point for treatment. A CBT therapist seeks to isolate the problem consequences (emotion and/or behavior) and determine the thoughts/beliefs that cause this unwanted consequence. The identified pattern of thought is either challenged directly by looking for actual evidence for the belief or indirectly by engaging in new behaviors which provide evidence which differs from (or disconfirms) the currently held beliefs/thoughts. For the CBT therapist emotions and behaviors function like red flags, indicating that a thought is present. These therapists help individuals identify what these thoughts are and how they are related to the emotions and behaviors. Change the way you think, and you change the way you feel and act.
In the next post we will discuss 10 common thought distortions that give often give rise to psychological distress and how to identify them. In the meantime try to be mindful of your thoughts. Next time you experience a feeling (positive or negative) or engage in a behavior pause for a moment and think about the thought that immediately preceded the emotion or behavior. There was one, but you may not have even noticed it. Try slowing down and be mindful of the thousand of thoughts you have about your world and that occur before your feelings and actions.
Trying to find the source of some psychological distress this morning…this reading is hopeful!!
Indeed thoughts give rise to feelings and actions. Further, symbols give rise to thought, as Paul Ricoeur says. What symbol gives rise to the thought of thoughts, the idea of ideas, or as Socrates calls it in Plato’s Republic, the idea of the good. The idea of the good is not an abstraction from the good, but true to the etymology of “idea” in Greek, the thing immediately and ultimately seen. The idea of the good, or idea of ideas is the source of all things spiritually as physically seen, just as the sun, which is the symbol of the idea of the good in Plato’s Republic, is the source of all things physically seen. In actuality, God Our Father is the idea of the good, and His perfect actual Symbol is His Word, the Logos (Greek for gathering)Who creates and gathers all limited being according to their natures. He became flesh of the Blessed Virgin Mary in order to gather all human beings into His Person and Nature, to be in Love (the Holy Spirit)as He has been eternally with Our Father.
In order to have right emotions leading to right actions, one must indeed have the right thought=idea. In order to have the right thought one must have the right Symbol, Yeshuah Messiah, Jesus Christ, I am Who Saves, Annointed. One is drawn into that Symbol in Baptism, but the Symbol must be kept alive by being gathered into the Eucharistic Symbol,what appears to be bread and wine, but what is actually the Body and Blood, Soul and Divinity of Yeshuah Messiah, the Word made flesh. This is why St. Ignatius Loyola, Founder of the Society of Jesus, requires in Chapter 16 of the Constitutions of the Society of Jesus, WHAT PERTAINS TO GOOD MORAL HABITS,:
[481] Very special care should be taken that those who come to the universities of the Society to obtain knowledge should acquire along with it good and Christian moral habits. It will help much toward this if all go to confession at least once every month, hear Mass every day and a sermon every feast day when one is given. The teachers will take care of this, each one with his own students.
Complete “hearing” of the Mass every day is complete “hearing” of the Word made Flesh every day, and that involves not just being vibrated by a sound which symbolizes that Real Presence but consuming His Flesh and Blood, consuming Him, and as St. Augustine notes in his Confessions, being consumed by Him. (When we eat ordinary food it becomes part of us, but when we eat the Word made flesh, we become part of Him, we become One Body, One Spirit in Yeshuah Messiah’s love of Our Father.)
How far does a psychologist go? Does he just tell his patient that he should have good thoughts in order to have good actions? Or does he tell him that he needs to have the thought of thoughts, the idea of the Good, the idea of Our Father to have good actions. Or does the psychologist go even further to tell the patient that in order to act on the idea of the Good, to share in the life of Our Father he must consume the Word made Flesh daily (as he asks Our Father…Give us this day our Daily Bread)and daily be consumed by, possessed by Him, so that his actions are the actions of the Word? Further, does the good psychologist (the one who gives the logos about the psyche)just refer to the Logos with which the psyche is created to be united with, or does the complete psychologist provide the Word made Flesh itself? Does he allow the Word made Flesh to Person (etymology=sound through)him, saying “This is My Body,” “This is My Blood” through him, so that the patient for whose psyche he desires healing and action of life, temporal and eternal, may consume and be consumed by the Bread of Life?
Finally, with regard to “Thoughts cause feelings and actions,” should you not say “Thoughts give rise to feelings and feelings give rise to actions?” “Cause” suggests if-then determination, but do you want to say that if one has a thought, one will necessarily have an implied feeling and if one has the implied feeling one will necessarily act according to it? This gets one into the ineffable mystery of the grace-free will relationship which the Pope, on the advice of a Jesuit saint, Robert Bellarmine, told the Jesuits and Dominicans to stop disputing about years ago. One can see the mystery in the logical chain which I have developed, extended, from yours, namely: actions are caused by feelings, feelings are caused by thoughts, thoughts are caused by the thought of thoughts, the idea of ideas, the idea of the Good, the idea of the Good, Our Father, is caused in us by His Symbol (literally throwing together=gathering), His Logos made Flesh, the Logos made Flesh causes the gathering of us into the ultimate action, the Love of Our Father by Overwhelming-Washing us in Baptism and being consumed and consuming us in the Holy Eucharist, Complete and Eternal Thanksgiving. To allow for “free will” in all of this, should you use “gives rise to” instead of cause?
Padre,
Thanks for the thoughts. I particularly like how you have traced it all back to the Logos–the thought of Thoughts. As for the idea of causation, I actually debated using the phrase “gives rise to,” but opted for causation because I think there is a real way in which feelings and behaviors do not occur without thought (implicit or explicit). I do see your point, however. I wonder if primary and secondary causality helps makes sense of this? So thoughts are real causes, but they are secondary causes. It seems like in your reply you have showed a relationship between the Primary Cause (God the Father) and secondary causes (thoughts). Behaviors and feelings can give rise to or cause thoughts as well, but it seems that there is a certain priority that thoughts have in the causal chain because the behaviors and feelings that can give rise to thoughts would not have occurred themselves without thoughts. Thoughts seems to be causes in the way that my finger causing a ball to roll is a cause (albeit secondary cause). God would still be the Primary Cause of these movements. Regardless, I think “gives rise to” is still likely a safer phrase to avoid some of this confusion.