When rational/adaptive responses do not result in "feeling better"

All of the above suggestions are good ones. When a client's responses to problematic cognitions do not result in their feeling better right a way, this may be due to a variety of problems. For example: 1) they may not have identified all of the important dysfunctional thoughts and thus may have not responded to all of them, 2) they may have come up with responses which sound good but which "miss the point" and fail to address their concerns, 3) they may not believe their responses, 4) they may have additional "Yes, but.." cognitions which undercut the effectiveness of their responses, etc.

It is also important to remember that not all emotions respond to adaptive responses in the same way. Some emotions, such as sadness/depression tend to improve immediately in response to effective responses. Other emotions, such as anxiety or guilt respond more slowly. In particular, with anxiety problems it is necessary to use repeated, prolonged exposure to avoided situations and stimuli in order to reduce the anxiety. In a situation like the one in the post at the beginning of this thread, we would not expect rational responses alone to eliminate the client's anxiety about going to bowls. We would expect it to be necessary for them to go to bowls despite their anxiety and to cope effectively with the situation a number of times (perhaps 6-8 times) in order to produce a significant reduction in their anxiety.

Remember, there is more to Cognitive Therapy than just generating adaptive responses. With anxiety problems in-vivo exposure is essential.

Replies:

Re:When rational/adaptive responses do not result in , by Gerry, 02/16/04

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