The 6 techniques of cognitive restructuring

Many will be surprised, but our life is not defined by our experiences, but by how we interpret them. Our thinking greatly influences how we perceive our reality and, in turn, affects our way of relating to the world.

For example, if we make a mistake we can interpret it as that we are useless, or if someone disagrees with something we have said, it means that they do not like us. This can affect our self-esteem and skew reality worryingly

Cognitive restructuring techniques focus on changing this pathological thinking pattern, to make the person change their way of seeing reality and choose to face it in a more appropriate, optimal and efficient way.

• Related article: "Cognitive restructuring: what is this therapeutic strategy like?"

The main techniques of cognitive restructuring

Each of us understands the world through mental representations and subjective images, that is, we perceive the world based on our beliefs and expectations. Whatever happens to us, no matter how apparently neutral it may be, we always add some kind of subjective meaning to it. This makes our life, our feelings, and our well-being largely dependent on our cognitions.

Cognitive restructuring is a methodology used to identify and correct dysfunctional thinking patterns. Its main purpose is to change the way in which experiences are interpreted, modifying irrational thoughts that cause us discomfort, and replace them with others that will improve the mood of the patient.

People with dysfunctional thought patterns have subjective evaluations that cause them discomfort, especially if they decrease their level of self-esteem and self-efficacy. For example, a person who has failed an exam and presents these types of thoughts may believe that they are not worth studying instead of understanding that she needed to study more.

In cognitive restructuring working on these dysfunctional thinking patterns, causing the person to question their pessimistic belief system and have a better way of relating to the world. It is about changing your thinking and behavior so that you can enjoy life, or at least reduce the symptoms linked to your low self-esteem.

1. Down arrow

The downward arrow technique seeks to identify the basic belief underlying dysfunctional thinking. To do this, the therapist begins to formulate a series of questions with the intention of gradually expanding knowledge about the origin and maintenance of dysfunctional thinking and how it affects the psychological problem that has led the patient to consultation.

Among the questions that the therapist asks the patient we can find the following:

• What would it mean to you if that thought were true?
• What's wrong if it were that true thought?
• What could happen wrong?

The patient is constantly being asked questions so that he can give all the answers that he thinks fit, until the moment comes when he is unable to answer more.

The descending arrow technique is one of the most basic in the treatment of most psychological disorders and allows the modification of the patient's thinking patterns. Seeing that he has no more answers for what he fears, he raises the veracity of his excuses and fears.

It is through this technique that part of the main objective of cognitive restructuring is achieved, which is to make the patient let go of irrational and limiting beliefs, to adopt other more functional. Beliefs, attitudes and points of view are modified with the intention that the person passes interpret experiences differently, and set more realistic goals and expectations and adequate.

2. Socratic dialogue

Socrates (470-399 BC. C.) was a Greek philosopher in whose philosophy there was, as the most important notion, questioning everything to explore more complex ideas. This same way of thinking has reached today's psychology, and is known as Socratic dialogue. Through this technique, the patient's belief system is questioned, although the cognitive distortion that he manifests must first be detected.

The questions posed through Socratic dialogue are somewhat similar to those of the downward arrow. However, here the realism of your thought patterns or worry is directly questioned. Among some of the questions that we can find we have:

• Is my way of thinking realistic?
• Are my thoughts based on facts or feelings?
• What evidence do I have to support this idea?

3. Paradoxical intention

Paradoxical intention is a cognitive-behavioral technique in which the patient is asked to do just the opposite of what he would never have thought he would do. It consists of giving you a series of guidelines and indications that, far from seeming to solve your problem, what seems to be achieved is to enhance your problem.

For example, one of the problems in which paradoxical intention is used the most is with insomnia. The patient has probably tried to do everything to fall asleep, such as meditating, going to sleep earlier, avoiding caffeine, among others.

When she goes to therapy, she hopes that the therapist will give her the same indications or start a therapy with a very obvious methodology to solve her sleep problems. However, with the paradoxical intention not only will the therapist not give you directions to get to sleep, but will tell you not to sleep, to do everything possible to avoid falling asleep.

This, at first, will shock the patient, since it is a clearly not instinctive alternative. The patient had been struggling for a long time to get to sleep, and now they tell him to do the opposite. This is beneficial, since the patient will go from straining each day to trying to sleep, presenting anticipatory anxiety before the fear of not achieving it, a situation that she can control, which is not staying slept.

Since the perspective is just the opposite, the cycle is broken from trying to sleep and not getting it, going to one in which the external cause that prevented him from sleeping, previously unknown, is now the demand of his therapist. Basically, the patient can control not sleeping, and when she tries not to sleep, she will unconsciously end up falling asleep.

Regardless of the psychological problem for which this technique is used, the truth is that it implies a change in the way of thinking. She goes from trying each and every one of the options aimed at solving the problem in an obvious way to one that is not so instinctive, seeing that even what seems to enhance your problem serves to solve it.

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4. Roleplay

Cognitive therapy works on emotions, behaviors and beliefs that are not functional for the patient. An attempt is made to change the way of thinking with the intention of incorporating positive changes in the patient's thinking and behavior. One of the ways to achieve all this is through "role-playing" or role play.

Through role-playing and role-playing, significant changes can be made in the patient's mind, in addition to increase emotional control and empathy. An example of the use of role playing is the staging of an interview that the patient will face in the future, and that is causing him a lot of anxiety because he asks questions such as:

• Am I going to get nervous?
• Won't I know what to say?
• What if I am wrong answering the interviewer's questions?

By simulating an in-office interview, the patient has the opportunity to practice. In addition, he will be able to see if all the fears that he believes can appear while in a real interview are given, even in a controlled situation. Emulating this scenario can be of great help, since it allows you to work on his emotions and thoughts, discovering that it is not so bad.

He can see if he is indeed getting nervous or if he has a problem formulating the questions and answers during the interview. Also you can see how your physiological response occurs or if some of the fears are fulfilled that he had told the therapist. In turn, you can discover what is wrong and see how to work on it, with the professional help of the therapist.

• You may be interested: "Cognitive Behavioral Therapy: what is it and on what principles is it based?"

5. What would happen if…?

Generally, the patient's cognitive distortions are nothing more than an exaggerated view of reality, a fearful way of interpreting it. The technique of what if??? is very useful, since it consists of asking the patient that same question, or ask you what you think is the worst thing that could happen in a certain situation.

The idea is that, even in the worst case scenario, there are things that are acceptable and that most likely are not things of life and death.

6. Judge thoughts

This technique consists of have the patient act as a defense attorney, prosecutor, and judge at the same time, defending, attacking and judging their own distortions. He will first act as a defense attorney trying to provide objective evidence of his thinking, never opinions or interpretations. Then he will act as a prosecutor, also attacking them with evidence. Finally, he will act as a judge, and will assess whether the time has come to get rid of that way of thinking.

This technique is very useful because the patient is subjected to a rigorous process of criticizing his way of thinking, but from different points of view. You have to give convincing evidence of why you have this way of thinking, as well as refute it. Basically it is comparable to the typical “pros vs. cons ”, only from a therapeutic perspective and addressing it in the most objective way possible.

Bibliographic references:

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