The Case of Jane
Cognitive behavioral theory (CBT) can be applied to a variety of mental health problems. CBT is based on the notion of how people reason which is referred to as cognition, how they feel emotions and how they act behavior (Lorenzo-Luaces, Keefe & DeRubeis, 2016). The theory states that all these concepts interact together to produce a specific outcome, for example, unrealistic and negative thoughts have the potential to result in distress and eventually cause individuals to act in negative behavior. When people experience psychological distress the way they understand, circumstances become compromised which may lead to a negative reaction to their actions.
The cognitive-behavioral theory assumes that it is essential to know the processes that come into play in the way something acts, how it comes into being for one to be able to change or correct it (Tsang, et al., 2015). Modern cognitive-behavioral theorists, however, refute the above assumption. They assert that it is not always necessary to know how things operate to replace them (Lorenzo-Luaces, Keefe & DeRubeis, 2016). Modern CBT now prefers to seek for an immediate solution that is useful to the problem rather than focusing on the origin of behavior. CBT emerged from the idea that individuals react emotionally and behaviourally to occurrences basing on how they perceive those events. A reasonable explanation of this theory is when one person unintentionally steps on the other person’s toe. The person who was stepped on may interpret that the event was done intentionally to hurt him and therefore react hungrily to the offender or may alternatively understand the action to be accidental and maintain his calmness.
An explanation of how CBT plays a role in determining one’s personality can be best explained using Jane’s case. The experience she went through with her parents beginning with her drunken father frequently beating her and eventually the divorce of her parents created negative emotions of not being loved resulting in the behavior of suicidal tendencies. Her parents’ behavior towards her negatively influences her emotions and how she perceived the world. An excellent example is when Jane was made to sit in the closet for a long time because of mourning her pet fish’s death. She developed emotions of being unloved and uncared for, and these emotions were worsened when her parents divorced no one willing to take her.
The emotions and experience she went through with her parents’ situations continued to affect her behavior which is evident in her report that she began cutting her arms and legs with a razor blade. This can be associated with the beatings she had continuously received from her drunken father which influenced her cognition that she deserved pain and she translated this through her action of continually wanting to cut herself with a razor. The negative thoughts she carried from her experience with her parents can be said that it continued to affect her thoughts, emotions, and subsequent behavior which was translated to poor academic performance in school.
What is of importance in Jane’s personality disorder is how the external occurrence in her surrounding interact with each other which becomes the core of her beliefs (Bateman, Gunderson, ; Mulder, 2015). Childhood experience usually attributes to individuals’ beliefs about their world. These beliefs if not altered develop to be core principles in one’s personality and establishes how people will view the world. For Jane’s case she was brought up interpreting the world to be harsh with nothing positive about the relationship with other people and this was translated latter in her life for lack of friends.
The core beliefs of individuals are derived from nature and nurture (Wong, 2013). Nature, in this case, is the natural events that one is brought up in, whereas nurture is how a person is raised, the principles and values instilled in them by their caregivers. In Jane’s case, both nature and nurture came into play in her adoption of aggressive behavior. She was raised observing her parent fight, and she was frequently punished for no reason. These principles made her adopt negative thoughts about herself developing low self-esteem and translating the emotions into the behavior of frequently cutting herself and suicidal tendencies.
CBT emphasizes that when one’s core beliefs are distorted or biased, an individual may end up adopting incorrect conclusions on how they translate events (Bateman, Gunderson, & Mulder, 2015). Such misinterpretation is likely to make one react in a provoking manner that will make others act furiously. In Jane’s case, this explains why she has few friends. The unfortunate of developing biased core beliefs is that individuals misinterpret actions that are positive and perceive them to be negative. Such interpretations are based on the perception that the world is a harsh place and there is nothing good about it. Such negative beliefs motivate the paranoid persons to engage in risky behavior.
In Jane’s case, her belief that the world is a harsh place can be translated into her negative behavior such as her involvement in drugs, over speeding, being fired from numerous jobs and her attempt to stab her husband. Jane is unable to maintain a relationship with people because of her negative core beliefs regarding the link which explains her constant lose of friends, changing jobs and getting divorced twice. Her negative thoughts have made her develop a selfish desire hence not able to consider the interests of others except for hers, and as reported she was willing to do anything to get whatever she wants. A good example is of the silly decision she had considered to sell their house to buy a houseboat after learning from a TV show she had watched.
CBT model would be best applied in the treatment of Janes case. CBT will increase her awareness of undesirable understandings, and behavioral patterns which contribute to inaccurate thinking (Bateman, Gunderson, & Mulder, 2015). Cognitive therapy would best help Jane to develop alternative ways of thinking which will eventually help her overcome psychological distress. For instance, making Jane aware of various actions may result to both negative and positive consequences and not always all situations are meant to harm her will guide her in making right decisions, for example, developing a positive relationship with others, quitting drugs and spending money wisely.
CBT will be helpful to Jane since it will help her recognize and change dysfunctional thinking patterns regarding her marriage. The reason why she had been divorced twice might be as a result of her likening her parent’s marriage to hers and therefore concluding her marriage will also not work. CBT will help her recognize that not all situations are the same and different circumstances come to play for the wedding to work which includes her efforts to team up with her husband for a successful marriage. CBT will help her do away with the negative thoughts that all marriages end up in divorce.
CBT will help Jane replace the faulty interpretation that she must always get her way in everything she wants, for example, attempting to stab her husband with a knife for his refusal to sell their house in exchange of a houseboat (Bateman, Gunderson, ; Mulder, 2015). CBT will improve on her cognitive ability to critically think about the consequence of her actions before attempting them and not blindly jump into conclusion based on their belief. In this case, CBT will improve her negotiation skills with others and make her learn to communicate effectively without necessarily resolving into violence when her needs are not met.
CBT is considered as an umbrella term for the many cognitive therapies that can be applied to rectify the distorted thoughts of individuals. One of the earliest cognitive behavioral treatment commonly used is the Rational Emotive Behavior Therapy REBT by Albert Ellis and Cognitive Therapy developed by Aaron T. Beck (Wong, 2013). The theories were governed by the belief that abnormal behavior originated from misinterpreted cognitions about others and the world. The faulty thinking might be because of cognitive shortages or distortions. Ellis suggested that cognition distortions resulted from irrational thinking whereas Beck projected the cognitive trio. Another assumption of CBT is that individuals interact with the world basing on their mental representation. If their rational interpretation is inaccurate, then their behavior will be chaotic.
A therapist will help Jane identify distorted cognitions by an evaluation method (Vernon ;Ann 2016). Jane will, therefore, learn how to discriminate between her perceptions and reality. Jane will be educated on the impact that various cognitions have on her feelings and learn to identify and monitor her thoughts. The behavioral therapy will involve setting up homework for Jane to accomplish one of them is keeping a record of all her feelings and thoughts. The therapist will offer Jane with tasks that will help her challenge her misinterpreted beliefs about others and her world. The idea is that Jane will be able to identify her distorted beliefs and change them.
Rational Emotive Behavior Therapy aimed at rectifying the emotional and behavioral problem faced by individuals. The Main objective of this theory was to replace false beliefs with those that are logic (Vernon ;Ann 2016). REBT encouraged individuals to discover their irrational thinking for example desire for perfection and challenge these illogical thinking with real reasoning. Albert stated that everyone has an exclusive set of perception about themselves. These sets of assumptions are used by individuals to guide them throughout life and determine their reactions to various instances they encountered.
In some individuals, most of their expectations are irrational leading them to act and respond in a manner that restricts their chances for happiness or success. Albert Ellis referred to such thoughts as basic unreasonable assumptions (Vernon ;Ann 2016). Some individuals perceive that they are let-downs if they are not loved by everybody and will continuously seek approval and many times experience rejection. All of their relations are governed by this mentality given that a single outfall might leave them disappointed because they have not received the expected number of compliments. For example, in Jane’s case, it was reported that she frequently loved to be in the company of other people than being alone and she could quickly fall out with her friends if she does not get the approval she craves.
Based on Ellis one of the common irrational assumptions is the belief that one should be perfect in everything (Vernon &Ann 2016). Such illogical assumptions result to distress in areas that individuals are unable to prove their competency. Another flawed premise is the negative belief that it is terrible when things are not the way one would wish them to be. This explains the tendency of Jane always to want things to go her way, and she would be very temperamental in case of fallout. Another wrong assumption according to Ellis is the belief that other people have no control over their happiness. This result in poor relationships with other people and many episodes of conflict which best explains Jane’s relationship with her friends, husbands, and workmates.
Another wrong assumption that some individuals might experience is the belief that one needs other people to depend upon (Vernon ;Ann 2016). This best explains why Jane loved being in the company of others rather than staying on her own. Another reason for the fallacious assumption is the belief that one’s past automatically influences their future. This dramatically makes individuals blame their past negative experiences to their current failures. In janes case, she could easily lay blame on her parents’ failed marriage to be the reason why her marriages were not working. Another wrong assumption is that there is a perfect solution to one problem and becomes disastrous if the answers are not found. For example, Jane resolved to drug abuse after things were not working well for her.
One of the cognitive therapy aids suggested by Albert Ellis is referred to as the ABC Technique of Irrational Beliefs (Vernon ;Ann 2016). The three columns table will help Jane in recording her irrational beliefs. In column A, Jane will record situations that stimulate emotional responses and negative, dysfunctional thinking. In column B which represent beliefs, Jane will record the negative thoughts that she experienced. in Column C which serve consequences, Jane will record her negative feelings and behaviors that emerged. The undesirable beliefs in the second column will, therefore, act as a link to the situation and the distressing feelings. The third column, on the other hand, will explain the emotions which cause negative thoughts that Jane believes.
Ellis believed that it is not through activation of event A that lead to negative emotions and behavioral consequence in C but instead a person misinterpreted these events, therefore, developing an irrational assumptions belief system that leads to Consequences C (Vernon ;Ann 2016). For example, in Janes case of engaging in drug abuse activating A being she has been declared bankrupt, the belief B is that she must get a job to get money. The Consequence C is that Jane feels depressed and unworthy. Once the irrational beliefs have been identified the client will continuously work with Jane to challenge the unreasonable assumption with ones that are more realistic.
A therapist should, therefore, help Jane realize that the failed marriage of her parents should not determine the kind of marriage she wants with her husband. A therapist should also make Jane understand that she does not need to copy a TV reality show couples in what they do for her connection to be considered worthwhile. A therapist should also make Jane understand that it is not a must for her to buy whatever is lacking and also make her know that abusing drugs will not eliminate the problems she is undergoing. Jane will learn to realize that her parents’ divorce was disappointing but not depressing and she, therefore, needs to use it as a lesson so that she does not make the same mistakes her parents made.
Alternatively, a cognitive therapy developed by Aaron Beck can also be used to guide Jane in avoiding unrealistic assumptions (Beck et al., 2015). The cognitive theory will help Jane to identify the negative thoughts and errors in logic that leads to her depression. A therapist will guide Jane in answering specific questions that challenge her dysfunctional idea. Jane will also be tested to try out new interpretations which will eventually lead her to apply the alternative way of thinking in her daily life. Aaron Beck assumed that one’s reaction to upsetting thoughts might arise from abnormality. As individuals encounter various situations in life both positive and negative thoughts come to their heads of which Beck termed them as automatic thoughts.
According to Beck, the cognitive triad was one of the factors causing depression (Beck et al., 2015). This implies the three negative thought that people usually think about and include negative beliefs about oneself, the world and the future. A therapist should, therefore, consider Jane’s feelings towards these aspects to help her change her illogic assumptions. Another factor causing depression according to Beck is negative self-schema. Beck stated that individuals continually develop a set of believes and expectations that are negative and unrealistic (Beck et al., 2015). In Jane’s case, she established the negative schema through parental rejection and violence when she was at a tender age. A therapist should thus help Jane to avoid such negative schema when she is faced with challenging situations. Cognitive distortion is also one of the factors according to Beck that might result in negative thinking about oneself and the world leading in depression. Such thoughts tend to be involuntary in depressed individuals as they occur spontaneously. A therapist should guide Jane in avoiding negative thoughts by changing the perception that she is bound to go through adverse experiences.
The Case of Jane