Core beliefs in psychotherapy
Recently I had the chance to dive a bit deeper into how our core beliefs, often shaped from childhood, influence our current lives in a class paper as I complete my training as a psychotherapist. I like multiple modalities (eg., mindfulness-based, acceptance-based). Here are some highlights based on my understanding:
Core Beliefs in Cognitive Behavioral Therapy (CBT): Highlights
“Man has the key to understanding and solving his psychological disturbance within the scope of his own awareness.” (Beck, 1976, p. 8).
Underlying the cognitive-behavioral therapy (CBT) model is the idea that dysfunctional (ie., limited) thinking and beliefs influence an individual’s behavior and mood (Beck, 2011). CBT helps individuals observe, identify, evaluate, and change blind spots in perception and thinking (Beck, 1976). Little less known of CBT is the importance of identifying core beliefs that are formed from early childhood experiences. Beck (2005) conceptualizes three main categories of negative core beliefs about oneself: 1) helpless core beliefs (eg., self as inadequate, vulnerable, weak, a failure, a victim); 2) unlovable core beliefs (eg., self as unlikable, ugly, unloved, unwanted, rejected, different, defective) and; 3) worthless core beliefs (eg., self as worthless, toxic, evil, unacceptable). Identifying the core beliefs help therapists orient future therapy sessions (Beck 2005; Beck 2011). A therapist can identify underlying core beliefs about oneself by examining an individual’s automatic thoughts and intermediate beliefs (ie., schemas) about the world and relationships (Beck, 2011; Beck, 2005; Beck 1976). Automatic thoughts can be found in an individual’s utterances (eg., “If I don’t get an A on the exam, people will think I’m incompetent”). Automatic thoughts can reveal an individual’s conditional assumptions (ie., intermediate beliefs that fall between superficial automatic thoughts and underlying core beliefs) (Beck, 2005; Beck, 2011). For example, the intermediate belief for the student who must get an A on the exam may be, “people are critical and harsh to me”. Beck (2005) says that these intermediate beliefs are often demonstrated by coping strategies (eg., if I’m hypervigilant about possible harm, then I can protect myself from criticism). When coping strategies are maladaptive or fail (eg., a hypervigilant individual still makes a mistake and receives a lot criticism and then becomes very depressed), negative core beliefs can become evident (Beck, 2005). The core belief in my example here, is an individual who believes she is helpless. This structure of beliefs and cognition is organized in Beck’s (2020) Cognitive Conceptualization Diagram (Appendix A). The functions of the core beliefs, negative automatic thoughts, negative affect and resulting behavior often serves as a closed system that becomes a filter to experience the world (Beck, 1976)…..
Core beliefs can appear inflexible and absolute (Beck, 2011). In modifying core beliefs, a particular process I resonate with is restructuring early memories through imagery (Edwards, 1989 in Beck 2011). Beck (2011) says that the intellectual techniques in CBT are effective to modify core beliefs if an emotion is active, and this technique is not always necessary. Restructuring early memories through imagery in the presence of emotions is a Gestalt type technique (Beck, 2011). While this technique is adapted for patients more often with personality disorders (Beck, 2005), I believe it is a helpful experiential technique that helps individuals reinterpret earlier traumatic experiences that contributed to the origin of the negative core belief. For example, a therapist would ask the client to close their eyes and locate the physiological response in the body of the sadness from an earlier situation, ask if she remembers when she experienced this the first time as a child, experience it from the child’s point of view, and then she is asked to bring in the older adult self to speak with the child and reassure her (eg., would she like a hug, and explaining to her a more adaptive and positive meaning to the event) (Beck, 2011). At the end of the session, the client may now believe she is 70% more competent than before through re-interpreting the past event in the presence of a rational and caring older self (Beck 2011)….
Why does this psychotherapeutic theory resonates with me personally?
As I have been practicing my daily gentle qigong meditative movements, which is like a calming mindfulness-based practice that has allowed me to become more attuned to the thoughts and feelings in and around me, overtime I’ve developed greater awareness of my internal dialogue (ie., automatic thoughts). This awareness coupled with the last ten years of my research-analytic minded-ness, interest in psychology, and introspection has made me dive to the core of where my emotions and behaviors stem from. From my non-academic reading (eg., Louise Hay), it has made me recognize that maladaptive responses come from negative beliefs about ourselves (eg., “I’m unlovable” or “I don’t deserve all of my good”) and working on these with processes like the restructuring early memories using imagery and other techniques, have provided me with lasting transformations. I believe that negative core beliefs are at their core, irrational and have this way of creating a perpetual loop that makes one buy into them, where one only sees evidence perpetuating that negative and distorted belief. As a therapist, I think it is important to help guide people to identify a way out of the loop of distorted negative beliefs and thinking so they can achieve that “aha!” moment. Beliefs that are deeply entrenched and practiced for many years, reinforced by environmental and social factors (eg., unsupportive family members), may require a little more work between the client and therapist. However, I do think the beginning stages of letting them go necessitates that one must start to see the negative core belief for what it is: a non-truth that one bought into as a child but does not have to choose to believe anymore. Other theories related to Jungian (eg., our dreams), Rogerian (eg., unconditional positive regard), Adlerian (eg., birth order), and mindfulness-based therapies (eg., acceptance and commitment therapy) also resonate a lot with me, but I think it is empowering to evaluate our key deeply held beliefs consciously and rationally as well.
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. The Penguin Group.
Beck, J. S. (2005). Cognitive behavioral therapy for challenging problems: What to do when the
basics don’t work. The Guilford Press.
Beck, J. S. (2011). Cognitive behavioral therapy: Basics and beyond, 2nd ed. The Guilford Press.