ABSTRACT
At the heart of any CBT approach lies a deceptively simple idea. Perceptions of ourselves, the world and the future shape our emotions and behaviours. As Shakespeare’s Hamlet put it: ‘There is nothing either good or bad, but thinking makes it so.’ People are thought to develop emotional disorders when they are locked into unhelpful patterns of interpretation and behaviours. From this comes the idea that if we evaluate and modify dysfunctional thinking, we can profoundly affect our emotional well-being. Enduring changes occur when people are able to modify dysfunctional beliefs and learn healthier and more adaptive beliefs. This central feature of CBT is based on two broader assumptions. First, a biopsychosocial context is implicated in the development and maintenance of emotional disorders. Biological and social theories of emotional disorders (e.g. Beck 1999) are not seen as competing theories, but rather as complementary theories operating at different levels of analysis with different points of focus. Second, even though a client’s presenting problems arise in a biopsychosocial context, the client’s perspective and agency are seen as the main focus in CBT. Cognitive theory takes into account the broadest range of factors that can help understand why a client presents with a particular set of problems, and then focuses on how the client has shaped this through a process of making sense of their lives. A powerful illustration is the work of Victor Frankl, a survivor of Auschwitz who went on to describe how he was able to draw meaning from his experience and how this process enabled him to survive Auschwitz and its aftermath (Frankl 1963). It is beyond the scope of this chapter to describe the breadth and depth of CBT approaches but interested
readers are referred to the work of Beck (1995) and Padesky (1996; Greenberger and Padesky 1995).
