Therapy Everyday – Cognitive Triads

I didn’t get round to updating my blog yesterday, but I had a really interesting supervision session with one of my guys and I have been mulling over some of the work we completed yesterday ever since our session. During the session, we used a simple tool which can help to identify what SCHEMA’s or belief system we are working from in any given situation. I have no doubt over the coming year we will look at SCHEMA’s, so I am going to leave a fuller explanation of this for another time, but in simple terms we were looking at how our worldview can be affected by beliefs we hold, and vice versa, in particular we were looking at how family rules and beliefs can influence our own thoughts and belief systems.

 

Examining our beliefs is a cornerstone of cognitive behaviour therapy (CBT) and it is something I utilise in every single session I have with clients to some extent. There are a multitude of ways to explore our beliefs, and once again I have no doubt we will explore these over the next year, but for today I want to use a simple, clear, and fast way of identifying which beliefs about myself are triggered in situations, which in turn tells me a lot about myself, which in turn can help me develop strategies to challenge these thoughts/beliefs, particularly if they are unhealthy (maladaptive).

 

The tool itself is very simple and I believe it was formulated by Aaron Beck, a man who literally wrote the book on CBT https://www.beckinstitute.org/aaron-beck/ . I have included an image below which illustrates Beck’s cognitive triad, and I will show some of my scribbles which hopefully will illustrate how this works for me.

cognitivetriad aaron beck

 

 

As you can see, the Beck model looks at the three points of the triangle, uncovering how I am thinking about myself, how I am thinking about others (or world), and how I am thinking about the future. Aaron Beck formulated this tool in order to use it with persons presenting with low mood and depression, so in this regard a focus on the future could easily uncover unhelpful thinking about one’s place in the world. When I use the tool, I am often working with people who are affected by anxiety and/or depression, so I often adapt the tool to incorporate an examination of other people and the environment (world) we inhabit, and/or the future.

The easiest way I can illustrate how the tool works is by looking at different stages of my life, which should give an idea about how this tool can be adapted and how effective it is. If I try to look at my 12 year old self, I can see that I was living with my Mum in the North East of Glasgow in a housing scheme. I had just started secondary school, and my Dad had left the home. My parents were in the process of divorcing after years of unreasonable behaviour predicated by my Dad’s drinking.

Cognitive Triad 1

Utilising the tool, the first point of the triangle I would enter is the ‘Other People Are’ point at the top of the triangle. Looking through the prism of my 12 year old self’s belief system (a truly terrifying thought!!!) I think I probably would see other people as being unreliable. The next point of the triangle I would look at is the ‘The World Is’ point, and I believe I probably thought at the time the world is unpredictable. Now comes the interesting part, I can ask myself a simple question, “If a 12 year old me, with my experiences and thought processes, believes other people are unreliable, and the world is unpredictable, what would I think about myself?”

Cognitive Triad 2

The answer I believe is that I would see myself as vulnerable. Vulnerable to the whims of other people and a victim of the unpredictability of the universe (I was prone to hyperbole and drama, especially during my tweens/teens!!).

 

The version above drifts slightly from the standard Beckian method, which I can complete and come up with slightly different answers. If the 12 year old me still believes people are unreliable, I may also believe people are untrustworthy. I will still believe that I am vulnerable based on the belief others are untrustworthy, but my ideas about what the future might hold for me can be seen in the final point of the triangle, where I probably believe the future is uncertain. Although most people might look at the future and say, “duh, of course it’s uncertain!” a 12 year old might also have a belief which is more prevalent in the region of, “the future is exciting”, or even “the future is daunting”. The uncertainty speaks to the lack of belief in one’s self, in this case probably driven by my belief that “I am vulnerable”.

Cognitive Triad 3

 

If we move forward in time from the 12 year old me to the 25 year old me, we can see my belief’s have shifted. At 27 years old, I have dropped out of university, moved from London back to Glasgow and back to my Mum’s house. I have a crap job working as a telephone debt collector, I have lost my first long-term relationship, I am using alcohol and illicit drugs at dangerous levels, I accept I have a serious long-term addiction but I am keeping it secret and not sharing this with any of my friends, I am anxious and depressed, I am affected by insomnia, and life is extremely chaotic. It will surprise no-one to discover the 12 year old me was extremely anxious and was affected by migraines a lot of the time.

Cognitive Triad 4

 

Once again, I can complete the triad’s and the first point in the triangle I will start with is ‘Other People Are……..’ and in this case I think the 27 year old me would be envious and think other people are successful. As I am envious of other’s success, I would look at the next point in the triad and think the wold is unfair. The 27 year old me who thinks other people are successful and the world is unfair would probably believe that “I am useless”.

Cognitive Triad 5

 

I think the 27 year old me, who has just been dumped by his girlfriend (for good reason I might add) and thinks she has abandoned me might see other people as selfish. If I looked to the future from this point of view I probably also thought the future looked very bleak. And the 27 year old me who believed other people were selfish, and the future looked bleak, saw in himself a person who was completely unloveable. I don’t suppose it will come as much of a surprise to learn the 27 year old me was affected by anxiety and depression, certainly when it’s clear my belief’s about the world and myself are so unhealthy, and irrational. This lack of self awareness was exacerbated by my addictive behaviour and continued substance misuse, and using this simple tool can help to investigate the belief’s I hold, because the chances are if things are happening in my life now which act as stressors, there is a good chance these irrational belief’s are not far from the surface and can rise up and begin having an impact on my life again. These belief’s I hold haven’t went away, but what has happened is that I can now successfully dispute the belief’s most of the time. One of the ways the belief’s can be disputed is highlighted in the DIBS tool from an earlier blog.

Finally, the triad can also highlight beliefs or thoughts which are helpful and healthy. When I am acting from a rational perspective, feeling capable and resourceful, I can look at other people in a more balanced way as being caring, and I can view the world as a surprising place. And when I am able to see other people as caring, and the world as surprising, I am able to view myself as capable.

Cognitive Triad 6

 

 

 

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