Cognitive behavioural therapy

Cognitive behavioural therapy (CBT)was developed by Aaron Beck in the 1960s to
help treat depression. Beck believed that the way people thought about their lives
and the events around themwould affect the way they felt. If a person had positive
or rational beliefs they would feel fine; if they had negative or irrational beliefs they
would feel emotionally unhappy.
The beliefs that you have about your condition can influence how you cope
with it.Negative or irrational beliefs such as, ‘I have done something bad to deserve
this illness’, or ‘Everything in my life is ruined now’, will inevitably make you feel
low and upset. More positive beliefs on the other hand, such as, ‘The illness is only
a small part of me and I will cope with it’, will make you feel more positive about
your condition.
Negative or irrational thoughts are often the result of ‘errors in processing’
wherebyexperiencesandinterpretationsaredistorted(Beck,1976).Such‘cognitive
errors’ include:
l Selective abstraction – attending only to negative aspects of your
appearance, so that your skin becomes the defining feature of the way you
look, e.g. ‘It doesn’t matter that people say that I have a nice body or pretty
eyes, the only thing that I notice about myself is the psoriasis’.
l Personalisation – feeling responsible or upset about things that have
nothing to do with you, e.g. ‘The reason that he didn’t shake my hand is
because of my eczema’.
l Arbitrary inference – reaching conclusions based on insufficient or
inadequate evidence, e.g. ‘The reason that he asked me to his party is
because he feels sorry forme; there is no way someone would want to be nice
to me when they can see how bad my acne is’.
l All-or-nothing thinking – thinking in extremes, e.g. ‘If I can’t get to the
point where I will never think about my port-wine stain again, then I’ll
never be happy’.
l Generalisation – exaggerating the effect of an unpleasant experience so
that it affects every aspect of your life no matter how unrelated, e.g. ‘My
friend’s 3-year-old daughter didn’t want to touch my hand because of my
vitiligo, so everybody must be disgusted by it’.
l Catastrophising – thinking of only the worst-case scenario and hugely
exaggerating the effects of what might happen, e.g. ‘If I go out without any
make-up to cover up my port-wine stain, then everybody in the street will
laugh and sneer at me and I won’t be able to do the shopping that I have to
do’ (Papadopoulos and Bot, 1999).

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