What is Cognitive Restructuring?

Cognitive restructuring is a therapeutic procedure in which the patient identifies and questions their maladaptive thoughts with the help of the therapist. We'll tell you all about it here!
What is Cognitive Restructuring?

Last update: 25 September, 2021

Cognitive restructuring is considered an indispensable element in the therapeutic process. Since the psychologist Albert Ellis gave shape to its theory in the mid-twentieth century, the success of this method has remained valid to this day.

In general terms, cognitive restructuring refers to changing the mental schemas of patients, making them more adaptive. It’s a way of redirecting a person’s life experience towards healthier outcomes, all through their own mental resources.

Let’s take a closer look.

What is cognitive restructuring?

People’s psyches are complex entities. Specialists agree that they have an important influence on human behavior. In this sense, cognitive restructuring employs conversational techniques to modify the psychic patterns that lead patients to problems.

For example, we know that psychologists use Socratic dialogue in psychotherapy for the patient to reach the necessary answers for their improvement. In other words, the therapist plays the role of a guide, using rhetorical questions so that person can restructure their cognition using mental resources.

In short, cognitive restructuring is a technique of the cognitive-behavioral models of treatment. It seeks to change human behavior by altering specific cognitive processes, such as the analysis and interpretation of life experiences.

How does it work?

The cognitive restructuring technique works through mental flexibility. The better people demonstrate an ability to incorporate new coping styles into their lives, the better the outcome of therapy.

In this framework, therapists should use the patient’s experiences to detect where the problems are occurring and together come up with the best alternative solutions. People aren’t aware that their thoughts are the origin of their negative behaviors.

It’s normal for there to be mental barriers during the therapeutic process. These unconscious defense mechanisms represent a challenge for health professionals, who try to make the patient recognize their reality as it’s happening around them.

A man in therapy
In cognitive-behavioral approaches, this technique is part of the therapeutic arsenal.

Cognitive restructuring techniques

Overall, cognitive restructuring techniques are the set of procedures that therapists use to achieve a significant and lasting change in the mental schemas of patients. Let’s see the techniques most psychologists use during psychotherapy.

1. Socratic dialogue

Socrates’ philosophy is based on questioning everything to find a more objective view of the world. In the same vein, modern psychology uses specific questioning to change the belief system of patients.

During the Socratic dialogue, the psychologist asks specific questions they direct towards the cognitive biases that people present. For example, what evidence is there? Do they give more priority to facts or feelings? (Etc.)

2. Judging thoughts

In this case, the idea is to have patients take on different roles concerning their own thoughts. They’ll play the roles of a defense attorney, prosecutor, and judge.

This way, they help people dissect their ideas, defend them and make the most objective decision.

3. Psychodrama

Psychodrama is a technique in which patients must play a role as if it were a play. In this role-play, they’re confronted with situations that are difficult for them but in a controlled environment. For example, a person with social phobia will have to play themselves during an important event.

The main objective of this technique is to familiarize patients with the situations that motivate their conflicts. After some time and with the correct intervention of the therapist, people will be able to face their fears adaptively.

4. Downward Arrow

This strategy is a pillar in the cognitive restructuring process. During these sessions, the therapist asks a series of questions to identify the thoughts that support irrational beliefs.

Once the irrational ideas are identified, they move on to rhetorical questions regarding the dysfunctional schemas that don’t fit reality. For example, what would happen in life if such a thought were true?

These types of questions should be asked until the patient exhausts their answers. The aim is for people to recognize the disproportionality of their initial distress and to understand that the situation can be coped with.

5. Paradoxical intention

This resource works to work on anxiety problems. The method used is to indicate to the patient exactly the opposite of what they expect to solve their problem.

An example of paradoxical intention would be when a patient comes for consultation because of erectile dysfunction and the therapist’s recommendation is to try not to have an erection. In this case, the person has likely tried everything to achieve an erection without success.

Instead of complying with what the patient expects, the therapist will tell them the opposite. That is, to try not to achieve an erection with his partner. This surprises the mind and will lead the person to a state in which his unconscious problem becomes a task to be achieved voluntarily. Thanks to the therapist’s indications, the anxiety dissipates.

A woman crying
Cognitive restructuring has a special application in anxiety disorders.

When do specialists recommend cognitive restructuring?

Cognitive restructuring is effective when there aren’t any underlying disorders. If the patient presents a physical-chemical imbalance, the specialists should refer them to a psychiatrist to start working together. However, when the conflict is purely psychological, cognitive restructuring therapy works.

Studies show that by changing people’s dysfunctional cognitions, their behavior becomes more adaptive and healthier. In summary, we can state that it’s one of the most popular and validated therapies today.

Who can apply cognitive restructuring?

Overall, psychologists who have been training in clinical areas can apply cognitive restructuring techniques. However, some psychiatrists are trained in psychotherapy and also have the necessary skills to apply the techniques we mentioned in this article.

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