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Understanding Depression from A Different Cognitive Perspective

Understanding Depression from A Different Cognitive Perspective

I disagree with the assertion that the self concept serves both as a main source of and as the solution to depression (as suggested by the self-focused cognitive therapy). In stead, I argue that our core cognition involves our levels of understanding of social interaction--the knowledge structures or interaction schemas we use to understand, balance and regulate our interactions with others and environments. The self concept (either positive or negative) is actually defined in relation and according to the interaction schemas.

Our interaction schemas typically take the forms of mental standards, rules, criteria, and/or categories that are believed to define, govern, and regulate human experiences and interactions. Regardless of people's cultural backgrounds (e.g., independent or individualistic cultures, interdependent cultures), they all have to develop the core cognition, which may be adaptive or maladaptive, in order to explain and regulate their experiences in the social and physical environments. For example, for many violent offenders, they believe that violence and threat of violence or fear are the rules regulating human behavior. That's why they are inclined to use violence or aggression to get they want. Many people, however, believe that love is the universal law that controls human operations and that's why they tend to use love to deal with frustrations in interpersonal situations. We can see right away that our cognitions may range from misunderstanding to accurate understanding of the principles governing social and interpersonal reality. People often have misapprehensions about what truly regulate human interaction but they are unaware of that and are using the wrong guidelines to evaluate, explain and adjust their experiences and actions.

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Let me explain the interaction schemas model with an example. A previously cheerful young man had developed severe depressive symptoms (e.g., feelings of sadness and inferiority, self-loathing, excessive guilt and anxiety, with many sleepless nights), despite of his very happy childhood and outgoing personality (thus, making diathesis or internal vulnerabilities an unlikely explanation for his depression). His symptoms occurred after he had experienced several frustrations in the love relationship. His frantic search for the answer led to his attention and belief that his physical imperfection was the very reason for his frustrations--his right pinky (little) finger was shorter than the normal. This condition was due to an accident he experienced several yeas before and subsequent surgical removal of a tiny part of bone on that fingertip.

According to the conventional cognitive therapy (see my early post "four drawbacks of cognitive therapy), it is irrational or negative cognitive beliefs about the self, rather than negative activating experiences, that lead to negative emotional states (e.g., depression or anxiety). However, the counseling practice that intended to restructure his irrational/negative beliefs regarding the self into rational/positive ones failed to change his intensified sense of hopelessness and other depressive symptoms. Apparent, he was fully aware of his many achievements and positive aspects, but these cognitions were ineffective in helping him know how to succeed in finding love. This is because he truly believed that he would not be able to meet his need in this very important area because of his physical defect. In other words, his negative self concept persisted because he had two distorted cognitions. First, he had inaccurate interaction schemas-his belief that physical flawlessness determines the outcome of acceptance in the relationship. Second, he had the inaccurate self concept because he used this assumed rule to evaluate the self and to explain his interpersonal experiences. Please note that the rule he perceived as true and his self concept are two different cognitions.

However, the interaction schemas model rescued him from depression. This approach helped him understand that it was his misunderstanding about what regulates human interaction (including how and why people experience invalidations) that shaped his irrational self concept. He obtained new understanding about what really regulates human interaction and interpersonal rejection or acceptance. Differing from the cognitive therapy focusing on the changing negative self concepts, this interactions schemas model suggests that our mind (cognition) consists of three components:

1. the mental representations of the self, others, events, and nature;
2. the perceived patterns that regulate the social interactions;
3. perceived relations (consistency/inconsistency) between the target of evaluation (self, others) and the perceived patterns. (I have more detailed discussions about the notion of interaction schemas in the book "Correctional Counseling" (2008) and some of my recent articles).

It should be noted that the perceived patterns in interaction schemas represent perceived "why" people act the way they do. They are different from the concept of relational schemas in relational therapy, which denote cognitive representations of exchange experiences and interpersonal scripts (How).

In short, I maintain that although various symptoms of mental conflict (e.g., depression, anxiety, guilt) are associated with negative self-concepts and repeated frustration, failure, and other damaging experiences, they are caused neither by negative self-concepts nor by destructive encounters. Rather, mental conflicts are engendered by the use of false criteria or categories (believed to represent general principles of human behavior) to define, evaluate, explain, and subsequently adjust the self's experiences and attributes.

This model also sheds a new light on how we learn from negative experiences. Negative experiences do not impact the self concept (or the brain) directly, but influence our understanding (or misunderstanding) of human behavior, which becomes contents of our interaction schemas by which we evaluate ourselves.

Key Sun is a psychologist, social worker and a professor of law and justice at Central Washington University.

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