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Four Drawbacks of Cognitive Therapy

For all its effectiveness, cognitive therapy also has its weaknesses.

Cognitive therapy is a generic term that refers to diverse cognitive approaches to modifying human experiences and activities. This critique focuses on cognitive therapy that focuses on altering negative self-concepts. This approach is based on the theories developed by A. Beck and A. Ellis.

The self-focused cognitive approach assumes that 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) and dysfunctional behavior. The behavior includes a sense of defeat and the withdrawal of investment in people and in conventional goals, as well as an intensified sense of vulnerability. The purpose of cognitive therapy is to restructure the client's irrational, negative, and/or distorted beliefs into rational, accurate or positive ones.

Although self-focused cognitive therapy has been shown to be superior to medication treatment for symptoms of depression and anxiety, it also suffers at least the following weaknesses:

First, this model appears to confuse the symptoms (i.e., negative self-concepts) of depression with its cognitive causes. Examples of the negative cognition include low self-esteem, self-blame, self-criticism, negative predictions, unpleasant memories, erroneous interpretations of experiences, all-or-nothing thinking (dichotomous thinking), jumping to conclusions, selective abstraction, overgeneralization or exaggeration of negative experiences, the presence of a negative cognitive shift (i.e., positive information relevant to the individual is filtered or blocked out, whereas negative self-relevant information is readily admitted).

In short, for those individuals, negative cognitions permeate internal conversations about self-evaluation, attributions, expectancies, inferences, and recall. Are they the cognitive causes or are they are the symptoms? I think that the above examples all represent the symptoms. In other words, they are not the cognitive reasons why people engage in self -blame, exaggeration of negative experiences, and or other types of distorted thinking.

Second, this cognitive therapy uses such terminology as negative self-concepts, irrational beliefs about the self, dysfunctional self-concept, and biased cognitions about the self, as if they are synonymous and interchangeable. In fact, they have diverse meanings.

Research has shown that the valence of evaluations (e.g., being positive or negative) is independent and separate from the accuracy of evaluations. In many cases, clients' appraisals and reports of their negative or distressful experiences are quite rational, realistic, and accurate.

For example, their experiences of sexual or physical abuse at the hands of another or the tragedies of their loved ones have left enormous scars in their life. In such circumstances, cognitive-restructuring exercises, with their emphasis on reframing reality and not on changing it, do not deal with the true problem.

Third, research has shown that positive self-evaluations may be dysfunctional and maladaptive. It is often the positive, rather than the negative self-assessment that is characterized by inaccuracy and bias in the fields of health, education, and the workplace.

Fourth, the self-focused cognitive model puts a strong emphasis on examining the association between negative thoughts and mental dysfunction, but it has not answered the question of why individuals choose to focus on their negative attributes when the positive evaluation of the self is more accurate. Neither cognitive model adequately reconciles the two types of finding: (1) self-blame bias and (2) self-serving bias. Research has shown that people have the motivation to see the self positively and avoid a negative self-concept, exhibiting a self-serving bias (including blaming failures on the situation while taking credit for success).

Please read my recent related post, "Understanding Depression From a Different Cognitive Perspective."