The Cognitive Model in a Nutshell

Cognitive therapy is based on a model that describes the relationship between emotions, behavior, body physiology and most importantly, our thoughts and beliefs (or cognitions).  Cognition refers to our thinking,  including our perceptions, interpretations, conscious and pre-conscious stream of thoughts, the conclusions we draw about events and (not always conscious) belief systems.  The cognitive model understands that the relationships between thoughts and  beliefs (cognitions) on the one hand, and emotions, behavior and physiology on the other, is complex.  It recognizes that emotional stress is created by our thoughts and beliefs about events in our life, not the events themselves.   Emotional stress is experienced with intense accompanying physical responses such as changes in heart rate, blood pressure, breathing rate, etc., as well as more delayed or long term effects such as changes in sleeping patterns, appetite and sexual drive. 

Consider someone with a fear of heights.  When that person walks out onto a high balcony (behavior), they react with an intense fear (emotional response).  Immediately their heart starts pounding, muscles tense, breathing changes and many other physical reactions (physiology) will occur in an instant.  They will feel compelled to get off the balcony (behavior) and when they do, the emotion and physical symptoms will calm.  Our emotional, behavioral and physical responses are very closely connected.  Consider a second person who walks out onto the balcony but who does not experience fear, instead calmly comments 'what a beautiful view'!  The cognitive model states that the critical difference between these 2 people is not their fear, behavior or physical response, no matter how intense these are experienced. The critical factor is the immediate interpretation, appraisal and belief about the situation.  The person with the fear automatically interprets (cognitive) the situation to be a danger (i.e.: 'I could fall').  The person who calmly stands on a high balcony enjoying the view believes (cognitive) that it is safe. 

The cognitive model therefore considers emotions and the behavior and physiological responses accompanying the emotions to originate in the interpretations, thoughts and beliefs that an individual brings to a situation, not the situation itself.  A famous quote is from the ancient philosopher Epictetus "People are disturbed not by things, but by their view of things".  The goal of the cognitive therapist is to help people understand the types of thoughts and beliefs underlying strong emotional and behavioral problems and to apply the most effective techniques available to change them. 

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