Cognitive and humanistic-existential therapies

Cognitive therapies say that distress comes from irrational thoughts, not from events themselves.

Albert Ellis: Rational Emotive Therapy (RET), based on the ABC analysis:

• A: the Antecedent event (failing a test);
• B: the Belief about it ('I must never fail, so I am worthless');
• C: the emotional Consequence (depression).

It is B, not A, that causes C. Irrational beliefs are full of 'musts' and 'shoulds'. The therapist disputes them and helps replace them with rational beliefs ('I wish I had passed, but one failure does not make me worthless').

Aaron Beck: early experiences create core schemas (deep beliefs, like 'I am unlovable'). A critical incident later activates them, producing negative automatic thoughts and cognitive distortions (like overgeneralising). Therapy uses cognitive restructuring: gently questioning these thoughts until the client sees them differently.

Cognitive Behaviour Therapy (CBT), the most popular therapy today, combines cognitive therapy with behavioural techniques, within a bio-psychosocial approach. It is short and effective for many disorders.

Humanistic-existential therapies say distress comes when our drive for self-actualisation (growth) is frustrated, or when life seems to lack meaning.

• Viktor Frankl's logotherapy: helping people find meaning in their lives, even in suffering. Frankl developed it after surviving Nazi concentration camps.
• Carl Rogers' client-centred therapy: the therapist offers empathy, unconditional positive regard and reflection: rephrasing the client's statements so the client hears and understands their own feelings.
• Fritz Perls' Gestalt therapy: increasing the client's awareness and acceptance of their own feelings, here and now.

So thoughts and meaning shape distress, and changing them can heal.