Philip Berman, like the rest of us, has cognitive abilities—special intellectual capacities to think, remember, and anticipate. These abilities can help him accomplish a great deal in life. Yet they can also work against him. As he thinks about his experiences, Philip may misinterpret them in ways that lead to poor decisions, maladaptive responses, and painful emotions.

In the early 1960s two clinicians, Albert Ellis (1962) and Aaron Beck (1967), proposed that cognitive processes are at the center of behaviors, thoughts, and emotions and that we can best understand abnormal functioning by looking to cognition—a perspective known as the cognitive model. Ellis and Beck claimed that clinicians must ask questions about the assumptions and attitudes that color a client’s perceptions, the thoughts running through that person’s mind, and the conclusions to which they are leading. Other theorists and therapists soon embraced and expanded these ideas and techniques.

According to cognitive theorists, abnormal functioning can result from several kinds of cognitive problems. Some people may make assumptions and adopt attitudes that are disturbing and inaccurate (Beck & Weishaar, 2014; Ellis, 2014). Philip Berman, for example, often seems to assume that his past history has locked him in his present situation. He believes that he was victimized by his parents and that he is now forever doomed by his past. He seems to approach all new experiences and relationships with expectations of failure and disaster.

Illogical thinking processes are another source of abnormal functioning, according to cognitive theorists. Beck, for example, has found that some people consistently think in illogical ways and keep arriving at self-defeating conclusions (Beck & Weishaar, 2014). As you will see in Chapter 7, he has identified a number of illogical thought processes regularly found in depression, such as overgeneralization, the drawing of broad negative conclusions on the basis of a single insignificant event. One depressed student couldn’t remember the date of Columbus’ third voyage to America during a history class. Overgeneralizing, she spent the rest of the day in despair over her wide-ranging ignorance.

According to cognitive therapists, people with psychological disorders can overcome their problems by developing new, more functional ways of thinking. Because different forms of abnormality may involve different kinds of cognitive dysfunctioning, cognitive therapists have developed a number of strategies. Beck, for example, has developed an approach that is widely used, particularly in cases of depression (Beck & Weishaar, 2014).

In Beck’s approach, called simply cognitive therapy, therapists help clients recognize the negative thoughts, biased interpretations, and errors in logic that dominate their thinking and, according to Beck, cause them to feel depressed. Therapists also guide clients to challenge their dysfunctional thoughts, try out new interpretations, and ultimately apply the new ways of thinking in their daily lives. As you will see in Chapter 8, people with depression who are treated with Beck’s approach improve much more than those who receive no treatment.

In the excerpt that follows, a cognitive therapist guides a depressed 26-year-old graduate student to see the link between the way she interprets her experiences and the way she feels and to begin questioning the accuracy of her interpretations:

The cognitive model has had very broad appeal. In addition to a large number of cognitive-behavioral clinicians who apply both cognitive and learning principles in their work, many cognitive clinicians focus exclusively on client interpretations, attitudes, assumptions, and other cognitive processes. Altogether approximately 31 percent of today’s clinical psychologists identify their approach as cognitive (Prochaska & Norcross, 2013).

The cognitive model is popular for several reasons. First, it focuses on a process unique to human beings—the process of human thought—and many theorists from varied backgrounds find themselves drawn to a model that considers thought to be the primary cause of normal and abnormal behavior.

Cognitive theories also lend themselves to research. Investigators have found that people with psychological disorders often make the kinds of assumptions and errors in thinking the theorists claim (Ingram et al., 2007). Yet another reason for the popularity of this model is the impressive performance of cognitive and cognitive-behavioral therapies in formats ranging from individual and group therapy to cybertherapy (see PsychWatch below). They have proved very effective for treating depression, panic disorder, social phobia, and sexual dysfunctions, for example (Barlow, 2014; Zu et al., 2014; Clark & Beck, 2012).

Nevertheless, the cognitive model, too, has its drawbacks. First, although disturbed cognitive processes are found in many forms of abnormality, their precise role has yet to be determined. The cognitions seen in psychologically troubled people could well be a result rather than a cause of their difficulties. Second, although cognitive and cognitive-behavioral therapies are clearly of help to many people, they do not help everyone. Is it enough simply to change cognitions? Can such changes make a general and lasting difference in the way people feel and behave? A growing body of research suggests that it is not always possible to achieve the kinds of cognitive changes proposed by Beck and other cognitive therapists (Sharf, 2012).

In response to such limitations, a new group of cognitive and cognitive-behavioral therapies, sometimes called the new wave of cognitive therapies, has emerged in recent years (Prochaska & Norcross, 2013; Hollon & DiGiuseppe, 2011). These new approaches, such as the widely used Acceptance and Commitment Therapy (ACT), help clients to accept many of their problematic thoughts rather than judge them, act on them, or try fruitlessly to change them (Swain et al., 2013; Hayes & Lillis, 2012). The hope is that by recognizing such thoughts for what they are—just thoughts—clients will eventually be able to let them pass through their awareness without being particularly troubled by them.

As you will see in Chapter 5, ACT and other new-wave cognitive therapies often employ mindfulness-based techniques to help their clients achieve such acceptance. These techniques borrow heavily from a form of meditation called mindfulness meditation, which teaches individuals to pay attention to the thoughts and feelings that are flowing through their minds during meditation and to accept such thoughts in a nonjudgmental way. Early research indicates that ACT and other new-wave cognitive therapies are often helpful in the treatment of anxiety and depression (Swain et al., 2013).

A final drawback of the cognitive model is that, like the other models you have read about, it is narrow in certain ways. Although cognition is a very special human dimension, it is still only one part of human functioning. Aren’t human beings more than the sum of their thoughts, emotions, and behaviors? Shouldn’t explanations of human functioning also consider broader issues, such as how people approach life, what value they extract from it, and how they deal with the question of life’s meaning? This is the position of the humanistic-existential model.