Neuroscientific based therapy of dysfunctional cognitive overgeneralizations caused by stimulus overload with an "emotionSync" method E-Book

Christian Hanisch

• Herausgeber: Books on Demand
• Kategorie: Geisteswissenschaft
• Sprache: Englisch
• Veröffentlichungsjahr: 2019

Seitenzahl: 266

Beschreibung

In this book Prof. (UCN) Dr. Christian Hanisch has now published his dissertation with the scientific investigations, statistical evaluations and the results. The research shows that trauma, depression, anxiety and much else can be caused by mental blockages and how to counteract this through neuro-coaching. How psychotherapy or coaching, based on physical and physiological - especially neuroelectric - principles can work, he makes clear on the basis of comprehensible test series.

Leseprobe

Abstract

One of the basic assumptions of cognitive behavioral therapy is that cognitions influence internal reactions – such as emotions – to external events. Cognitions are possibly dysfunctional.

Dysfunctional cognitions may be overgeneralizations. They are unreflected generalizations about oneself, other people and how the world is. Dysfunctional cognitions become psychological strains and can result in a variety of mental disorders (depression, e. g.).

This paper describes a psychotherapeutical method for treating and changing negative emotions related to dysfunctional cognitions. This method – called emotionSync – is guided by methods of cognitive behavioral therapy, especially exposure therapy. During this therapy, the dysfunctional cognition is treated and new functional ones are learned to enable new behavioral choices. A theory for both pathogenesis and treatment of mental disorders is generated on a neuroscientific basis. It thus takes part in building a bridge between psychotherapy and neuroscience. Already existing links between psychotherapy and neuroscience are critically discussed.

To empirically evaluate the method three studies were conducted. Two studies examined the efficacy of the method on a subjective level. In the first study a one dimensional measurement tool (emotional valence). 52 subjects participated in this study. In the second study a validated multidimensional questionnaire was used („Mehrdimensionale Befindlichkeitsfragebogen (MDBF)” (Multidimensional mood questionnaire) by Steyer, Schwenkmezger, Notz und Eid (1997)). 50 subjects participated in this study.

For both the one dimensional measurement tool as well as the three subscales of the MDBF after invention the change was highly significant (p<0.001). Very large effect sizes and analyses of the individual changes satisfy criteria for the clinical relevance of the intervention. A follow-up in study 2 showed lasting effects of the therapy after three months. Possible critical points of design and analysis of both studies are intensively discussed.

The third study generated hypotheses for evaluating the therapy on a neuroscientific level. Electromyographic activity, skin resistance, respiratory frequency and heart rate turn out to be promising parameter for evaluating the method on a neuroscientific, objective level.

The main conclusion is that for this scope empirical evidence suggests effectiveness of this method on a psychological level – operationalized by valence of emotion and multidimensional mood measurements – and is promising for the evaluated parameters on a neuroscientific level. The methods used for collecting empirical data are critically reflected based on the criteria for evidence-based medicine. Possible further developments of the methods are discussed. The effectiveness of the intervention is discussed in comparison with other psychotherapeutical and pharmacological methods.

Table of Contents

Abstract

List of Figures

Table Index

List of Abbreviations

Acknowledgement

Introduction

1.1 Overview

1.2 Problem Definition

1.3 Aim

1.4 Structure of the work

Basics of the analysis – specialization

2.1 Overview of the history of psychotherapy

2.1.1 The origins of psychotherapy

2.1.2 The development of modern Psychotherapy

2.2 Methods of Psychotherapy

2.2.1 Cognitive Behavioural Therapy

2.2.2 Methods of Stimulus Confrontation

2.3 Pschotherapy and Neuroscience

2.4 The neuroscientific Approach of this Work

2.4.1 Basics – the Electrical and Neuronal Approach of this Work

2.4.2 Electrical Stimulation

2.5 Learning and Unlearning

2.5.1 Learning

2.5.2 Unlearning

2.6 Development of the emotionSync-Method (clapSync)

Questioning and Methodology

3.1 Introduction

3.2 Subjective Level

3.2.1 Study 1

3.2.2 Study 2

3.3 Physiological level

3.3.1 Scientific Questions

3.3.2 Implementation

3.3.3 Measuring Instrument and Parameter

3.3.4 Methodological Critique

Results

4.1 Presentation of Results

4.1.1 Presentation of Results on the Psychological Level

4.1.2 Presentation of Results on the Physiological Level

4.2 Subjective Level

4.2.1 Study 1

4.2.2 Study 2

4.3 Physiological Level

Critical Reflection of the Results

5.1 Overview and Introduction

5.2 Methodological critique

5.2.1 Statistics

5.2.2 Sample

5.2.3 Study Design

5.2.4 Manualization

5.2.5 Phases of clinical Examination

5.3 Further Developments

5.3.1 Further Development regarding other Sense Channels

5.3.2 Further Development regarding other Disorders

5.3.3 Further Development as a Psychotherapy Method

5.3.4 Further Development of Quality Management Measures

5.3.5 Further Development regarding neuroscientific Evaluation

5.3.6 Further Study Options

5.4 Comparison to other Therapy Methods

5.4.1 Comparison to other Psychotherapy Methods

5.4.2 Comparison to pharmacological Therapy Methods

5.5 Outlook

5.6 Conclusion

Afterword

Bibliography

Annex

Annex A – Therapy Manual: clapSync as a Method of treating dysfunctional Cognitions

Explanation

Therapist-Client-Relationship

Structure of Intervention

Annex B– Case Studies

Case Study 1

Case Study 2

Anhang C – Curriculum Vitae

List of Figures

Figure 1: Schematic presentation of learning processes

Figure 2: In In electrical engineering two principles of erasure are known: two energies overlap (a) or a stimulus is increased until an abrupt abortion is achieved (b). In case of classic habituation the energy is increased and then decreases again (red line). In case of the methods presented here, the energy is increased up to a maximum and then an abrupt abortion is achieved.

Figure 3: Design of a typical therapy setting, sessions normally took place in twos (client and therapist), sometimes in threes (client, therapist and recording person). A recording person was available upon express request and with the consent of the participant, but was seldomly requested. In larger seminar rooms, private areas were separated with the help of partitian walls.

Figure 4: Scale for the evalutation of the valence in stuy 1.–10 stands for maximum negative and +10 for maximum positive.

Figure 5: The measuring instrument used for the generaion of hypotheses

Figure 6: The test setup

Figure 7: The average (n=52) valence of the emotion before the intervention (time t0), after therapy of the dysfunctional cognition (time t1) and after learning of a functional cognition (time t2). The error bars indicate the standard error.

Figure 8: (a) Scatter Plots (blue) of the individual values before the intervention (time t0) and after therapy of the dysfunctional cognition (time t1). (b) Scatter Plots (blue) of the individual values afer therapy of the dysfunctional cognition (time t1) and after learning of a functional cognition (time t2). Shadows indicate identical values. The red points mark the border where no change takes place. Points above this border indicate an improvement, below the border a deterioration. The numbers within the points mark the number of test persons with identical values.

Figure 9: The value of the subscale GS of the MDBF before the intervention (time t0), after the intervention (time t1) and after three months (time t2). The error bars indicate the standard error. „***“ means of utmost significance (p<0.001; see chapter 4.1.1), „n. s.“ is the abbreviation for non-significant.

Figure 10: The values of the subscale WM of the MDBF before the intervention (time t1) and after three months (time t2). The error bars indicate the standard error. „***“ means of utmost significance (p<0.001; see chapter 4.1.1), „n. s.“ is the abbreviation for non-significant.

Figure 11: The values of the subscale RU of the MDBF before the intervention (time t0), after the intervention (time t1) and after three months (time t2). The error bars indicate the standard error. „***“ means of utmost significance (p<0.001; see chapter 4.1.1), „n. s.“ is the abbreviation for non-significant.

Figure 12: (a) individual change on the scale GS between measuring time t0 (before the intervention) and t1 (afer the intervention). (b) individual changes on the scale GS between measuring time t0 (before the interventon) and t2 (after three months). The red line marks values remaining equal at both measuring times. The yellow lines mark the 95%-confidence interval. Reliable changes only take place outside of the yellow area (1), values between the two yellow lines are regarded as “no change”. Values above the upper yellow line mean reliable improvements, values below the lower yellow line mean reliable deteriorations. Both groups can be further divided, depending on whether the values were below the values of the normal population before and above or below the values of the normal population after (blue lines). Group 2 was below the average value before the intervention. After the intervention/after three months the values of group 2 improved reliably, but are still below the average. Group 3 was below the average before the intervention and is above the average after the intervention/after three months. Group 4 was already above the average and further improved until the second measuring time. Group 5 was above the average before the intervention, deteriorated reliably until the second measuring time but remained above the average. Group 6 was above the average at the first measuring time and deteriorated below average until the second measuring time. Group 7 was below the average at the first measuring time and further deteriorated reliably.

Figure 13: (a) individual changes on the scale WM between measuring time t0 (before the intervention) and t1 (after the intervention). (b) individual changes on the scale WM between measuring time t0 (before the intervention) and t2 (after three months). For interpretation see figure 12.

Figure 14: (a) individual change on the scale RU between measuring time t0 (before the intervention) and t1 (after the intervention). (b) individual change on the scale RU between measuring time t0 (before the intervention) und t2 (after three months). For interpretation see figure 12.

Figure 15: (a) Percentual group membership under consideration of the criteria for clinical relevance (see figure 12 – 14 and chapter 4.2.2.4) for the difference between time t0 and t1. (b) percentual group membership under consideration of the criteria for clinical relevance (see figures 12 – 14 and chapter 4.2.2.4) for the difference between times t0 and t2.

Figure 16: (a) The middle difference of the scale value between time t0 and t1. (b) The middle difference of the scale value between time t0 and t2. Error bars indicate the standard error. „***“ means of utmost significance (p<0.001; see chapter 4.1.1), „n. s.“ is the abbreviation for non-significant.

Figure 17: Results of the physiological examination. The blue boxes mark the three examined intervals: before the intervention, during the intervention and after the intervention. Explanations see text.

Table Index

Table 1: Overview of the procedures and their terms (according to Neudeck and Wittchen, 2005)

Table 2: criteria for the scientific recognition of psychotherapy methods and psychotherapy procedures according to the WBP (WBP, 2010). Criteria for the evaluation of the methodological quality, the internal and external validity are available (WBP, 2010).

List of Abbreviations

APA

American Psychological Association

DBS

deep brain stimulation

DSM

Diagnostisches und Statistisches Manual Psychischer Störungen

(Diagnostic and Statistical Manual of Mental Disorders; APA)

EBM

Evidenzbasierte Medizin (evidence based medicine)

ECT

electroconvulsive therapy

EKG

Elektrokardiogramm

EEG

Elektroenzephalogramm

EKT

Elektrokrampftherapie

EMG

Elektromyographie

ICD

International Statistical Classification of Diseases and Related Health Problems

G-BA

Gemeinsamer Bundesausschuss

GS

Gute Stimmung – schlechte Stimmung (Subskala des MDBF) (good mood – bad mood)

HPG

Heilpraktikergesetz (law on naturopathy)

KVT

Kognitive Verhaltenstherapie (cognitive behavioural therapy)

MDBF

Mehrdimensionaler Befindlichkeitsfragebogen (multidimensional questionnaire on mental state)

MKT

Magnetkrampftherapie

MRT

Magnetresonanztomographie

n. s.

nicht significant (not siginificant)

PTG

Psychotherapeutengesetz (law on psychotherapy)

RU

Ruhe–Unruhe (Subskala d MDBF) (rest – unrest subscale of the MDBF)

SRL

Skin Resistance Level

SRR

Skin Resistance Response

USB

Universal Serial Bus

tDCS

transcranial direct current stimulation

THS

Tiefe Hirnstimulation (deep brain stimulation)

TMS

Transkranielle Magnetstimulation

VT

Verhaltenstherapie (behavioural therapy)

WBP

Wissenschaftlicher Beirat Psychotherapie

WM

Wachheit – Müdigkeit (Subskala des MDBF) (awakeness – tieredness subscale of the MDBF)

Acknowledgement

I thank Professor / UCN Dr./UCN Karl Nielsen and Professor / UCN Dr./UCN Nandana Nielsen for their open, far-sighted way of helping and appreciating people. They are pioneers for the positive change in teaching and learning in the Faculty of Psychology. I also thank Dr. Claudia Wilimzig, Dr. Götz Wilimzig, Monika Pfaff, Stephanie Konkol, Fabian Müller, Torsten Seelbach AFNB, Peter Manns, Tanja Geppert and all my wonderful clients for their loving help and support. Many thanks also to my most important teacher, Klaus Grochowiak, who taught me the philosophical perspective. This also includes Frank Farrelly, who gave me love and humour.

The big thanks goes to my dear wife, Heidi and my children Ann Sophie and Maximilian. I thank Steve Jobs (Apple) for his memorable statements (his words have inspired me):

Apple Think Different Advertising Campaign (1997 – 2002)

Here’s to the crazy ones.

The misfits.

The rebels.

The troublemakers.

The round pegs in the square holes.

The ones who see things differently.

They’re not fond of rules.

And they have no respect for the status quo.

You can quote them, disagree with them, glorify or vilify them.

But the only thing you can’t do is ignore them.

Because they change things.

They push the human race forward.

And while some may see them as the crazy ones,

We see genius.

Because the people who are crazy enough to think

they can change the world,

Are the ones who do

Quelle: Spot Think Different von Apple-Weblinks:

http://www.youtube.com/watch?v=Rzu6zeLSWq8,

http://www.youtube.com/watch?v=nmwXdGm89Tk

http://www.youtube.com/watch?v=Ypp09Hq7T9g

http://de.wikipedia.org/wiki/Think_Different

1. Introduction

1.1 Overview

In this chapter (section 1.2) the central concepts of this work, as mentioned in the title, are defined and briefly explained. On this basis, the need for action leading to this work is derived and described. Subsequently, the objectives of this work are presented (Section 1.3) and the structure of the work outlined (Section 1.4).

1.2 Problem Definition

This work deals with the development and empirical examination of a (psycho) therapeutic approach. For psychotherapy, there are many different definitions, as there is a great variety of psychotherapy methods (a good overview is provided in Pritz, 2008), which makes an exact definition of psychotherapy more difficult (Van Deurzen-Smith & Smith, 1996). The presumably oldest definition comes from Anna O., one of the "classicals" clients of the early psychoanalysis who described Breuer's therapy as "talking cure" (Breuer and Freud, 1895). Corsini and Wedding (2000) argued the pessimistic view that psychotherapy can not be defined with precision (interestingly, this is missing in the newer version (Corsini and Wedding, 2011)). Similarly, Raimy (1950) found psychotherapy as an undefined method applied with unpredictable results to unspecific problems. There may be agreement that psychotherapy has developed beyond this.

Here, some characteristics of psychotherapy are to be listed, which does not mean that they always apply to all forms of therapy (see Corsini and Wedding, 2000). The following characteristics are given for the following examples: Strotzka (1978), Baumann, Hecht and Mackinger (1984), Wittchen, Hoyer, Fehm, Jacobi and Junge-Hoffmeister (2011), Hautzinger and Pauli (2009) and Kanfer and Schmelzer (2005) Serious psychotherapy suggested:

a purposeful change process,

is consciously planned and systematicis carried out with psychological meansof psychological and stressful problemscurrent, scientifically based knowledge in theory and practicemethods whose principle effectiveness is valid for the relevant purposeaims at a reduction or reduction of the symptomsis variable in its objectives according to the respective problem constellation

It is also important that it is an interaction between at least two human beings and the therapeutic relationship is given great importance.

Psychotherapy is frequently equated with psychology in everyday language usage (Van Deurzen-Smith & Smith, 1996). Psychology is the scientific occupation of thinking, feeling, perception and behaviour and is defined as:

"The science of behaviour (everything that accounts for an organism) and the mental processes (subjective experiences that we tap into behaviour). The key word of this definition is science. "(Myers, 2008, p. 8).

The focus of psychology today is on empirical research, which is very strongly theorized (cf Myers, 2008, Gerrig and Zimbardo, 2008). Psychologists carry out basic research (see Myers, 2008). In classical psychology, basic research and applied psychology are separated (see Myers, 2008).

The fields of applied psychology include clinical psychology, which is most closely linked to psychotherapy within psychology, since it deals with the research topic of mental disorders and psychological aspects of somatic disorders (Wittchen and Hoyer, 2011a, 2011b, 2011c, Baumann et al Perrez, 1998).

These include research, diagnostics, etiology, conditional analysis, classification, epidemiology and therapy / intervention (Wittchen and Hoyer, 2011a; Baumann and Perrez, 1998). It is characteristic that it has close relations with other scientific disciplines. Psychiatry, sociology, neurobiology (including genetics and pharmacology), neurology and medicine (Wittchen and Hoyer, 2011a), and further behavioural medicine, medical psychology, clinical neuropsychology, depth psychology, social pedagogy, health psychology and public health (Baumann and Perrez, 1998), Schraml, 1970).

How does clinical psychology relate to psychotherapy? According to Wittchen and Hoyer (2011a), psychotherapy represents only a part of the intervention catalogue of clinical psychology. Baumann and Perrez (1998) regard psychotherapy as a sub - area of clinical psychology, or they demand a particularly narrow relationship between psychology and psychotherapy. A separation of the two disciplines would lead to a further development of psychotherapy and quality assurance (Baumann, 1995). This view is, however, strongly discussed (Pritz, 1996), which is illustrated below.

Psychologists point out that psychological means are a characteristic of psychotherapy and that changes in the personality structure caused by psychological means are subject of psychology (Grawe, Donati and Bernauer, 1994, Strotzka, 1978). Furthermore, many important therapeutic approaches have been developed by psychologists (for a counter position, see below), and a large part of psychotherapeutic research has been and is carried out by psychologists (Grawe et al., 1994, Datler and Felt, 1996).

On the other hand, physicians point out that psychotherapy is part of the healing professions und that any healing treatments therefore belong to their area of responsibility. (Datler und Felt, 1996; for critical presentation see Wagner, 1996; Sonneck, 1996). Physicians can also claim that significant methods have been developed by doctors (for example psychoanalysis). Furthermore, a significant number of physicians practices as psychotherapists. (Datler and Felt, 1996). With Psychiatry, there is a related area within medicine in analogy to clinical psychology which is related to psychotherapy within the field of psychology. (see above and see Filz, 1996). Just as clinical psychologists regard psychotherapy as a branch of their field, psychiatrists regard psychotherapy as a branch of their discipline (Möller, Laux und Deister, 2009).

Not least also pedagogues make a claim to psychotherapy. Promotion of personality development is seen as a pedagogical subject, healing pedagogy as an explicit branch of pedagogy and lots of pioneers of psychotherapy e.g. Anna Freud, August Aichhorn or Oskar Spiel – have originated from pedagogy (Datler und Felt, 1996).

The arguments can be summarized as follows:

Psychotherapeutic methods are applied by representatives of the according disciplines

the discipline has contributed to the development of psychotherapy

there is a special field within the discipline that overlaps with psychotherapy

There is an alternative pursued especially in Austria. It aims at the recognition of psychotherapy as an independent science, which is discussed in detail (Pritz und Teufelhart, 1996; van Deurzen-Smith and Smith, 1996; Datler and Felt, 1996; Buchmann, Schlegel and Vetter, 1996). The problem is that a consent has to be reached first what “independent science” means and how psychotherapy should position itself among the canon of humanities and natural sciences (Steinlechner, 1996; Hutterer, 1996; Reiter and Steiner, 1996; Schiepek, 1996). This is further complicated by different strategies of research and interests between rather theoretically oriented scientists working quantitatively and rather quality oriented practitioners (e.g. Jandl-Jager, Presslich-Titscher, Springer-Kremser and Maritsch, 1997). Dumont discusses the question whether psychotherapy is “science” or “art” along a similar line. Dumont (2011). This constitutes the field of tension in which psychotherapy exists. In this work psychotherapy is regarded as an independent discipline for pragmatical reasons under close consideration of the neighbouring disciplines without pursuing the question, whether this means the status of an independent science. The interdisciplinarity which is a characteristic for psychotherapy and which expresses itself in this debate as well as the question of the suitable scientific approach are taken into consideration. Psychotherapy is characterised by a variety of methods. Statements about the efficiency cannot be made on a general basis, but are always specific in regard of a problem and a method of therapy (see above and Myers, 2008).

For this work the cognitive behavioural therapy (KVT) is of importance, which has been significantly established by (e.g. Beck et al., 2010) and Ellis („rational-emotive therapy“(e.g. Ellis, 1978); later renamed into “rational emotive behavioural therapy” (Ellis, 1993)). KVT combines two forms of therapy:

Behavioural therapy (VT), which erases and modifies undesired behaviour (Myers, 2008, S. 802; an extensive definition in in Margraf and Schneider, 2009)

and

The cognitive therapies teaching the clients new, better and reality adjusted ways of thinking and acting. (Myers, 2008, S. 807; an extensive definition in Beck, 2011)

Whereby “cognitive therapy” and “KVT” are de facto identical in their meaning today (Beck and Dozois, 2011), as there is practically always an influence of aspects of behavioural therapy. (see Schöttke, 2010). In the following, only the term KVT will be used and is defined according to the already mentioned basic ideas as a

„Widespread integrative therapy in which the techniques of cognitive therapy (change of the self-devaluating thought processes) are combined with the techniques of behavioural therapy (change of behaviour)“ (Myers, 2008, S. 809).

Chapter 2 will go into more detail regarding those forms of therapy and their position within the entirety of methods of psychotherapy.

A central assumption of KVT is the central position of the idea that “between incidents and emotional reactions, thoughts can have an intermediary influence”. (Myers, 2008, S. 807). If these thoughts (cognitions) are dysfunctional, they will trigger psychological disorders from the perspective of KVT and keep them up. Such cognitions are defined as “dysfunctional, perceptual thought and attitude patterns” („cognitive schemes”, “cognitive errors”, “systems of belief”) (Mühlig and Poldrack, 2011) or “fundamental convictions” (Schöttke, 2010). What does dysfunctional mean? Schöttke (2010) criticizes that a lack of agreement upon the criteria of dysfunctionality complicates research. (Schöttke, 2010). For this work, the definition of Elli is supported which suggests that dysfunctionality affects the well-being of the individual and precisely the following is stated (quoted according to Schöttke, 2010):

„every thought, every feeling and every behaviour that leads to self-destroying or self-destructing consequences and affects the survival or happiness of the individual substantially” (Schöttke, 2010, S. 345).

This includes (according to Schöttke, 2010):

It is assumed of the persons concerned that the dysfunctionality is realistic although this is not the case in at least one significant way

The persons concerned run themselves down and are not able to accept themselves;

This leads to problems with their social environment;This seriously compromises satisfactory social relations and interactions;Affects happiness and success regarding productive work;Disturbs personal important interests in a significant way

In the individual case, any number of these criteria can apply. It can be stated according to Walen, DiGiuseppe and Wessler (1982) that dysfunctional evaluations are untrue and absolute and not helpful for the achievement of individual goals. Clinically this causes (according to Schöttke, 2010):

Disaster scenarios (always assuming the worst case)

Generalized assessment of oneself

Generalized assessment of others

Negative future perspectives

Which dysfunctional patterns (cognitive errors) can occur? (according to Beck, 1967; Ellis and Dryden, 1997; Mehl, 1991; Mühlig und Poldrack, 2011, Pössel and Hautzinger, 2009, and Wilken, 2010): the following are characteristic:

„Overgeneralization” (extrapolation from one situation to a similar situation). There is a similar process known as “labelling” if for example a generalized assessment results from a situation or an action (e.g. you regard yourself as an absolute failure just because you haven´t succeeded once).

“Assumption of a temporal causality, prediction without temporal evidence” (something has once been valid, so it will always be valid)

„Arbitrary conclusions” (conclusions without proof or in spite of counter proof)

“Selective abstraction” (a single information is overrated, other information negated) or “selective attention” in everyday language known as “tunnel vision” (you only regard selected aspects).

“Making up disaster scenarios” (you always think the worst will happen)

“Insurance thinking” (you expect the negative to prevent yourself from being disappointed.

„Reference to oneself“ (you always believe to be the center of general attention; incidents are always related to your own person)

„Absolute demand (must-thinking)” (Everything has to go according to your own desires and to be exactly as you want it to be)

„Dichotomous thinking” (there are only extremes – black/white, good/bad,…)

„Maximizing/minimizing” (negative experiences are overrated, positive ones underrated)

„emotional argumentation” (emotions are regarded as proof, e.g. because you feel worthless, you are worthless)

„mind reading” (you assume to know what others think)

Ellis (1962) classified eleven fundamental dysfunctional, disease causing, non-conductive cognitions. These can be summarized in three fundamental convictions or fundamental cognitions (Ellis, 1979; Pössel and Hautzinger, 2009; de Jong-Meyer, 2009):

I must be perfect in order to get recognition (otherwise I am worthless).

Others have to treat me courteously, friendly, considerately and fairly (otherwise they are “a null” in terms of humanity)

The circumstances and life conditions have to be good and easy and have to give me all that I want without hardship or effort (otherwise the world is basically bad and life not worth living). Ellis (1979) developed the expression “mustturbatory”” ideologies. “Mustturbatory” is derived from masturbate (“confuse manually”) and means “to confuse yourself with a must” (Kessler & Hoellen, 1982, S. 27).

Dysfunctional conditions can be analysed with the help of the metamodel of language (for further techniques of analysis see chapter 2.2.1.1). This model deals with the question how humans communicate with themselves and others. It is based on transformation grammar, developed by Chomsky and further developed repeatedly (e.g. Chomsky, 1957; 1981; 1995). Bandler and Grinder (1975, 1976) used Chomsky´s theories to develop the metamodel of language in which the surface of language (= what the speaker distorts [un-sconciously]) and the deep structure (the actual meaning) are analysed (see Grochowiak and Heiligtag, 2002). By means of a targeted question technique, the following terms resulting from the deep structure can be made conscious and analysed:

Generalizations

Distortions

Extinctions

The following are defined as generalizations (e.g. Bandler and Grinder, 1975, 1976; Grochowiak and Heiligtag, 2002):

individual experiences are translated into rules that are always valid (e.g. “everything goes wrong all the time”)

statements are formulated on behalf of all elements (e.g. “Germans don´t like risk”)

Something is communicated without considering the consequences (e.g. you have to do this – what would happen if you didn´t?)

The originator is withheld (also “you must do this” – who says so?)

Extinctions mean (e.g. Bandler and Grinder, 1975; Grochowiak and Heiligtag, 2002):

Simple extinction/lapse– absence of information (e.g. “I am enthusiastic” – about what?)

Verbs are described incompletely (“I suffer” – from what do you suffer?)

Incomplete comparison (“This is better” - in comparison to what?)

Absence of references (“This can´t be” – what can´t be?)

Nominalizations – nouns that are derived from verbs and adjectives, terms that are not objective (depression, success, wealth…)

Distortions are defined as follows: (e.g. Bandler and Grinder, 1975, 1976; Grochowiak and Heiligtag, 2002):

Causes are claimed (e.g. „His behaviour makes me angry.”) or reversely things are assumed in others (“He is angry, because I…”)

Complex equivalence (My husband didn´t bring me flowers, so he doesn´t love me anymore.”)

Pre-assumptions (“You will not lie to me anymore.” Pre-assumption: you lied to me.)

Clairvoyance/mind-reading („I know what will happen anyway”)

As apparent, this is a relatively complex construct for the analysis of language, which describes many elements of dysfunctional patterns (the above presentation does not claim to be complete but can be extended ad libitum.) In addition this model offers question techniques for each point in order to scrutinize them and analyses typical words which point at a pattern – e.g. “all”, “permanently”, “eternally”, “always”, “never”, “nobody” “one” implicate that a person translates individual experiences into generally valid rules. (Bandler und Grinder, 1975, 1976; Grochowiak and Heiligtag, 2002).

Many of these cognitive errors are connected to unreflected generalizations – as already clarified in the definition of “dysfunctionality”.

These can be

Convictions concerning oneself

Other persons

or

The world in general (see above the three “mussturbatory” ideologies according to Ellis (1979).

In some disciplines, such generalizations of doctrines are defined as “beliefs”. (Dilts, 1993). Beck and Ellis also use the term „belief“ (sometimes also „core belief“). In social psychology, researching how humans perceive and influence each other, (Myers, 2008) or, to be a bit more exact, how society influences individuals (society oriented approach) and the role of the individual as a part of society (individual oriented approach) (Graumann, 203), the term attitude is used for such generalizations or beliefs.

Attitude is defined as

Conviction, psychological tendency or emotion that predisposes people to react in a certain way towards things, stimuli, people, behaviour, terms and events (Myers, 2008) and can lead to a certain degree of agreement or rejection (Bohner, 2008). It can be conscious or unconscious respectively explicit or implicit (Myers, 2008; Gerrig and Zimbardo, 2008; Myers, 2013; for a detailed presentation see Crano und Prislin, 2008). Allport (1935) defined the term of attitude as one of the most central terms in social psychology. Fishbein and Ajzen (2005) point out that attitudes can have three kinds of manifestations:

cognitive (perception/knowledge),

affective (emotions),

behavioural/cognitive (behaviour resp. behavioural intention).

Social psychology has been interested for a long time in the question how such attitudes and generalizations influence behaviour (see Myers, 2008). In the 1960s (Wicker, 1969) this hypothesis faced a crisis because it was assumed that attitudes correlated only weakly with behaviour and the number of cases in which behaviour could not be predicted, was larger than that where it could be predicted. This has been examined thoroughly in the following decades. Three points have proven to be especially predicative for the prediction of behaviour (Myers, 2008; Gerrig und Zimbardo, 2008):

When other influences are weak.

When we are clearly conscious of the attitude (Myers, 2008) respectively when it is available (Gerrig und Zimbardo, 2008). Availability means that the association with the object to be assessed and the attitude are strong (due to experiences).

When the attitude is specific, meaning it directly aims at behaviour. (Myers, 2008; Gerrig and Zimbardo, 2008).

Those points are true for the attitudes examined in this work.

Attitudes also direct information processing (under certain circumstances) (attitude invoked selectivity), lead to selective attention and information intake, to selective perception and selective judgedment, selective elaboration and memory formation (Bohner, 2003).

Even if this differs from KVT in nuances, many overlappings and similarities are recognizable. As already mentioned, KVT emphasizes the influence of negative generalizations on different aspects of personal life up to psychological disorders. In social psychology there are also tendencies to apply social-psychological concepts to clinical psychology and therapy (Snyder & Forsyth, 1991a, 1991b). However, the efforts to apply the theory of attitudes to clinical psychology and therapy are so diverse that it cannot be discussed comprehensively at this point (for a short overview concerning this topic see Försterling, 1988).

In the following the term “dysfunctional cognition” will be used for such negative generalizations. Examples for such cognitions are over-generalizations like “I´m not worth anything”, “I am a failure” or “All people are bad”. As mentioned above, such a cognition can result from one or few experiences which are projected on the entire future.