How many times have we observed individuals completing a pre-programmed set of activities and still appearing apathetic with flat affect? On the other hand, we have observed individuals becoming animated after getting out of bed or going for a walk. The difference in the impact of these different sets of activities is in the meaning attributed by the individual to the activities. In the former circumstances, the individual perceives the activities as mechanical and as something he/she is expected to do. Whereas, in the latter case there is a meaning attached to the activity, for example, “ I find I have more energy than I thought… Going for a walk can be enjoyable…. etc.”. The conclusion from these examples is that the clinicians need to pay attention to the inferences the individual has about activities. More specifically, the clinician needs to draw out the patient in terms of his/her expected reactions in so far as it may reflect a given belief such as “ I won’t have the energy for the activity…I won’t enjoy it……People will reject me if I approach them”.In a subtle way, the clinician sets up a hypothesis regarding the activity and determines whether the hypothesis is confirmed or negated. In this way, the confirmed hypothesis regarding enjoyment or acceptance can be translated into beliefs about the self, the outside world, and the future. Given a series of successful experiences in which positive conclusions are drawn, the individuals can start to see themselves as more capable and acceptable and others as more supportive and accepting.
The meanings of the experiences are reflected in the enhancement of the self-image (connected, competent, and in control) and the image of others as agreeable, trustworthy, and cooperative. For example, we have found that many individuals do very well when their activity consists of helping another person. The self-image changes to efficient and considerate and their image of other people becomes collaborative and appreciative.
When the individual approaches a task that seems formidable and challenging, the clinician can influence the meanings attached to the task through being supportive and encouraging. An experiment by Grant, Perivoliotis, Luther, Bredemeier & Beck(2018) demonstrated that in a card-sorting task, individuals did significantly better than a control group when they were given positive feedback at each stage of the trial. The emotions generalize to the individual’s improvement in positive self-concept, mood, and a reduction in endorsed defeatist beliefs. We attributed the fact that the experimental group did better than the control group to an enhanced motivation resulting from the positive feedback from the examiner interacting with the actual performance.
Theoretical Framework of Meanings
The meanings attached to experiences are derived from the specific beliefs that have been activated. In terms of cognitive theory, the beliefs are embedded in cognitive schemas that have the characteristics of a) intensity or charge, b) permeability, and c) size. Some beliefs are relatively flexible and can be energized while others are rigid and may have a delusional characteristic. Some schemas are relatively small and may be relevant to only a discrete environmental stimulus/fear such as a fear of heights, whereas others are broad and have to do with fears of other people. The beliefs serve as formulas or algorithms for translating an experience into a specific attribute. There are parallel sets of these attributes which are summarized in the double column table below:
The attributes may have a specific charge and whether the belief is negative or positive, it is possible to diminish or activate it. At times, two opposite beliefs with varying degrees of intensity or believability may be present. The beliefs themselves are dimensional. That is they have a degree of believability from 0%-100%. While the individual may have 100% believability for both opposing beliefs, it is likely that instead, one belief will be more believable than the other and therefore the clinician can gain insight from the respective percentages of believability and use strategies to increase the positive and diminish the negative. It is important to keep in mind that positive beliefs can be activated even though they are latent. When this is accomplished, the individual is in the adaptive mode.
Grant, P., Perivoliotis, D., Luther, L., Bredemeier, K., & Beck, A. (2018). Rapid improvement in beliefs, mood, and performance following an experimental success experience in an analogue test of recovery-oriented cognitive therapy. Psychological Medicine, 48(2), 261-268. doi:10.1017/S003329171700160X2 / 2