Cognitive Mechanisms in the Avoidance of Painful and Dangerous Thoughts: Elaborating the Assimilation Model

Cognitive Therapy and Research - Tập 23 - Trang 285-306 - 1999
J. Mark G. Williams, William B. Stiles, David A. Shapiro

Tóm tắt

The emotional processing of problematicexperiences is a central feature of psychotherapy.Stiles et al. (1990) propose an Assimilation model as ageneric account of such processes. This paper focuses on two aspects of this model: the concepts of“warding off” and “unwantedthoughts” showing how a cognitive scienceperspective can enrich our understanding of them. Wefocus on the ways in which cognitive processes (particularly different sorts ofmemory) mediate between experience and psychopathology.Two classes of problematic experiences that can beavoided or barred from full awareness to varying degrees are distinguished. We refer to this distinctionas the “pain paradigm,” in which experiencesare inaccessible to memory retrieval using verbalmnemonics,versus the “panic paradigm,” inwhich experiences fail to be retrieved or reported because theperson anticipates catastrophic consequences. We discusshow understanding the cognitive origins of thesephenomena promises to allow researchers and therapists to generate new approaches to overcome blocksin therapy.

Tài liệu tham khảo

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Washington, DC, American Psychiatric Association. Bowlby, J. (1980). Attachment and loss III: Loss: Sadness and depression. New York, Basic Books. Baddeley, A. D. (1990). Human memory: Theory and practice. Hove, LEA. Brewin, C. R. (1989). Cognitive change processes in psychotherapy. Psychological Review, 96, 379–394. Brewin, C. R. (1996). A dual representation theory of post traumatic stress disorder. Psychological Bulletin, 103, 670–686. Brittlebank, A. D., Scott, J., Williams, J. M. G., & Ferrier, I. N. (1993). Autobiographical memory in depression: State or trait marker? British Journal of Psychiatry, 162, 118–121. Christianson, S.-A., & Nilsson, L.-G. (1989). Hysterical amnesia: A case of aversively motivated isolation of memory. In T. Archer & L.-G. Nilsson (Eds.), Aversion, avoidance and anxiety: Perspectives on aversively motivated behaviour (pp 289–310). Hillsdale, New Jersey, LEA. Clark, D. M. (1989). Anxiety states: Panic and generalised anxiety. In K. Hawton, P. M. Salkovskis, J. Kirk, & D. M. Clark (Eds.), Cognitive behaviour therapy for psychiatric problems: A practical guide (pp 52–96). Oxford, Oxford University Press. Ehlers, A., & Steil, R. (1995). Maintenance of intrusive memories in post traumatic stress disorder: A cognitive approach. Behavioural and Cognitive Psychotherapy, 23, 217–249. Ellis, J. A. (1988). Memory for future intentions: Investigating pulses and steps. In M. M. Gruneberg, P. E. Morris, & R. N. Sykes (Eds.), Practical aspects of memory: Current research and issues I (pp 371–376). Chichester, John Wiley. Evans, J., Williams, J. M. G., O'Loughlin, S., & Howells, K. (1992). Autobiographical memory and problem solving strategies of parasuicide patients. Psychological Medicine, 22, 399–405. Gilbert, P. (1992). Depression: The evolution of powerlessness. Hove, LEA. Goddard, L., Dritschel, B., & Burton A. (1996). Role of autobiographical memory in social problem solving and depression. Journal of Abnormal Psychology, 105, 609–616. Greenberg, L. S., & Safran, J. D. (1987). Emotion in psycho therapy. New York & London, Guilford. Harris, J. E., & Wilkins, A. (1982). Remembering to do things: A theoretical framework and an illustrative experiment. Human Learning, 1, 123–136. Horowitz, M. J. (1986). Stress response syndromes. Northvale, London: Aronson. Horowitz, M. J. (1988). Introduction to psycho dynamics. New York, Basic Books. Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology of trauma. New York, Free Press. Johnson, M. K., Kim, J. K., & Risse, G. (1985). Do alcoholic Korsakoff's syndrome patients acquire affective reactions? Journal of Experimental Psychology: Learning Memory & Cognition, 11, 22–36. Johnson, M. K., & Multhaup, K. S. (1992). Emotion and MEM. In S. A. Christianson (Ed). The handbook of emotion and memory: Research and theory. Hillsdale, NJ, Erlbaum. Kuyken, W., & Brewin, C. R. (1995). Autobiographical memory functioning in depression and reports of early abuse. Journal of Abnormal Psychology, 104, 585–591. Lindsay, D. S., & Read, J. D. (1994). Psychotherapy and memories of childhood sexual abuse: A cognitive perspective. Applied Cognitive Psychology, 8, 281–338. Macleod, A. K., Williams, J. M. G. & Bekerian, D. A. (1991). Worry is reasonable: The role of explanations in pessimism about future personal events. Journal of Abnormal Psychology, 100, 478–486. McNally, R. J., Litz, B. T., Shin, L.M., & Weathers, F.W. (1994). Emotional priming of autobiographical memory in PTSD. Cognition & Emotion, 8, 351–367. Moore, R. G., Watts, F. N., and Williams, J. M. G. (1988). The specificity of personal memories in depression. British Journal of Clinical Psychology, 27, 275–276. Parkin, A. J. (1987). Memory and amnesia: An introduction. Oxford, Basil Blackwell. Parkin, A. J. (1993). Memory: Phenomena, experimen t and theory. Oxford, Blackwell. Pennebaker, J. W. (1989). Confession, inhibition, and disease. In L. Berkowitz (Ed.), Advances in experimental social psychology, Vol. 22 (pp. 211–244). New York: Academic Press. Piaget, J. (1970). Piaget' s theory (G. Gellerie r & J. Langer, trans.). In P. H. Mussen (Ed.), Carmichael's manual of child psychology, 3rd. edition, Vol. 1 (pp. 703–732). New York: Wiley. Platt, J. J. & Spivack, G. (1975). Manual for the mean s-ends-problem-solving (MEPS): A measure of interpersonal problem solving skill. Philadelphia, PA: Hahnemann Medical College Hospital. Puffet, A., Jehin-Marchot, D., Timsit-Berthier, M., & Timsit, M. (1991). Autobiographical memory and major depressive states. European Psychiatry, 6, 141–145. Reason, J. (1990). Human error. Cambridge, Cambridge University Press. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed by the client-centered framework. In S. Koch (Ed.), Psychology: A study of a science: Volume III. Formulations of a person and the social context (pp. 184–256). New York: McGraw-Hill. Rubin, D. C. (1996). Remembering our past: Studies in autobiographical memory. Cambridge, Cambridge University Press. Schacter, D. L. (1993). Understanding implicit memory: A cognitive neuroscience approach. In A. F. Collins, S. E. Gathercole, M. A. Conway, & P. E. Morris (Eds.). Theories of Memory (pp. 387–412). Hove, Erlbaum. Schooler, J. W. (1994). Seeking the core: The issues and evidence surrounding recovered accounts of sexual trauma. Consciousness and Cognition, 3, 452–469. Schooler, J., Ambadar, Z., & Bendikson, M. ( in press). A cognitive corroborative case study approach for investigating alleged recovered memories of abuse. In D. Read & D. S. Lindsay (Eds.), Recollections of trauma: Scientific research and clinical practice. New York: Plenum. Sidley, G. L., Whitaker, K., Calam, R., & Wells, A. (1997). The relationship between problem-solving and autobiographical memory in parasuicide patients. Behavioural and Cognitive Psychotherapy, 25, 195–202. Smith, D. L. (1988). Narcissism since Freud: Towards a unified theory. British Journal of Psychotherapy, 4, 302–312. Stiles, W. B., Elliott, R., Llewelyn, S. P., Firth-Cozens, J. A., Margison, F. R., Shapiro, D. A., & Hardy, G. (1990). Assimilation of problematic experience s by clients in psychotherapy. Psychotherapy, 27, 411–420. Stiles, W. B., Morrison, L. A., Haw, S. K., Harper, H., Shapiro, D. A., & Firth-Cozens, J. (1991). Longitudinal study of assimilation in exploratory psychotherapy. Psychotherapy, 28, 195–206. Stiles, W. B., Meshot, C. M., Anderson, T. M., & Sloan, W. W. Jr. (1992). Assimilation of problematic experiences: The case of John Jones. Psychotherapy Research, 2, 81–101. Teasdale, J. D., & Barnard, P. J. (1993). Affect, cognition and change: Re-modelling depressive thought, Hillsdale, NJ: Lawrence Erlbaum Associates. Thorpe, S. (1994). Unpublished D. Phil Thesis, University of Oxford, Department of Psychiatry. Tulving, E. (1972). Episodic and semantic memory. In E. Tulving & W. Donaldson (Eds.). Organisation of memory (pp. 381–403). New York, Academic Press. Wahler, R. G., & Afton, A. D. (1980). Attentional processes in insular and non-insular mothers: Some difference s in their summary reports about child problem behaviors. Child Behavior Therapy, 2, 25–41. Warrington, E. K., & Weiskrantz, L. (1968). New methods of testing long-term retention with special reference to amnesic patients. Nature, 217, 972–974. Williams, J. M. G. (1992). The psychological treatmen t of depression: A guide to the theory and practice of cognitive behaviour therapy. London & New York, Routledge. Williams, J. M. G. (1996). Depression and the specificity of autobiographical memory. In D. C. Rubin (Ed.), Remembering our past: Studies in autobiographical memory. Cambridge, Cambridge University Press. Williams, J. M. G., & Broadbent, K. (1986). Autobiographical memory in attempted suicide patients. Journal of Abnormal Psychology, 95, 144–149. Williams, J. M. G., & Dritschel, B. H. (1988). Emotional disturbance and the specificity of autobiographical memory. Cognition and Emotion, 2, 221–234. Williams, J. M. G., & Dritschel, B. H. (1992). Categoric and extended autobiographical memories. In M. A. Conway, D. C. Rubin, H. Spinnler, & W. A. Wagenaar (Eds.), Theoretical perspectives on autobiographical memory (pp. 391–412). Dordecht, Boston & London, Kluwer Academic Publishers. Williams, J. M. G., Ellis, N., Tyers, C., Healy, H., Rose, G., & MacLeod, A. (1996). The specificity of autobiographical memory and imagineability of the future. Memory and Cognition, 24, 116–125. Williams, J. M. G., & Marker, H. R. (1991). Money hidden and rediscovered when manic: A case of state-dependent re-enactment. British Journal of Psychiatry, 159, 579–581. Williams, J. M. G., & Scott, J. (1988). Autobiographical memory in depression. Psychological Medicine, 18, 689–695. Williams, J.M. G., Watts, F. N., Macleod, C., & Mathews, A. (1997). Cognitive Psychology and Emotional Disorders. Chichester, John Wiley & Sons. Winograd, E. (1988). Some observations on prospective remembering. In M. M. Gruneberg, P. E. Morris, & R. N. Sykes (Eds.), Practical aspects of memory: Current research and issues I (pp 348–353). Chichester, John Wiley.