Beck's cognitive triad
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The triad involves negative thoughts about:
- The self (i.e., the self is worthless)
- The world/environment (i.e., the world is unfair), and
- The future (i.e., the future is hopeless).
From a cognitive perspective, depressive disorders are characterized by people's dysfunctional negative views of themselves, their life experience (and the world in general), and their future—the cognitive triad.
Depressed patients often view themselves as deficient, helpless and/or unlovable. They tend to attribute their unpleasant experiences to their presumed physical, mental, and/or moral deficits. They tend to feel excessively guilty, believing that they are worthless, blameworthy, and rejected by self and others. They may have a very difficult time viewing themselves as people who could ever succeed, be accepted, or feel good about themselves. Some of the most striking manifestations of this area of cognitive bias are such patients' propensity for overlooking their positive attributes, disqualifying their accomplishments as being minor or meaningless, and misinterpreting the care, good will, and concern of others as being based on pity or susceptible to being lost easily if those others knew the “real” patient.
Depressed patients view their lives as devoid of pleasure or reward, presenting insuperable obstacles to achieving their important goals. Everything seems and feels “too hard to manage” and other people are seen as punishing (or potentially so).
They believe that their troubles will continue indefinitely, and that the future will only bring further hardship, deprivation, and frustration. “Paralysis of the will” results from the depressed patients' pessimism and hopelessness. Expecting their efforts to end in failure, they are reluctant to commit themselves to growth-oriented goals, and their activity level drops. Believing that they cannot affect the outcome of various situations, they experience a desire to avoid such situations.
Suicidal wishes are an extreme expression of the desire to escape from problems that appear to be uncontrollable, interminable, and unbearable.
- Beck, Aaron T.; Rush, A. John; Shaw, Brian F.; Emery, Gary. (1979). Cognitive Therapy of Depression. New York: The Guilford Press. pp. 11. ISBN 0-89862-919-5.
- Kaplan and Sadock's Comprehensive Textbook of Psychiatry