Socratic dialogue - a method in cognitive-behavioral therapy

Socratic dialogue – a method in cognitive-behavioral therapy

Table of contents

Socratic dialogue is one of the basic questioning techniques in the cognitive-behavioral approach. First of all, it has a very important function in looking at the relationships between thoughts, emotions and behavior. It also allows you to work and create alternative beliefs, discovering new arguments, leading to a change (cognitive restructuring) of old, often maladaptive beliefs.

Cognitive content

Cognitive contentCognitive elements can be found in almost every problem. Even if it seemingly appears to us that we can’t recall or recreate anything in a given situation. Thoughts can often be elusive to us, especially when there is a strong affect. As Aron Beck pointed out, negative emotional states, however, usually include negative automatic thoughts. For example, in the reasoning of a depressed person, when he starts to stop and capture his cognitive content, thoughts such as: “I don’t know how to deal with life,” “I am helpless and weak.”

Dysfunctional thinking

Thoughts are not facts. Not every thought we have is an objective, rational fact. The source of our experiences influences our interpretations of current events. The primary problematic dysfunctional thoughts are often: negative automatic thoughts, de-adaptive thoughts and cognitive distortions based on faulty reasoning about events. To work with these types of difficulties, the therapist asks a series of questions. A well-posed question allows you to work on understanding thoughts, name them anew, promotes a change in the perspective of certain judgments, allows you to replace old beliefs with more healthy ones, which in practice allow you to formulate a healthier point of view.

Cognitive restructuring

This is the main cognitive strategy in which the patient reassesses the meaning of a stimulus in order to change his emotional response. The traditional approach in cognitive-behavioral therapy is cognitive restructuring, which is a guided, systematic process by which the therapist helps the patient recognize and, if necessary, modify unhelpful judgments. It is worth remembering that the opposite technique used in ACT is cognitive defusion, associated with distancing oneself from one’s own thoughts and and acceptance.

Cognitive behavioral therapy – the role of the therapist

The attitude of the cognitive-behavioral therapist is one of engagement, full of curiosity about the patient’s beliefs. The joint conversation takes place in a spirit of cooperation and understanding. The therapist questions and summarizes the patient’s statements, highlights statements that indicate a contradiction, signals but does not interpret, asks for details, tries to encourage the patient’s reflection. The therapist tries not to advise, decide for the patient or evaluate the patient’s assumptions. Instead of telling the patient what to think, the therapist uses guided discovery, in which he or she asks targeted but open-ended questions, such as in a Socratic dialogue. The therapist helps with appropriate questions to arrive at new and important information that changes the perspective and current insight.

Socratic dialogue, questions and other helpful cognitive-behavioral therapy techniques

Socratic dialogueThe technique of Socratic dialogue is to help uncover the truth, often different from what we originally assume. We do not try to change the patient’s thinking, but direct his or her attention to other perspectives on evaluating the situation of events. Frequent questions posed by the therapist are questions about the meaning of the thoughts in question and the consequences, e.g. “what would it mean to you” or “in connection with performing a given behavior, what would happen later?”

Socratic dialogue requires time, subtlety and creativity. In addition to characteristic questions and summaries, it includes elements of other techniques: clarification, scaling, checking evidence, using paradox, decatastrophizing.

  • Clarification – a basic principle of therapy, focusing on the patient’s statements with the aim of thoroughly understanding the patient’s thoughts, experiences and behavior.
  • Probing – (a.k.a. “downward arrow method”) – aims to uncover the meanings of the patient’s beliefs, helps identify often negative beliefs.
  • Scaling – to determine the level of intensity of emotions, beliefs, identify cognitive distortions, monitor changes during the therapy process.
  • Questioning the miracle – an intervention that explores the image of the ideal future, in order to diagnose discrepancies between the present and the patient’s vision and goals.
  • Paradox- following the patient’s direction to its logical but extreme conclusion.
  • Denying disadaptive thoughts- naming distortions of one’s beliefs, asking for evidence supporting and contradicting certain interpretations of events.
  • Seeking alternative explanations- looking for alternative evidence that the patient puts forward as confirmation of automatic thoughts.
  • Decatastrophizing- a tool particularly helpful in dealing with anxiety, creating a detailed plan of the worst-case scenario of events. It aims to note that the realistic outcome of events is often very far from catastrophic beliefs.

Cognitive techniques in cognitive-behavioral therapy are effective tools for working with negative, often maladaptive thoughts. Changing one’s thinking affects broadly well-being emotional experiences and changes in some harmful habits.

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I am a certified psychotherapist and CBT supervisor. I use the latest methods of cognitive-behavioral therapy and schema therapy. My specialty? Turning complex theories into practical advice and solutions! As an expert in the field, I not only run a clinical practice, but also train and supervise other psychotherapists. I invite you to read my articles and contact me if you need professional support.

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