Metacognitive therapy: psychological characteristics and effects

In the cognitive mainstream, it is argued that most of the discomfort a person suffers from is due more to the way they see and interpret reality than to the problem itself.

One of the therapies that take this into account is metacognitive therapy, Which focuses not only on the dysfunctional thoughts of the patient, but on the way he perceives them, that is, he takes his metacognition into account.

Throughout this article, we’ll dig deeper into metacognitive therapy and further explain the idea behind the concept of metacognition and the disorders for which it is used.

    What is metacognitive therapy?

    Traditionally, cognitive therapies have argued that alterations or biases in thinking are the cause of the patient’s psychological distress, rather than the situation itself. Discomfort is given in how reality is interpreted, not by reality itself.

    Metacognitive therapy, which was developed by Adrian Wells, agrees with the fundamental principle of cognitive therapies, give importance to cognitive factors in the onset and maintenance of psychological disorders. This is why it is part of these therapies.

    However, a key point of metacognitive therapy is its focus. This type of therapy seeks to understand why some people are capable of recklessness when faced with an unfavorable situation while others, when faced with the same situation, exhibit depressive and anxious symptoms.

    According to Wells’ theory, what would be behind this discomfort are the person’s metacognitionsIn other words, the way you see your own thinking. These metacognitions would be responsible for the individual to have a healthy or pathological control of his mind.

    Based on this, the goal of metacognitive therapy is to eliminate thought patterns that lead to dysfunctional beliefs. In other words, it is meant to change the inflexible way a person should view stimuli that in their state of mind are considered threatening. By changing this way of seeing and interpreting things, the person stops being trapped by the situation and acquires greater well-being know how to deal with problems.

    What do we mean by metacognition?

    In many cases, the discomfort felt in a given situation is not due to the situation itself, but to the way it is interpreted. That means the same situation can be seen very differently depending on the person. In this way, we understand that there are people who, faced with an unfavorable situation, know how to face it and do not worry too much while others suffer to the point of paralysis.

    Within the cognitive stream, therapy aims to identify, question and change these automatic thoughts which, activated in a given situation, are the real source of discomfort for the person. By questioning the strength of these dysfunctional thoughts, the negative emotions associated with these harmful beliefs will decrease.

    However, to achieve this, it is necessary to make the person aware of his own thoughts. In other words, let him think about what he thinks and how he thinks it. According to Wells, the term “metacognition” refers to a wide range of interrelated factors made up of any cognitive process involved in the interpretation, monitoring and control of one’s own cognition.

    Metacognition is an aspect closely related to the theory of mind. This concept can be subdivided into several components, being mainly the knowledge, experiences and strategies available to the person to cope with the situations presented to him. Metacognition is made up of beliefs and theories about our own way of thinking.

    In the metacognitive therapy model, a distinction is made between explicit or declarative beliefs and implicit or procedural beliefs.

      1. Explicit beliefs

      Explicit beliefs can be expressed verbally, and they refer to specific thoughts of patients that cause them discomfort.

      An example of this type of belief would be “I have bad thoughts, therefore I am a bad person”, “Worry can lead to a heart attack”, “What I thought is a sign that something is wrong no, it’s okay. ‘

      Explicit metacognitive knowledge it can be shown in the form of positive or negative beliefs. Positive explicit beliefs are those that the patient feels are beneficial to them, such as “if I worry I will be ready to deal with a worsening of things”, “focusing on the threat will help me know what to do “.

      On the other hand, the negatives they allude to negative assessments of feelings and thoughts related to perceived danger. They are formulated in terms of the uncontrollability, meaning, importance and danger of thoughts.

      Some examples of negative metacognitive beliefs would be “I have no control over my thoughts”, “if I think violently it is because I am going to do some aggression” …

        2. Implicit beliefs

        With the implicit beliefs, reference is made to those rules or programs that guide the person’s thinking, Such as paying attention to a particular stimulus, ruminating on particular memories or how others are judged.

        How and for what disorders is it used?

        Metacognitive therapy has been shown to be effective and efficient in terms of improving patient well-being. This has been observed empirically in research, citing for example the case of Normann and Morina (2018) who saw how this type of therapy improves the mental health of patients. However, it should be noted that it is particularly useful for anxiety disorders and depression.

        In fact, it has been shown in the clinical field how effective it is with multiple anxiety issues. Some of them are social anxiety, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder. However, when this model was formulated, the aim was for it to be used in a transdiagnostic manner, that is, for multiple psychological disorders of all kinds.

        Therapy is usually performed between 8 and 12 sessions. The therapist discusses with the patient the appropriateness of his way of interpreting his own cognitionThat is, thoughts, past experiences and applied strategies. Once it has been possible to see what is causing the discomfort, therapy focuses on promoting the patient’s thinking styles that are more adaptive and more appropriate to the situations that they had previously associated with problems.

        Cognitive attentional syndrome

        The metacognition of people with psychological disorders, according to Wells, gives rise to a particular way of responding to inner experience, that is, to their thoughts and emotions. This causes these negative feelings to become chronic and the person to continue in pain.. This thought pattern has been called cognitive attentional syndrome (ACS) which is said to be made up of the following three aspects:

        • Rumination and worry.
        • Fixed attention: attentional bias especially around threats.
        • Negative self-regulation strategy.

        This syndrome is essential for understanding the model of metacognitive therapy. This is especially understandable in people who suffer from an anxiety disorder: his attention is fixed on a threat, Which worries them a lot and, trying to get rid of this negative emotivity, they implement coping strategies which, in the long term, make them think even more about this problem. So they end up having thoughts like “what if this happens? 2,” I should be worried that it doesn’t get worse “…

        Bibliographical references:

        • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington DC: author.
        • Ashouri, A., Atef-Vahid, MK, Gharaee, B., Rasoulian, M. (2013). Efficacy of meta-cognitive and behavioral cognitive therapy in patients with major depressive disorder. Iranian Journal of Psychiatry and Behavioral Science, 7 (2), 24-34.
        • Normann, N. and Morina, N. (2018). The effectiveness of metacognitive therapy: systematic review and meta-analysis. Frontiers in Psychology, 9, 2211. doi: 10.3389 / fpsyg.2018.02211
        • Garay, C. J and Keegan, I. (2016). Metacognitive therapy. Cognitive attentional syndrome and cognitive processes. Argentine Journal of the Psychological Clinic. 25 (2). 125-134.

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