The basic tenet of Cognitive Theory is the fact that people are products of the way they think and construct their realities; and by identifying the flaws and distortions in thought patterns, the therapist can devise ways of rectifying the problem. Cognitive Theory is founded on the principle that each individual’s conditioned thought patterns go a long way in determining their perception of events and understanding of facts. While emotions such as loss, grief, loneliness and sadness are to an extent subjective to the particular individual, using broad analytic techniques the therapist can gain insights into the nature of patient experience. Cognitive theory is most useful when dealing with patients suffering from anxiety, depression, panic attacks, etc. Often, in these cases, the perceived threat/loss of the patient is likely to be exaggerated and aberrant. By bringing the patient to see the difference between his/her subjective internal assessment of situations to that of an objective neutral view the therapist can recondition the thinking patterns of the patient. This technique is at the core of Cognitive Behavior Therapy, which identifies a set of common distortions that people susceptible to psychopathological ailments are likely to suffer from.
The first task of the psychotherapist is to figure whether the feelings experienced by the patient are genuine or pathological. Feelings of grief, loneliness and loss are natural to all human beings and hence are not disorders per se. But when the response to a loss or threat becomes irrational, then they can lead to mental disorders like anxiety, panic and depression. Older people are especially more vulnerable to these disorders as their physical mental faculties are on the wane and their ability to fight them is reduced. Towards the end of their lives, people are likely to suffer from dementia, loss of memory, hearing loss, vision problems, etc. Having been weakened by the natural processes related to aging, they no longer have the resources to overcome loss and bereavement. This is where the Cognitive Explanatory Model can come in handy, in explaining to the patient their distorted thought processes and helping them rectify it.
One of the key roles of the therapist is to show to the patient how the latter’s thoughts are distorted. For example, when someone loses a loved one, it is only natural that they go through a period of mourning, which is an essential and healthy aspect of human life-cycles. But problems arise when the patient finds himself / herself unable to recover and move on from this loss. In this particular example, the distorted thinking would be something like this: ‘How am I ever going to live without my wife?’, ‘What is the meaning of life without her?’, etc. In other words, the bereaved person believes the loss to be the end of the world and see no hope beyond it. The psychotherapist then interjects this kind of thinking and tries to infuse optimism and hope. It is easier for the therapist to deal with younger people with respect to issues of loss. But at the same time, the principles of Cognitive Theory can also be applied to older patients with positive outcomes. For older people, personal losses and grievances are accentuated by their bodily and mental decline. Added to this, some of them feel a sense of disillusionment with the world and their place in it. All these feelings are a result of distorted thinking. The psychotherapist applying Cognitive Behavior Techniques can help the elderly patient see brighter things in life, say, their children and grandchildren. The elderly person can be made to remember the happier moments in their past and reconcile themselves with their own mortality.
Santrock, J. W. (2008). A Topical Approach to Lifespan Development (M. Ryan, Ed., 4th ed.). New York, NY: McGraw-Hill Companies, Inc. (Original work published 2002), pgs. 26, 30, 478
Judith S. Beck. “Questions and Answers about Cognitive Therapy”. About Cognitive Therapy. Beck Institute for Cognitive Therapy and Research., retrieved on 27th March, 2010
Neale, John M.; Davison, Gerald C. (2001). Abnormal psychology (8th ed.). New York: John Wiley & Sons. pp. 247–250. ISBN 0-471-31811-6.