What Does Healthy Cognitive Functioning Look Like

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Cognitive therapy is derived from research on clinical populations, particularly depressed patients. Characteristics of the diagnostic groups studied are assumed to be extreme manifestations of qualities that are also found in normal people. Among depressed patients, for example, thinking is characterized by cognitive distortions or errors in logic, by cognitive rigidity, and by maladaptive core beliefs. Does this mean that the thinking of nondepressed people is free of distortions or an accurate reflection of reality? It does not.

Considerable evidence from cognitive and social psychology testifies to the presence of illusion or a general, enduring pattern of error, bias, or both in the information processing of normal people. However, the bias in thinking is positively skewed. Experimental studies, typically done with college student volunteers, show that nondepressed thinking is characterized by unrealistically positive views of the self, exaggerated perceptions of control, and unrealistic optimism.

This is apparent in attributional or explanatory style. The explanatory style of depressed persons is to attribute causality of negative, uncontrollable events to internal, stable, and global causes. One fails a test because one is stupid, not because that particular test was especially difficult. Nondepressed people, who have positive illusions concerning control and self-perception, are better able to externalize failure and thus not damage their general sense of self-esteem.

It appears from several lines of evidence that mildly depressed people, those with low self-esteem, or both have more balanced self-perceptions, more evenhanded assessments of their future circumstances,

Cognitive Therapy and a more accurate sense of personal control than do nondepressed persons. In contrast, both clinically depressed and euthymic people have biased thinking.

It is not surprising that many of the same cognitive mechanisms operate in different mood states, but they operate to different ends. Studies in social cognition support many of the clinical observations on which cognitive therapy is based. In 1989, Janoff-Bulman wrote about the benefits of illusion for mental health. She describes how preverbal interactions with responsive caregivers establish supraordinate schemas that are positively biased and largely reflect reality at the time they are established. One need only substitute the experience of a child with unresponsive, neglectful, or depriving caregivers to arrive at maladaptive schemas. The early interactions among people receiving good care teach them that the world is benevolent and controllable, and that they are worthy of care. Although later experience may somewhat contradict or qualify these assumptions, they will remain fundamentally intact. Evidence that does not confirm positive assumptions can be ignored, dismissed, or reinterpreted to fit previously held beliefs. This process is the same as that in depression: cognitive distortions screen out positive information or distort neutral information to maintain negative schemas. Only traumatic negative events pose a serious challenge to the equilibrium of positive illusions.

Parallels between the cognitive processes in depression and those in well-being also appear in Taylor and Brown's theory of cognitive adaptation. They present a model of normal cognitive processing in which social and cognitive filters make information largely positive as opposed to the disproportionately negative bias that results from the mental filters operating in depression. These authors conclude that the mentally healthy person appears to have the capacity to distort reality in a direction that enhances self-esteem, maintains a sense of personal efficacy, and promotes an optimistic view of the future. This positive triad is in striking contrast to the cognitive triad in depression.

For both depressed and nondepressed people, biased thinking is most apparent in situations that are ambiguous and that are relevant to self-evaluation. For both negative and overly positive thinking, ambiguous information tends to be interpreted to fit with prior beliefs or schemas.

Just as the cognitive model of psychopathology might overemphasize the negative aspects of biased cognitive processing and thus appear to endorse rationality, models from cognitive and social psychology might overemphasize the benefits of positive illusion for mental health. Some researchers have addressed various types of illusions and the circumstances under which they appear helpful and not so helpful.

Taylor's research on cognitive adaptation to threatening events such as rape and cancer found that illusions of meaning, mastery, and self-esteem fostered positive adjustment. Individuals who made causal attributions that maintained a sense of personal control and who could construct some personal benefit from the negative experience fared better psychologically than those unable to use illusion. Taylor concludes that illusion is essential for normal cognitive functioning. She also argues that having an accurate self-perception should not be a criterion of mental health, as has been customarily believed.

It also appears from the work of others that illusions are only adaptive if they do not stray too far from the truth. Illusions that are too inflated may lead to self-defeating behavior. A small positive distortion of the truth, rather than unbridled optimism, seems optimal.

Janoff-Bulman proposes that positive illusions are most beneficial at the level of core beliefs or schemas. She sees conceptual (or cognitive) systems as hierarchically organized. Higher-order postulates represent one's most abstract, global, and generalized theories about oneself and the world. Lower-order postulates are narrow generalizations that relate to specific domains of life, such as one's abilities. These hierarchical distinctions are compatible with Beck's notions of core schemas and more accessible assumptions, respectively. Janoff-Bulman argues that higher-order postulates, which are least subject of all cognitions to empirical validation or invalidation, may contain positive inaccuracies without being problematic. However, inaccuracies and positive illusions at the level of lower-order postulates are maladaptive. In other words, it is not harmful to have a generally positive view of oneself as a competent person as long as one is aware of one's limitations in specific areas.

According to Janoff-Bulman's theory, the advantage of positive higher-order assumptions (or schemas) is that they enable a person to attempt to tackle new situations. Thus, positive illusion at this level

Cognitive Therapy benefits affect and motivation. One can see how such optimism might allow someone to engage in creative problem solving when faced with a novel situation.

Another benefit of generalized positive illusions about the self relates to efficacy in problem solving. People with high self-esteem appear better able to discriminate soluble from insoluble problems than are people with low self-esteem. They are more able than people with low self-esteem to know when to quit and to feel comfortable quitting. They may also choose to work only on problems that can be solved, thereby reinforcing their sense of self-efficacy.

In contrast to Taylor, Janoff-Bulman believes the healthiest people probably have a good sense of their strengths and weaknesses, their possibilities and limitations. The key appears to be maintaining positive illusions at the level of fundamental beliefs while aiming for and accepting accuracy at the level of everyday, specific interactions with the world. Healthy people can thus respond to environmental feedback and learn.

Healthy cognitive functioning is creative and flexible enough to reexamine strategies that no longer work. No doubt, healthy beliefs contain inaccuracies, but they are adaptive in that they allow one to maintain a sense of self-worth while trying to learn from one's experiences. Healthy functioning also recognizes emotions as important sources of information about the self and the environment. Cognitive therapy allows patients to reappraise and empirically test their lower-order postulates within the context of a caring and collaborative therapeutic relationship. Although schema change at the level of higher-order postulates is more difficult to achieve, longer term cognitive therapy may allow for these fundamental changes.

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