In this module, we will be examining the deepest part of the CBT Iceberg: Core Beliefs. Core beliefs are the most deeply held and strongest beliefs that people have. They form the foundation of who a person is and guide all of our goals, plans and behaviors. We will begin by examining their characteristics and when to begin addressing them in therapy. Afterwards, our focus will turn to how socialize and educate clients on core beliefs and then we will look at how to identify core beliefs in therapy. After learning how to identify these beliefs, we will discuss how to challenge and change those core beliefs. We will then put all levels of the iceberg together and look at schemas in general and the module will end with a brief discussion on termination and booster sessions.
Core Belief Characteristics
Core beliefs, as previously mentioned, are our most strongly held opinions, points of view and beliefs about ourselves, other people and the world within which we live. At the core of many mental health disorders are distorted core beliefs that fuel and maintain the disorder. CBT therapists seek to identify maladaptive core beliefs and eliminate them by replacing them with more adaptive core beliefs. There are certain Core beliefs have certain typical characteristics that include:
- Rigid and Resistant to change: Core beliefs tend to be deeply held and are infused with strong emotional content. They tend to be very difficult to challenge and change and often require great effort to do so.
- Tend to be polarized and over-simplified: Core beliefs often reflect all-or-nothing thinking and frequently contain words such as “all, every, none or nobody.” Negative core beliefs tend not to recognize nuance and tend to be over simplified.
- Formed in Childhood: Core beliefs are often formed in childhood during really important events. For example, being bullied by another student in grade school may cause a core belief: “I don’t belong anywhere” to form and exist subconsciously into adulthood. Core beliefs are often problematic because they are often unconscious and unexamined. However, not all core beliefs are formed in childhood as they can be formed during any pivotal life event. For example, experiencing a trauma as an adult, such as being raped, can alter core beliefs about how safe the world is.
- Maintained through distortions and biases: Core beliefs, once formed, are difficult to change because cognitive distortions, filters and confirmation bias tend to maintain them. For example, if a client believes she is incompetent then she will ignore evidence that contradicts this and be hyper-focused on signals that might confirm this belief. Other distortions such as overgeneralizing or disqualifying the positive will act to strengthen and maintain these beliefs. Distortions need to be identified and corrected for in order to change core beliefs.
- Are not necessarily true: People often hold their core beliefs as absolute truths and yet they are not necessarily true. Core beliefs can be maintained despite overwhelming evidence that they are not true and thus can be irrational. They are often based on partial truths but do not accurately capture the totality of a concept.
- Can be tested and evaluated: Core beliefs are often taken for granted and are not subjected to rigorous testing or evaluation. However, we can take a core belief and develop a test to determine its accuracy. For example, if a person has a core belief: “Nobody can be trusted” then we can identify a series of tests to determine if this is true. This may involve first defining trust and then having the client do something that requires trust in another person. The core belief will either be supported or challenged based upon the results.
Core Belief Socializing
You can use the “all roads lead to Rome” analogy to help clients understand that all of their thoughts and rules flow from their core beliefs. Their core beliefs are like the city Rome and the roads are comparable to their automatic thoughts and rules for living.
Another popular metaphor is of the blind men and the elephant. A group of blind men each touch different parts of an elephant such as the tusks, trunk, leg, ears and body. However, since each blind man only has experience with one aspect of the elephant it distorts his entire view of the creature. In the same way, core beliefs can form based upon a distorted experience of reality. The elephant is comparable to reality and the blind man is the client whose entire view has been distorted by a selective focus on only part of the whole.
Of course, you can also understand core beliefs using the metaphor of the partially submerged iceberg that we have already discussed and that you probably already know very well by now.
Another popular analogy is to compare the mind to a tree and each of the trees component parts to different levels of the mind. The roots of the tree are the core beliefs, the trunk is the rules for living and the branches are the automatic thoughts that flow from the tree and yield a certain kind of fruit. If the roots of the tree (core beliefs) are malnourished then the rest of the tree begins to die. You can also use this analogy to help yourself understand the utility of your core beliefs. Good core beliefs will yield good fruit from the branches of the tree while bad core beliefs can be known by the bitter fruit they produce. You need to learn to care for your mind by nourishing its roots and pruning away rotten branches.
One final metaphor to consider is that of the magnet. This metaphor is used to help you understand how core beliefs are maintained. Core beliefs are like magnets because they attract any evidence that supports them while repelling any evidence that does not.
From a neurological perspective, Core Beliefs are neural pathways that have established themselves through connections and highways in the brain. They are stored bodies of knowledge or structures that interact with incoming information to influence selected attention and memory search. Genetic predispositions can also contribute to the formation of Core Beliefs. Genetics can provide a predisposition to negative emotions which can then combine with certain environmental triggers to cause the onset of negative core beliefs.”
Judith Beck also provides a useful list of common core beliefs that you can examine. Recall that there are three major types of core beliefs:
- Beliefs about the Self: I am worthy/unworthy, good/bad, lovable/unlovable, success/failure, and competence/incompetence.
- Beliefs about Others: others are trustworthy/untrustworthy, others have certain group characteristics.
- Beliefs about the World: The world is safe/unsafe, beautiful/ugly, just/unjust.
Common Core Beliefs about the Self
- I am inadequate, ineffective, incompetent, can’t cope.
- I am powerless, out of control, trapped.
- I am vulnerable, weak, needy, a victim, likely to be hurt.
- I am inferior, a failure, a loser, defective, not good enough, don’t measure up.
- I am unlikable, unwanted, will be rejected or abandoned, always be alone.
- I am undesirable, ugly, unattractive, boring, have nothing to offer
- I am different, flawed, defective, not good enough to be loved by others.
- I am worthless, unacceptable, bad, crazy, broken, nothing, a waste.
- I am hurtful, dangerous, toxic, evil.
- I don’t deserve to live.
The theme across all of these negative core beliefs about the self appears to be: “I am incapable of having intrinsic needs met.” If a client believes she is helpless then she believes she does not have the capacity to handle life problems to meet important goals. If she believes she is unlovable then she believes she lacks the capacity to be loved. If she believes she is worthless, again she believes she lacks the capacity to contribute in any meaningful way. The overall theme is about not having the capacity to have important needs met.
Identifying Core Beliefs
There are many sources of data that you can draw upon to identify key maladaptive core beliefs. Some of the major sources include:
- Themes in Thought Records: Once you have done enough thought records, you can begin comparing them to identify common themes. While situations or surface thoughts might change, you will probably be able to identify common core beliefs that do not change across thought records. If you see a belief continually popping up in thought records, this is a good indication that it is a core belief.
- List of Core Beliefs: A therapist can also give a client a list of core beliefs (like Judith Beck’s list) and have the client select which ones resonate. This is useful to use with clients who have a hard time articulating themselves or who may say they have no idea what their core beliefs are.
- Client reports: You can also simply ask yourself what you believe your core beliefs are. Describe pivotal events in your life and then look for how those events changed your view of either yourself, the world or other people.
- Fears: Fears can also be a good source of core beliefs. Negative core beliefs elicit a lot of fear and people are constantly on guard to protect against the core belief activating. Ask yourself what you fear is true about yourself, the world or other people.
- Judith Beck’s Case Conceptualization: Judith Beck provides a good worksheet for you to help fill in the blanks of the client’s cognitive map. If you are struggling with core beliefs, fill out the rest of the form and you should be able to make an educated inference on what the core beliefs are. It has been provided below for your convenience.
The Downward Arrow
The Downward arrow technique is an especially useful tool for identifying core beliefs. It involves starting with a surface level thought and probing for implications of the thought. Clients typically go no deeper than their surface thought but the downward arrow technique prompts them to examine the implications of their surface thoughts until we arrive at the true core belief being masked.
The general question for the downward arrow technique is: “And if that were true, what would that mean to you?” This is an incredibly powerful question and is one that you may need to stick with until you can provide an answer. It isn’t’ unusual that you might think: “I don’t know” so you may need to stick with it until you can answer it.
Here are some examples of using the downward arrow technique to go from surface thought to core belief:
- “I can’t accept that my husband is gone for good.” (If that were true what would it mean?)
- That would mean what I believe about marriage isn’t true.
- If what I believe about marriage isn’t true, what else am I wrong about?
- I am a foolish person.
- “It’s 11 pm and my wife isn’t home yet.” (If that were true what would it mean?)
- She must not value spending time with me.
- I am not worth of her time
- I am unlovable.
- “The soup I made is terrible.” (If that were true what would it mean?)
- I am a bad cook.
- I cannot fulfill my role obligations.
- I am a failure.
- “I didn’t get a call back from the job I applied to.” (If that were true what would it mean?)
- I am never going to get a job.
- I will not be able to provide for my family.
- I am a failure.
Restructuring Core Beliefs
After educating yourself on core beliefs and identifying the key core beliefs that are maintaining the presenting issue it’s time to begin challenging and restructuring those core beliefs. You can begin challenging core beliefs in the same way that you would challenge normal thoughts or rules for living, including generating evidence and identifying distortions. You can begin by listing any evidence at all that might indicate this belief is not always true. If this isn’t enough (it often isn’t) then you can turn to a few new techniques to help challenge these problematic beliefs including: cognitive continuum’s, behavioral experiments, a historical review of data and the positive data log. We have already discussed continuum and experiments so we will turn our focus now to the historical data review and the positive data log.
Since core beliefs form during pivotal events that often occur in childhood, we may need to analyze those pivotal events to allow you to reprocess them and interpret them from what is usually a more mature perspective (adult self vs. child self). A historical review of the data simply involves listing all of the key pivotal events that you believe are reasons why the core beliefs are true and then doing thought records around them and coming to balanced interpretations of those events. This can be time consuming but also very powerful as it can defuse emotional memories that are holding you hostage. You treat these memories just like you would situations that you analyze with thought records every week. Identify what the situation meant , whether the interpretation was distorted and what evidence there is that this is the best interpretation possible. Construct a new balanced interpretation of the memory for each of the memories you list. A worksheet developed by Judith Beck has been provided below that illustrates this technique.
Another important tool for changing core beliefs is the positive data log. This is a relatively simple intervention to understand but is often difficult to practice. It simply involves taking the balanced core belief that you are trying to adopt and then listing evidence every day that supports the new belief. It’s important to understand that you have had a lot of practice (sometimes decades) rehearsing your old core beliefs and that we need to create new connections in the brain by rehearsing new beliefs. If you have trouble doing this as homework then do it in session until you become better at adopting alternative perspectives.
In summary, core belief work progresses in the following way:
Step 1: Educate yourself on core beliefs.
Step 2: Identify key core beliefs.
Step 3: Develop balanced alterations of the core belief using CB techniques.
Step 4: Implement new core belief in new situations.
Step 5: Pay attention to new evidence and reinforce new balanced belief.
Putting it all together: Schemas
One final term that you may come into contact with in the CBT literature is that of the schema. Going back to the iceberg analogy, the schema can simply be thought of as encompassing the entire iceberg and includes all levels of mental life. Thus a singular schema may consist of a core belief, the rules for living and then the automatic thoughts that flow out of that core belief. In cognitive therapy, we seek to identify maladaptive schemas and replace them with adaptive schemas. Below are some example of both adaptive and maladaptive schemas in certain situations.
- Situation: A friend doesn’t talk to the client at a party.
a.) Adaptive Schema
CB: I am a generally likable person
RFL: If I mingle, I might have a new friend at the end
AT: “Wow! My friend is busy tonight!”
Embedded memory: simply of last year’s party.
b.) Maladaptive Schema
CB: Others are more interesting than I am
RFL: If I am not interesting, I will be ignored
AT: My friend doesn’t really like me
Embedded memory: Rejection
- Situation: Husband doesn’t remember what the wife told him earlier.
a.) Adaptive Schema
CB: Husband cares about me.
RFL: If my husband forgets what I told him, it doesn’t mean he doesn’t love me.
AT: “He has a lot on his mind.”
Embedded memory: conversation with husband.
b.) Maladaptive Schema
CB: Husband doesn’t care about me.
RFL: If my husband forgets what I told him its proof he doesn’t love me.
AT: I can’t believe my husband forgot this.
Embedded memory: Rejection and isolation.
- Situation: A man who was mugged 5 years ago won’t leave his house.
a.) Adaptive schema
CB: The world can be dangerous at certain places and times but where I live it is mostly safe.
RFL: If I take precautions and be reasonable, I will be safe.
AT: “It’s dark out so I should be safe.”
Embedded memory: feeling in control.
b.) Maladaptive schema
CB: The world is dangerous.
RFL: If I don’t leave my house I can’t get hurt.
AT: I can’t leave my house.
Embedded memory: Fear and powerlessness.