Metacognitive therapy: characteristics and psychological effects

Within the cognitive current, it is argued that most of the discomfort that a person suffers is due more to his way of seeing and interpreting reality rather than the problem itself.

One of the therapies that takes this into account is metacognitive therapy , which not only focuses on the patient’s dysfunctional thoughts, but also on how he perceives them, that is, he considers his metacognition.

Throughout this article we will go deeper into metacognitive therapy, in addition to explaining in more detail the idea behind the concept of metacognition and for what disorders it is used.

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What is metacognitive therapy?

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

Metacognitive therapy, which was developed by Adrian Wells, agrees with the fundamental premise of cognitive therapies, giving importance to cognitive factors in the onset and maintenance of psychological disorders . That is why this is within the therapies of this type.

However, a key point of metacognitive therapy is its focus. This type of therapy tries to understand why there are people who, in the face of an adverse situation, are capable of becoming unconcerned, while others, in the same situation, manifest depressive and anxious symptoms.

According to Wells’s theory, what would be behind the continuation of this discomfort are the metacognitions of the person , that is, the way he sees his own thinking. These metacognitions would be responsible for the individual having a healthy or pathological control of his mind.

Based on this, the goal of metacognitive therapy is to eliminate ways of thinking that incur dysfunctional beliefs. That is, it is intended to change the inflexible way that the person has to see the stimuli that, within their mentality, are considered as something threatening. By changing this way of seeing and interpreting things, the person stops being trapped by the situation and acquires a greater degree of well-being by knowing how to deal with the problems.

What is meant by metacognition?

On many occasions, the discomfort experienced in a given situation is not due to the situation itself, but to the way in which it is interpreted. This means that the same situation can be seen in very different ways depending on the person . In this way, it is understood that there are people who, faced with an adverse situation, know how to deal with it and do not worry too much while others suffer to such an extent that they remain paralyzed.

Within the cognitive current, therapy aims to identify, question and change those automatic thoughts that, activated in a given situation, are the true source of discomfort of the person. When the strength of these dysfunctional thoughts is questioned, the negative emotions associated with these harmful beliefs will diminish.

However, in order to accomplish this, it is necessary to make the person aware of their own thoughts . That is, think about what you are thinking and how you think. According to Wells, the term ‘metacognition’ refers to a wide range of interrelated factors composed of every cognitive process that is involved in the interpretation, monitoring and control of one’s cognition.

Metacognition is an aspect that has been closely related to the theory of the mind . This concept can be subdivided into several components, being mainly the knowledge, experiences and strategies that the person has to face the situations that are presented. Metacognition is composed of beliefs and theories about our own way of thinking.

Within the metacognitive therapy model, they distinguish between explicit or declarative beliefs, and implicit or procedural beliefs.

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1. Explicit beliefs

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

An example of such beliefs would be ‘I have bad thoughts, which I am a bad person’, ‘worrying can cause a heart attack’, ‘what I have thought is a sign that something is wrong.’

Explicit metacognitive knowledge can be shown in the form of positive or negative beliefs . Explicit positive beliefs are those in which the patient believes they are advantageous, such as ‘if I worry, I will be prepared for when things are worse’, ‘focusing on the threat will help me know what to do’.

On the other hand, the negative ones refer to negative evaluations of sensations and thoughts related to the perceived danger . They are formulated in terms of uncontrollability, meaning, importance and danger of thoughts.

Some examples of negative metacognitive beliefs would be “I don’t have control over my thoughts”, “if I think violently, I’m going to make some aggression” …

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2. Implicit Beliefs

With 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 particular memories or the way in which other people are judged.

How and for what disorders is it used?

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

In fact, in the clinical field it has been possible to see how effective it is with multiple anxiety problems. Some of them are social anxiety, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder. However, when this model was formulated, the objective was to be used transdiagnostically, that is, for multiple psychological disorders, of any kind.

Normally the therapy is carried out between 8 and 12 sessions. The therapist discusses with the patient about the tightness of their way of interpreting their own cognition , that is, thoughts, past experiences and applied strategies. Once it has been possible to see what causes the discomfort, the therapy is focused on promoting more adaptive thinking styles in the patient to the situations that had previously been associated with problems.

Cognitive Attention Syndrome

The metacognition of people who suffer from psychological disorders, according to Wells, gives rise to a particular way of responding to internal experience, that is, their thoughts and emotions. This causes those negative feelings to be chronicled and the person continues to suffer . This thought pattern has been called Attention Cognitive Syndrome (ACS) which would be composed of the following three aspects:

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

This syndrome is of vital importance to understand the metacognitive therapy model. This becomes especially understandable in those people who suffer from an anxiety disorder: their attention is fixed on a threat , which generates a great concern and, trying to get rid of this negative emotionality, they carry out coping strategies that, to In the long run, it makes them think about this problem even more. So, they end up having thoughts like “what if this happens? 2,” I should worry that this doesn’t get worse “…

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