Cognitive Behavioral Analysis System of Psychotherapy

Cognitive Behavioral Analysis System of Psychotherapy, henceforth CBASP, is a psychotherapeutic treatment for chronic depression. The approach based on various psychological procedures goes back to the American psychologist James P. Mccullough. The development of CBASP began in the 1980s. It has been in a mature condition since around 2005.

What is the Cognitive Behavioral Analysis System of Psychotherapy?

CBASP is a collection of psychological explanatory models and the resulting forms of interaction between therapists and patients. CBASP aims to cure chronic depression.

Depending on the situation and the judgment of the people involved, CBASP is the sole therapy method or psychotropic drugs, namely antidepressants, are also used. CBASP alone without psychotropic drugs has about as much treatment success as psychotropic drugs without CBASP. The joint use of CBASP and psychotropic drugs increases the healing success, but leads to medical side effects that should be prevented through the use of psychological methods. Due to the specific explanatory models and the resulting psychotherapy, CBASP is not suitable for every type of depression.

The method is specially designed for chronic depression that has been present since childhood. The CBASP explanatory model assumes that such chronic depression has been caused by trauma or prolonged abuse. As a result, the patient's ability to communicate naturally with other people has been impaired. CBASP starts working on and restoring these natural communication and empathy skills.

Function, effect & goals

CBASP is based on the assumption that chronic depression is based on a complex of causes, which is characterized as a lack of self-confidence on the part of the patient in communication and in living together with others.

Patients with chronic depression avoid fellow human beings. Even caregivers who take great care of the patient experience rejection or even openly hostile reactions from the chronically depressed. Presumably, chronic depression is not just a question of the mind, but also severe developmental behavioral disorders that are caused by the patient's lack of empathy and communication skills.

According to Jean Piaget, children develop beyond an egocentric self-image even before puberty and learn to put themselves in the shoes of others and to use these insights gained through empathy about the diversity of interpersonal reactions to develop their interpersonal relationships. A developmental defect in this phase leads to chronic depression, which affects human interaction well into adult life. The function of CBASP is to analyze the understanding of interpersonal reactions by the patient, to shed light on it critically and then to replace it with an expanded understanding.

The aim is therefore to supplement and expand on the negative basic assumptions anchored since childhood with more realistic and life-affirming assumptions about interpersonal reactions. In the course of this expansion of the access to interpersonal communication in the respective environment of the patient, the patients ideally also get introspective access to the trauma that caused this disruption of the child's development process according to Jean Piaget.

This trauma, which caused the depression for years, may have been a brief traumatic event, but it could also have been a prolonged state of abuse or neglect. Patients and therapists use situation analyzes to analyze how they deal with other people and also think of possible alternative ways of dealing with them; they work out lists of defining caregivers and think about what these relationships have been like; they practice interpersonal discrimination exercises through which patients learn to replace problematic interpretations of the behavior of others with more favorable interpretations. This is how the patient's self-confidence and confidence develop.

At CBASP, interpersonal, psychodynamic and behavioral methods are used. Therapists who practice CBASP know that the behavioral disorders of patients when dealing with other people naturally also manifest themselves in interactions with the therapist. Therefore, therapists expect to encounter hostility and exaggerated subservience from the patient during treatment. You are trained to respond appropriately. CBASP is a highly specialized form of psychotherapy that also deals with the hurting memories of the patient.

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Risks, side effects & dangers

CBASP has an explanatory model for chronic depression. However, it has not been scientifically proven that all chronic depression has precisely this complex of causes. Psychological treatments are an alternative to psychiatric drugs that have many side effects.

In fact, the side effects of psychotherapeutic forms of treatment are so far not well known. Psychotherapy costs time and money. However, people with chronic depression are often dependent and dependent on other caregivers. Since the therapy itself is strongly aimed at finding alternative ways of dealing with caregivers, the patients themselves can radically question and change this entire life situation.

This sometimes leads to new life crises. Is the depression really the result of a developmental disorder in the ability to build relationships with other people, or does the depression have completely different causes? CBASP is based on the assumption of childhood trauma. The classic form of trauma psychotherapy deals with people who can be shown to have suffered trauma during a war or an accident. The situation is more difficult with chronic depression because it is not known whether there was trauma, neglect, or abuse at all. In many cases, the trauma remains only a vague hypothesis that is difficult to prove.