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THIS PAPER IS CONCERNED with cognitive changes occurring in a 35 year old woman during the course of psychotherapy. The patient, a divorced woman with three children, came to treatment seeking relief from a long-standing depression, expecting to improve her relationships with her children and boyfriend. Like many patients, she hoped therapy would change her behavior and improve her emotional state. Implicit in this discussion, in which cognitive changes are emphasized, is the idea that changes in behavior and emotions cannot occur without cognitive modifications, since these play a major role in effecting such responses.
For the purposes of this paper cognition is defined as those processes which come into play somewhere between a stimulus and a formulated response. Emotions, like behavior, are at the response end of the continuum. These processes include attention and perception, attention being the selective aspect of perception. Before a response is produced, perceived stimuli are organized. This is done in a more or less concrete or abstract manner depending on the level of intellectual development and degree of psychological integration. Memory and judgment give added meaning to perceptions as these are understood in the light of past experiences and value systems. In a more general sense, cognition refers to any process by means of which one arrives at knowledge.
When evaluating patients' progress in therapy, clinicians tend to stay close to the response end of the continuum.1 References