Cognitive Processing Therapy Resources

About Cognitive Processing Therapy (CPT) from the founders’ site:

“Cognitive Processing Therapy (CPT) is a cognitive-behavioral therapy (treatment that focuses on thoughts and feelings) for Posttraumatic Stress Disorder, or PTSD, and related conditions. PTSD can develop when an individual experiences a traumatic event such as physical and sexual abuse or assault, accidents, threats, military combat, or being a witness to violence or death. CPT focuses on the connections between thoughts, feelings, behavior and bodily sensations. CPT is an evidenced based therapy which means that it has been proven to be effective through rigorous scientific research. CPT provides a way to understand why recovery from traumatic events is difficult and how symptoms of PTSD affect daily life. The focus is on identifying how traumatic experiences change thoughts and beliefs, and how thoughts influence current feelings and behaviors. An important part of the treatment is addressing ways of thinking that might keep individuals ‘stuck’ and get in the way of recovery from symptoms of PTSD and other problems.”

Cognitive Processing Therapy for PTSD: A Comprehensive Manual.
Patricia A. Resick, Candice M. Monson, and Kathleen M. Chard, Guillford Press, 2016.

CPTWeb: A web-based learning course for Cognitive Processing Therapy, from the Medical University of South Carolina. Free, online training in foundations of CPT published in 2009. Registration required. Manual published in 2016 contains revisions and updates. CPT was featured in the New York Times in 2013.

“The just-world belief holds that good things happen to good people, that bad things happen to bad people, and that the world should be a fair and just place. This belief emanates from the desire to find an orderly, cause-effect association between an individual’s behavior and the consequences of that behavior…this is a hard-wired, evolutionary need of humans to predict and control events in order to survive.” (65)
– Resick, et al., Cognitive Processing Therapy for PTSD: A Comprehensive Manual, 2017

Here’s a brave and candid narrative on YouTube by a person who engaged in CPT.

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The works listed below show real and fictional examples of individuals examining and challenging beliefs they hold about themselves, and beliefs held about them by others. In these works, the authors or characters first internalize the beliefs, then challenge and reject them, opening up perceptions of identity and possibility, and of novel choices and actions. Works are listed in suggested reading order.

Becoming: A Memoir, Michelle Obama

Educated: A Memoir, Tara Westover

In this excerpt published in the New York Times from her book Rowing North: Navigating Life’s Currents and Flourishing as We Age, Mary Pipher, Ph.D. expresses the freedom that can result from “de-identifying” with others’ beliefs – including cruelly stigmatizing beliefs.

Almost Everything: Notes on Hope, Anne Lamott*

Where the Crawdads Sing: A Novel, Delia Owens

*One caveat about Lamott’s book: Requiring people to “hit bottom” before receiving treatment for the medical illness of addiction is *not* an evidence-based treatment for addiction. Letting symptoms of any illness continue without treatment puts people at risk of dangerous complications, even premature death. Jail time, with its traumatization and punishing deprivations, is *not* a treatment for addiction. For further reading on the false belief in “hitting bottom” – a very dangerous – in CPT terms – stuck point held by many – please consider reading this, this, and this.

[Dr. Sarah Wakeman] asks them to imagine telling a diabetic she has to “hit bottom” before she can have her insulin. Or telling a cancer patient he has to drive to a clinic 150 miles away to get his daily dose of chemotherapy. Or telling a patient with heart disease to use her will to heal her heart. Or handing someone who’s had a heart attack a list of cardiologists and wishing them good luck. “They often say, ‘I’ve never thought of that before—that would be malpractice!’” she says. “And yet that’s how we routinely treat people who come into the hospital with some sort of complication related to addiction.”
– from Sarah Baldwin, “Vocal Advocate,” [email protected], 2/8/19

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When people are asked to challenge the beliefs they have surrounding trauma, they may be uncertain about criteria to use. They may have trouble conceiving of alternate possibilities. Questions might arise such as “How do I know what should or might have happened instead?” Considerations of various concepts of human rights can be helpful. A few are listed below with related excerpts.

United Nations Universal Declaration of Human Rights

  • Article 3. Everyone has the right to life, liberty and security of person.
  • Article 5. No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.
  • Article 9. No one shall be subjected to arbitrary arrest, detention or exile.

United Nations Convention on the Rights of the Child

  • Article 19 (Protection from all forms of violence): Children have the right to be protected from being hurt and mistreated, physically or mentally. Governments should ensure that children are properly cared for and protect them from violence, abuse and neglect by their parents, or anyone else who looks after them. In terms of discipline, the Convention does not specify what forms of punishment parents should use. However any form of discipline involving violence is unacceptable. There are ways to discipline children that are effective in helping children learn about family and social expectations for their behaviour – ones that are non-violent, are appropriate to the child’s level of development and take the best interests of the child into consideration. In most countries, laws already define what sorts of punishments are considered excessive or abusive. It is up to each government to review these laws in light of the Convention.

The Challenging Questions Worksheet coaches individuals in how to use Socratic dialogue on their own. Socrates asked his students questions that helped them discover 1) assumptions and hypotheses from which they had derived conclusions, 2) the logic and reasoning they had used to build these conclusions, and 3) the definitions of the terms they were using. Once people become aware of these components, they can define terms precisely, examine their thinking in terms of facts, data, and evidence, and detect logical fallacies in how they’ve built their arguments. With self-kindness and matter-of-factness, people can use Socratic dialogue to approach – rather than to avoid – the reality of what occurred, ease the suffering caused by beliefs that have become “stuck points,” and conceive of next steps for themselves based on their own deep understandings and values.

Last updated 4/16/19