3.2 The Theoretical Frameworks that Guided the Study
3.2.1 The Cognitive Theory of Depression
Aaron Beck (1967) is the founder of the cognitive theory of depression. This theory was formulated after he had studied people suffering from depression and found that they appraised events in a negative way. His approach focuses on people’s beliefs rather than their behaviours. It is believed that depression results from systematic negative bias in thinking (Kirby, 2020). Within the scope of the cognitive theory of depression, Wills (2013) asserts that human beings are susceptible to develop an amount of negative thoughts or dysfunctional beliefs that lead to depression. Human beings go through many life transitions that make them vulnerable and overwhelm them if they do not seek professional help. According to the Beck’s theoretical perspective, there are three
38 | P a g e mechanisms that are responsible for depression: the cognitive triad (of negative automatic thinking), negative self-schemas, and errors in logic that lead to faulty information processing (Nemade, 2020).
• In the cognitive triad there are three forms of negativity, namely negative thoughts about the self, the world, and the future. These thoughts are said to be automatic in depressed people as they occur spontaneously. For instance, people who are suffering from depression tend to see themselves as helpless, worthless, and inadequate. In addition, their perception of the world around them is unrealistically negative and they see the world as presenting difficulties that cannot be overcome. Furthermore, they have an unreasonably gloomy view of the world around them and they regard the world as presenting challenges that cannot be overcome. Finally, they perceive the future as completely hopeless because their worthlessness will prevent their circumstances from improving (McLeod, 2015).
• In negative self-schemas people with depression develop beliefs and expectations about themselves that are essentially negative and pessimistic. Beck says that these negative schemas could originate in childhood due to a traumatic event such as losing a loved one through death, parental rejection, criticism, overprotection, abuse, exclusion from the peer group, etc. It happens that at a later stage in life some stressful event/s will activate the past trauma which may lead to illogical thoughts (McLeod, 2015).
• Depressed people view their struggles as something that is bigger than it is and, whenever a solution comes, it is never enough and negative events are interpreted as their fault (McLeod, 2015). This increases the depressive symptoms that people develop in response to stressful situations.
Beck’s cognitive theory is linked to the discourse in the previous chapter as it argues that depression has a lot to do with automatic negative thoughts and that it is generated by dysfunctional beliefs that, in turn, lead to a depressive mood or state of mind. The holistic approach proposed by this theory is that a thorough diagnosis should be made of factors that lead to a person being depressed.
The thoughts of the depressed person are also influenced by different types of environmental interactions, which is a factor that this study observed through a cultural lens in order to address
39 | P a g e the research questions. The pivotal contribution of this theory was that it acknowledges that the environment influences human thought and impacts how people interact with themselves and the people and world around them. Allen et al. (2003) refer to the large number of studies that agree that females are more susceptible to depression than men due to their thinking which is impacted by society. Various scholars state that the way females and males are raised is not the same, as males are given a foundation to face things with a positive mindset because not doing so will make others view them as weak. Thus depressed males “…often appear physically awkward or lacking social/interpersonal skills” (Ibid.). The social structure affecting females is much different, and therefore they are more prone to develop irrational and dysfunctional beliefs. Also, females are more likely to form dysfunctional beliefs due to mixed signals from society (Allen et al., 2003).
The following diagrams graphically explain Berk’s cognitive theory of depression and what it proposes. The summary resonates with the discourse in Chapter One and Chapter Two of this thesis:
Figure 3.1: The cognitive theory of depression Source: Beck et al., 1979
Beck asserts that this is a schematic representation of a model of reactive depression. For example, a depressive reaction occurs when a person vulnerable to depression experiences a negative life event. As discussed in the introduction to Chapter Two, this depressive reaction is characterized
Onset Symptoms Duration
DIATHESIS
Factor that makes a person
vulnerable to depression
STRESS
Negative life event
Initial Depressive
Reaction
Hopelessness
---
Worthlessness
Long-Term Depressive Episode
Hopelessness
---
Worthlessness
40 | P a g e by feelings of hopelessness and/or worthlessness. Other symptoms include somatic disturbances (trouble sleeping), motivate ional disturbances (e.g., apathy) and emotional disturbances (e.g., sadness and helplessness). Helplessness may also give rise to a feeling of worthlessness. For most people feeling weak, ineffective, and powerless contributes to a sense of worthlessness. The dashed line indicates that a short-term depression reaction may resolve quickly or turn into a long- term depressive episode.
Another critical contribution of Beck’s theory of cognitive depression is the illumination of experiences that hammer the self-esteem of a person. The following diagram depicts those experiences that could potentially lead to a person being depressed.
Figure 3.2: Cognitive therapy of depression: Negative social experiences Source: Beck et al., 1979
The cognitive theory of depression also elucidates what is called the congruency model of depression. This model assumes that there are two personality types that are prone to depression.
One of these is highly dependent on social sources of approval while the other is highly dependent on achievement outcomes.
Table 3.1: Elements of the cognitive therapy of depression DIATHESIS
Low self- esteem
Depression
STRESS
Negative life event
Negative Social Experiences
41 | P a g e Depression-
prone personality
type
Bases of self-worth
Events that threaten self-worth
Themes Expressed During a Depressive
Episode Conditional
interpersonal orientation
Interpersonal
relationships: excessive need for acceptance, support, and approval
Social exclusion, rejection, or disapproval
Loneliness, loss, abandonment, rejection
Conditional achievement orientation
Achievement outcomes:
meeting internalized standards and goals;
excessive need for success, power, and control
Failure to achieve goals or attain standards
Inadequacy, personal failure, guilt, self- recrimination.
Source: Beck et al., 1979
The table above summarises the conditions and factors illuminated by Beck’s cognitive theory of depression that were discussed in Chapter Two.
42 | P a g e
Figure 3.3: Beck’s cognitive model of depression Source: Beck et al., 1979
Diathesis Beliefs
Stress significant live event
Negative Self- Schema:
Negative and distorted information processing
Negative Cognitive Triad negative belief about self, the world,
and the future
Somatic disturbances Motivational disturbances
Effective disturbances
43 | P a g e This figure illustrates that dysfunctional beliefs are a vulnerability factor (a diathesis). When activated by appropriate environmental events such as stress, these dysfunctional beliefs lead a person who is prone to depression to interpret experiences in negative and distorted ways. These negative interpretations, in turn, lead to negative views of oneself, one’s world, and one’s future.
These negative beliefs are what Beck refers to as the ‘negative cognitive triad’ as they are primary symptoms of depression which, in turn, stimulate other features of the disorder, including somatic (sleeplessness), motivational (passivity) and affective (sadness) disturbances.