Schemas and beliefs

Reducing emotions and behaviour to a person' beliefs and goals appears to be closely associated with the idea of the human as rational actor. This notion may have some explanatory virtue in non-clinical areas, but it may be hard to see how beliefs and intentions may account for psychiatric problems.

An initial solution was proposed by psychoanalytic theory, which stated that intentions (wishes, desires) unknown to rational consciousness direct the emotions and behaviour of people with emotional problems. The main problem with this view is that there is no corpus of scientific data to support it. (99> That is, many psychological processes like memory or attention do not require consciousness (see the discussion of attention, above), but these 'unconscious' or 'preconscious' processes are typically rather diffuse and non-specific, or 'quick and dirty', (!.°0) and far less elaborate than beliefs.

A second way of applying intentional explanations to psychopathology is bluntly to assume that the emotions and behaviour of patients and healthy people are guided to the same degree by beliefs. The crucial difference between clinical and non-clinical groups may be the content of their beliefs. In cognitive theories of the type discussed here, it is assumed that various forms of psychopathology are associated with specific beliefs about the self, others, or the outside world. According to cognitive psychology, such basic beliefs are organized in schemas. Schema is a highly theoretical term denoting a hypothetical knowledge structure in memory. Schemas are assumed to organize selective attention, interpretation of events, and strategies for survival. In other words, schemas underlie information processing, conscious thoughts, emotions, and behaviour. Although much of the content of the knowledge represented in these schemas is not necessarily accessible to direct introspection, it is possible to reconstruct it in verbal terms. Such reconstructions are usually called assumptions or beliefs, and it is assumed that, in psychiatric patients, such 'pathogenic' beliefs are unrealistic or dysfunctional, resistant to disconfirmation by corrective information, and play a crucial role in the genesis and/or maintenance of the disorder/633 In the remainder of this section, we first discuss evidence relating to the existence and nature of such unrealistic ideas, and then consider the rather important issue of the causal status of unrealistic/dysfunctional beliefs in psychiatric disorders.

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