The Cognitive Perspective

The information-processing perspective, which you may have encountered in cognitive and experimental courses in psychology, is particularly relevant to the avoidant personality. In general, there are several information-processing models that attempt to explain cognitive process in humans. Some of these models are focused on neural networks (e.g., a particular cue, such as the word flower, primes linguistic systems for words such as pretty, rose, red, and each of these, in turn, primes other associations), while others are rule-based production systems (e.g., a sound leaves a sensory imprint, which is then translated into the multilevel memory system, prompting a comparative match from previous experience already stored in memory, all of which is necessary for the ensuing response). All of these cognitive process models have a common thread: The system is limited. There is but a finite capacity for attention and processing in humans. When attention becomes divided or fragmented, essential features of the stimulus world are neglected, all inputs are processed to a more shallow depth, and the overall quality of processing degrades substantially.

Generally, when cognitive theorists discuss personality, they focus on the contents of cognition—on how core and conditional beliefs influence and sustain a vicious circle of pathological interpersonal behavior, for example (Beck et al., 1990). In the avoidant personality, however, the contents of cognition establish a pathological reciprocity with the structure (i.e., the information-processing apparatus) of cognition, which in turn helps perpetuate the entire disorder. Here, hypervigilance is central. Avoidants constantly scan their environment for signs of danger. Sensitive to the most subtle feelings and intentions of others, they are acutely perceptive observers who appraise every movement and expression of those with whom they come into contact. Their incredibly sensitive instruments pick up and magnify incidental actions and reinterpret them as indications of derision and rejection.

What results from this flooding is an information-processing system overwhelmed with excessive stimuli that prevents attending to many of the ordinary, yet also relevant, features of the environment. In effect, the baseline expectancy of danger is so high that even innocuous events cross the avoidant's threshold at a point where they are appraised as harmful. Bombarded with a superabundance of potential threats, no single piece of information is processed at depth. The hypothesis that every source of stimulation is harmful is sustained because the consequences of uncertainty, of letting even one threat go unnoticed, are simply too great. As a result, anxiety increases, sensitivity to cues of threat increase, and depth of processing suffers further. Eventually, the entire cognitive processing system becomes so overburdened that everything is threatening, and the avoidant must withdraw to a safe haven, where the sources of stimulation (e.g., a few trusted others) are known to be safe. If unable to withdraw, they are left with a mind full of free-floating associations and a vague but powerful sense of danger. Figure 6.2 diagrams this vicious circle.

Your intuition may have already informed you that hypervigilance is likely a key contributor to Allison's panic attacks. As she moves from the safety of her home and into the surrounding world, Allison becomes increasingly attuned to the facial expressions and mannerisms of everyone around her. She notes where people are looking and at what. If she thinks they are looking at her (a not-too-uncommon finding for her), her self-consciousness escalates, since she will typically think that they are always looking just a little too long. She checks her dress and makeup for some social gaffe. She finds nothing, but her vigilance increases. Maybe she just can't see what they can. With her

FIGURE 6.2 The Vicious Circle of the Avoidant's Information Processing.

attention heightened, she notes even more looks. At this point, time slows down for her, and she begins to feel "found out." With her defects public, she begins to feel shamed, and her anxiety level shoots off the scale, a full-fledged panic attack.

Many avoidant persons engage a form of cognitive defense designed to short-circuit this self-perpetuating vicious circle. To regain a measure of tranquility, they engage a series of reinterpretations and digressions, actively blocking, destroying, and fragmenting their own thoughts, seeking to disconnect relationships among what they see, what meanings they attribute to their perceptions, and what feelings they experience in response. Defensively, they intentionally destroy the clarity of their thoughts by intruding irrelevant distractions, tangential ideas, and discordant emotions. Rather than let the associations to threat further overwhelm them, they consciously introduce irrelevant thoughts and emotions into the cognitive stream to displace anxiety-ridden content with more neutral associations. In effect, they have learned to disrupt the automatic processing of stimulation with a form of self-consciously practiced cognitive interference. For some, this strategy assumes an automaticity of its own, giving it the characteristics of a personality trait. At least superficially, such individuals may resemble the schizotypal personality.

Much like an intoxicating drug, this strategy of cognitive interference may win anxiety reduction, but at the expense of cognitive clarity. By habitually interfering with the natural flow of cognitive processes, avoidants further diminish their ability to deal with events efficiently and rationally. No longer can they attend to the most salient features of their environment, nor can they focus their thoughts or respond rationally to events. Moreover, their thinking becomes too scattered and cluttered to learn new ways of coping. Social communications may also become tangential and irrelevant, further distorting others' responses to the avoidant. In their attempt to diminish intrusively disturbing thoughts, they fall prey to a coping mechanism that further aggravates their original difficulties and ultimately intensifies their alienation from both themselves and others. Allison does not appear to be this severe; although she is certainly overwhelmed cog-nitively, she does not seek (actively or automatically) to disrupt the coherence of her own self-awareness as a means of protecting herself against pain, as does the young man in our second case example (see Case 6.2).

In addition to information processing, the cognitive perspective also informs us that beliefs about the world, self, and others (i.e., the aforementioned contents of cognition) are critical in determining behavior (Beck et al., 1990). The influence of schemata in mediating behavior can be shown by reinterpreting the traits and diagnostic criteria of a given disorder, as we do in the following paragraphs. Cognitivists refer to core beliefs, as beliefs held to be absolutely and eternally true; factors in the world may change, but the validity of such beliefs endures essentially forever, usually at a level below conscious awareness. Core beliefs are a powerful and pervasive influence in organizing other beliefs, especially in predicting the consequences of various courses of action, expressed as conditional beliefs, if-then statements that are contingent on the subject's behavior. In turn, conditional beliefs feed into instrumental beliefs, notions about the mode through which the individual can affect the world.

The DSM-IV criteria for the avoidant personality can be conceptualized in terms of two core beliefs, two conditional beliefs, and three instrumental beliefs (see Figure 6.3). There are probably other formulations, depending on the degree of detail desired at the level of core beliefs. For example, is the first box in Figure 6.3 a single core belief, as shown here, or is it really four beliefs—one core belief for each piece of the self-image?

FIGURE 6.3 Belief and the Avoidant Personality (some beliefs from Beck & Freeman, 1990).

Because there are only fine distinctions among such descriptors, we have chosen to group them together. Core beliefs should be global and generalized, for they influence all other beliefs below them in the schematic hierarchy. Accordingly, Figure 6.3 maps the first DSM-IV diagnostic criterion directly to a single core belief. Such direct translations are rare and occur mainly in the self-image realm. Thus, the first criterion, "Views self as socially inept, personally unappealing, or inferior to others" (p. 665), is directly translated into the belief, "I am inept, unappealing, and inferior."

Moreover, Figure 6.3 shows that some diagnostic criteria reflect the same instrumental belief, only expressed in different situations. For example, the first and fourth criteria are almost the same, except that the first refers to vocational concerns and the fourth to social concerns. The second criterion essentially repeats the same theme. Such redundancy suggests that some taxonomy of situations should be developed so that the same belief does not become needlessly multiplied, weighting the disorder too much in a particular direction. For example, each instrumental belief might be expressed through a single criterion in the vocational, educational, recreational, and interpersonal domains. This criticism applies to nearly every personality disorder, not just the avoidant.

As mentioned before, the avoidant's instrumental beliefs of ineptitude and unworthi-ness, which create a perpetual downward spiral of depleting self-esteem, also tend to manifest significant underachievement. Given that many of these people are talented and intelligent, this is a very unfortunate hindrance. Because they internalize their parents' high expectations, many avoidants acquire considerable skills but never judge themselves "good enough" to apply what they have learned in front of others. Alternatively, other avoidants try to develop an interest in something, only to quit prematurely because they judge their own performance as inadequate, just as mother and father did.

Although the case discussion does not say so, this may contribute to why Allison feels she may not be able to attend classes. She may not be motivated to, because she may believe that no matter how expert her teachers, she would just screw things up anyway. Why learn to be anything when you'll never do anything with it anyway? Better to save yourself the agony of trying, especially with panic attacks in your way.

You can easily see the relevance of the cognitive perspective on beliefs to the personality disorders in Allison. Her core belief in her own inadequacy has been amplified, with cascading influences down the hierarchy to the level of conditional and instrumental beliefs. Allison is no longer certain that she will be able to attend classes, a variation of, "If I try something, I am likely to fail." She consolidates her shopping trips to avoid others, an expression of the underlying belief, "If I have to interact with others, I will be rejected." She notes the context in which her inadequacy beliefs were formed, under high parental expectations and equally strong parental criticism. She was afraid to be herself with her former boyfriend, a behavioral manifestation of the instrumental belief that she must put up a "false face" or be rejected. Other examples could be noted. Consult Beck et al. (1990) for a discussion of these and other avoidant beliefs.

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