The technique of reattribution in psychotherapy: what is it and how is it used?

This technique is widely used in cognitive-behavioral therapy in different psychological disorders.

Everything we do and don't do has some effect on the world. We have some ability to control our actions: we choose what we want to do and what we do (although sometimes it is imposed on some people), which ultimately gives us the ability to direct our own actions. ultimately gives us the ability to direct our own lives..

However, we must also bear in mind that our action and intervention in the world is limited: there are many elements that may or may not come together to bring about a given situation. In this sense, attributing causes to a particular event can be much more difficult than it seems. However, it is common that at a mental level we try to quickly give an explanation in which what happens has one or a few factors that generate it.

In some cases this attribution can be unrealistic and generate discomfort, and can even become a pattern in which the causes of positive and negative events are considered rigidly and become a problem. Fortunately, through various techniques we can modify this pattern. One of them is the technique of reattribution, widely used by psychologists.one of them is the technique of reattribution, very used by psychologists, of which we are going to speak here.

What is the technique of reattribution?

The technique of reattribution is a technique of psychological intervention frequently used in the clinical practiceeither directly or as part of a more complex program or treatment (such as Beck's cognitive therapy).

This is a cognitive technique that tries to work on the patient's attribution of causes and is characterized by helping the patient to assess what may be the causes of a given situation in order to discuss and modify their beliefs regarding such causality, redirecting the patient's attribution towards a more realistic, objective and functional perspective..

Where does it start from?

The technique of reattribution starts from the idea of locus of control, i.e. from the fact that when analyzing a given situation we tend to attribute to the existence of that situation specific causes that can be either internal (i.e. that the person himself is responsible for it) or external (the environment, other people or abstract elements such as chance), global or specific, stable (the cause is permanent) or unstable (the cause is variable).

The realization of this attribution allows us to try to attribute a cause to what is happening, but sometimes the result of this attribution is unrealistic and dysfunctional.However, sometimes the result of this attribution is unrealistic and dysfunctional and can generate anxieties, anguish, sadness or discomfort among other possible effects. It is at this point that the technique of reattribution is useful.

What is its objective?

The main objective of the use of this technique of reattribution is to help the patient to modify his locus of control, i.e. to be able to modify the attribution of causes for positive and negative events. In this sense, work is done by making the person value the different factors that may be influencing or participating in a given event, situation and problem.

Thus, the aim is to reduce or eliminate the cognitive biases linked to a certain attribution of the causes of a situation. of the causes of a situation.

This technique allows the person to gradually realize that there are a large number of factors that can influence the occurrence or resolution of certain situations or problems, so that in the case of negative events the subject does not attribute sole responsibility for the outcome and blame himself/herself in the case of negative events, or does not attribute successes and positive results to luck alone.

There are different variants of this technique, often specialized in different types of problems. For example, we can find Goldberg's symptom reattribution technique, which focuses on the attribution of physical symptoms to psychic causes in cases of disorders such as somatization.

In which cases is it used in therapy?

The technique of reattribution is applicable to a large number of situations in which the person tends to maintain a rigid, unrealistic, biased or dysfunctional locus of control.unrealistic, biased or dysfunctional locus of control. In this sense we can be talking about both clinical and non-clinical problems, although its use in the former is much better known.

Some of the problems in which it is usually used are shown below.

1. Depression

Among the various disorders in which it is usually used, the following stand out in particular mood disorders. One of the most frequent is major depression, in which we can generally find the presence of cognitive biases that make the interpretation of oneself, the world and the future negative and aversive.

At the level of internal locus of control, stable and global for negative events, while successes and positive events are usually associated with external, unspecific and unstable causes (such as luck).

2. Anxiety-related disorders

Anxiety disorders, such as panic disorder or generalized anxiety disorder, are another type of problem that can be treated with the technique of reattribution.

Specifically, what can be treated in this way is the anticipation of anxiety crises and the attribution of certain symptoms to not necessarily dangerous causes. to causes that are not necessarily dangerous. An example can be found in tachycardia and increased cardiorespiratory rate.

Also the anxiety of a generalized anxiety disorder can benefit from the use of this technique by helping to objectify the possible causes of their discomfort and trying to promote a more objective view of the situations experienced.

3. Acute stress disorder and post-traumatic stress disorder

In addition to mood disorders, another type of situation in which this type of technique may be useful is in the context of acute stress disorder or post-traumatic stress disorder. While these disorders already have different methodologies that allow them to be treated effectively, variants of the reattribution technique may be considered in the case of persons who attribute blame for the traumatic event in question. event in question.

This is the case of people who have the so-called "survivor syndrome", people who have overcome an illness that has killed many others and feel guilty or unworthy of it, people who survive a traffic accident in which one or all the other people have died, people who have lived through a war conflict (both civilian and military) or cases such as people who have suffered rape or sexual abuse and blame themselves for it.

4. Obsessive-Compulsive Disorder

One of the main characteristics that many subjects with obsessive-compulsive disorder share is a very high level of self-doubt and a tendency to feel guilty about their obsessive thoughts, or else to have anxiety about the responsibility they would believe they would bear if the content of their thoughts were to come true..

For example, a person who has obsessive thoughts of contagion and rituals around cleanliness because of them will tend to feel guilty if they do not perform the rituals and make sure everything is properly disinfected, or they may feel responsible if someone in their environment becomes ill.

In this sense, the technique of reattribution can be useful as a way for the subject to try to see the situation in a more objective way and to value that there are several variables that could explain the occurrence of the reason for their anxiety and that would not have to do with their own actions. The aim would be to reduce the tendency to attribute responsibility or blame for those situations whose evocation generates anxiety.

5. Somatization disorder

Somatization disorder, together with other somatoform problems, is one of the disorders that can cause anxiety.is one of the disorders that can benefit from this type of techniques. In this case, the technique of reattribution can be used to help the patient to identify the possible psychic causes of the ailment he/she feels on a physical level.

6. Hypochondria

Although the approach to hypochondriasis requires more in-depth treatment, variants of the technique of reattribution can also be used to help sufferers learn to appreciate the possible causes of their discomfort without associating them with a physical illness.

However, great care must be taken to ensure that the possible causes cited by the subject are not illnesses but rather those elements that generate the sensation of being ill and what factors may be involved.

7. Adaptive disorder and other problems

Dismissals, separations, divorces, marital or family problems, bullying at work or school... all of these can generate a high level of stress and can generate a great level of stress and discomfort that is beyond the person's control and generate great suffering, without meeting the criteria to be considered as suffering from depression or an anxiety disorder. These are cases in which symptomatology typical of these two types of disorder may appear and which usually appear in a reactive manner to a situation (without which the symptomatology would not be present).

We are talking about the adaptive disorder, which can also benefit from the technique of reattribution in those cases in which the problem raises or generates an interpretation or attribution of causes that are dysfunctional to the person.

In addition, even if a disorder does not appear as such, it is also possible to work with this technique in a preventive way, especially with people with rigid beliefs, hyperresponsibility or low self-esteem.

Bibliographical references:

• Beck A.T., Rush A.J., Shaw B.F. & Emery, G. (1979) Cognitive Therapy of Depression. New York: Guilford Press.
• Burns, D.D. (1990). Feeling good. Barcelona: Paidós.
• Guzman, R.E. (2011). Somatization disorder: its approach in Primary Care. Clinical Journal of Family Medicine, 14 (3).