This technique in Cognitive Therapy involves the therapist attempting to determine with the client what the client’s core beliefs, fears and concerns might be. It involves the therapist asking about the relevance of content and drilling down into this content for further meaning.
For example, Beth doesn’t want to go to a school reunion because she says that “People will ignore me!” Beth thinks that this fear is what is driving her to avoid the reunion. Vertical descent into the meaning Beth places in rejection could go something like this:
Beth: I don’t want to go to the reunion!
Beth: People will ignore me!
Therapist: People ignoring you will be significant because?
Beth: I will feel isolated!
Therapist: Feeling isolated would make you feel . . . ?
Beth: Like I am not worth being around.
Beth: I was never as good as those people!
Beth moves here from a fear of being rejected to a belief that she has held since school – that she is not as good as her former classmates. Notice the present tense – “is not as good”! Therapy is always about the present. Discussing further, we find that Beth has always believed herself to be inferior to these others and if she goes to the reunion and is rejected, the rejection will confirm her belief. So, the issue is not simply rejection, but a long-term belief that needs to be considered. Vertical descent allows the client and therapist to delve into the ideas and beliefs behind immediate concerns.