In his classic introduction to the subject, CognitiveTherapy and the Emotional Disorders, Aaron Beck observes that “the philosophical underpinnings” of cognitivetherapy’s (CT) approach to the emotional disorders “go back thousands of years, certainly to the time of the Stoics, who considered man’s conceptions (or misconceptions) of events rather than the events themselves as the key to his emotional upsets” (Beck 1976, 3). But beyond acknowledging that the stoics anticipated the central insight of CT, Beck (...) has very little to say about the philosophical underpinnings of CT, content it would seem for it to be an empirically grounded system of psychological principles and therapeutic methods. Yet even this little .. (shrink)
In this study, we examine the philosophical bases of one of the leading clinical psychological methods of therapy for anxiety, anger, and depression, Cognitive Behavioral Therapy (CBT). We trace this method back to its philosophical roots in the Stoic, Buddhist, Taoist, and Existentialist philosophical traditions. We start by discussing the tenets of CBT, and then we expand on the philosophical traditions that ground this approach. Given that CBT has had a clinically measured positive effect on the psychological (...) well-being of individuals, it becomes important to study the philosophical foundations on which this therapy is based. (shrink)
Pt. I. Philosophy and cognitive-behavioral therapy (CBT) -- Ch. 1. The "philosophical origins" of CBT -- Ch. 2. The beginning of modern cognitivetherapy -- Ch. 3. A brief history of philosophical therapy -- Ch. 4. Stoic philosophy and psychology -- Ch. 5. Rational emotion in stoicism and CBT -- Ch. 6 Stoicism and Ellis's rational therapy (REBT) -- Pt. II. The stoic armamentarium -- Ch. 7. Contemplation of the ideal stage -- Ch. 8. (...) Stoic mindfulness of the "here and now" -- Ch. 9. Self-analysis and disputation -- Ch. 10. Autosuggestion, premeditation, and retrospection -- Ch. 11. Preditatio malorum and mental rehearsal -- Ch. 12. Stoic fatalism, determination, and acceptance -- Ch. 13. The view from above and stoic metaphysics. (shrink)
This chapter examines two premises of cognitive-behavioral therapy (CBT) - that emotions are caused by beliefs and that those beliefs are represented in the mind as words or images. Being a philosophical examination, the chapter also seeks to demonstrate that these two premises essentially are philosophical premises. The chapter begins with a brief methodological suggestion of how to properly evaluate the theory of CBT. From there it works it way from examining the therapeutic practice of capturing the mental (...) representations that supposedly elicit emotional reactions to examining the assumption that emotions are caused by beliefs. The chapter ends by briefly pointing to some consequences of what has been said to the practice of CBT. (shrink)
Cognitive Behavioural Therapy (CBT), is a therapy based on cognitive manipulation which denies the existence of ontological truth. Merleau-Ponty warned of such a development which he labelled a “decadent psychoanalysis.” Merleau-Ponty believed in the existence of ontological truth, not as a matter of cognitive representation nor as something that can be designated by positive indices such as those of psychometric measures or statistical analysis, but as an ontological dimension of the pre-cognitive world. Openness to (...) this pre-reflective truth differentiates a therapy based on truth from one based on suggestion and manipulation. When a suicidal patient, approaches a psychotherapist for help and is told that he or she can feel better by adjusting his or her dysfunctional thinking in normative directions, this truth of lived experience is denied, and so is the opportunity for patient and therapist to recognise their shared ontological pre-reflective connection in which truth may find a way to express itself safely, that is, intersubjectively. (shrink)
Imagery is one of the new, exciting frontiers in cognitivetherapy. From the outset of cognitivetherapy, its founder Dr. Aaron T. Beck recognised the importance of imagery in the understanding and treatment of patient's problems. However, despite Beck's prescience, clinical research on imagery, and the integration of imagery interventions into clinical practice, developed slowly. It is only in the past 10 years that most writing and research on imagery in cognitivetherapy has been (...) conducted. The Oxford Guide to Imagery in CognitiveTherapy is a landmark book, which will play an important role in the next phase of cognitivetherapy's development. Clinicians and researchers are starting to recognise the centrality of imagery in the development, maintenance and treatment of psychological disorders - for example, in social phobia, agoraphobia, depression, PTSD, eating disorders, childhood trauma, and personality disorder. In the fields of cognitive psychology and cognitive neuroscience, researchers are identifying the key role that imagery plays in emotion, cognition and psychopathology.The Oxford Guide to Imagery in CognitiveTherapy has been written both for clinicians and researchers. For clinicians, it is a user-friendly, practical guide to imagery, which will enable therapists to understand imagery phenomenology, and to integrate imagery-based interventions into their cognitivetherapy practice. For researchers, it provides a state-of-the-art summary of imagery research, and points the way to future studies. Written by three well-respected CBT researcher-clinicians, it is essential reading for all cognitive therapists, who have recognised the limitations of purely 'verbal' CBT techniques, and want to find new ways to work with clients with psychological disorders. Readership: CBT therapists. (shrink)
This study explores and assesses the nature and practice of Mindfulness-Based CognitiveTherapy (MBCT) from the perspective of Therav?da Buddhism. It is particularly concerned with how both models of training understand and apply ?mindfulness?. The approach here is, firstly, to examine how the Therav?da understands and employs mindfulness and, secondly, to explore, and more accurately contextualize, the work of MBCT. The evaluation of MBCT in terms of the Therav?da suggests the former has both a strong affinity with, as (...) well as some significant distinctions from, its dominant Therav?din influences. (shrink)
Mindfulness-based cognitivetherapy creates an unlikely partnership, between the ancient tradition of mindfulness meditation rooted in Buddhist thought, and the much more recent and essentially western tradition of cognitive and clinical science. This article investigates points of congruence and difference between the two traditions and concludes that, despite first appearances, this is a fruitful partnership which may well endure.
Behavioural experiments are one of the central and most powerful methods of intervention in cognitivetherapy. Yet until now, there has been no volume specifically dedicated to guiding physicians who wish to design and implement behavioural experiments across a wide range of clinical problems.The Oxford Guide to Behavioural Experiments in CognitiveTherapy fills this gap. It is written by clinicians for clinicians. It is a practical, easy to read handbook, which is relevant for practising clinicians at (...) every level, from trainees to cognitivetherapy supervisors.Following a foreword by David Clark, the first two chapters provide a theoretical and practical background for the understanding and development of behavioural experiments. Thereafter, the remaining chapters of the book focus on particular problem areas. These include problems which have been the traditional focus of cognitivetherapy, as well as those which have only more recently become a subject of study, and some which are still in their relative infancy. The book also includes several chapters on transdiagnostic problems, such as avoidance of affect, low self-esteem, interpersonal issues, and self-injurious behaviour. A final chapter by Christine Padesky provides some signposts for future development.Containing examples of over 200 behavioural experiments, this book will be of enormous practical value for all those involved in cognitive behavioural therapy, as well as stimulating exploration and creativity in both its readers and their patients. (shrink)
ABSTRACTMajor depressive disorder is a prevalent condition with high relapse rates. There is evidence that cognitive reactivity is an important vulnerability factor for the recurrence of depression. Mindfulness-based interventions are designed to reduce relapse rates, with cognitive reactivity as one of the proposed working mechanisms. In a randomised controlled trial we compared the effect of mindfulness-based cognitivetherapy with treatment-as-usual on cognitive reactivity in recurrently depressed patients. Depressive symptoms, cognitive reactivity, and mindfulness skills were (...) assessed pre and post treatment. Patients in the MBCT group reported a significantly greater reduction in cognitive reactivity than those in the TAU group. The reduction of cognitive reactivity appeared to mediate the association between MBCT/TAU and decrease of depressive symptoms, using pre and post scores. The current study provides evidence that MBCT reduces cognitive reactivity and preliminar... (shrink)
The following paper argues that Husserl’s description of the natural attitude can be used as an alternative to Beck’s cognitivetherapy’s understanding of the change process and the perpetuation of an emotional disorder. Conversely this also provides further insight into the natural attitude. Specifically the works of Sebastian Luft and Alfred Schutz are referred to as a means of developing what is termed by the paper as the universalising attitude. The paper extrapolates the incidental, yet significant, phenomenological structures (...) within CBT’s process of guided discovery to support its hypothesis that the change process can be understood as the patient undertaking at various times in therapy, a series of differing epoché. It is argued that CBT ultimately ‘works’ by the patient learning to achieve a rudimentary phenomenological attitude. The patient acquires insight by ‘standing back’ from their factual understanding of self, others and the world. (shrink)
This article critiques the inadequate attention given to the question of meaning in mainstream clinical psychiatry and psychology. The author reviews the history of phenomenological and existential psychiatry, especially the work of Erwin Straus, and highlights the emphasis on the personal world of experience and on such existential dimensions as time and ethical experience. Aaron Beck's school of cognitivetherapy appropriates many themes and concepts from phenomenology, including the central concept of meaning, and turns them into a systematic (...) technology for personal change. The author contrasts the phenomenological and cognitive approaches to meaning. The relationship between the cognitive and existential therapies is described by analogy to William James's healthy-minded and morbid-minded religion. (shrink)
Wittgenstein compared his treatment of philosophical questions to the cure of an illness, his philosophical methods to different types of therapies. This paper seeks to spell out the point of these comparisons. To this end, it analyzes Wittgenstein's problems and proceeding in sections 138-197 of his "Philosophical Investigations", with the help of some new concepts, in part adapted from clinical psychology, namely, cognitivetherapy. They are used to conceptualize the problems at issue in such a way as to (...) bring out why anything worth calling a 'therapy' is required, in the first place. Then, the paper employs the model of cognitivetherapy to clarify what Wittgenstein is doing in response. The chapter thus identifies a little noted but highly important kind of philosophical predicament, and explains a straightforward approach to it that is, in many ways, revolutionary. (shrink)
The ambiguity regarding whether a given intervention is perceived as enhancement or as therapy might contribute to the angst that the public expresses with respect to endorsement of enhancement. We set out to develop empirical data that explored this. We used Amazon Mechanical Turk to recruit participants from Canada and the United States. Each individual was randomly assigned to read one vignette describing the use of a pill to enhance one of 12 cognitive, affective or social domains. The (...) vignettes described a situation in which an individual was using a pill to enhance the relevant domain under one of two possible enhancement conditions, one perceived as enhancing above the norm, what most people recognize as a clear case of enhancement, whereas the other perceived as enhancing towards the norm, with the individual using the enhancement having a modest, but subclinical deficit. Participants were asked how comfortable they were with the individual using the enhancement and about the impact the enhancement might have had in the individuals’ success in life. We found that irrespective of the domain to be enhanced, participants felt significantly more comfortable with ETN than with EAN, and they regarded the enhancement intervention as contributing to greater success in life with ETN rather than EAN. These data demonstrate that the therapy enhancement distinction is morally salient to the public, and that this distinction contributes to the angst that people feel when considering the propriety of CAS enhancement. (shrink)
Spinoza shared with his contemporaries the conviction that the passions are, on the whole, unruly and destructive. A life of virtue requires that the passions be controlled, if not entirely vanquished, and the preferred means of imposing this control over the passions is via the power of reason. But there was little agreement in the seventeenth century about just what gives reason its strength and how its power can be brought to bear upon the wayward passions.
Cognitive Behavioral Therapy has become the dominant form of psychotherapy in North America. The CBT model is theoretically based on the idea that all external and internal stimuli are filtered through meaning-making, consciously accessible cognitive schemas. The goal of CBT is to identify dysfunctional or maladaptive thoughts and beliefs, and replace them with more adaptive cognitive interpretations. While CBT is clearly effective as a treatment, there is good reason to be skeptical that its efficacy is due (...) to the causal mechanisms posited by the CBT model. This paper will argue that the specific cognitive schemas posited by the CBT model likely do not play a direct role in the development or treatment of psychological illness. Cognitive schemas, as identified in CBT interventions, are likely to be the result of patient confabulation and epistemically under-supported practitioner-based identification. CBT interventions appear to impose coherence on patients’ psychological states, rather than identifying and modifying preexistent causally efficacious core beliefs. (shrink)
Background: There is a growing interest in using cognitive behavioural therapy with people who have Asperger Syndrome and comorbid mental health problems. Aims: To examine whether modified group CBT for clinically significant anxiety in an AS population is feasible and likely to be efficacious. Method: Using a randomised assessor-blind trial, 52 individuals with AS were randomised into a treatment arm or a waiting-list control arm. After 24 weeks, those in the waiting-list control arm received treatment, while those initially (...) randomised to treatment were followed-up for 24 weeks. Results: The conversion rate for this trial was high, while attrition was 13%. After 24 weeks, there was no significant difference between those randomised to the treatment arm compared to those randomised to the waiting-list control arm on the primary outcome measure, the Hamilton Rating Scale for Anxiety. Conclusions: Trials of psychological therapies with this population are feasible. Larger definitive trials are now needed. Declaration of Interest: None Trial Registration: ISRCTN 30265294, UKCRN 8370. (shrink)
Whilst individuals deal with divergent sorts of stimuli from the environment, they also tend to display some regularity in the way they respond to related patterns. These consistent responses can be conceptualised as cognitive schemas. A paramount component of Cognitive Behaviour Therapy (CBT) is the notion of cognitive schemas as they are a favoured point of therapeutic intervention. CBT as articulated by Beck in the 1960s owes intellectual acknowledgment to Merleau-Ponty and Heidegger and their notions of (...) “atmosphere” and “clearing” respectively. This essay explores the notion of cognitive schema and atmosphere as applied to emotional pathology. It suggests that the well-known influence that phenomenology had on existential psychology could be extended to empirical clinical psychology, like CBT. The strategy adopted in this paper is to use Dreyfus’ ontological and epistemological distinction in psychopathology and then make a similar distinction, albeit using different terminology, in the CBT tradition. Some empirical findings from the literature are examined which render support to the existence of cognitive schemas and their crucial contributory role in the aetiology and maintenance of emotional disorders. It is noted that some of the features of these cognitive schemas were espoused well before Beck by Merleau-Ponty and the phenomenological-existential tradition. Indo-Pacific Journal of Phenomenology , Volume 4, Edition 1 July 2004. (shrink)
Opioid use disorder can encompass a number of behavioral, psychological, physiological, and interpersonal symptoms which collectively impair one’s functioning to different degrees. Of all the personal and societal problems associated with OUD, the most destructive and absolute is death. Given the caustic effects of OUD on quality of life and mortality, evidence-based pharmacotherapy and psychosocial interventions are necessary. It is the collective potential for buprenorphine to increase safety and concurrent cognitive-behavioral group therapy to address substance use triggers as (...) well as comorbid psychiatric conditions, which makes this combination particularly promising for RCT of effectiveness. The purposes of this article are to identify specific ethical issues which may hinder community partners from collaborating with clinical trialist wishing to conduct CBGT buprenorphine efficacy-effectiveness trials at their agency and provide some basic guidelines and methods for addressing these community partner ethical concerns. The purpose of the manuscript is to facilitate university and substance use/mental health center community collaborations that will result in ethical clinical trial methodology and findings that meaningfully translate to efficacious, effective, and generalizable CBGT and buprenorphine hybrid interventions for OUD. (shrink)
It is estimated that one in ten U.S. adults suffers from chronic insomnia. If left untreated, chronic insomnia reduces quality of life and increases risk for psychiatric and medical disease, especially depression and anxiety. There are two forms of insomnia: secondary insomnia, in which it is comorbid with another condition such as psychiatric disorders, chronic pain conditions, or cardiopulmonary disorders, and primary insomnia, which does not coexist with any other disorder. This treatment program uses cognitive-behavioral therapy methods to (...) correct poor sleep habits. CBT has been proven in multiple studies to improve sleep hygiene by reducing time spent in bed before sleep onset, reducing time spent awake after first sleep onset, and increasing the quality and efficiency of sleep. Developed by the authors, this evidence based treatment can be used for both primary and secondary insomnia sufferers. Patients are first given information about healthy sleep and the reasons for improving sleep habits, then a behavioral program is developed to address that patient's specific sleep problems. Use of sleep logs, assessment forms, and other homework allows client and therapist to work together to develop an effective sleep regimen tailored specifically for each client. Finally, several sessions are dedicated to increasing compliance and problem-solving.TreatmentsThatWork represents the gold standard of behavioral healthcare interventions!BL All programs have been rigorously tested in clinical trials and are backed by years of researchBL A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to dateBL Our books are reliable and effective and make it easy for you to provide your clients with the best care availableBL Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivatedBL A companion website offers downloadable clinical tools and helpful resourcesBL Continuing Education Credits are now available on select titles in collaboration with PsychoEducational Resources, Inc. (shrink)
This revised workbook is designed for patients' use as they work, either with a qualified mental health professional or on their own, to manage social anxiety. Based on the principles of cognitive-behavioral therapy, the treatment program described is evidence-based and proven effective. Complete with user-friendly forms and worksheets, as well as relatable case examples and chapter review questions, this workbook contains all the tools necessary to help patients manage their anxiety and improve their quality of life.
Empirical assessments of Cognitive Behavioral Theory and theoretical considerations raise questions about the fundamental theoretical tenet that psychological disturbances are mediated by consciously accessible cognitive structures. This paper considers this situation in light of emotion theory in philosophy. We argue that the “perceptual theory” of emotions, which underlines the parallels between emotions and sensory perceptions, suggests a conception of cognitive mediation that can accommodate the observed empirical anomalies and one that is consistent with the dual-processing models dominant (...) in cognitive psychology. (shrink)
Nowadays psychology as a scientific discourse and a positive practice finds itself in an epistemologically critical situation. The analysis of the actual state of the academic discussion in cognitive-behavioural psychology, the most representative and widespread theoretical-practical trend in European nations, reveals that it frequently is misunderstood as a exclusively technical proceeding, an amount of deficiently articulated operatory interventions, alienated from its underlying anthropological assumptions. This paper proposes to exam how far the gap between theoretical reflection and effective practice, a (...) cleavage frequently confirmed, may be reduced discussing the concept of Menschenbildannahmen, an idea firmly rooted in anthropological thinking. Actualmente, la psicología en tanto discurso científico y práctica positiva se encuentra en un estado epistemológicamente crítico. El análisis del estado actual de la discusión académica en la psicología cognitivo-conductual, la corriente teórico-práctica más representativa y más difundida en los estados europeos, devela que ésta frecuentemente es malentendida como un mero procedimiento técnico, un conjunto precariamente articulado de intervenciones operatorias, desentendidas de sus supuestos antropológicos subyacentes. Se propone examinar en qué medida la brecha entre reflexión teórica y práctica efectiva, una escisión ampliamente constatada, puede ser aminorada sometiendo a discusión el concepto de las Menschenbildannahmen, de extensa raigambre en el pensamiento antropológico. (shrink)