Cutting Edge Psychology

New variants of CBT?

Posted on March 13, 2013 at 6:40 AM

I recently had a minor email spat with another psychologist over my claim that psychology has been dumbed down and 'de-psychologized' over the last 2-3 decades by Cognitive Behaviour Therapy (CBT). He felt the need to protest, and to point out recent advances in CBT such as mindfulness. I have to agree- mindfulness approaches are excellent. I began meditating 30 years ago, and was reading Alan Watts etc since around the same age; and more recently, Echart Tolle as well. I also like the Acceptance & Commitment Therapy (ACT) approach, and although his book did nothing for me personally, I can see that Hayes has done a great service for psychology with his innovations. However- i think it is disingenuous (but politically smart) for Hayes, Kabbat Zin et al to claim that these developments fit within the CBT framework. Sure, they are variations of cognitive behavioural psychology (as are constructivist cognitive behavioural psychologists), however CBT and cognitive behavioural psychology are not the same thing- the former is a subset of the latter.

CBT is a  manualised, specific cook book type approach devised by Aaron Beck (as Rational Emotive Therapy- RET- is a specific approach devised by Albert Ellis). These approaches represent merely one form of cognitive behavioural psychology- ie. those of a rationalist epistemology type, wherein there is assumed to one reality operating, and people are either in touch with it (i.e the therapist) or not (ie. the client). They also happen to have been the most prominent form of psychotherapy (especially CBT) in the last 2-3 decades. BUT- they are not the total sum of cognitive behavioural psychology. There have always been cognitive behavioural psychologists with a constructivist bent (those who suggest that we all construct our own reality, and that this is a socially negotiated process, e.g we agree that this is a table). Constructivist  cognitive behavioural psychology creates an extremely different set of approaches to psychotherapy compared to rationalist approaches, e.g the work of George Kelly, Gordon Allport, Michael Mahoney, Donald Michenbaum; the Solutions Focused Brief Therapy approach, as well as  Coherence Therapy  (not to mention the psychologists who have of late discovered the value of ancient meditative practices and mindfulness  etc, including ACT). These are all excellent constructivist approaches to therapy, and none of them are CBT (which is that specific approach created by Aaron Beck).

Many of these recent innovators have chosen to call their innovations a new variation of CBT, and personally I think none of them are correct in doing so. They have all done this false labeling for marketing and political purposes- marketing, because its become the only way to have a new approach achieve any immediate credibility and be given a fair go. And for political purposes, as the CBT enthusiasts have held power in psychology for the last couple of decades- nothing else is viewed as being credible or worthy of research funds. As such, anything which is seen to work in psychology is now referred to as a 'version of CBT'. The Australian Centre for Posttraumatic Mental Health even refer to EMDR as a 'form of CBT with a novel variation'! I am just waiting for the announcement to be made that psychology has discovered a new form of CBT, and it is called Buddhism.  Francine Shapiro, the originator of EMDR, needs to be congratulated for having chosen to not seek credibility of her innovation by coat-tailing it on CBT (unlike what the others have done). I also note that Bruce Ecker and Laurel Hulley, who co-devised Coherence Therapy, quite correctly refer to Coherence Therapy as a constructivist cognitive behavioural psychology, and eschew any connection with CBT (listen to his Shrink Rap Radio and Wise Counsel interviews). He emphatically states, 'this approach (referring to CBT) plays no role in what we do in coherence therapy' - or something very close to that.

So, you will gather that when i say that psychology has been 'un-psychologized' by CBT, I am referring to the effects of  CBT- as in the Cognitive Behavior Therapy of Aaron Beck (ditto for the RET of Ellis), and specifically to the long term changes this has had on psychology, ie. a loss of depth-psychology awareness and appreciation, and the replacement with a dumbed down rationalist epistemology presented in a standardised cook-book format. I am not referring to the excellent innovations which are incorrectly referring to themselves as forms of CBT for political and marketing purposes. In this meaning of 'psychology', I am following the lead of Martin Gross in his 1977 book 'The Psychological Society', in which he criticised psychology for following Freud's lead, and praised the 'new' cogntive revolution in psychology as being non-psychological (ie. not interested in the depth-psychology agendas). I dont agree with his overall argument, but am borrowing from him his depiction of the cognitive revolution (as seen in RET and CBT) as 'non-psychological' in that it ignored the unconscious mind, and instead utilised the philosophical approach of Stoicism.

My preference, for the sake of honesty and to save confusion, would be for the new cognitive  psychology innovators to follow the lead provided by Ecker & Hulley and Shapirio, and to accurately refer to their approaches as constructivist cognitive behavioural psychologies (but this would be harder to say than CBT, and be much less advantageous- plus, CBT has a much more snappy ring to it). By the way, meditation (both sitting and walking varieties) were in existence a long time before psychology 'discovered' them and called them mindfulness- we are the new kids on the block (and Buddhism really isnt a new innovative form of CBT!)

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Reply Back2-It
11:41 PM on May 20, 2013 
It is a shame that when so many can benefit from a real psychological approach that it is virtually non-existent. When extended families were the part of many lives in Western society there was an automatic psychological approach taken by some concerned relative, even if it was not the parent but an aunt or uncle or even a close neighbor. Then, the "subject" acted in a cognitive fashion with this advice. CBT without a mindfulness approach is like serving fast food: it is quick (er) and easier than messing with the ingredients for a special order, but, in the end, not as good and not as lasting. Your work on the forum has helped a good number of people it seems. Maybe someday better practices will return?
Reply James
4:33 AM on May 21, 2013 
I think the wheel is slowly turning. The fast food variety of CBT is losing favour as it is found more and more to be the emperor's new clothes. Meta-analytic studies and studies looking at publication bias in journals have pretty well demonstrated that traditional CBT is no more effective than any other approach to psychology, despite what its zealots insist. Psychology as a profession has way over identified itself with CBT, without realising that it is just a working myth (ie. its theory of emotions), and that it can essentially be done by a computer program. I am pleased with the developments in psychology such as ACT and mindfulness etc- it shows a greater deepening.But ultimately, i think psychology needs a large scale re-discovery of depth-psychology. Ironically, this is being aided by findings in contemporary neuroscience which are supporting some of the basic depth-psychology contentions. With these new findings in place, modern depth psychology is set to become something somewhat different to traditional psycholanalysis (which was a foundational building stone, but which we are not compelled to adhere to).
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