CBT founder dies
By Mark Vernon on Thursday, July 26 2007, 10:16 - Philosophers - Permalink
Albert Ellis, the founder of Cognitive Behavioural Theory - CBT - died on 24th July. There's a portrait of the man written by a believer in Prospect this month, following apparently the last interview he gave. It is ugly to speak ill of the dead, though Ellis by all accounts did not hesitate to speak ill of the living when alive. However the portrait conflates so many different philosophies and religions, including Socrates' scepticism, Stoicism, cynicism, Buddhism, Taoism and Zen Buddhism - saying they're all pretty much like CBT but without the focus - that one must I fear speak gentle ills of the writer, Jules Evans.
As a placeholder, I think it was Freud who said 'the ego is pain', meaning that it is our struggle with ourselves that causes our distress in life. In this, he shared much in common with Socrates, who put knowing yourself in order to transform yourself at the heart of his philosophy. Similarly, the Stoics and the cynics believed that you must effectively become a different person or you would not have a happy life. At the risk of just replacing one generalization with another, the Eastern religions broadly have a similar diagnosis but a different solution. In short, they say that not only is the self the problem but it must be recognised as nothing short of a delusion and transcended.
CBT is entirely different. It is behavioural, proudly operating at the level of what you do not the depth of who you are. In intent, it is as different as papering over the cracks and rebuilding the whole house - which isn't to say that sometimes papering over the cracks is not enough, but it is still only papering over the cracks. CBT works to bolster self-esteem and fortify bashed egos, not question and transform the self. This is why it has much in the common with positive psychology and positive thinking. It is also why it flourishes in a consumer culture - one that would do anything to avoid facing the pain that lies beneath the surface.
Comments
I disagree Mark. Both Stoicism, CBT and Buddhism suggest that the root of our suffering is in our opinions and perceptions, and that be becoming mindful and attentive, we can control our minds and lessen suffering.
One founder of CBT, Aaron Beck, has spoken and written about the similarities between CBT and Buddhism - you can find a dialogue he held with the Dalai Lama on the subject on the internet.
And Ellis himself was writing a book on REBT and Buddhism when he died.
Hi -
May I disagree again! But perhaps say first that I am someone who has benefited from a CBT-type approach as part of a way out of depression. I felt it helped me manage my life, which was important before I could address the real issues. It made the house liveable in, as it were, but the house required more substantial attention in the long term. That is CBT's value, it seems to me. It's like a first step (and I suppose sometimes people only want to take that first step or the first step is enough).
The reason I suspect the conflation between CBT and Buddhism is that in Buddhism wrong opinions and perceptions are not the root of suffering; opinions and perceptions are suffering, regardless of whether someone thinks them good or bad. So becoming mindful in order to control our minds is to stop short of the goal, for the Buddhist, the real aim of which is to realise that all opinions and perceptions are as illusory as the self itself, and thereby become 'awake'. From what I've seen of it, this is confused in Western appropriations of Buddhism where the radical denial of the self is toned down - no doubt so as not to put people off, or meet them where they are - which is what the Dalai Lama is so good at doing. But there is a reason why Tibetan Buddhism requires you to spend years in a monastry training. It is very hard to shed the illusion of the self!
The reason I suspect the conflation between CBT and Stoicism is that the Stoic too wants to become a different person though not at the level of his or her behaviour but at the level of the alignment of his or her soul. This is the meaning of Chryssipus' famous cylinder. In particular, the Stoic must change the habitual dispositions of their soul in order not to conflict with the world around them, or nature as a whole, but rather to go with the flow. I just don't see this kind of model in CBT at all - but again is rather just to 'modify patients' perceptions of the external and internal reasons for their successes and failures in life'.
Mark
Hmmm, having trouble posting a comment.
You're right that CBT doesnt suggest the total dismantling of the self in order to arrive at Nirvana. If it did, not a single western government would have given it funding, and no western medical institution would have taken it on board.
Its been quite unambitious in its claims, precisely so as to be accepted by these institutions without being seen as some religion. Essentially, it has taken cognitive techniques from some philosophies/faiths, particularly Stoicism and Buddhism, but without the faith in the Logos or re-incarnation. I think it has done remarkably well to do that, because it has brought back and popularized these techniques, for people who might otherwise never have got access to them.
We can recognize that, cant we, without sneering at CBT for being superficial or simplistic.
Also, I don't understand what you mean by saying 'just to modify patients' perceptions of the external and internal reasons for their successes and failures in life'. why 'just'? thats an enormous task!
what is the 'pain beneath' if not perception? thats what stoics suggested - our suffering comes from perceptions, from opinions. thats what buddhists suggest as well.
Yes, CBT doesnt take you all the way. its just designed for acute emotional disorders, like my social anxiety or your depression (both of which, it appears, it has successfully tackled).
A wise person would then go further, to explore the philosophies from which CBT's cognitive techniques were taken - particularly Stoicism and Buddhism.
I also dont understand what you mean by saying CBT is somehow consumerist. On the contrary, it teaches you mindfulness, awareness of dumb coping mechanisms such as binge eating, binge drinking or binge spending. The anti-consumerist movement is based on the idea of 'having enough', of learning to do without, learning that happiness can come from controlling rather than indulging ones every desire. the origin of that movement is Cynicism and Stoicism. So can does a therapy which re-introduces Stoic and Cynic thinking be labelled consumerist?
Well, I think that the unhooking from the metaphysics makes a lot of difference.
The faith that the stoic had in their way of life was that it aligned them to a divinely order plan of things. If you don't believe in the plan, why bother with the realignment - which might in itself be very painful (as you can sense from Marcus Aurelius).
Similarly, the faith that the Buddhist has makes their struggles worthwhile too. Sure, Western Buddhism has value in providing a sense of centredness. But I think it risks being misleading too - in the way that someone might go to their meditation class on a Friday and think that is what it is to be somehow spiritual.
So the techniques are fine. But they just are stoicism or Buddhism lite, as it were. This can sound sneering. Apologies. I suppose I am as frustrated at myself for not being able to commit to the deeper faith that lies behind the older traditions. But then we are children of our times.
Which is also the consumerist point. It does seem to me to be consumerist to cherry-pick from older traditions as if the acceptable bits can be bought into and the unacceptable bits disguarded.
And this matters. For it could be that the cherry-picking doesn't deliver on what it promises - which is what I worry when CBT is presented as a cure rather than a first step (or as an antibiotic when it is really an aspirin, as someone else rather neatly put).
This is another matter entirely, but the evidence for CBT is far more ambivalent than is often suggested by its advocates. I think Prospect had a piece on this too a while back, though I can't find it now. But the main problem with CBT research is that it sets the parameters for success according to its own definitions of success and then tends to find that it is successful.
So, it is probably a good thing that CBT is being funded by Western governments. Any more spent on mental health is good, given the low base right now. But it is not good if it is oversold.
Doh! Wrote a response but then it didnt appear. Will try again.
"If you don't believe in the plan, why bother with the realignment - which might in itself be very painful (as you can sense from Marcus Aurelius)."
Why bother? Because you have an emotional disorder like social anxiety that makes your life a complete misery, and using Stoic techniques helps you to get better and feel more empowered. Yes, sometimes the realignment is painful, but not half as painful as havng a chronic anxiety disorder.
In fact, both Stoicism and Buddhism are quite rational, there's not so much metaphysics involved. In Marcus Aurelius, for example, alot of his rationalizing with himself is along the lines of 'why should i worry about what this person thinks of me? is their opinion really so wise or valuable?' Its just a wise, sensible way of thinking, never mind the Logos.
Why accept bad things happening in CBT, without faith in the Logos or Karma? Because some bad things just happen - other people will always be foolish and judgemental. So if the foolishness or rudeness of other people makes you angry and depressed, as it does alot of people with emotional disorders, then you better accept it simply because THAT's HOW IT IS, and it will most likely always be that way.
Likewise, you're almost certainly going to die, so you better accept it simply because THAT's HOW IT IS.
Once you accept the things which you were terrified of, you find that that acceptance is very powerful, very transformative. Acceptance, as one CBT hand-out said to me, is an active experience.
The Sufi poet Rumi put it very beautifully:
"Learn the alchemy True Human Beings know: the moment you accept what troubles youve been given, the door opens.
Welcome difficulty as a familiar comrade. Joke with torment brought by the Friend.
Sorrows are the rags of old clothes and jackets that serve to cover, and then are taken off. That undressing, and the beautiful naked body underneath, is the sweetness that comes after grief."
You wrote: "It does seem to me to be consumerist to cherry-pick from older traditions as if the acceptable bits can be bought into and the unacceptable bits disguarded."
Well, we all cherry-pick, don't we? The early Christians cherry-picked from Stoicism, Cynicism, Roman mystery cults and Judaism. St Augustine cherry-picked from Plato. Muslim philosophers cherry-picked from the Greeks. And so on. That's globalization. You can never define something as being 'purely' from one tradition or culture.
You're right, it's pointless if someone has a little buffet of lots of different cultures and traditions without understanding their historical and cultural context. Most importantly, you need to have a sincere heart, and be prepared to WORK. Otherwise it's just channel-hopping. And you need to work on the basics - westerners tend to hop into some spiritual tradition, and they immediately want the most advanced and esoteric teachings. Plus they have enormous egos, so they immediately think they're luke skywalker, rather than accepting theyre absolute novices.
Personally, as I said in my piece, I think there are certain cognitive techniques which we can identify in various contemplative or cognitive traditions. its very important to be alive to the differences in these traditions, but i think we can outline certain shared basic cognitive techniques, what Foucalt called technologies of the self, and pass them on to young people in schools and universities. these techniques are incredibly useful. and if you find a particular tradition or master that youre drawn to, follow that, master it, teach it to others.
And the fact that these techniques are drawn not JUST from buddhism or stoicism or christianity, but also from Sufism, Taoism, Epicureanism etc, will help teach young people a respect for other cultures and traditions, and lead them away from the exclusivist 'my prophet is the best prophet' school of thought. that way jihad lies.
thats what im advocating - a fresh look at the idea of the perennial philosophy which Aldous Huxley advocated, but from the viewpoint of ordinary, struggling people, rather than from the point of view of the wannabe saint.
that is the best way, i think, to pass on 'thought as therapy' to young people.
anyway, ill stop clogging up your blog! ill keep reading it though, it looks good.
all the best
Jules
Hello Mark,
I hadn't seen that there was a blog on this - thanks for the reply by email. I have a few more points.
I think you have become overly fixed on the notion that CBT is short. It is, compared with most psychoanalysis, and it is usually highlighted as such, partly perhaps, as you've pointed out, to sell it. However, it may run 12-18 months; particularly the forms that engage with deeper dynamics - DBT, REBT, Schema Therapy. Moreover, even in simple CBT, people are encouraged to return for further sessions to manage a relapse, or when they might wish to go deeper. Unlike psychoanalysis it is not a 'one-stop shop', or a "MOT for the soul" as one eminent analyst described it to me. The CBT setup is akin to learning a language - wherein a good teacher would acknowledge and accept the pupils' needs and goals in acquiring the language, encourage practice/work outside the lessons, and allow the pupil to finish and return as they see fit.
Psychoanalysts frequently express grave warnings to those who wish to finish "early" - 'you will fail the exam!'. In this respect they are very dissimilar to the Stoics, as they claim to have privileged access to an absolute knowledge of all things psychological - those who have not been successfully and fully analysed cannot understand the truth. The bearded men in hats have the answers; obey even if you suffer, it is for your own good.
Would you label the CofE, "Christianity lite"? I suspect you would talk with CofE members on an individual basis to find out how committed a Christian each person is - take each as you meet him or her. You might also read a lot, and witness many many services. Why then label CBT (thousands of therapists, patients, and a huge body of theory, practice and research) as 'lite', because you have done a short course at little depth, and perhaps read a book or two? Isn't that a bit 'lite'?
As to the cherrry-picking and further to Jules' point above; the distinction being taught in psychology schools now is that 'eclecticism' - pick and mix without a coherent structure - is undesirable, and quite different from integration, where one draws ideas and inspiration from a variety of sources but combined into a coherent whole in theory and practice, ie CBT. No shame in that. It seems it would be mad to throw out the old books, but also equally mad to read them without some attempt at translating into modernity (for example where the Stoics speak of a divinely ordered plan, one might well interpret this as Einsteinian/Dawkinsian science). It is also mad not to attempt to seperate the wheat from the chaff. We all agree that the truth is ever far away, but to claim that, in the past few thousand years, no valid knowledge has been realised and can inform and update past ideas.... and/or that all such revisions are based on 'bad' things - the market economy, intellectual laziness - well that would make one a cynic!
Thank you so much, Mark Vernon, for your essay. I'm from the USA where nearly no other option but stoic CBT exists, and I refuse to deny metaphysics, which puts me at constant odds with the establishment. I'm trying so hard to maintain my integrity and learn my way through to a better life, but is is overwhelming sometimes to have only the most dry and lifeless counseling. We've got to get back to psychology as the study of the soul, rather than the denial of the soul. Thanks again.