Posted by bob on May 19, 2000, at 23:46:45
In reply to Re: Psychotherapy v. CBT--to boBB, posted by Snowie on May 19, 2000, at 22:36:52
boBB, I'd say that text book describing what cognitive therapy is has a pretty poor grasp on the topic. If anything, the "type" of therapy relies more on the theory underneath it than what patients are supposed to be doing with it. And, quite frankly, few cognitive theories rely all that much on human thought being logical. Most of the time, we aren't, and logic and reason often have no sway over pathology.
Snowie, boBB makes some really good points about just how broad "psychotherapy" can be, although a lot of people tend to think of a psychodynamic, Freudian approach (I imagine) just due to cultural biases on the nature of therapy. My roommate, who is in the long process of becoming an analyst, would try to make a rather broad distinction between therapy and analysis, tho.
I can't say that I've been through any CBT (outside of being subjected to advertising), but it's based on the same theories I use in the psychological research I've done ... so I can at least fill you in a bit on the theoretical basis. Here's a little history lesson. Behaviorism, as a psychological theory, dominated American psychology from early in the 1900's till the 1960's. It tried to be very objective and scientific, and so ruled out any notion of mind -- you've got no objective, empirical means of directly measuring mind or thoughts, only their consequences. BF Skinner was the darling of behaviorism for a long, long time -- his version of it (including operant conditioning) is what most people think of, if they think of anything, when they hear "behaviorism". (Then there's classical conditioning -- Pavlov's dogs and all that -- which is quite different from operant conditioning.)
Anyway, when the 1960's came along, a couple of things happened. First, theories from Europe (Piaget for one, Vygotsky for another) started intruding on behaviorism's hegemony, due to the second thing -- a reaction against the "dehumanizing" nature of behaviorism. While operant conditioning works really well to explain the behavior of cockroaches, rats, and pidgeons living in mazes, it failed miserably at explaining things like language acquisition. Then there were those pesky emotions.
Of course, the Freudians, Jungians, Gestalt folk and others had been there all the time, but they got no respect from the research establishment because of behaviorism's seeming objectivity and more scientific nature.
All this opened the door for what's called the cognitive revolution -- the development and testing of psychological theories that do try to account for thinking and having a mind and memories, studied through indirect methods and inference.
One problem about behaviorism, tho ... well, as a professor of mine said, "You may disagree completely with Skinner's ideas, but you can't argue with his results." Operant conditioning just plain works in a lot of situations. Madison Avenue has made a killing off of it.
Anyway, some dyed-in-the-wool behaviorists who were also dissatisfied with ruling out thoughts started modifying behaviorism to account for cognitive processes. Albert Bandura is responsible for much of the foundation of this area of psychology -- his approach is more commonly known as social cognitive theory. One core element of SCT is the bidirectional relationships between the mind, our behaviors, and feedback from our environment. Another critical aspect of his work was pointing out that we act on our perceptions of reality, not on some objective measure of it. Self-efficacy is predicated upon that idea -- it refers to how good we *believe* we are at doing something, not how good we are compared to some external standard.
One very powerful concept that started off based more on behavioral/neurological science but quickly latched onto SCT is "learned helplessness". It's based on somewhat of an idea of a lack of resiliency in our efficacy judgments, so when facing a series of failures a learned helpless response is to ascribe the cause of the failure to internal, unchangeable flaws. This concept has been applied to just about every psychological pathology around, and you can probably find a paper with Bandura's name on it for each (he's quite a prolific writer). Other major theorists in social cognition have done considerable work on the social bases of personality and the relationship between our thoughts, our emotions, and our subsequent behaviors.
Anyway, to make a long story short, CBT often relies on operant conditioning techniques (because they work) but in the context of approaches to psychology that account for cognitive (thinking) and affective (feeling) processes. Due to the nature of SCT and operant conditioning, such approaches tend to focus on very specific behaviors and/or beliefs. As such, CBT can be a great approach to treating something like a phobia or social anxiety in specific circumstances. The more generalized and global a psychological issue, the more trouble CBT has with treating it.
Well, I'm a bit surprised that the folks out there who've had gone through some CBT haven't chimed in yet, but I imagine we'll be hearing from someone soon.
cheers,
bob
poster:bob
thread:34042
URL: http://www.dr-bob.org/babble/20000517/msgs/34081.html