I promised some time ago that I’d write more about Cognitive Behavioural Therapy (CBT). I’ll begin by telling you a bit about where it comes from. It was initially developed as a treatment for depression. Three therapy approaches were originally integrated in CBT. These are 1) Behavioural psychology, 2) Cognitive Therapy developed by Aaron T. Beck and 3) Rational Emotive Therapy developed by Albert Ellis. You should have no problem finding out more about these on the internet. More recently, new approaches have influenced CBT. These are mainly Mindfulness Based Cognitive Therapy, Acceptance and Commitment Therapy and Schema Therapy.
I will write more details about all of this later but for now I just wanted to highlight the fact that CBT is a unique approach which has evolved over many decades and which has many different influences. Nowadays it has overtaken many of the traditional psychotherapies and has developed new ways of working with a variety of different psychological disorders. CBT is also used by life coaches with clients who want to learn new skills to manage stress and anxiety and to bring about positive change in their lives. I’ll write more about life coaching later and about how useful CBT skills are for all of us in our everyday lives.
What is CBT?
CBT is about collaborating with people to bring about positive changes in their life. It’s focused on change, exploring the present situation with the client and working together. A big focus can be on thinking processes relating to behaviours and emotions. In recent years CBT is the model of therapy most likely to be offered to clients with depression within public mental health services across Europe and the USA. CBT practitioners frequently work with clients with a medical diagnosis of depression. However, prior diagnosis is not required as ‘assessment’ is an important stage in CBT.
The other day someone asked me about Cognitive Behavioural Therapy CBT. They thought that it was the one therapy that’s coming from science, particularly Cognitive Psychology. In this post I hope to clarify that this is not the case. Later I will post something about CBT but for now here’s something about Cognitive Psychology and its relationship to the psychological therapies.
Cognitive psychology is at best a sub discipline within the sciences of the mind. In particular it’s a branch of psychological science that develops tasks
to explore the mechanisms and processes of mind, in other words to discover more about how the mind works. It’s been around since the 1950s and it’s probably the only new thing in psychology because it sees the mind in a very contemporary way. It treats the mind as a ‘processor’ similar to a computer. You only have to look at the language of Cognitive Psychology to recognise this. It perceives the mind in terms of inputs (perceptual processes), systems (operating systems) that integrate memories and processing (apps), and outputs in the form of thoughts/perceptions, feelings/emotions and actions/behaviours. Cognitive Psychology is not ‘the’ science of the mind, it is a sub discipline within science.
Attempts to turn ‘psychology’ into a ‘discipline’ like philosophy for example has undoubtedly failed. Cognitive Psychology belongs in the discipline of science. Other branches of western psychology do not belong in ‘science’, with ‘counselling’ being the branch of psychology that is least related to science. Counselling has its history in religion. The people who have developed the practices of counselling and psychotherapy on the ground have done so independently and with little or no reference to science. At the macro level there were major movements that seem to belie this reality but somehow the ideas of science always seemed to get lost in the mix as each new theorist became worshipped as a guru and their ideas were treated like dogmas. The problem as I see it is that the people who were developing the therapies on the ground, and training the therapists, were rarely thinking scientifically. In fact it’s really unusual for people to think scientifically. Religion has been around forever and science is the new kid on the block. Science and technology have rocked our world but culture is slow to change and the way people think is developed early in life long before children begin to learn science.
Thus the science of the mind and the practices of counselling and psychotherapy are like two separate entities. Both are recent historical developments and each still has a long way to go. There is a key difference, on the one hand scientists and psychologists can continue to develop the science of the mind and to discover more about how the mind works with no reference to the practices and views of therapists. Therapists on the other hand cannot disregard science. Sure they can disagree with it and try to ignore it. However, In the end it becomes a moral issue, a matter of ethics. The question we should be asking therapists are whether their practices are ethical and whether they are harmful based on rational and not magical thinking.
The whole idea of consciousness took a turn about a 100 years ago when Freud raised our consciousness about the ‘unconscious’. Freud’s theory about ‘the unconscious mind‘ has fascinated people for more than a century. The world we live in today has changed beyond the imagination and undoubtedly this has changed our consciousness? People are better educated and with the developments of radio, television and now the internet it has become increasingly difficult for anyone or any group to control knowledge and consequently to control our consciousness about reality and the endless possibilities that exist. But what’s happened to ‘the unconscious mind’?
This is a question I will return to but first I want to say something about consciousness. Looking back to the 19th century we can see that the idea of consciousness became highly controversial especially with the work of Karl Marx and his ideas about the false consciousness of the poor impoverished masses. We’ve come a long way since then and people today, in western society, are no longer impoverished, they are better educated and live healthier and longer lives than in the past.
Psychologists are really interested in the social context of development because better environments are essential for better psychological health. Violent and abusive contexts are especially bad for people so a move towards a more peaceful existence is a move for better psychological well-being. Watch this video by psychologist Stephen Pinker about how and why the world is a less violent place today than it has every been before:
How does this relate to consciousness and what is the relationship between Marxist ideas about false consciousness and Freud’s ideas about an unconscious mind. I am not the first person to notice that the ideas of Marx and Freud have something in common and I will write more about that in my next post. Suffice to say, the question remains, how conscious are we on a personal level? What do we know about consciousness and the idea of ‘the unconscious mind’.This is a really important question for the psychological professions, possibly the most important question’. Thus I plan to make consciousness an important theme in this blog.
In the beginning there was Sigmund Freud who is undoubtedly the most famous of all psychologists. I have discovered that people are unaware that Sigmund Freud founded and developed his own independent school of psychology call Psychoanalysis which still exist today. ‘Psychology‘ in the Western tradition, is a completely different profession with an independent history. In Western Universities such as Trinity College, Dublin and University College Dublin, ‘Psychology’ is the scientific study of the human mind and human behaviour. It’s an academic discipline and a science. Within Psychology there are a wide range of professions such as Clinical Psychology and Counselling Psychology which involve completely different specialist trainings. What is central to all the Psychology professions is that a ‘psychologist’ must have a degree or higher diploma in Psychology just as a medical doctor must first have a medical degree in order to become a GP, an obstetrician or dermatologist etc. Within medicine there is the specialism of Psychiatry. A psychiatrist is a medical doctor who specialises in mental illnesses and mental disorders.
Now here’s where it gets interesting. All of the above, Psychoanalysts, Clinical Psychologists, Counselling Psychologists and Psychiatrists may be providing counselling and psychotherapy within their practices. If you are totally confused right now, I promise that it is nothing to how confused you will be by the time you finish reading. Why? Because there are even more professions in this field. Quite independently to the above there are counsellors and psychotherapists who are not psychologists, psychiatrists or psychoanalysts. There are institutes, colleges and universities that provide different training in counselling and psychotherapy and just to add a little bit more to the confusion they are not all the same. In fact in my experience they are all quite different. There are different traditions, philosophies and beliefs within counselling and psychotherapy.
This is just an insight into the psychological professions that exist. In recent years, I have found that increasingly people who do my evening classes in Psychology in Rathmines college and University College Dublin are actually trying to make sense of where to go if a person has mental health problems or common problems of everyday life such as anxiety and/or depression. So I will continue blogging on this topic in order to undo some of the confusion and to bring some light to the subject.
Recently a few friends and family advised me to get a bit more outspoken and maybe even controversial in expressing my views about the current state of counselling and psychotherapy. This is a big and growing industry that is largely based on trust. When a person goes to a counsellor they enter into a relationship of trust. They assume that the therapist knows what they’re doing. Just as when we go to a doctor. We find a GP that we like and trust and we are confident that they practice western medicine which is based in scientific research, that the doctor is up to date in prescribing treatments and that they belong to a profession that is highly regulated.
Is this the case with counselling and psychotherapy? In my experience it is not and while I am aware that there are highly professional practitioners out there, my problem is that what counsellors do in practice is poorly regulated. So I’ve decided to write about the diversity of therapies and beliefs that exist within these practices. Over the next few weeks I plan to write on this topic so I hope you will enjoy.