By José Dahab and Claudio Ojeda
One of the most widespread myths about psychology based on behavioral sciences (PCC) – including cognitive behavioral therapy and all its aspects – is the belief that this would be a simple set of techniques that would seek to attack the “symptoms.” ” of the consultant; but it has no relationship with the “philosophical and idiosyncratic” human questions inherent to the subjectivity and particularity of the consultant. It is also prejudged that it would disregard psychological theory and that it would much less take into account philosophical perspectives in the process of delimitation, behavioral analysis, the formulation of therapeutic objectives and the treatment to be implemented. Something like a pure technology based on science and technique without clear philosophical bases. However, nothing could be further from the truth.
For this reason we will take a brief tour of the philosophical influences that give rise to cognitive behavioral therapy (we select from here the term CBT, – since the term has been installed in the scientific community – to refer to the application in the clinical field. of the behavioral sciences, they include behaviorism, cognitivism, ACT, PAF, metacognitive therapy, general psychology, psychobiology, etc.; it is not, of course, our intention, in this article, to point out the theoretical differences between such slopes); We will limit ourselves simply to the problem of normal behavior and its relevance to the analysis of behavior and its relationship with psychological philosophy according to the methodology and epistemology of the behavioral sciences. We will now highlight the relationship between philosophy and CBT. After an outline of such belonging, specific meanings will be addressed, which would lead to classifying certain behavior as normal or abnormal.
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Philosophy and cognitive therapy
Psychotherapy as we know it today has existed for very few years in the history of human beings, however, a large part of its objectives were already sought by philosophy centuries before the creation of psychology as an autonomous science. and psychotherapy as a field of application. What are those objectives? Colloquially we will say: find some way to address human suffering.
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The Buddhist tradition, originating in India in the 5th century BC, attempted to find a way to eliminate human suffering. The Greeks, for their part, with both stoicism and cynicism, searched for a philosophy that could bring them closer to happiness and freedom (in a society where slavery predominated). Among the most important representatives of Stoic philosophy we find figures in Greece and Rome such as Epictetus, Zeno of Cyto, Marcus Aurelius, Seneca, among others.
For their part, more contemporary philosophers have carried out the same enterprise. To mention an example of this, the philosopher and mathematician: Bertrand Russell, who wrote “The Conquest of Happiness”, where he states that happiness must be achieved through effort and is not simply a capricious state of mind.
In this way, we can observe that concern for the “discomforts of life” beyond just taking care of physical health, is a concern as old as the human being himself. And each culture gave different answers depending on its own worldview.
It is important to mention the influence of these philosophies that, although they were always known, only had a great impact on psychotherapy in the mid-20th century, when many of their basic postulates began to be tested, but under the magnifying glass of the scientific method. in psychology. For this reason, the psychologist Albert Ellis, creator of REBT (rational emotive behavioral therapy), predecessor of cognitive therapy, recognizes in his writings on “Practice of rational emotive therapy” as his main philosophical influences, both representatives of the Stoic philosophy (mainly Epictetus and Marcus Aurelius), as well as authors of great importance in the development of the philosophy of science (such as Kant, Popper and Russell). The latter gave it a rational, logical approach and, fundamentally, shed light on the importance of corroborating the validity of the hypothesis that REBT assumed about human suffering and its causes.
Within cognitive behavioral therapy, the so-called rationalist or “pure” cognitive authors (such as Aaron Beck and Albert Ellis), that is, those who relied on changing thoughts as a way to change the associated emotional responses, took the central idea of Epictetus. , specifically from his lectures compiled by his disciple Flavius Arrian in the manual “Enchyridion” or “Epictetus manual” (in particular, the statement made in section 5 of the manual: “It is not things that disturb people, but the judgments that are formed about them”). In this way, reason, judgments, interpretations and thoughts take center stage in cognitive therapies, designing a series of interventions aimed at cognitive change (cognitive restructuring, dialogue or Socratic method, experiments behavioral, the evaluation of pros and cons, humor, etc.), as well as a whole conceptual repertoire to explain cognition and its role in emotional distress. This repertoire consisted of concepts such as: beliefs, schemas, biases, cognitive distortions, among others.
It should be noted that the influence of Greek philosophy was not only at the conceptual level of how emotional discomfort originates, but also at a technical level, that is, how to intervene on it. To such an extent that the “Socratic method or dialogue” was incorporated into cognitive therapy as it was carried out by Socrates as illustrated by his disciple Plato in his writings. Even today it is used as a way to question irrational beliefs or maladaptive thoughts, surprisingly almost without any alteration from how the founder of philosophy: Socrates did it. This reveals to us that the philosophical influence was even greater than just Stoicism, including much of all Greek thought.
Perhaps at this point, it should be noted that rational emotive behavioral therapy had as one of its objectives, in the words of Albert Ellis, “to produce a profound change in the patient’s personal philosophy.” That is, the patients were able to adopt a rational personal philosophy, not just question some problematic thoughts. For Ellis, within the theory of therapeutic change, an inferential change is not enough if it does not include a deep philosophical change. Quoting the author, “when a person makes a philosophical change in B (beliefs) according to the ABC model, he is usually able to spontaneously correct his distorted inferences from reality.” This objective shows the place that philosophy had within the problems of patients for these authors. He considered a personal philosophy to mean a rational way of thinking based on flexibility, self-acceptance, acceptance of others, acceptance of uncertainty, compromise and risk-taking are the hallmarks of an adaptive life philosophy.
In summary, both Albert Ellis and later , guided their research on different problems in the field of human psychopathology, strongly influenced by the thought of ancient philosophy, particularly the Stoics, among others. But taking the rigor provided by the thinking of philosophers of science, and testing their hypotheses, they built a set of innovative interventions to modify the way patients think, thus building a refined working model that could be useful. to any psychotherapist.
So much for cognitive therapy, but what about the behavioral aspect?
Cognitive behavioral therapy, as its name indicates, is made up of the developments of behavioral therapy. Something similar happens with the latter; many myths exist around behavioral models. When behaviorism is mentioned, extremely simplistic explanations of its bases are made. A very common mistake is to use the word behaviorism as a synonym for behavior therapy. Therefore, it is important to clarify that behaviorism is a rigorous philosophy, with which the science of behavior is founded. From this philosophical position it is established what questions should be asked in psychology, what ways of approaching problems are valid, and what methods to use and why.
The author has developed his own philosophy in his book “On Behaviorism.” More precisely, he called what he called radical behaviorism, introducing the study of the private world from a Monist philosophy and differentiating himself from methodological behaviorism (which, in general, was the subject of multiple criticisms). Some of the obvious influences of this author were: B. Russell, Francis Bacon, among others.
With the latter, the importance of the behavioral models of philosophy and its development is evident, in such a way that it supports a way of research and thus allows the development of a corpus of scientific knowledge.
Eastern philosophy and contextual therapies
Eastern philosophy, for its part, has also sought answers to human suffering as such. But in a different way from the West. Mainly, based on meditative and contemplative practice as in Buddhism, and through the use of parables and metaphorical language as in the case of Taoism and Zen Buddhism. The Buddhist tradition, as we mentioned before, sought the “cessation” of suffering. through detachment and identifying the causes in desire, and pointed out the problems brought about by the human tendency to attach to impermanent things. He also introduced Vipassana meditation as a common practice among his followers.
It is extremely ancient Buddhist meditation. People have been practicing it daily for thousands of years, however it was not until the 1990s that it was fully incorporated into the medical and psychological field. The molecular biologist, who had trained in meditation and Buddhism, specialized in researching treatments to reduce stress and pain. He is primarily responsible for conducting research on how meditation impacts patients. Although there was already precedent in the use of meditation in psychotherapy, it is Jon Kabat-Zinn who, after seeing what it was…