Stoic Resilience Blog Posts

Foreword by Prof. Stephen Palmer

This is the foreword by Prof. Stephen Palmer to The Philosophy of Cognitive-Behavioural Therapy (2010) by Donald Robertson

Foreword by Prof. Stephen Palmer

The Philosophy of Cognitive-Behavioural Therapy (2010)

Cognitive behavioural therapies are at the cutting edge of modern psychological therapeutic interventions. They are evidence based and therefore are underpinned by much research. In The United Kingdom (UK) the National Institute for Health and Clinical Excellence has recommended cognitive behavioural therapy for depression and anxiety-related disorders such as panics, obsessive compulsive behaviour, body dysmorphic disorder and post traumatic stress disorder (e.g. NICE, 2004, 2005; 2006; 2009). It is no surprise that this interests stakeholders wishing to provide cost-effective psychological therapies to their customers, ie the public, in order to improve wellbeing and reduce financial expenditure. In the UK the Government has taken the next logical step and funded cognitive behavioural therapy training as part of the Improving Access to Psychological Therapies (IAPT) programme. Stressed, depressed and anxious citizens cost countries billions of pounds according to the research data, and understandably reducing absenteeism from work due to psychological illness is an attractive target to focus on. An effective IAPT programme can benefit both the country and the individual.

Cognitive behavioural therapy has become one of the main approaches for dealing effectively with a wide range of psychological disorders and this has led to a large increase in the training of health professionals in this approach especially within the UK. Key handbooks available to trainees based on Dr Aaron Temkin Beck’s Cognitive Therapy (Beck, 1976) or Dr Albert Ellis’ Rational Emotive Behaviour Therapy (REBT) (Ellis, 1958) only briefly, if at all, cover the historical roots of these therapies. Dr Albert Ellis in his publications is often more explicit about the early origins of REBT in comparison to the books on Cognitive and Cognitive-behavioural therapy. 

Yet, for many of us something is missing from most of the literature. What has been needed is a book that covers the underlying philosophy of the cognitive behavioural therapies in much greater depth. This book on the Philosophy of Cognitive-Behaviour Therapy by Donald Robertson provides us with the missing link between the theory and the philosophy. This book takes us on a historical journey through millennia and highlights the relevant philosophies and the ideas of the individual philosophers that can inform modern cognitive behavioural therapies. This book also includes some therapeutic techniques that seem to be modern yet were been developed and written about many years ago. It is a fascinating read. The Philosophy of Cognitive-Behaviour Therapy could be considered as either a prequel or a sequel to the standard textbook read by a trainee or experienced cognitive behavioural or rational emotive practitioner who wants to understand these approaches to therapy within an historical framework.

Professor Stephen Palmer PhD  FAREBT  FBACP

Director of the Centre for Stress Management, London, UK 

REFERENCES

Beck, A.T. (1976). Cognitive Therapy and The Emotional Disorders. New York: International Universities Press.

Ellis, A. (1958). Rational psychotherapy. The Journal of General Psychology, 59, 35-49.

NICE (2004) .Anxiety: Management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care (http://guidance.nice.org.uk/CG22/guidance/pdf/English).

NICE (2005). Post-traumatic stress disorder: The management of PTSD in adults and children in primary and secondary care (http://guidance.nice.org.uk/CG26/guidance/pdf/English).

NICE (2006). Obsessive-compulsive disorder: Core interventions in the treatment of obsessive compulsive disorder and body dysmorphic disorder (http://guidance.nice.org.uk/CG31/guidance/pdf/English).

NICE (2009). Depression in adults (update): Depression: the treatment and management of depression in adults National Clinical Practice Guideline 90. (http://www.nice.org.uk/nicemedia/live/12329/45896/45896.pdf).

Excerpt: The Philosophy of Cognitive-Behavioural Therapy (CBT)

This article contains a brief excerpt from the introduction to the new book by Donald Robertson, The Philosophy of Cognitive-Behavioural Therapy: Stoic Philosophy as Rational and Cognitive Psychotherapy (Karnac).

The Philosophy of Cognitive-Behavioural Therapy (CBT)

Stoic Philosophy as Rational and Cognitive Psychotherapy

Copyright (c) Donald Robertson, 2010. All rights reserved.

[F]or many of us something is missing from most of the [CBT] literature. What has been needed is a book that covers the underlying philosophy of the cognitive behavioural therapies in much greater depth. This book on the Philosophy of Cognitive-Behavioural Therapy by Donald Robertson provides us with the missing link between the theory and the philosophy. […] It is a fascinating read. The Philosophy of Cognitive-Behavioural Therapy could be considered as either a prequel or a sequel to the standard textbook read by a trainee or experienced cognitive behavioural or rational emotive practitioner who wants to understand these approaches to therapy within an historical framework.
— From the Foreword by Professor Stephen Palmer PhD FAREBT FBACP, Director of the Centre for Stress Management, London, UK


This is a brief excerpt from my new book, The Philosophy of Cognitive-Behavioural Therapy: Stoic Philosophy as Rational and Cognitive Psychotherapy, published by Karnac and available for order online now. You can also now order The Philosophy of Cognitive-Behavioural Therapy from Amazon, where you may preview a sample of the contents online free of charge.


Donald Robertson

Critics might say that it is actually a healthy sign that so little attention has been given to the historical and philosophical origins of CBT because it is inherently a forward-looking, scientific approach to psychotherapy. Just because ideas are very old, it doesn’t necessarily mean that they are particularly valid or useful today. However, there are number of legitimate reasons for exploring this matter in more detail. As [US naval pilot vice-admiral James] Stockdale [who used his knowledge of Stoic philosophy to survive incarceration in a Vietnamese torture camp] wrote,

Most of what Epictetus has to say to me is “right on” for modern times. Will Durant [an American philosopher] says that human nature changes, if at all, with “geological leisureliness.” According to me, not much has happened to it since the days of Homer. Epictetus lived a tough life: born a slave, crippled by a cruel master, went from boy to man in the murderous violence of the household of a totally indulgent Emperor Nero. And he read human nature across a spectrum like this, and by the standards of my spectrum it rings with authenticity. (Stockdale, 1995, p. 180)

Indeed, a handful of cognitive-behavioural therapists have already attempted to make some headway in the direction of increasing dialogue concerning the relationship between Hellenistic philosophy and REBT or CBT (Still & Dryden, 1999; McGlinchey, 2004; Herbert, 2004; Reiss, 2003; Montgomery, 1993; Brookshire, 2007; Robertson, 2005).

The Philosophy of CBT (Karnac)

Moreover, there are still therapeutic concepts and techniques to be found in classical literature that have good “face validity”, appear consistent with CBT, and may well deserve empirical investigation in their own right. Nevertheless, in his recent article, Herbert, while defending the notion that comparisons between ancient philosophy and modern psychotherapy are interesting and valuable in their own right, has called into question the extent to which correlation in their respective ideas can be taken as evidence of causation, i.e., of a historical influence (Herbert, 2004). While I agree that the question of influence is a complex one, and perhaps something of a diversion from the bigger issues, in the following chapters I will discuss the extent to which the founders of both REBT and cognitive therapy have explicitly stated, in some of their principal texts, that Stoicism and other ancient philosophical traditions were regarded by them as providing the “philosophical origins” of their approach, e.g., ‘The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers’ (Beck, Rush, Shaw, & Emery, 1979, p. 8).

Hence, some of the key points of the following text might be summarised as follows, for the benefit of readers requiring an overview of what may seem a complex and somewhat inter-disciplinary subject matter,

  • The origins of modern cognitive-behavioural therapy can be traced, through early twentieth century rational psychotherapists, back to the ancient therapeutic practices of Socratic philosophy, especially Roman Stoicism.
  • The notion of Stoicism as a kind of “intellectualism” opposed to emotion is a popular misconception. Stoicism has traditionally attempted to accommodate emotion, especially the primary philosophical emotion of rational love toward existence as a whole.
  • Ancient philosophy offers a clear analogy with modern CBT and provides many concepts, strategies, and techniques of practical value in self-help and psychotherapy.
  • The contemplation of universal determinism, of the transience or impermanence of things, including our own mortality, and the meditative vision of the world seen from above, or the cosmos conceived of as a whole, constitute specific meditative and visualisation practices within the field of ancient Hellenistic psychotherapy.
  • Contemplation of the good qualities (“virtues”) found in those we admire and in our ideal conception of philosophical enlightenment and moral strength (the “Sage”) provides us with a means of role-modelling excellence and deriving precepts or maxims to help guide our own actions.
  • The rehearsal, memorisation, and recall of short verbal formulae, precepts, dogmas, sayings, or maxims resembles the modern practice of autosuggestion, affirmation, or the use of coping statements in CBT.
  • The objective analysis of our experience into its value-free components, by suspending emotive judgements and rhetoric, constitutes a means of cognitive restructuring involving the disputation of faulty thinking, or cognitive distortion. By sticking to the facts, we counter the emotional disturbance caused by our own “internal rhetoric.”
  • Mindfulness of our own faculty of judgement, and internal dialogue, in the “here and now”, can be seen as analogous to the use of mindfulness meditation imported into modern CBT from Buddhist meditation practices, but has the advantage of being native to Stoicism, the philosophical precursor of CBT, and to European culture and language.
  • The enormous literary value, the sheer beauty, of many of the classics with which we are concerned marks them out as being of special interest to many therapists and clients, just as it has marked them out for many thousands of previous readers throughout the intervening centuries.
  • Socratic philosophy has a broader scope than modern psychotherapy, it looks at the bigger picture, and allows us the opportunity to place such therapy within the context of an overall “art of living”, or philosophy of life.

The modern industrialisation of psychotherapy, the division of the therapist’s labour, has compartmentalised it in a manner that is bound to cause certain contradictions. What was once a lifestyle and calling, a vocation in the true sense of the word, has now been degraded into a mere “job”. By nature, however, we do not merely study the cure of human suffering in order to alleviate it, but also to understand and transform ourselves and our relationship with life itself. Perhaps, as the ancients seemed to believe, the philosopher-therapist must first transform his own way of life, making it a living example of his views, in order to be able to help others. By contrast, if the goal of the “rational” or “philosophical” therapist is merely to do his job and leave it all behind him at the weekend, to treat what we call “psychotherapy” as just another profession then perhaps that’s not a very rational or philosophical goal.

Philosophers and psychotherapists have a great deal to talk about, and a better common ground is required on which the two traditions can meet each other and exchange ideas. I hope that this study of the philosophical precursors of modern cognitive-behavioural therapy will help to clarify and strengthen the basis for further dialogue between philosophers and therapists in the future.


This is a brief excerpt from my new book, The Philosophy of Cognitive-Behavioural Therapy: Stoic Philosophy as Rational and Cognitive Psychotherapy, published by Karnac and available for order online now. You can also now order The Philosophy of Cognitive-Behavioural Therapy from Amazon, where you may preview a sample of the contents online free of charge.