The Philosophy of CBT in BABCP’s newsletter CBT Today (May 2012)

An excerpt from the May 2012 edition of CBT Today, the BABCP newsletter, which discusses the book The Philosophy of CBT.

Living it up for death

Patricia Murphy’s Special Feature¬†in CBT Today (May 2012)

The following excerpt from CBT Today mentioned The Philosophy of CBT:

In The Philosophy of Cognitive-Behavioural Therapy, Donald Robertson cogently explains why modern psychotherapists should remain interested in ancient philosophy, not least because it has a ‚Äėbroader 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 ‚Äúart of living‚ÄĚ, or philosophy of life‚Äô. We are reminded that the origins of modern CBT can be traced back to the ancient practices of Socratic philosophy while, according to Epicurus,‚Äėliving well‚Äô also requires the individual to ‚Äėrehearse death‚Äô.The contemplation of one‚Äôs own mortality was viewed by the Stoics as a therapeutic exercise to be repeated daily. The imaginary embodiment of the ideal role model or sage was seen by ancient philosophers as necessary to provide a standard for the ‚Äėart of living‚Äô.

Robertson suggests that, unlike Stoicism and most classical philosophies,‚ÄėCBT lacks any clear account of the ideal toward which it aims‚Äô. That said, he observes how many techniques and concepts found in classical literature, including mindfulness,modelling behaviour, cognitive restructuring and distancing/perspective changing techniques, are well rehearsed in CBT. Meanwhile, individual therapists may use poetry, prose, music, metaphor, imagery, archetypes and historical figures to demonstrate qualities or sentiments that also reflect the qualities of the sage, including wisdom, courage and compassion.

Jules Evans on Ancient Philosophy

Jules Evans on Ancient Philosophy

The Browser

Jules discusses The Philosophy of CBT as one of his five book choices:

…the founders of CBT were directly inspired by ancient Greek philosophy. Unfortunately, not many people are aware of that connection at all. Even a lot of cognitive therapists are unaware of it. That is partly because Aaron Beck was keen to present CBT as an evidence-based scientific therapy, so the philosophical roots of CBT were somewhat swept under the carpet. Donald‚Äôs was really the first book to properly explore the relationship between ancient philosophy and CBT.

Full Article on The Browser

Ancient Healthcare and Modern Wellbeing Blog

Ancient Healthcare & Modern Wellbeing

“After reading a passage in which Marcus advocates this approach to himself, Patrick played a pre-recorded ‚ÄėView from Above‚Äô meditation. The text for this meditation was adapted slightly from D. Robertson‚Äôs The Philosophy of Cognitive Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy. […] This visualization was well-received and followed by lively discussion.”

The ancient healthcare and modern wellbeing blog contains an article describing the use of the View from Above meditation, derived from Stoicism.

New Book: Build your Resilience (Teach Yourself)

Short article describing resilience-building and introducing the new book Build your Resilience (2012), containing a chapter on Stoic philosophy and resilience.

New Book: Build your Resilience (Teach Yourself)

This new book by Donald Robertson, the author of The Philosophy of CBT, contains a chapter on Stoic philosophy in relation to resilience-building.

Psychological Resilience-Building

Teach-Yourself-ResilienceCopyright © Donald Robertson, 2012. All rights reserved.

Based on my book for the Teach Yourself series, Build your Resilience(2012).

What is Resilience?

How can you improve your ability to ‚Äúthrive and survive‚ÄĚ in any situation? What disadvantages, stresses, or difficulties do you currently face? What future problems might you need to anticipate and prepare for? What strengths and assets have helped you to cope well with difficult events in the past? What can you learn from the way other people deal with life‚Äôs challenges? These are all questions about psychological resilience. Building resilience is a way of improving your ability to cope with adversity or stressful situations in general.

We all need some degree of resilience in order to cope with the problems life throws at us. Indeed, research shows that resilience is normal and involves ordinary skills and resources. Everyone is capable of being resilient and becoming more so by developing appropriate coping strategies. The types of adversity that demand resilience can range from ordinary ‚Äúdaily hassles‚ÄĚ to major setbacks, stressful life events such as divorce, redundancy, bankruptcy, illness, or bereavement, and perhaps even more severe trauma in some cases. Most people believe that they are at least moderately resilient. However, few people are as resilient as they could be in all areas of life, and there are always more aspects of resilience that can be developed.

Building Resilience

So how is resilience built? The American Psychological Association (APA) has published its own research-based public information leaflet entitled The Road to Resilience, developed by a team of six psychologists working in this area. Their ten recommendations for developing and maintaining resilience can be paraphrased as follows:

  1. Maintain good relationships with family, friends, and others
  2. Avoid seeing situations as insurmountable problems and look for ways forward where possible
  3. Accept certain circumstances as being outside of your control, where necessary
  4. Set realistic goals, in small steps if necessary, and plan to work regularly on things that are achievable
  5. Take decisive action to improve your situation rather than simply avoiding problems
  6. Look for opportunities for personal growth by trying to find positive or constructive meaning in events
  7. Nurture a positive view of yourself and develop confidence in your ability to solve problems
  8. Keep things in perspective by looking at them in a balanced way and focusing on the bigger picture
  9. Maintain a hopeful and optimistic outlook, focusing on concrete goals, rather than worrying about possible future catastrophes
  10. Take care of yourself, paying attention to your own needs and feelings and looking after your body by taking healthy physical exercise and regularly engaging in enjoyable, relaxing and healthy activities, perhaps including practices such as meditation

Books like Build your Resiliencecan help you learn specific techniques and strategies to develop these attitudes and skills, and learn other resilient ways of thinking and acting.

The Penn Resilience Program (PRP)

The Penn Resiliency Program (PRP) is perhaps the best example of an established resilience-building approach. It was developed initially as a means of preventing depression over the long-term with schoolchildren, based on Martin Seligman‚Äôs earlier work on ‚Äúlearned optimism‚ÄĚ and adapting the techniques of standard cognitive therapy to serve a preventative rather than remedialfunction. It has been supported by compelling evidence showing its effectiveness as preventative treatment for depression and also, in some studies, for anxiety. For example, up to two years after undergoing classes in resilience-building, children considered at risk of depression were found to be about half as likely to have actually developed it as their peers in ‚Äúcontrol‚ÄĚ groups, who did not receive any resilience training (Reivich¬†& Shatt√©, 2002, p. 11). In schoolchildren, for whom this approach was originally designed, research found that ‚Äúconduct problems‚ÄĚ, their behaviour, also improved as a result.

The version of the Penn Resiliency Program (PRP) described by Reivich¬†and Shatt√© (2002) consists of ‚Äúseven key skills‚ÄĚ:

  1. Monitoring your thoughts: Learning to catch your unhelpful thoughts as they occur and to understand how they influence your feelings and actions
  2. Spotting ‚Äúthinking errors‚ÄĚ: Spotting common errors (or ‚Äúthinking traps‚ÄĚ) among your thoughts such as excessive self-blame or jumping to conclusions, etc.
  3. Identifying unhelpful beliefs: Identifying unhelpful underlying (‚Äúcore‚ÄĚ or ‚Äúiceberg‚ÄĚ) beliefs and evaluating them
  4. Challenging unhelpful beliefs: This includes problem-solving as well as learning to dispute faulty ‚ÄúWhy?‚ÄĚ beliefs, or rumination, about the causation of problems that can get in the way of solving them
  5. Challenging catastrophic worries: Dealing specifically with ‚ÄúWhat if?‚ÄĚ thinking, or unrealistic worry, by challenging catastrophic beliefs about consequences of problems and focusing instead on the most likely outcomes (‚Äúdecatastrophising‚ÄĚ or ‚Äúputting things in perspective‚ÄĚ)
  6. Rapid calming and focusing strategies: Coping skills for use in real-world situations, consisting of a simplified form of Applied Relaxation (Reivich¬†& Shatt√©, 2002, pp. 192-196) and coping imagery used to ‚Äúcalm‚ÄĚ stressful emotions and distraction (‚Äúfocusing‚ÄĚ) techniques to quickly manage intrusive thoughts, worry, and rumination
  7. ‚ÄúReal-time resilience‚ÄĚ: This involves using a much-abbreviated version of the disputation skills (4 and 5) above to challenge unhelpful thoughts more quickly and replace them with resilient ones in specific situations by completing the ‚Äútag lines‚ÄĚ or self-statements: ‚ÄúA more accurate way of seeing this is‚Ķ‚ÄĚ, ‚ÄúThat‚Äôs not true because‚Ķ‚ÄĚ, and ‚ÄúA more likely outcome is‚Ķ and I can‚Ķ to deal with it.‚ÄĚ (Reivich¬†& Shatt√©, 2002, pp. 206-210)

New Book: Build your Resilience

Due for publication by Hodder in May 2012, as part of the popular Teach Yourself series of self-help books.

ISBN: 1444168711

Resilience: How to Thrive and Survive in Any Situationhelps you to prepare for adversity by finding healthier ways of responding to stressful thoughts and feelings. You will learn a comprehensive toolkit of effective therapeutic strategies and techniques, drawing upon innovative ‚Äúmindfulness and acceptance-based‚ÄĚ approaches to cognitive-behavioural therapy (CBT), combined with elements of established psychological approaches to stress prevention and management. The book also draws upon classical Stoic philosophy to provide a wider context for resilience-building.

This book is a complete course in resilience training, covering everything from building long-term resilience by developing psychological flexibility, mindfulness and valued action, through specific behavioural skills such as applied relaxation, worry postponement, problem-solving, and assertiveness. Each chapter contains a self-assessment test, case study, practical exercises and reminder boxes and concludes with a reminder of the key points of the chapter (Focus Points) and a round-up of what to expect in the next (Next Step), which will whet your appetite for what’s coming and how it relates to what you’ve just read.

The author, Donald Robertson is a psychotherapist with a private practice in Harley Street. He is a CBT practitioner specialising in treating anxiety and building resilience and director of a leading therapy training organisation. He is the author of many journal articles and three books on therapy, The Philosophy of CBT, The Discovery of Hypnosis, and The Practice of Cognitive-Behavioural Hypnotherapy, and blogs regularly from his website www.londoncognitive.com.

Pre-Order Online

Available for pre-order online from….

New Review in The European Journal of Psychotherapy and Counselling

Links to a new review of The Philosophy of CBT in the European Journal of Psychotherapy and Counselling with some key quotations.

Review of The Philosophy of CBT

The European Journal of Psychotherapy and Counselling

http://dx.doi.org/10.1080/13642537.2011.596726

Another positive review in a peer-reviewed academic journal.  This one by John W. Owen of the University of Manchester and Bolton Primary Care NHS Trust, a clinical psychologist and former IAPT supervisor,

In The philosophy of cognitive-behaviour therapy, Robertson proposes that the connections between Stoic philosophy and CBT deserve deeper consideration.  Within this book, the author offers a detailed comparative analysis of these two schools of thought, and compellingly argues that the origins of CBT are evident in the theory and practice of Stoic philosophy.

He adds,

The philosophy of cognitive-behavioural therapy particularly highlighted to me the extent to which REBT¬†has its origins within Stoic philosophy. […] Being unfamiliar with the details of Stoic philosophy, I was surprised and intrigued to learn of the important practical aspects of this school of thought.¬† Stoicism does not appear to have been a solely introspective form of philosophy, instead, a range of practical techniques were advocated in the service of self improvement. […] Robertson details an impressive range of Stoic techniques that are analogous to those found in CBT, for example the practice of self-monitoring, the use of coping statements and the practice of journal keeping.

He concludes,

Overall, I found The Philosophy of CBT¬†to be informative and thought provoking. It was both interesting and sobering to reflect upon the possibility that variants of some of the psychotherapeutic techniques that I use on a day-to-day basis in clinical practice may have also been employed to alleviate emotional disturbance in ancient Greece. I would particularly recommend this book for trainee cognitive-behaviour therapists.¬†[…] I wonder whether Robertson‚Äôs book could serve to foster a broader understanding of the assumptions, philosophical underpinnings and overarching goals of cognitive-behavioural approaches to the alleviation of
emotional disturbance.

See the full review in The European Journal of Psychotherapy and Counselling,

http://dx.doi.org/10.1080/13642537.2011.596726

The View from Above (Stoic Meditation Script)

Script for the Stoic meditation exercise known as “the view from above.”

The View from Above

Stoic Meditation Script

Socrates in the clouds
Socrates in Aristophanes’ The Clouds

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

(This is a brief excerpt from my book, The Philosophy of Cognitive-Behavioural Therapy: Stoic Philosophy as Rational and Cognitive Psychotherapy, published by Karnac and available for order online now.)

Plato has a fine saying, that he who would discourse of man should survey, as from some high watchtower, the things of earth. (Marcus Aurelius, The Meditations)

Take a moment to settle into your posture and make yourself comfortable‚Ķ Close your eyes and relax‚Ķ [Pause.] Be aware of your breathing‚Ķ Notice the rhythm and pattern of the breath‚Ķ Do nothing for while, just be content to contemplate your breathing more deeply‚Ķ [Pause.] Now, begin by paying attention to the whole of your body as one‚Ķ From the top of your head, all the way down into your fingers and down into your toes‚Ķ Be aware of your body as one‚Ķ every nerve, muscle and fibre‚Ķ Don’t try to change anything. Don’t try to stop anything from changing‚Ķ Some things can change just by being observed‚Ķ

Just be content to notice whatever you notice, and feel whatever you feel… Be a passive, detached observer… As you continue to relax, turn your attention deeper within, and become more aware of your body… until you can almost imagine how you look right now… Begin to picture yourself as if seen from the outside… Now just imagine that you are taking a step back and looking at yourself. It really doesn’t matter how vividly you can picture yourself, it’s just the intention, just idea that matters. Imagine your body posture… your facial expression… the colour and style of your clothing…

Now keep looking at the image of yourself resting there, and imagine your own feet are gently leaving the ground. You begin floating serenely upwards, slowly and continuously, rising upwards. All the while your gaze keeps returning to your own body, now seated there below you as you rise above it. Keep looking down toward your body as you float higher and higher…. The roof and ceiling disappear, allowing you to float freely upward. Gazing down you see yourself seated comfortably below in the building, looking contented and contemplative. You see all the rooms, and any other people around.

As you continue to float gently higher and higher, your perspective widens more and more until you see the whole surrounding area. You see all the buildings nearby from above. You see the people in buildings and in the streets and roads. You observe people far below working, or walking along the pavement, people cycling or driving their cars, and those travelling on buses and trains. You begin to contemplate the whole network of human lives and how people everywhere are interacting with each other, influencing each other, encountering each other in different ways…

Floating higher, people become as small as ants below. Rising up into the clouds, you see the whole of the surrounding region beneath you. You see both towns and countryside, and gradually the coastline comes into view as your perspective becomes more and more expansive… You float gently up above the clouds, above the weather, and through the upper atmosphere of the planet Earth… So high that you eventually rise beyond the sphere of the planet itself, and into outer space… You look toward planet Earth and see it suspended in space before you, silently turning… resplendent in all its majesty and beauty…

You see the whole of your home planet… the blue of the great oceans… and the brown and green of the continental land masses… You see the white of the polar ice caps, north and south… You see the grey wisps of cloud that pass silently across the surface of the Earth… Though you can no longer see yourself from so far above, you know and feel that you are down there on Earth below, and that your life is important, and what you make of your life is important. Your change in perspective changes your view of things, your values and priorities…

You contemplate all the countless living beings upon the Earth. The population of the planet is over six billion people… You realise that your life is one among many, one person among the total population of the Earth… You think of the rich diversity of human life on Earth. The many languages spoken by people of different races, in different countries… people of all different ages… newborn infants, elderly people, people in the prime of life… You think of the enormous variety of human experiences… some people right now are unhappy, some people are happy… and you realise how richly varied the tapestry of human life before you seems.

And yet as you gaze upon the planet Earth you are also aware of its position within the rest of the universe… a tiny speck of stardust, adrift in the immeasurable vastness of cosmic space… This world of ours is merely a single planet, a tiny grain of sand by comparison with the endless tracts of cosmic space… a tiny rock in space, revolving around our Sun… the Sun itself just one of countless billions of stars which punctuate the velvet blackness of our galaxy…

You think about the present moment on Earth and see it within the broader context of your life as a whole. You think of your lifespan as a whole, in its totality… You think of your own life as one moment in the enormous lifespan of mankind… Hundreds of generations have lived and died before you… many more will live and die in the future, long after you yourself are gone… Civilisations too have a lifespan; you think of the many great cities which have arisen and been destroyed throughout the ages… and your own civilisation as one in a series… perhaps in the future to be followed by new cities, peoples, languages, cultures, and ways of life…

You think of the lifespan of humanity itself… Just one of countless billions of species living upon the planet… Mankind arose as a race roughly two hundred thousand years ago… animal life itself first appeared on Earth over four billion years ago… Contemplate time as follows… Realise that if the history of life on Earth filled an encyclopaedia a thousand pages long… the life of the entire human race could be represented by a single sentence somewhere in that book… just one sentence…

And yet you think of the lifespan of the planet itself… Countless billions of years old… the life of the planet Earth too has a beginning, middle, and end… Formed from the debris of an exploding star, unimaginably long ago… one day in the distant future its destiny is to be swallowed up and consumed by the fires of our own Sun… You think of the great lifespan of the universe itself… the almost incomprehensible vastness of universal time… starting with a cosmic explosion, a big bang they say, immeasurable ages ago in the past… Perhaps one day, at the end of time, this whole universe will implode upon itself and disappear once again… Who can imagine what, if anything, might follow, at the end of time, in the wake of our own universe’s demise…

Contemplating the vast lifespan of the universe, remember that the present moment is but the briefest of instants‚Ķ the mere blink of an eye‚Ķ the turn of a screw‚Ķ a fleeting second in the mighty river of cosmic time‚Ķ Yet the ‚Äúhere and now‚ÄĚ is important‚Ķ standing as the centre point of all human experience‚Ķ Here and now you find yourself at the centre of living time‚Ķ Though your body may be small in the grand scheme of things, your imagination, the human imagination, is as big as the universe‚Ķ bigger than the universe‚Ķ enveloping everything that can be conceived‚Ķ From the cosmic point of view, your body seems small, but your imagination seems utterly vast‚Ķ

You contemplate all things, past, present and future‚Ķ You see your life within the bigger picture‚Ķ the total context of cosmic time and space‚Ķ The totality is absolute reality‚Ķ You see yourself as an integral part of something much bigger, something truly vast, the ‚ÄúAll‚ÄĚ itself‚Ķ Just as the cells of your own body work together to form a greater unity, a living being, so your body as a whole is like a single cell in the organism of the universe‚Ķ Along with every atom in the universe you necessarily contribute your role to the unfolding of its grand design‚Ķ

As your consciousness expands, and your mind stretches out to reach and touch the vastness of eternity… Things change greatly in perspective… and shifts occur in their relative importance… Trivial things seem trivial to you… Indifferent things seem indifferent… The significance of your own attitude toward life becomes more apparent… you realise that life is what you make of it… You learn to put things in perspective, and focus on your true values and priorities in life… One stage at a time, you develop the serenity to accept the things you cannot change, the courage to change the things you can, and the wisdom to know the difference… You follow nature… your own true nature as a rational, truth-seeking human being… and the one great nature of the universe as a whole…

Now in a moment you are beginning to sink back down to Earth, toward your place in the here and now… Part of you can remain aware of the view from above, and always return to and remember that sense of serenity and perspective.

Now you begin your descent back down to Earth, to face the future with renewed strength and serenity… You sink back down through the sky… down… down… down… toward the local area… down… down… down… into this building… down… down… down… You sink back gently into your body… all the way now… as your feet slowly come to rest upon the floor once again…

Now think about the room around you‚Ķ Think about action‚Ķ movement‚Ķ think about looking around and getting your orientation‚Ķ raising your head a little‚Ķ Begin to breathe a little bit more deeply‚Ķ a little bit more energetically‚Ķ let your body feel more alive and ready for action‚Ķ breathe energy and vitality into your body‚Ķ breathe a little deeper and deeper again‚Ķ until you’re ready to take a deep breath, open your eyes, and emerge from meditation‚Ķ taking your mindfulness and self-awareness forward into life‚Ķ beginning now‚Ķ take a deep breath‚Ķ and open your eyes now‚Ķ when you’re ready‚Ķ entering the here and now with deep calm and serenity‚Ķ

Review in The Journal of Value Inquiry

Links and some quotes from a detailed review of The Philosophy of Cognitive-Behavioural Therapy in The Journal of Value Inquiry.

The Philosophy of Cognitive-Behavioural Therapy (CBT)

Review in The Journal of Value Inquiry

The Philosophy of CBT CoverA very detailed and favourable review of The Philosophy of CBT has been published in The Journal of Value Inquiry by Dr. William Ferraiolo, a lecturer in the philosophy department at Delta College in San Joaquin, California.  Dr. Ferraiolo writes,

It is high time that some member of the community of contemporary therapists, so many of whom deploy one or more of the many permutations of cognitive behavioral therapy (CBT) to help manage their patients’ psychological dysfunction, paid proper obeisance to the ancient architects upon whose work so much modern therapeutic theory and practice are built. […] Fortunately, Donald Robertson undertakes precisely this task of uncovering and acknowledging the Stoic taproot of popular modes of contemporary therapy and counsel in his recent and admirable book, The Philosophy of Cognitive-Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy.

He adds,

This down payment on the practicing therapist’s debt of gratitude to the ancient Stoics is a very welcome addition to both the academic’s and the practitioner’s library.¬† It ought to be required reading for students of Hellenistic philosophy, psychotherapists, and anyone undertaking an exploration of the human condition, or efforts to deal with challenges endemic to it, or both.

He concludes, after an overview and discussion of the contents,

For anyone interested in Hellenistic philosophy, Stoicism in particular, or in contemporary talk therapy and its foundations, The Philosophy of Cognitive-Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy is an invaluable resource.¬† Philosophers, psychologists, therapists, counselors, and all others who hope to cultivate equanimity through rational self-governance are certain to benefit from Donald Robertson’s exploration of Stoicism as a wellspring of indispensable therapeutic wisdom.¬† Reading Robertson’s book should, itself, be considered a form of “bibliotherapy” and an effort of which the ancient Stoic masters would, no doubt, approve.