Review of The Philosophy of CBT (2nd ed.)

The Philosophy of Cognitive-Behavioural Therapy: Stoic Philosophy as Rational and Cognitive Psychotherapy (2nd edition) was reviewed in the journal Cognitive Neuroscience by Andrea E. Cavanna. Dr. Cavanna is Honorary Reader in Neuropsychiatry and Consultant in Behavioural Neurology at the Department of Neuropsychiatry, Birmingham and Solihull Mental Health Foundation NHS Trust. He is also Deputy Director for the MSc in Clinical Neuropsychiatry. You can view the original article here. Also see my article from The Behavior Therapist on Stoicism as a form of cognitive psychotherapy.

Some excerpts below:

What do ancient Stoicism and cognitive behavioural therapy have in common? As shown by Scottish psychotherapist Donald Robertson, they might well share the very core principles. The new edition of The philosophy of cognitive-behavioural therapy (CBT): Stoic philosophy as rational and cognitive psychotherapy sees the light ten years after its first edition, the first detailed account of the influence of Stoic philosophy upon modern psychotherapy (Robertson, 2010).

Robertson’s excellent work joins a growing number of recently published academic books that mark the revival of interest in ancient Western philosophy, especially Stoicism, as a guide to modern living… Overall, Robertson’s exploration of the relationship between ancient Greek philosophy and cognitive-behavioural therapy has provided evidence-based support to the idea that philosophy and psychotherapy were not always separate disciplines (Gill, 1985, 2013). Among mental health specialists, this book appeals particularly to practitioners working in the field of neuropsychiatry, where cognitive behavioral therapy interventions can have a significant positive impact on the health-related quality of life of patients with chronic conditions.

9 replies on “Review of The Philosophy of CBT (2nd ed.)”

The paperback and Kindle versions are only $30. That might be expensive for people in some regions unfortunately but it’s a pretty normal price for an academic text in the US.

While it is true that Stoicism has influenced CBT as it has other methodologies the two are dissimilar in a variety of ways too numerous to mention here. CBT focuses on conscious issues but life has many, if not most, dealings with the unconscious. I personally cannot get enough of stoicism and read everything I can but recognize that CBT has been shown, in the long run, to be not as effective as claimed. Here comes the DoDo Bird effect. To those that think that any modality is verified via it being labeled evidenced based they have not read all the literature orn statistical studies on what is effective. I applaud all your efforts as a CBT therapist and note that when Ellis et.al. saw what stoicism is capable of for many he advanced thinking in stoicism and therapy. CBT is a viable modality but surely not the only one that is effective. I, like many others, see it as an effective way to address the problems of living and strongly recommend it to people and use it’s philosophy in therapy when essential.

My book begins by emphasizing that Stoicism and CBT are not the same thing. It then proceeds to document the historical relationship between them and similarities, having recognized from the outset that there are also many differences. Nevertheless, as this review also notes, the main similarity happens to be that, partly because CBT was influenced by Stoicism, they share a central theoretical premise. So it can’t be said that’s a trivial similarity – it’s very fundamental.

CBT does not focus exclusively on conscious issues – that’s just a popular misconception. Cognitive schemata are largely non-conscious, as Beck and most CBT clinicians and researchers recognize and frequently discuss. The Dodo Bird verdict (not “effect”) is false, and I think it’s now easy to show that it’s contradicted by most research if we avoid the common fallacy of comparing “apples to oranges” in meta-analysis and distinguish between specific treatments, populations, and outcomes. (If you just mash everything together, including all sorts of dissimilar studies, of course you’re going to negate any meaningful differences – that’s tantamount to cooking the books, though.) I don’t think anyone has ever really claimed that CBT is “the only one that is effective” – that’s a straw man. It is fair to say, though, that it dominates the lists of empirically supported treatments, and there are logical reasons why that would be the case. CBT is not a single therapy but an umbrella term for lots of protocols that are directly updated based on scientific research. That approach, for instance, is bound, in many instances, to lead to more effective results than using pre-scientific approaches to treatment like Freudian psychoanalysis, Gestalt Therapy, et al. So I think it’s a mistake in your comment to view CBT as though it were just one modality of therapy alongside others because that’s just not how, in reality, it was developed. Some forms of CBT are more effective for some conditions and populations than others and other modalities of treatment are potentially also effective but, at present, if you look at the range of modalities the fact is that many turn out to be problematic because they’re not directly based upon research findings or significantly adapted to meet the needs of specific problems or populations. I was fortunate enough to train in many different modalities of therapy and to experience them as a client, in groups and individually, and to work with therapists from many different modalities, over the space of 25 years. I originally completed my masters in Psychoanalytic Studies, for instance, trained in and practised psychodynamic therapy, before focusing more and more on CBT approaches. (But I’ve also worked with many other modalities over the years.)

I applaud your good comments and recognize it is a biased one. That’s OK. I believe strongly in stoicism and have a vast collection of readings that were augmented by taking a course with The Stoa School, which was based on the John Sellars book. Since you mentioned your education and experience I feel I must as well. I hold 5 academic degrees with my last masters being post doctoral in theology. I have been in private practice for about 40 years and was (I retired) a Board Certified Training Analyst in Medical Hypnoanalysis. For the last 10 years i have been an Associate Professor. I don’t mean this to be a pissing contest just to demonstrate I’ve been in and out of the field and have taught doctoral students a variety of modalities including CBT. Still the recent research that tested effectiveness of a multitude of therapies statistically resulted in only 1/3 of therapeutic encounters were effective with the majority over 50% were less than helpful. I believe stoicism would be more effective as it stands. Once again I applaud your emphasis on CBT and stoicism and wish you continued success.

Thanks. I wouldn’t say I’m “biased” any more than you are. People normally use that term to discount what someone is saying without addressing the logic of their argument or the evidence on which it’s based. I’d rather just say that I disagree with you, and have reasons for doing so which I consider to be very sound. I wasn’t really looking to know what your credentials are. I don’t think that’s very relevant to the discussion – what matters is the scientific evidence the logic of the points I raised. I only mentioned that I’d worked with different modalities in the past because I got the impression you were saying you thought I was solely a CBT practitioner, which is not the case actually, so I was correcting what seemed to perhaps be a mistaken assumption.

Thanks Donald,

I read your first edition during my school planning periods,
It was Excellent and Comprehensive;

“You must make Philosophy your mistress, if you would be Happy” Seneca

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