CBT, Surface and Depth

I wish I had this week’s readings around when I first heard of CBT. It was described to me in direct contrast to psychodynamic approaches. Whereas in psychodynamic therapy, the therapist may probe into the past for explanations of behaviors, in CBT, the therapist addresses the present tense with a problem solving approach. “The way to change a behavior is to change the behavior,” I heard. Psychotherapy:Depth::CBT:Surface. Even this simplistic conception of CBT is really compelling. Leave moms alone! ¡Viva the superficial!

I now see that there’s nothing superficial about CBT. After reading Alfred Ellis’ 1999 description of Rational Emotive Behavior Therapy, I’m convinced that this guy has to be one of the most underappreciated wonderful thinkers. I think he created not just an effective and efficacious therapeutic program but also a comprehensive theory of human nature at least as compelling as Freud’s and much more accurate. To summarize, people generally move towards happiness and self-realization, but “three major absolutistic musts frequently plague the human race:” the demand for success; the demand for good treatment by others; and the demand for easy life circumstances. When these “musts” don’t happen people get unhappy and behave badly. Quip revision: the only way to change the behavior is to change the belief. The only way to change the belief is through experience, so help your clients “experiment” with their self-defeating beliefs, and reckon with real world evidence that challenges them to change at the level of belief systems. And so when behavior change comes, the belief is in place to sustain it.

I’m not sure why Ellis isn’t as mainstream popular as Freud, or at least as famous as Buddha (their views on demands/attachments actually seem quite similar). Is Ellis (1913-2007) still too new? I wonder if Ellis’s ideas suffer from a marketing problem. The Freud brand has that iceberg, The Unconscious; the complexes with sexy Greek names; and phalluses everywhere. What are the punchy names and imagery for Ellis and Rational Emotive Behavior Therapy? In vivo desensitization? Unless I missed a nuanced difference, I think he should have stuck with calling it “exposure.” The best icon for REBT seems, for now, Ellis’s picture, late in life, smiling genuinely, pants pulled way up over his Buddha belly.