Cognitive therapy is a geological phenomenon.(1) The steady accretion of information and practitioners has made it an event comparable to the Grand Canyon, Microsoft, or the dinosaurs. Your moods, your thoughts, and life events are intertwined, any one of them can influence the other two. Shift the thought and mood shifts as well. For example, depression is assumed related to distorted belief systems; challenge the beliefs and life brightens.
However, recent trends in evolutionary psychology suggest that people probably CAN "mindread" feelings reliably in each other and possibly in other species. Detecting emotions accurately and using the information to adjust personal behavior would seem adaptive, perhaps even in Homo habilis societies with primitive language capacity. It appears reasonable that quickly assessing disgust, jealousy, cheating, lying, skepticism, and empathy are important for social cooperation, for the operation of that large prosthesis, Psychological Adaptations (PAs) for handling coalitions and alliances.(2)
Even if people are generally accurate with their social perceptions, there is massive data that cognitive therapy, that assumes perceptual inaccuracy and exaggeration, is highly effective even outside of Philadelphia. Indeed, there are responsible forecasts that cognitive-behavioral therapy will gain wider acceptance as one of the few psychological treatments that meets evolving standards for "experimentally supported treatments" and, therefore, eligible for insurance reimbursement.(3) Still, there are periodic hints that the structures and rules of cognitive therapy are not fully what they may seem. It might be that cognitive therapy works for reasons apart from repairing flawed mental gauges, flaws described as mindreading, catastrophizing, etc.
One cognitive therapy model holds that depression is associated with cognitive distortions about yourself but Alloy (1995) reports that depressed people can be more accurate than undepressed people, at least with respect to tests of self-appraisal. Undepressed people overestimated their probable performance in her studies. In contrast, depressed people tended to overestimate the ability of other people.
Several recent notes in the Harvard Mental Health Letter summarize reports that "activation" techniques for depression were as effective as cognitive treatment. Further, "client ability to form alliances" was more predictive of therapeutic outcome than cognitive methods; the quality of the treatment alliances was a function of the client rather than the therapist.(4)
The concept of "domain specificity" applied to our thinking suggests that cognition is not a "bucket of mush" but is efficient or random as a function of the content.(5) Thus, cognitive drills elicit a different mix of PAs than exist under depressive conditions. Shifting thoughts can elicit PAs that compete with social rejection, hopelessness, escape, avoidance, or inhibition. Thoughts of events associated with success (e.g., physical, vocational, sexual), food, relaxation, comfort, and safety could have significant impact on anxiety, depression, obsessions, and compulsions. Selecting the right set of cognitions could facilitate recovery markedly.
The advantage of using "Adaptation" is that cardiac, digestive, adrenal, and even muscle tension are acknowledged as parts of a bi-directional information system involving the brain in synchrony with the rest of the body. If Psychological Adaptations are network structures, rather than isolated levels of the brain, then there are multiple access points to influence operation of the Adaptation. Thus, systematic exercise can be as effective as medications for relieving depression. Thus, the troublesome fact that a range of disciplines, many outside traditional health professions, claim efficacy for symptoms highly similar to those within the turf now roamed by psychiatry and psychology. The concept of Adaptations raises the possibility that some of those claims may gain experimental validation. Physicians, psychologists (including masters!), social workers, chiropractors, nurse practitioners, acupuncturists, foot rubbers, astrologers, palmists, ministers, teachers, barmaids, harlots, mothers, talk show hosts, friends next door, hairdressers, geishas, and village elders may have similar effectiveness for many emotional warts. Adaptations may even lead someday to an explanation of placebo effects, a singularly powerful variable in treating anxiety and depression.
There is more to effective therapy than swapping thoughts; ignoring this fact puts the therapist in company with other specialists who "just do kidneys." Thoughts occur in an intact person. The gain from invoking PAs is that an entire system of cognitive, emotional, cerebellar, autonomic, and muscular responses shift activity in a coordinated fashion. Considering PAs as complimentary but competing mechanisms might allow therapists someday to choose tactics more creatively. Cognitive drills, self-hypnosis, behavior modification, diet, physical activity, medication, and medical interventions may eventually provide an integrated solution to specific client discomforts.
1) Apologies to Jim Pretzer, Ph.D., of Behavior OnLine, who knows far more about cognitive therapy than I ever will.
2) Psychological Adaptations are primitive, evolved mechanisms that solve a problem of survival. They are usually efficient and thought to occur in nearly every member of a culture. They are also like notes on a piano, played in combinations and varied speeds, sometimes out of tune. PAs vary in their intensity and quality between people; some of this variability is probably handled by the formation of alliances such that the group has a greater range of skills than any single member.
3) Nathan P, (1997) Fiddling while psychology burns? Register Report, 23 (2), June, pp. 1, 4-5. The article reflects the Darwinian pressures that continue to make psychological practice more uniform as a function of uniform economic conditions. The resulting population reduction (fewer nt alliances was a function of the client rather than the therapist.(4)
The concept of "domain specificity" applied to our thinking suggests that cognition is not a "bucket of mush" but is efficient or random as a function of the content.(5) Thus, cognitive drills elicit a different mix of PAs than exist under depressive conditions. Shifting thoughts can elicit PAs that compete with social rejection, hopelessness, escape, avoidance, or inhibition. Thoughts of events associated with success (e.g., physical, vocational, sexual), food, relaxation, comfort, and safety could have significant impact on anxiety, depression, obsessions, and com 13 (12), p6. Review of Krupnick J, Sotsky S, Simmens S, et al. The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings in the NIMH treatment of depression collaborative research program. J consulting clinical psychol, 64:3:532-539 (1996) (1997) How does cognitive therapy work? Harvard Mental Health Letter, 13 (12), pp 6-7. Review of Castonguay L, Goldfried M, Wiser S, et al. (1996) Predicting the effect of cognitive therapy for depression: A study of unique and common factors. J of consulting clinical psychol., 64:3:497-504.
5) Hirschfeld L & Gelman S, Eds., (1994) Mapping the Mind: Domain Specificity in Cognition and Culture. NY: Cambridge. I found it rough going in places; subtly (not "apparently" for a lot of reasons!) our thinking skills vary sharply with context and content. Problems linked to survival programs appear to come easier than more formal, abstract ones that require the identical analytic steps. See the chapter by Cosmides & Tooby; another presentation of their work is in Barkow J, Tooby J, Cosmides L, (Eds), 1992, The Adapted Mind: Evolutionary Psychology and the Generation of Culture, NY: Oxford.