Know Thyself? Questioning the Theoretical Foundations of Cognitive Behavioral Therapy

Review of Philosophy and Psychology 8 (2):391-410 (2017)
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Cognitive Behavioral Therapy has become the dominant form of psychotherapy in North America. The CBT model is theoretically based on the idea that all external and internal stimuli are filtered through meaning-making, consciously accessible cognitive schemas. The goal of CBT is to identify dysfunctional or maladaptive thoughts and beliefs, and replace them with more adaptive cognitive interpretations. While CBT is clearly effective as a treatment, there is good reason to be skeptical that its efficacy is due to the causal mechanisms posited by the CBT model. This paper will argue that the specific cognitive schemas posited by the CBT model likely do not play a direct role in the development or treatment of psychological illness. Cognitive schemas, as identified in CBT interventions, are likely to be the result of patient confabulation and epistemically under-supported practitioner-based identification. CBT interventions appear to impose coherence on patients’ psychological states, rather than identifying and modifying preexistent causally efficacious core beliefs.

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Garson Leder
Medical College of Wisconsin

Citations of this work

Psychotherapy, placebos, and informed consent.Garson Leder - 2021 - Journal of Medical Ethics 47 (7):444-447.

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References found in this work

Thinking, Fast and Slow.Daniel Kahneman - 2011 - New York: New York: Farrar, Straus and Giroux.
Strangers to Ourselves: Discovering the Adaptive Unconscious.Timothy D. Wilson - 2002 - Cambridge, Mass.: Harvard University Press.
The unreliability of naive introspection.Eric Schwitzgebel - 2006 - Philosophical Review 117 (2):245-273.

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