Cognitive Behavioral Therapy - A Western Guide to Eastern Thought

Back when there was still a Borders bookstore, I would regularly receive emailed coupons for 30% or 40% off a single item. I would then go wander through the store looking for something - anything - I could buy with that coupon. My journey through the stacks would take me first to chess books, then graphic novels, then math and science, sometimes history and in the end - eastern religions. It happens that right next to eastern religions was psychology, and in that section I saw a big yellow book called Cognitive Behavioural Therapy for Dummies [its British so its spelled funny]. I will confess, I'm a sucker for Dummies books on complicated sounding subjects.

Here is the Wikipedia link to Cognitive Behavioral Therapy  (CBT), but I will give you my key takeaways. CBT is a higly successful therapy technique which is based on a person taking an active responsibility for their own mental health. In a sense, a person becomes their own therapist and CBT offers advice and tools to use in this task - so its really a methodology.

CBT is scientific in its approach. It encourages a person to analyze their problems, break them into pieces, theorize how these pieces work together and then test their theory. Analyze, theorize, test, repeat - and document everything. Essentially you use the scientific method on yourself. Its sounds scarey, so maybe the ABC form will illustrate what I mean.


ABC Form

The ABC form is a tool that you can use to analyze a bad situation - lets say you became angry at a coworker and you stormed out of a meeting. Start with C first - it stands for Consequence. The consequence is that you became angry and stormed out of meeting - simple enough. Now go to A - or Activating event. This isn't so easy because you need to strip the activating event of its emotional content - its just an event - nothing more. In this case Susie (your coworker) said: "Bob [you] has not finished his assignment for this week". That is A. B stands for Belief and connects the activating event to the consequence.  Lets say the belief is "Susie was belittling me and thinks I am worthless (maybe I am)". You write all this down on a piece of paper which we will call the ABC form.

The basic idea of ABC is that an activating event occurs, it triggers a belief, which then triggers consequence. The thought model most people use is: "I stormed out of the meeting because Susie was an asshole and made me mad. I'm not responsible, Susie is." With ABC , Susie isn't responsible for your storming out. Susie said something which you then interpreted with a negative belief which you then allowed to trigger your storming out mad. You and your beliefs are in charge of what you do, not Susie. [I note that the A and C don't have to be external events. It could be that the activating event is a random thought that comes to you and the consequence could be a resulting depression.]

Now look at the ABC form with a scientific eye. Did Susie really say what you think she said [Question the A]? Does she really think I am lazy and was she really belittling me? [Test the B: what other evidence do I have for and against] Maybe what she said was true and she was just stating a fact. [was it?] Maybe she was just having a bad day and it came out wrong?  Even if you can't disprove your theory that she was belittling you, maybe you can come up with alternate theories that work just as well. Or maybe you find that it is not Susie who thinks you are lazy, you think you are lazy.

After all of this, even if you decide you were probably right about Susie - you still need to deal with the consequences. You stormed out mad. As Dr. Phil would say, "How did that work out for you?" Did the consequences - your own behavior - help or hurt?

The above discussion of the ABC form illustrates that CBT is 1) self driven and 2) scientific. My last key takeaway from CBT for Dummies is that it that CBT is about being mindful as opposed to judgmental. In the above ABC discussion, Bob might unfortunately come away thinking, "Oh there I go again. I'm such a hothead - an idiot. If I were a good person I wouldn't behave like that." But CBT doesn't mean for you to cast judgements on yourself. Just note things. With the ABC form, you analyzed the situation, created and tested alternate theories and you reflected on whether your beliefs and actions were helpful or unhelpful in your life. Now accept the situation and move on. Just be mindful and going forward note your own actions and belief systems. This will lead you in the right direction.

There is a lot more to CBT for Dummies. A lot of it has to do with methods to document and explore unhelpful beliefs and different approaches for testing and facing them. CBT is all about facing your problems and testing your fears. And its all about documentation - very scientifc. Rate your fear of heights on a 1-100 scale. Now go stand on a ladder and rerate your fear, etc.  The thing I found interesting about this area of the book was that avoidance behaviors due to a fear are almost as bad as the fear itself.

Buddhism and CBT

When I originally picked up the book at Borders, as I said before, I had been looking in the section on eastern religions and I happened to see this book in the next section over - in psychology. When I flipped this book open, my eye fell on the word "mindfulness". I thought, "mindfulness - that sounds Buddhist, did this get put in the wrong section?" As I read the book at home, the thought that this was a Buddhist book never really left me.

Or perhaps its the other way around - Buddhist teaching really belongs in psychology. After all, Buddhism is a cognitive behavioral therapy technique. Its about dealing with suffering through exploring your beliefs and behaviors. In Buddhism, you take responsibility for your own thinking, behavior and path to nirvana. You guide the process.  Buddha's teaching are scientific. He said, "Don't take my word for it- you need to come explore this for yourself and make it your own." Buddhist teachings are non-judgmental. They talk about accepting what is, being mindful of your thoughts and actions and being aware of what is helpful and unhelpful.  And Buddhist teachings talk of being careful of what you believe (attachments), and equally careful of what you avoid.

Obviously there is a lot more to Buddhism, as there is more to CBT.  But the part of Buddhism I am particularly interested in is not its cosmology or any particular doctrine. The aspect of Buddhism I am particularly interested in is that it can be seen as simply an approach to living your life as best you can - day to day, minute to minute. Its about right now, plain and simple. 

CBT is a powerful technique - and its meant to help people with real problems. People with anger, fear, suicidal thoughts, phobias, addictions.... real suffering. These problems have to be dealt with in the here and now - and every day.

 I don't want to end this on a heavy note. I feel strange saying one of the world's great religions is "just" a therapy technique and that a modern day Buddha would have a couch and charge by the hour.  Maybe the difference is that for a Buddhist, this technique is not a technique but a way of life -and that is a serious difference. But I do find the similarities between CBT and Buddhism striking, and I choose to think that the Buddha would be happy with that.