Relationship of ISTDP To CBT
Cognitive Behavioral Therapy (CBT), developed by Aaron T. Beck, focuses on illogical thoughts as the main driver of emotional difficulties. These beliefs, such as, "Everything I attempt inevitably fails," are postulated to cause emotional states like depression or hopelessness. The therapist collaborates with the patient to determine which faulty cognitions are currently accepted by the patient as true. Together, the patient and therapist discover these cognitions and collaboratively explore the evidence for and against them. Relief of symptoms comes from replacing unfounded cognitions with more reality-based thoughts. CBT has been shown effective in numerous trials, particularly for depression and anxiety disorders.
While ISTDP accepts the presence of faulty cognitions, the causality is thought to be reversed. The ISTDP therapist would posit that unconscious emotions lead to unconscious anxiety, which is managed by unconscious defences. These defences can certainly include hopeless, helpless, or self-deprecating cognitions. Rather than examining evidence for and against a thought like, "I am unable to know my own true feelings," an ISTDP therapist might say, "If you adopt that position, which is essentially a position of helplessness, we will not get to the engine driving your difficulties. If you renounce this helpless position, how are you truly feeling right now?"
Both the CBT and ISTDP therapist call the thought into question, with the goal of ultimately liberating the patient. The difference is that the ISTDP therapist sees the faulty cognition as preventing access to the true, buried feelings, while the CBT therapist sees the faulty cognition as the cause of the painful emotions leading to the painful psychological state. It may well be the case that causality flows in both directions, dependent on the individual, the emotions, and the cognitions involved. As of this writing, though both CBT and ISTDP show good evidence of clinical efficacy, the theoretical question of whether feelings drive thoughts or thoughts drive feelings remains unresolved; it could well be the case that thought and feeling are inextricably bound, and that we have not yet developed adequate psychological or neuroscientific concepts and tools to frame these sorts of questions properly.
Read more about this topic: Intensive Short-term Dynamic Psychotherapy
Famous quotes containing the words relationship of and/or relationship:
“Most childhood problems don’t result from “bad” parenting, but are the inevitable result of the growing that parents and children do together. The point isn’t to head off these problems or find ways around them, but rather to work through them together and in doing so to develop a relationship of mutual trust to rely on when the next problem comes along.”
—Fred Rogers (20th century)
“Only men of moral and mental force, of a patriotic regard for the relationship of the two races, can be of real service as ministers in the South. Less theology and more of human brotherhood, less declamation and more common sense and love for truth, must be the qualifications of the new ministry that shall yet save the race from the evils of false teaching.”
—Fannie Barrier Williams (1855–1944)