
CBT and Christianity
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Person
Content
List of Figures xii
List of Boxes xiii
List of Tables xiv
About the Author xvi
Author's Preface xvii
Part 1 Rationale for the Use of the Teachings of Jesus in CBT 1
1 Introduction 3
Topics in Chapter 1 3
A historical view of spirituality, religion and psychotherapy 3
The development and dominance of cognitive therapy as a psychotherapy 4
The importance of Christianity in the West 6
The appreciation of the role of non-specific factors in psychotherapy 6
Interest in the Buddhist technique of 'mindfulness' 7
Findings relating religious adherence to positive mental and physical health 8
The growing respect for cultural and individual differences 9
The decline of logical positivism and the rise of postmodernism and social constructionist theory 9
The question of a logical connection between cognitive therapy and the teachings of Jesus 10
A general outline of the book 11
2 Introduction to Cognitive Therapy 12
Topics in Chapter 212
General aspects of psychotherapy 12
The basis of cognitive therapy 13
Beck's cognitive therapy 14
Rational emotive (behaviour) therapy 16
Schema therapy 21
Similarities amongst the three main schools of cognitive therapy 26
3 The Context of the Teachings of Jesus 27
Topics in Chapter 3 27
Why we should consider the teachings of Jesus 28
The records of Jesus the person 29
The location of the teachings of Jesus 30
The approach taken in this book towards the teachings of Jesus 31
The historical context of the New Testament 32
The social context of the New Testament 40
Stages in the early dissemination of the teachings of Jesus 47
Jesus' own context 56
The written Gospels 56
Conclusion 59
4 What Did Jesus Teach: A Biblical Scholarship Approach 60
Topics in Chapter 4 60
The purpose of the chapter 60
Problems with direct use of the Gospels 61
Summary of factors influencing the content of the Gospels 65
The historical Jesus and the Jesus of faith (and the inerrancy of scripture) 66
Biblical scholarship: Tracking the words and deeds of Jesus 68
Conclusions about Jesus' life, circumstances and characteristic behaviour 73
Jesus' teachings as conveyed in words 75
The proverbial sayings (apophthegms/aphorisms) 79
Other kinds of sayings 82
Conclusion 82
5 Comparison of Jesus' Teaching with Cognitive Therapy: Part I: Logic 84
Topics in Chapter 5 84
Content and process of thinking 84
The nature of logic 85
Logic in cognitive therapy 88
Logic in the teaching of Jesus 89
A method for comparing cognitive therapy with the teachings of Jesus 89
Jesus' references to the use of logic 90
Conclusions 124
Comparison of Jesus' logic with cognitive therapy 125
6 Comparison of Jesus' Teaching with Cognitive Therapy: Part II: Content 127
Topics in Chapter 6 127
The content of cognitive therapy 127
The content of Jesus' deeds 132
The content of Jesus' teachings as reported by experts 135
The implicational content in Jesus' teachings 147
Relationship of themes identified in the teachings of Jesus to cognitive therapy 169
Part 2 Approach to Using the Teachings of Jesus in CBT with Christians 177
7 A Schema-Centred Model of Psychological Dysfunction 179
Topics in Chapter 7 179
A schema-centred model of psychological dysfunction 179
Assessment 189
Assessment as therapy 194
Choosing the intervention 196
Using the results of assessment in conjunction with the rest of this book 198
8 New Life in Cognitive Therapy 200
Topics in Chapter 8 200
Reasons for seeking therapy 200
Ways of doing therapy 201
The need to address Christian issues in therapy 202
Preliminary considerations for doing cognitive therapy with Christians 203
Use of the scriptures in cognitive therapy 204
Ways of using scripture in cognitive therapy 206
Making choices 207
Commitment 209
Is it appropriate for a Christian to use logic? 212
Using logic like Jesus 216
Jesus' view of logical errors 218
Values 223
Conclusion 224
9 Introduction to Content Interventions 226
Topics in Chapter 9 226
Overview of content intervention 226
Working with propositional content 227
Working with implicational content 234
Part 3 Resources for Using the Teachings of Jesus in CBT with Christians 239
10 Jesus and the Value of People 241
Topics in Chapter 10 241
Teachings relevant to the value of people 241
Social inclusion 242
Implicational work 247
Interpersonal considerations 250
The value of people 257
Loving 264
Conclusions 270
11 Relationship to God, the World and the Future 271
Topics in Chapter 11 271
God, the world and the future 271
Acceptance and trust versus fear and anxiety 272
Knowing the future 281
Spiritual versus material concerns 283
The relationship of Jesus' teachings to the Jewish Law: Principle versus literal/old versus new 289
The inconsequential becomes greatly valuable 295
12 The Christian's Behaviour 297
Topics in Chapter 12 297
The relevance of Jesus' teaching to the Christian's behaviour 297
Commitment, allegiance, readiness 298
What is important versus what is not important 304
Assumption of status 311
Asking for desires/praying 312
Prophecy, signs, logic 314
The relationships amongst intention, fantasy, action and responsibility 321
Conclusions 339
13 Following Jesus: The Ongoing Dialectic 341
Topics in Chapter 13 341
Dialectics in clinical psychology 341
Consistency between cognitive therapy and the teaching of Jesus 342
Assessment for treatment 343
Commitment to therapy 344
Using logic like Jesus 345
Values 346
Content interventions 347
Tensions in the content of Jesus' teaching 350
Resolution 351
Appendix 1: Life History Questionnaire 352
Appendix 2: Christian Values Rating Scale 357
Appendix 3: Some Useful Sets of Commentaries 358
References 360
Index 366
1
Introduction
Topics in Chapter 1
- A historical view of spirituality, religion and psychotherapy
- The development and dominance of cognitive therapy as a psychotherapy
- The importance of Christianity in the West
- The appreciation of the role of non-specific factors in psychotherapy
- Interest in the Buddhist technique of 'mindfulness'
- Findings relating religious adherence to positive mental and physical health
- The growing respect for cultural and individual differences
- The decline of logical positivism and the rise of postmodernism and social constructionist theory
- The question of a logical connection between cognitive therapy and the teachings of Jesus
- A general outline of the book
A historical view of spirituality, religion and psychotherapy
Psychotherapy, a form of treatment for people suffering from emotional and behavioural disorders such as anxiety disorders, had its major period of development during the twentieth century. With rare exceptions, for most of this time there was seen to be little connection between the conduct of psychotherapy on the one hand, and spirituality and the practice of religion on the other. Two very significant figures in the development of psychotherapy, Sigmund Freud and Albert Ellis, have taken an essentially negative view of religion. Freud saw it as an illusion and the result of wish fulfilment in terms of longing for the father (Wulff, 1996). Ellis (1980) contended that all forms of religious belief were pathological and lead to neurosis. For much of the twentieth century the view prevailed that values, including religious values, could be kept out of psychological theory, research and practice (Patterson, 1958, cited in Bergin, Payne & Richards, 1996).
Developments in general psychology for most of the twentieth century were also antagonistic to the exploration of the relevance of religion to psychotherapy. In the economic crisis after World War I the United States of America shifted to a preoccupation with scientific progress and economic success. Within psychology this was parallelled by the 'spectacular success of behaviourism and its ideal of an objective and mechanistic science' (Wulff, 1996, p. 45).
At the beginning of the twenty-first century it is appropriate to reconsider the issue. The divorce of psychotherapy from religion may never have been logical nor appropriate, and there have been developments that make it timely to consider the potential for integration of religion and psychotherapy. Some of these developments are: the development and dominance of cognitive therapy as a psychotherapy; the appreciation of the role of non-specific factors in psychotherapy, including the role of values; the interest in the Buddhist technique of 'mindfulness' by a number of respected authors within the cognitive therapy tradition; the finding that 'intrinsic' religiousness is positively related to mental health; the growing respect for cultural and individual differences; the decline of logical positivism and the scientific worldview and the rise of postmodernism and social constructionist theory; and cultural changes in Western society.
The development and dominance of cognitive therapy as a psychotherapy
Cognitive therapy is a psychotherapy that aims to assist people with emotional disorders such as the anxiety disorders, and depression. It has also been used with a wide variety of other disorders, including chronic pain, eating disorders and personality disorders. Cognitive therapy considers that emotional disorders, such as depression, are caused and/or maintained by faulty thinking. It works by the therapist using a variety of verbal and intellectual techniques to assist the patient to identify and change the dysfunctional beliefs and thought processes. Cognitive therapy (CT) was developed by Aaron T. (Tim) Beck in a series of books and papers in the 1960s and 70s, most notably Beck (1976) and Beck, Rush, Shaw and Emery (1979). CT continues to be refined by Beck and others (e.g. J. S. Beck, 1995). It is aligned with other therapies with a similar view of psychopathology and focus of treatment, including cognitive behaviour therapy (e.g. O'Donohue & Fisher, 2012); cognitive restructuring therapy (e.g. McMullin, 2000); rational emotive therapy/rational emotive behavior therapy (e.g. Ellis & Harper 1975; Ellis & Grieger 1977); acceptance and commitment therapy (e.g. Hayes, Strosahl & Wilson, 1999); and mindfulness based cognitive therapy (e.g. Segal, Williams & Teasdale, 2002).
Cognitive therapy is accepted by the American Psychological Association as a 'well-established' treatment for depression, a very common mental health problem, and is a component in about half of the psychological therapies considered to be well-established treatments by the clinical psychology division of the American Psychological Association (Chambless, et al., 1996, 1998; Task Force on promotion and dissemination of empirically validated psychological treatments, 1995), The relationship between cognitive therapy and cognitive behaviour therapy is complex and has been subject to misunderstandings and, in some cases, mislabelling of a particular therapy. Cognitive behavioural therapy was originally the integration of cognitive phenomena into traditional behaviour therapy, but in popular understanding it has come to mean the reverse. The following is a representative definition:
Cognitive therapy is a psychosocial (both psychological and social) therapy that assumes that faulty thought patterns (called cognitive patterns) cause maladaptive behavior and emotional responses. The treatment focuses on changing thoughts in order to solve psychological and personality problems. Behavior therapy is also a goal-oriented, therapeutic approach, and it treats emotional and behavioral disorders as maladaptive learned responses that can be replaced by healthier ones with appropriate training. Cognitive-behavioral therapy (CBT) integrates features of behavior modification into the traditional cognitive restructuring approach.
(Encyclopedia of Mental Disorders, n.d.)
Arden and Linford (2009, p. 55) define 'Pure CBT' as follows:
Pure CBT - as opposed to the elements of it many of us employ in our practices - has five components
- Psychoeducation
- Breathing retraining
- Cognitive restructuring
- Exposure
- Relapse prevention
The situation is further complicated in that Beck's original 'Cognitive Therapy of Depression' (Beck et al., 1979) included a large behavioural assignment component. Thus both 'cognitive therapy' and 'cognitive behaviour therapy' include attempts to change both thoughts and behaviour directly.
It is this set of components that has been very successful in achieving outcomes for people with emotional and behavioural disorders by assisting people to change their thinking and their behaviour without recourse to attempts to change anatomy or physiology. The CT-CBT approach has outperformed other non-physiological/non anatomical approaches. It has also largely been a 'Western' phenomenon. It is therefore appropriate to consider the relationship of CT-CBT with the dominant religion of the West: Christianity.
The importance of Christianity in the West
The teachings of Jesus, a first-century Palestinian Jew from Nazareth, a small town in the north of Israel, are important to a very large number of people. Christianity, the religion based on those teachings, is unarguably the world's most popular religion with two billion adherents. The point prevalence for depression in adults ranges from 2-3 per cent for men and 5-9 per cent for women (American Psychiatric Association, 2000). Therefore between 40 and 180 million people with an adherence to Christianity are likely to be suffering from depression at any point in time, not to mention at least the same number who suffer from one of the many other disorders, including anxiety disorders, that benefit from cognitive therapy.
Many people with depression and other emotional disorders will (or should) receive CT as a component in their treatment. Many of these people, particularly in the West, will be practising Christians. If there are connections between the teachings of Jesus and CT, and if the teachings of Jesus can then be integrated positively with CT, clearly it could be very beneficial for people receiving CT who have Christian beliefs.
The appreciation of the role of non-specific factors in psychotherapy
Since the discovery in the mid 1980s that all psychological theories appear to have about the same positive effect on symptoms of disorders such as depression, interest has developed in the so-called non-specific effects of therapy. These are factors that are not necessarily derived from the theory the therapy is based on, but which affect therapy, or occur in the context of therapy. They have included the therapeutic alliance, and client factors such as motivation for therapy and expectancy of success in therapy. A non-specific factor explored explicitly in the context of psychotherapy is the role of both the therapist's and...
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