Yalom's criticism of CBT

Someone's got to do some more research, but I would really like to know:
when a CBT therapist really gets distressed, who does he go see? I just
have a strong sense it's not another CBT therapist. I think he wants to
go out and search for somebody who's wise and can help him explore
deeper levels.
Irvin Yalom
http://blogs.psychologytoday.com/blog/in-therapy/200903/seven-questions-irvin-yalom

Wise Therapy recommended by Guardian/Observer guide to Understanding People

**Wise Therapy was one of only 25 books recommended by The Guardian on
therapy and personal development
**

**This is what they said**

*Wise Therapy*: Tim LeBon(Sage, £18.99)

A practical guide to using philosophy as therapy. LeBon encourages
counsellors and psychotherapy practitioners to use philosophy with their
patients to help them make better decisions.

How to create effective collaboration with clients (for CBT and philosophical counselling)

In both CBT (cognitive behaviour therapy) and philosophical counselling,
effective collaboration with clients
in considered to be a crucial element of wise therapy.
In their highly recommended /Introduction to CBT/, Westbrook et al list
4 ways of building a positive collaborative relationship (p.29)
1) Careful listening
2) Creating a shared agenda at the beginning of each session
3) Welcoming feedback
4) Establishing client's goals
These are all very important - I'd like to suggest 4 other ways of
ensuring there is good collaboration
5) Use Socratic questioning -also known as guided discovery (as opposed
to lecturing)
6) Write down key points and ensure the client gets a copy as well as you
7) Be transparent - explain your rationale
8) Use frequent summaries

A less-heralded benefit of therapy

One of the less heralded-yet very real - benefits of wise therapy is
to help clients get out of their everyday mindset on to a different plane.
For an hour a week, they are thinking about life from a broader
perspective, from a wiser perspective. They look at what matters in
life, they brainstorm options creatively, they look at their old
strategies in living and explore new, better ways. Therapy clients
learn about ideas from the great thinkers and from psychologists,
and can experiment with them to see if they help.

Inevitably, when they go back into the everyday world, some of will get lost -
but some will remain, too. Therapy is a sanctuary away from the herd, a
place to reinvigorate the thinking process, a precious time for self-renewal.

But I'm not exactly sure how anyone would capture all these benefits
in an outcome study ...

Mood logs plus

 

Mood logs (Burns, Padesky)  are an extremely usefuly tool for therapist and client alike.

I do recommend you try them if you havent already.

I believe they can be tweaked to be made better.

One enhancement is to include an "existential message" and "action plan"

Emotions don't always involve distortions, and even if they do they still may have a message and require  a plan

 

Another is to separate out factual and evaluative rational responses.

When the rational response is about whether something is the case or not,

then treat this like a detective or scientist. Put in qualifiers like "perhaps" and "probably" or better still give a probability estimate. Make an action plan for finding out more evidence.

When the rational response is about your evaluation of it, then first

- remember that you dont know if the factual stuff is true. Remember Socrates "I know nothing". This calms down the evaluaitons

- Try a thought experiment "If this hypothesis is true", what is the wise response.

The problem is you might not really feel this to start with. Then have a dialogue between your automatic thought evaluation and your rational response evaluation.

This is rather like a dialogue between Plato's charioteer and white horse.

You might also identify core beliefs ("bottom lines") to work on further - put this in the action plan.

Describe yourself in the third person

After a twenty hour training in practical philosophy, most students are well able to apply philosophical methods to case vignettes - such as

 

1)My sister (who is five years older than I am) is a high-flying lawyer, and my parents want me to go to law school after I finish my law degree. But the part of the law degree I've enjoyed most is ethics. I'd like to do a post-graduate degree in philosophy instead! But my parents won't want to lend me more money, and I already feel somewhat envious of my sister's lifestyle. What should I do? (Ulya)

The trick is to then apply the same methods to their own situation.

So, first teach people the methods, then ask them the following question

"Describe your situation from a third-person standpoint, stating your dilemma as clearly as you can. Then treat it as a case vignette. What would you recommend."

Best regards
Tim
Personal Development Through Philosophy and Psychology
http://www.timlebon.com

Use bibliotherapy

You only have 50 minutes or so a week with the client, and are also limited by your own ability and memory.
Why not encourage clients to learn from books that they might find are helpfu

Suitable texts for bibliotherapy include

• Bertrand Russell – The Conquest of Happiness
• Viktor Frankl – Man’s Search for Meaning
• Alan de Botton – Consolations of Philosophy
• Covey 7 Habits of Highly Effective People
• Carlson Dont sweat the small stuff

I suggest all of these to clients, and have also written “readers companions” to each of these 5 texts to make them more accessible, foreground the more practical elements of each book and also raise critical questions. I