I just finished a fascinating small book by Harvard psychologist Jerome Bruner (that’s him on the right), called Acts of Meaning. Although it was published in 1990, I don’t think it’s widely known among lay-people, and I think its ideas are worth briefly discussing – because they offer an interesting critique of cognitive science, including Cognitive Behavioural Therapy (CBT), and a call for it to become more culturally aware.
Let me say at the outset that CBT helped me enormously and that what follows is not a rejection of CBT but an exploration of how it could be expanded to include more from the arts and humanities.
Bruner was one of the pioneers of the cognitive revolution, which transformed psychology from the 1950s on. The cognitive revolution was a rebellion against behaviourism, which insisted that all human behaviour could be described by a very simple process: Stimulus – Response. There was no need, behaviourists said, to inquire into human thoughts or beliefs or values. We simply respond to external stimuli, and change our automatic responses accordingly, like automatons, or rats in a laboratory.
The psychologists of the cognitive revolution rebelled against this view of human psychology, and countered that humans’ internal thoughts and values play a powerful role in defining how we experience reality, how we feel about it, and how we respond to it. Between the Stimulus and Response lies a person’s beliefs and values – and we can change our beliefs and become the ‘authors of ourselves’.
This, of course, is a very different view of humanity. We go from being helpless automatons passively reacting to stimuli, to autonomous beings, actively creating meaning from our experience, able to choose how we respond to life’s challenges.
Part of the cognitive revolution is Cognitive Behavioural Therapy (CBT), which was invented by Albert Ellis and Aaron Beck in the 1950s. Both Ellis and Beck were inspired by their reading of ancient Greek philosophy, particularly of the Stoics, who declared that humans create their experience of the world through their beliefs. As the Stoic philosopher and Roman emperor Marcus Aurelius wrote: “Life itself is but what you deem it.”
The Stoics were the vanguard of the cognitive revolution, 2000 years before it happened. Humans, they insisted, were “disturbed not by events, but by their opinions about them”, as Epictetus wrote. Therefore, to heal yourself of emotional disorders, you should simply become aware of your beliefs, see how they cause your emotions, and then change your beliefs if you decide they are false and irrational. Eventually, the Stoics believe, we will be able to perfectly match our beliefs to external reality (or God), and nothing that ever happens will ever upset us.
The therapeutic process is, the Stoics believe, entirely individual. We can’t expect society to change its foolish ways. Rather, the lone Stoic heroically separates themselves from their toxic culture, and makes of themselves a perfect little fortress of calm rationality amid the irrationality of their society. CBT might not believe in God, but apart from that, this is pretty much a description of CBT’s therapeutic approach. We must rationally examine our beliefs, and reject any that are false, until we become perfectly adapted to reality and nothing truly upsets us anymore. As in Stoicism, this recovery process is entirely individual.
Clearly the Stoics got something right – our emotions do follow our beliefs, and if we change our beliefs we change our emotions. Realising this helped me personally to overcome depression. But perhaps both CBT and Stoicism are too individualist, and ignore the importance of culture both in emotional disturbances and in the recovery process. Other Greco-Roman philosophers, like Plato and Aristotle, agreed with the Stoics that our emotions are caused by our beliefs. But they had a much keener sense of how our beliefs are shaped by our culture and political system. So the process of recovery is not just individual – it is also cultural and political.
From meaning-makers to information-processors
Certainly, Jerome Bruner argues that the ‘cognitive revolution’ went wrong, and that cognitive science in general lost a sense of how our beliefs are shaped by culture. Bruner warns that the cognitive revolution went wrong when it moved from the idea of humans as ‘meaning-makers’ to the idea of humans as ‘information-processors’. The computational model of the human mind become paramount in cognitive science.
This shift, he writes, had enormous consequences for psychology. According to the computational model of the mind, there is an objective reality ‘out there’ which the mind simply has to process correctly. Beliefs can be logically analysed for their truth-content, and either accepted or rejected.
It’s very much a positivist, scientific rationalist view of the human mind. Cognitive science has shown an indifference or even intolerance for people’s cultural beliefs about the universe, or what cognitive scientists dismiss as ‘folk psychology’ – things like a person’s religious beliefs. Look, for example, at the scorn cognitive scientists like Daniel Dennett or Steven Pinker show for religious beliefs. Religious people are simply faulty information-processors with outdated operating systems. They need to be upgraded to Scientific Rationalism 2.0, then they will see the world clearly and feel less emotional disturbance.
In many ways, CBT also has a computational model of the mind. If you’re suffering from an emotional disorder, it’s the fault of your ‘thinking errors’. You are processing information incorrectly – catastrophising, say, or discounting the positive, or jumping to conclusions. You just need to rid yourself of these thinking errors, like someone listening to a radio who tunes it to get rid of static (to use a metaphor from the famous CBT expert David Burns). Reality is ‘out there’ to be picked up correctly, like a radio broadcast, as long as our information-processing equipment works correctly.
Eventually our beliefs will perfectly match with reality, and we will be free of any emotional disturbance. And this recovery process in CBT is individual, as it is in Stoicism. It doesn’t matter what your culture believes. We can create an island of perfect rationality amid the sea of human foolishness – so CBT and Stoicism insist.
No man is an island
There are several potential problems with such an approach. Firstly, it ignores the fact that our beliefs can impact on social reality, and become self-fulfilling prophecies. For example, we may strongly believe that other people don’t like us. This will make us less trusting and more wary of other people, more quick to take offence. And that, in turn, will mean others react to us badly. So a person’s negative beliefs about their environment might become accurate. The question then becomes not ‘Is this true?’ but ‘Is this something I should care about?’ and ‘Is this something I can change?” It becomes an ethical and cultural question rather than an information-processing one. Our beliefs exist in a dynamic relationship with our social environment, feeding off each other.
For example, a young black man might feel paranoid in British society. They might feel like other people are judging them negatively and ‘out to get them’. Orthodox CBT would simply say this is a thinking error. But it might not be! They might genuinely exist in a racist culture, which fears them, thereby feeding their own sense of alienation and anger, thereby feeding their society’s fear of them, and so on. In which case, the therapeutic approach becomes more existential: ‘if my evaluation of my society is true to some extent, what can I do about it? How can I shape a wise response and transform this situation?’
The computational model found in CBT is completely culture-blind. It shows no interest in how a person’s beliefs are shaped by their culture. It asks only if they are true or not. So if a Rastafari hears voices, for example, conventional CBT would show no interest in how that experience might be shaped by that person’s culture. It would expect that person instead to upgrade their operating system to Scientific Rationalism 2.0 (though some new CBT is much more culturally aware than this, as I discuss here).
CBT also ignores the crucial role of narrative in shaping a person’s experience. It only asks, is this belief here in the present moment true or false. But we shape our experience into narratives, into a story. And the recovery from mental illness is an incredibly important part of that story. We are not simply information-processors, we are story-makers.
And, again, this is why culture is so important – we take the narratives we use to shape our experience from our culture. Our culture is a cupboard, as it were, of available narratives for people’s lives, which they try on and wear. A good psychologist, Bruner writes, should be as much a sociologist or cultural anthropologist, or even a literary critic, as a scientist. They should be alive to the narrative structures a person uses for their experience.
This doesn’t mean that ‘anything goes’, that a person can believe whatever they want about reality without asking if their beliefs are plausible. We are part of a shared public culture, and need to fit our narrative into that culture – although we also shape that culture and change it with our personal narrative, as Martin Luther King did. We don’t necessarily have to adapt to our culture’s values. We can choose not to adapt but instead to push back, thereby creating new narratives for the people in our culture to follow.
The process of therapy, in other words, may be political as much as individual. If your culture’s values are making you sick, you can try and make yourself a perfect island of rationality, like the Stoics suggest. Or you can find a group of people who share your new values, and work together to support each other, like a lifeboat in a sea (this is how the Epicureans approached therapy). Or you can go a step further, and actively try and change your culture, challenge those beliefs and values that you think are toxic, and shape it into something better.
Of course this is quite a lot to ask of therapy! We already have a hugely over-worked CBT services in the UK’s NHS, trying to help millions of people quickly. I guess we don’t want them all to turn into Marxist sociologists. Nonetheless, Bruner makes some good points, and I very much recommend his book.
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I read this book and wrote a review of it many years ago. Your review is great and has made me want to re-read the book. I think you have highlighted the strengths and weaknesses of CBT well in the review. However, I would also add one more comment. CBT has largely overtaken other forms of therapy, in part, because it is cheaper to provide. This is because it requires fewer sessions and also because psychology as a profession, at times, steers clear of emotions – however strange this may seem. CBT is sometimes prescribed when other forms of therapy may be more successful. If people have developed behaviours which cause them distress, such as issues with eating or obsessive compulsive behaviour, then although CBT may be prescribed it may not get to the heart of the issue. If such behaviours were simply an error of thought alone (and resolvable within ten weeks – an average set of CBT sessions) then I think more people would be able to solve the issues without needing therapy. I.e. things are rarely that simple. While distorted thoughts may form part of such behaviours, they are rarely the whole picture. Often CBT works best when it is carried out alongside other approaches which also help a person to work through other emotions and experiences. While CBT can be life changing for people it is often not enough and change which results from simply changing thought patterns is often only temporary. This observation sits alongside your other comments, and I agree entirely with the view that thoughts are not formed in a cultural vacuum.
Hi Jane, thank you.
Yes I agree – the cheapness is definitely a persuasive factor for government. Unfortunately I hear that the budget for more psychodynamic stuff on the NHS is being cut, so CBT people are being handed severe cases of bipolar etc which they’re not trained to handle. Not good.