The Problem with Thinking

[This is not the post I thought I would put up this weekend. That one is pretty much in the can, and will see the light of day before long. In the meantime, here’s the thing about trying to be Spirit-led: sometimes a topic will just grab hold and insist on jumping to the head of the line.]

First question: What’s the problem with Cognitive Therapy?

(Waves hand in air:  Ooo ooo ooo, I know this one.)

Anyone? Arnold?

The problem with Cognitive Therapy is that it doesn’t go far enough.

(Right. Here’s your gold star.)

What does that have to do with “The Problem with Thinking?” Keep reading.

When I was a young social worker, trying to do a good job with just a decent liberal arts education (a very good starting place BTW ; highly recommended), a smattering of psychology, and some native intuition, I sat down after a couple of years and tried to sum up what I’d learned. The result was an essay which described a new form of therapy, which I called Empirical Therapy. I discarded the essay later, when I found out that I was late to this party. It had been done, 10-15 years earlier, and a lot better. It was called Cognitive Therapy. (I went to a Master of Social Work program at around this time because I knew I was wasting time and effort every day, re-inventing the wheel. Boy, was I.) I encountered Cognitive Therapy in a counseling class, and recognized it for the mature expression of what I’d been groping for on my own. Aaron Beck had done stellar work in this area. So had Albert Ellis, who called his version Rational Emotive Therapy.

In 1994 I was introduced to Dr. David Burns’ work in this field, called Cognitive Behavioral Therapy (CBT). It was like putting on a tailored suit. I’ve been fortunate to have attended a 2-day seminar with Dr. Burns. I’ve been even more fortunate to have seen the results. I literally use CBT every day, in every professional interaction, in some way or another. It’s that good.

In 2006, I was lucky enough to be included in a pilot program run by the North Carolina Child Treatment Program, a joint venture of Duke University and UNC-Chapel Hill. 60 therapists in eastern NC were taught Trauma-Focused Cognitive Behavioral Therapy. This was a fantastic educational experience, led by a group of talented young clinicians. Representing pediatrics, psychology, and social work, most were young enough to be my children. I got over that pretty quickly, when I saw how much they had to offer. The thrust of the pilot program was this: TFCBT had proven its worth over years of research. Could it be taken off campus, and taught on a wide scale to active clinicians actually out in the trenches? Yes, it could. Working with survivors of sexual assault has been a specialty of mine ever since sort of accidentally getting involved with a case in 1980. With TFCBT, I’ve seen the time it takes for good treatment reduced from a year or so to around 4 months, with very good results. Once more, CBT has proven its worth, not just in its effectiveness but in its flexibility as well.

I’ve said for years that CBT is the most important development in psychotherapy in the last 50 years. I stand by that today. I’m not as disdainful of other forms of therapy as some CBT practitioners are. Psychodynamic psychotherapy is a powerful tool in the hands of a well-trained clinician. It’s a lot harder to produce well-trained clinicians in that mode, though. Good old B.F. Skinner-style behaviorism is being used with good results too. Ericksonian hypnosis and its many offspring are superb, the psychotherapeutic equivalent of laser and arthroscopic surgery. And nothing has ever superseded Carl Rogers’ insights into the nature and importance of the relationship between therapist and patient.

I dearly love a good dream analysis, and watching the ensuing changes in mood, thought and behavior as they unfold.

But if for some dire reason we were forced to select only one mode, I would have to pick CBT. You can teach more providers to be more effective with this one system than any other I have used. And, once patients have learned how to use CBT, they can use it themselves, for the rest of their lives, without a therapist. Slam dunk.

At the risk of over-simplification, here’s how it works: If you have negative thoughts, you will have negative feelings. Negative thoughts can be easily changed, with new information that either changes the thought itself, or calls the negativity into question. So if I think you are angry with me, and this makes me anxious, this can change either by finding out that you aren’t angry — new information — or learning that I can be calm even if you are angry at me — calling the negativity into question.

What, then, is the problem with CBT?

It doesn’t go far enough.

Why doesn’t it go far enough? Take, for instance, the problem of information. Computer folks have known from the dawn of time (computer time) that old saying, Garbage In, Garbage Out. CBT is like a computer program, software for the mind. The best program in the world cannot overcome bad data that is fed into it. As a grad student, I was introduced to a statistics program called SAS. SAS was marvelous. You could use it to slice and dice your data any way you chose. You could run all kinds of analyses, and turn out all kinds of charts and graphs. Here’s the thing: if your data collection was bad, SAS couldn’t point it out. It would give you wonderful stats and graphs that meant nothing, or were actually misleading.

Same with the mind. The information I have, from so many sources, affects my mood, outlook, ideas, opinions, etc. How can two people — patient and therapist — be certain that they are using the best information? They can’t. Neither can see past the blind spots they share. If I really think that women should never wear pants, and I am counseling a woman who is struggling with restrictions placed on her by a church that only allows dresses for women, where is the new information that she needs going to come from? Worse yet, if I only ever really talk to people who agree with me, will my basic fallacies ever be challenged?

Also, neither of us knows that there is needed information that we don’t know. It seems this goes without saying — you don’t know what you don’t know, duh — and yet it is seldom taken into account. As Thomas Kuhn pointed out in his landmark work “The Structure of Scientific Revolutions”, science advances when it becomes apparent that what we think we know is wrong. Scientific advance is held back by people who are certain that they know what isn’t so.

I see this all the time. It is a major factor in our public life. Liberals who only talk to liberals. Conservatives who only talk to conservatives. Religious people who only talk to other religious people, and atheists who only talk to other atheists. People who get angry and bitter when confronted with different beliefs than their own. People only read books and magazines, or watch TV shows, that support their own favored views. Things seem evidently correct, because “everyone agrees.” It reminds me of the Chicago socialite who couldn’t believe Eisenhower beat Stevenson, because “no one voted for Eisenhower.” No one she knew, that is.

Try it yourself. Take any random politically oriented post on Facebook. Say something that disagrees with it. Watch the fireworks.

Many people who are the most convinced that they have an open mind, have very closed minds. As A.A. Milne put it, “The third-rate mind is only happy when it is thinking with the majority. The second-rate mind is only happy when it is thinking with the minority. The first-rate mind is only happy when it is thinking.” There are so few first-rate minds. The other two are not really thinking at all. They are massaging their biases.

Which brings us to the second way in which CBT does not go far enough. The first is that it can’t guarantee that you will get better information than you have. The second is that it doesn’t really teach how to think. It does a very good job of pointing out some of the most common fallacies — perfectionism, taking things personally, etc. — but learning what constitutes the wrong way to think does not equal learning how to think.

For that matter, there are many ways to think poorly that are not covered in CBT. For these, you might need to take a basic course in logic. There, you would find out about the ad hominem fallacy, circular reasoning, “post hoc ergo propter hoc,” the straw man, and others.

It’s not a matter of intelligence. Not entirely. I know some people of average intelligence who are better thinkers than those of vastly greater intelligence. They are, however, limited in what they can think about; the ability to reason abstractly does not show up until somewhere around an IQ of 120. But having a big brain is no guarantee of being a good thinker; some of the poorest thinkers I know have very high IQs. They’ve learned how to use it in some ways, but not in this important way.

What does it take to be a good thinker?

1. High quality information, from a variety of sources. For instance, when a major world political crisis takes place — say, the fall of the Berlin Wall — don’t just watch your favorite news programs. Get a shortwave radio and tune in to news shows from around the world, such as Deutsche Welle, the BBC, Radio Canada International, Voice of Japan, Voice of China, and one of my favorites, Radio Prague. Shortwave radio listening is fun, too — check out all that different music. (If for some silly reason you don’t want to fool with a radio, many stations also livestream over the Internet. But this is cheating.) If you like Fox News, listen to NPR. If you hate Fox news, find one of the more reasonable conservative bloggers such as Victor Davis Hansen. Do whatever it takes to stay out of the “echo chamber.”

2. Be aware of the signal-to-noise ratio. Signal is useful information. Everything else is noise. Most of what you get in daily conversation and via the mainstream media is noise. With just enough signal to make it seem worthwhile. This is a tough one! Recognizing good information from bad takes work.

3. Learn about the obstacles to clear thinking. CBT is very good at identifying the most common cognitive distortions — ways we let our emotions affect our thinking. And there are many websites, such as the Wikepedia article on logical fallacies, that describe ways in which we fail to keep our thinking straight in a more formal sense. Learn them. Learn to spot them when other people are under their sway. Your favorite commentator might look very different.

4. Learn to trust the limits of knowledge. Get comfortable with the idea that no one knows all there is to know about anything. We have to make decisions, even though there is never sufficient high-quality data for complete assurance.  That person you dislike so much just might know something you don’t — and it’s just as likely you know something he doesn’t. Live and let live.

5. In a special application of #4, but worthy of a spot all its own because it is so dang important, learn to accept the legitimate difference of opinion. Everyone who disagrees with you is not a fascist, or a communist, or whatever your bete noir may be. I’ve written a whole essay on this and posted it on this blog. It is the least-read of any essay I’ve posted. Many, many people just don’t really want to know how to think.

6. Practice, practice, practice. If you want to learn how to think, you have to read the works of great thinkers. Not novelists (although some of them were great thinkers), not poets, not biographers, not cookbooks. You can’t become a great musician without listening to great music, and practicing your scales over and over and over. You can’t become a good thinker without the company of other good thinkers.

7. Honesty. You have to be able to take an honest account of who you are, what you do, which distortions you allow into your thinking, what poisons do you allow into your data stream, and so forth.

As always, I know I will get comments that will add a lot to this. Good data stream!

Something About Love

[It’s lovely to have friends on the Internet who I’ve never met and perhaps never will. Kindred souls. I remember stories of young men and women, back in the days when people Wrote Letters and Mailed Them To Each Other, who had penpals in far-off countries that became deep and enduring friendships, all through correspondence. There are people like that in my life, but the medium is not through pen and ink and snail mail, but through email, blogs, and so forth. One who I’ve only recently encountered, but who might perhaps have staying power as a friend, is Ember. We have a lot in common, in some important ways, and I appreciate her quiet humor and quiet strength. Who knows, she might be a holy terror in person, but that’s not the Ember I know. She recently wrote a post on Love which I found thought-provoking. Now, there has been so much written, sung, and otherwise portrayed about love that one thing emerges clearly: it is a huge topic, and no one has the complete story. There’s a lot I don’t know about love, for sure. But there is some that I do know, and of a particular sort, I have a great deal of experience. Here is an excerpt from a book I wrote entitled Concordia: Psychotherapy, Healing, and the Vital Force. Ember’s blog just put me in mind of this, and while I hadn’t intended to post it, suddenly it seemed like a good idea.]

In the old science of alchemy, there were considered to be four elements of which all the universe was formed: earth, water, fire and air. Then, in the alchemical operation which was to produce “gold” from “lead”, a fifth essence – the quintessence – was introduced. Since Jung, the world has known what only initiates knew before: alchemy does not describe a chemical reaction in which one metal transforms into another, but a spiritual process in which our flaws are transformed into strengths. The philosopher’s stone, that which the alchemist strove to create, is not a physical object, but the psyche of the alchemist himself, transformed into what has been called cosmic consciousness or enlightenment.

And what is this quintessence? What is it which is essential to the process of spiritual transformation? Simply put, it is love.

Love, in all its forms. Love, unreservedly. Love, without fear of destruction or hope of gain.

Love, without which I am but a clanging gong or a clashing cymbal.

Love, which is the most inward nature of the prana or vital force of which we are formed. Love, which seeks to be healed and which is the healer.

Love, which is the dance of Krishna.

Love, which is Christ on the Cross, and Him risen on Easter Sunday.

Love, which is the Buddha returning from the bliss of nirvana to teach all sentient beings the Noble Four-fold Truths.

Love, which is in the symphony, the folk tune, the mockingbird’s song. Love, in the sunset, the painting, the new mother’s first glance at her baby.

Love, which is the Void and the One and the Manifest.

Love, as the crucible in which you and I meet for healing, and which brooks no deception or fear, but which unites and makes us whole.

Let me be more specific. The motive force in the healing relationship, that which energizes the activity of the vital principle in the interaction between healer and patient, and which most influences a positive outcome, is love.

To love our patients takes courage of the highest order. Some of my patients have required me to dig way down deep into myself, to face whatever may be there, in order to verify for them that they  could take the risk to open themselves to me. They would not have risked that kind of vulnerability if I were not willing to do the same. They understood the general rules of the game, that I would not share my life story with them to the degree that they would share theirs with me. But had I not been willing to undergo the same personal exploration I asked of them, they would have walked out. Rightly so. Only cowardice or hypocrisy could have explained any unwillingness to do so.

Bruno Bettelheim once remarked that we can approach the care of our patients in two ways. We can look at them, down in the pit of whatever their trouble may be, lower a ladder down to them, and instruct and encourage them as they learn to climb it. Or, we can go down the ladder, join them in the pit, and ascend the ladder together. The first is treatment; the second is healing.

I recall a patient I worked with many years ago, a young lady who had been through immense mistreatment as a child and in marriage. I knew that if I was ever the least bit inauthentic with her, I would lose all the ground we had gained; even the least betrayal, even the “little white lies” that are so common in everyday communication would have shown her that I could not be trusted. Her experiences had made her a superb judge of character and had given her exquisite sensitivity to what was going on around her. I was not going to fool her. Had I been unwilling or unable to dig as deeply into my own self as I was asking her to do, our sessions would have come to an end. While it was not always necessary for me to reveal what my own inner explorations discovered – I could say that I would rather not share and she would accept that, when it was clear that I was not just dodging – many times it was of the greatest value to her when I did share, so she could measure her own experience against that of someone she had learned to trust. Certainly this took dedication and the highest degree of professional discipline of which I am capable; more than that, though, it took a huge measure of that love which places someone else’s welfare as highly as my own.

At one time, after having made a great deal of progress and during a time of relative calm in her life, she thought about skipping a session. I knew, however, that although she was handling some recent disappointments quite well, it was not necessary for her to have to handle them alone. What I said on the telephone was, “You may not need to process these feelings. But you need at least to come be in the love.”

May I note at this moment that I do not see this kind of love as a personal choice or ability. I suppose, in one sense, I could just have accurately said “you need to come be in the prana.” For at times the flow of prana between us was palpable. In my experience, such love is not possible without that pranic flow. It is a love of which the healer is a conduit, not the origin. The healer must not confuse this with the kind of love which wishes to incorporate the other into his own life. Rather, the two of them, patient and healer both, are incorporated into a life greater than either of them, that One Life which is the source of all the cosmos, which is not so distant as to be unable to enfold two small people on one small planet within its embrace.

For this reason, the healer must also adopt the lifestyle which cultivates concord. She must also be well-balanced, reasonably healthy, have a daily practice of some sort which puts her into regular contact with the vital force, and all that was indicated above. (By “reasonably healthy”, I do not mean to overlook the fact that Milton Erickson did some of his best work from a wheelchair, later in life, orthat Sigmund Freud continued to perform admirably with cancer of the mouth. They were still in concord, even in the midst of these challenges.)

Such a lifestyle would promote all of these virtues in the life of the healer: integrity, flexibility, harmony, curiosity, kindness, determination, congruency, balance, duration. It would acknowledge that he has flaws, as we all have flaws. It would allow him to make the most of his assets, while minimizing his flaws.

…

I gave a draft copy of Concordia to a friend to review. She is not a medical or mental health professional, but is an intelligent and well-educated woman. I didn’t want her to offer copy editing or technical commentary; I wanted to know if I had communicated well to  the audience which she represents so well. She made a number of helpful comments. One of them was, “The word which keeps coming up for me is ‘grace.’ ”

I couldn’t agree more. The same word keeps coming up for me. I could not see a way to work it into the text as it stands, but it seems to fit here, in the conclusion, quite well. Because I want to say that there is no way to think our way out of fear. There is no way to act our way out of fear. There is no way to feel our way out of fear. The answer to living in a state of fear is to live in a state of grace.

The word grace has many theological connotations, especially among Christians, for whom it is a central issue. I do not use the word here in any way that contradicts those connotations. I do wish to say that it is not only Christians, not only those who believe in the God of the Christians and Jews, but anyone at all who can live in a state of grace. For a Christian, the state of grace is owing to faith in Jesus Christ. That’s OK. But anyone who has an understanding of a Higher Power, whether of God or of a deep comprehension that we are all, no matter how small we may be, an integral part of the cosmos, and we are all doing what our part of the cosmos does, can live in this state of grace.

One does not live in a state of grace by thought alone. Anyone who follows some of the suggestions of this present work, whether they be a healer or not, will be able to live that way. I refer especially to the suggestions regarding the regular experience of prana or vital force. Whether by movement such as yoga, by meditation, by music, art, or poetry, anything that puts you “in the groove” with the vital force will, if allowed to do what it does, enable you to live in grace.

At this point, some might ask “but what is this state of grace?” I will not try to define it or even describe it. Neither of these would be helpful. For one thing, to do so renders the unconscious suggestion that this is an intellectual exercise. This would be less than helpful. My suggestion is, rather, to experience it for yourself. You can easily do this; you probably already have, without knowing it.

If you have ever been enraptured, then you already know what grace is like. If you have been enchanted by a piece of music, taken “outside of yourself” by a beautiful piece of scenery, lost yourself in your lover’s eyes, or been completely smitten by holding a newborn child in your arms, you know all you need to know about grace. Now, the only thing is to get on with it. Make it a regular part of your life. Do it so often that it becomes your natural state. It has been done, and so you can do it too.

[Copyright © 2012 by Bruce R. Arnold, just so we keep that straight. And yes, I’m looking for a publisher. No luck so far. Still trying.]

All the Truth that Can Be Said …

All the truth that can be said in a certain way is in the Bible. Having been said in that way, it cannot be said in another way. But there are other ways.

All the truth that can be said in a certain way is in the Bhagavad Gita. Having been said in that way, it cannot be said in another way. But there are other ways.

All the truth that can be said in a certain way is in the Tao Te Ching. Having been said in that way, it cannot be said in another way. But there are other ways.

All the truth that can be said in a certain way is in the Diamond Sutra. Having been said in that way, it cannot be said in another way. But there are other ways.

All the truth that can be said in a certain way is in the Upanishads. Having been said in that way, it cannot be said in another way. But there are other ways.

All the truth that can be said in a certain way is in the Lotus Sutra. Having been said in that way, it cannot be said in another way. But there are other ways.

All the truth that can be said in a certain way is in the I Ching. Having been said in that way, it cannot be said in another way. But there are other ways.

And so forth.