The Evolution of CBT

We thought we would pose the question, what is CBT and how did it get to be what it is today?

Well, let’s start with expanding the acronym CBT. We can see straightaway, Cognitive Behavioural Therapy, is a treatment but what for? Best to start at the beginning….

The evolution of CBT took places in three stages. The first stage was back in the 1950s, when behaviour therapy emerged in both the UK and America. The second stage, the growth of cognitive therapy, took place in the US in the mid 1960s onwards. The third stage, the merging of behaviour and cognitive therapy into cognitive behaviour therapy, gathered momentum in the late 1980s and is now well advanced in Europe and in North America.

Behaviour therapy was very successful in the treatment of anxieties like phobias. However, as is still the case, most adults complain of both anxiety and depression. Whilst behaviour therapy was successful in treating the anxieties, it was not very successful in treating depression. This opened the door for cognitive therapy that provided education, explanation, rationality, common sense and showed that beliefs such as ‘I’m worthless’ were untrue and distorted. Two of the most productive and influential pioneers of cognitive therapy, Ellis and Beck, shared the view that most disturbances arose from faulty thinking or faulty cognitions. The remedy was to be found in correcting such attitudes, beliefs and thoughts.

Beck’s form of cognitive therapy was based on the rationale that an individual’s feelings and behaviour was largely determined by the way in which he viewed and structured the world. Ellis believed emotional or psychological disturbances were largely a result of thinking illogically or irrationally. It may be easier to understand these ideas, if you view problems and symptoms as stemming from unhealthy beliefs and thoughts. With the cognitive approach, you take on the role of a detective and examine the problematic beliefs and thoughts, which you are holding on to so tightly.

Beck’s early work was on understanding and treating depression, a clinical problem that remained essentially unsolved by behaviour therapists. Depressed people are subject, to what Beck described as the ‘cognitive triad’ in which they have feelings of pessimistic helplessness about themselves, the world, and their future. Understandably, clinicians turned to the work of Beck for guidance in trying to help people overcome their depression. Ellis, provided a scientific as well as a philosophical theory that could be applied to the treatment of anxiety, depression, guilt and other emotional, symptomatic and behavioural problems.

Both Ellis and Beck showed that in addition to proving the connection between cognitions and feelings, challenging erroneous and unhealthy attitudes and beliefs and replacing them with their healthy realistic alternatives, people need to take corrective actions and behave in accordance with their new healthy cognitions. Homework assignments and behavioural changes form a vital part of the therapy and hence the name Cognitive and Behavioural Therapy.

Development of other CBT influenced therapies such as Cognitive Behavioural Hypnotherapy
CBT has continued to develop and there are other schools that come under its umbrella. There are such therapies like Mindfulness and Acceptance and Commitment Therapy that advocate meditation and being in the present. There is also valuable research that demonstrates the effectiveness of CBT and Hypnosis.

Even though cognitive therapy was developed during a time in which psychology was rapidly moving towards cognitive explanations, there was a gap between CBT and cognitive psychology. One main difference was that both Ellis and Beck’s therapies are concerned with conscious processes (thoughts and images). However, in cognitive science, it is assumed that the majority of cognitive processing is not experienced as consciously accessible thoughts or images. This is the area that cognitive behaviour hypnotherapy can bridge. Many of our beliefs outside of our conscious awareness and hypnosis is used to access deeper held beliefs. Hypnosis can also lend itself to strengthening healthy beliefs and attitudes and weakening their unhealthy versions.
CBT is now widely accepted and practiced all over the world, and enhanced by developments such as Cognitive Behavioural Hypnotherapy. If this post, has piqued your interest, check out some of our other blogs on the applications of CBT and CBH.