Book Review by David McDonagh
Therapy Breakthrough: Why some psychotherapies work better than others. Michael R. Edelstein, Richard K. Kujoth and David Ramsay Steele.
The book is about the old Freudian psychotherapy and the new, Cognitive Behaviour Therapy [CBT] that has largely replaced it over the last 60 years. The main difference seems to be that, bit by bit, and in their own innovative way, during the last 60 years the various followers of Freud tended to abandon the Unconscious mind idea or meme that many authors and psychotherapists today tend to think does not exist. I think, with the authors, they are right in that assumption.
The authors say that Freud made a distinction that he did not always follow up, but his disciples, like Melanie Klein, did, between fantasy, or conscious whimsy, and phantasy that never could be other than the unknown wishes of the Unconscious mind but this distinction allows the authors to correctly say that all such phantasy is mere fantasy on the part of any psychoanalyst (p194) who thinks that it exists; as is the Unconscious mind itself. Here, and below, I use a similar distinction between what is usually unconscious, like the workings of the autonomic nervous system [ANS], and the capitalised fantasy of the Unconscious mind. We are always aware of our own thoughts, though many of them, all of them that are on the periphery of our mind, as Michael Polanyi might put it, will be tacit, fleeting and very easy to forget; or even easy hardly to notice at all, unless we deliberately attempt to do so. Thoughts monitoring habits or skills are rather like that but, unlike the authors, who do say they are unconscious, they seem quite conscious, nevertheless, as far as I can see.
Although there was some psychotherapy in the USA before the arrival of Freud, indeed Benjamin Rush did practice it even before 1776, as well as many years after that date, Freud soon conquered the culture of psychotherapy in the 1920s, following his visit there. Soon the Unconscious mind meme ruled the psychotherapist roost such that the whole practise was very nearly uniform for about twenty years up to about 1945. But after then, the Freudian orthodoxy began to become fragmented with a general gradual drift towards what we today would label CBT, that the authors call the new psychotherapy.
Early on, the authors contrast the old with the new paradigms of psychotherapy, though out there today we would find various mixtures from the few old Freudian versions to many partial or complete CBT but with many others still retaining some version of the old ideas. The old therapy held that our childhood was important but the new therapy tends to hold that any emotional problems that we may have is more to do with our very recent or our current thinking or outlook (p3) but usually only towards the problem area rather than any explicit philosophy or outlook that we may have. Both the old and the new remain techniques rather than wholesale ways of thought. The old paradigm holds that our Unconscious mind is our own worst enemy, so it is near the adage that we are our own worst enemy but the new paradigm tends to hold that there is no Unconscious mind, though brain activity, like most physiological activity will be unconscious, in that it is nothing to do with the mind at all. The old outlook holds emotional problems spring from repressed memories but the new that what we have forgotten is more or less inactive as an influence on what we do. The old that dreams can show us what we do no longer know about ourselves but the new tends to hold the dreams are less important than our current waking ideas about things in relation to problems that we may cause ourselves but by ordinary error or delusion [i.e.
false belief in the ordinary sense rather than a fixed false
belief is as much of a myth as is the Unconscious mind is
but, sadly, the
authors tend to retain that myth, especially in their Paris
example] rather than by some perverse self-opposition; or is the Unconscious to be taken as second agent in the mind?
Both the old and the new paradigms tend to think we cause problems for ourselves but the old tends almost to think that there are two minds but the new that there is just one but that it may be erring in regard to the problems causing concern. The old outlook recommends that that we should let our anger out, for to bottle it up inside might lead to later problems but the new outlook of CBT holds that Aristotle was right that we often learn by doing, so to practice anger will merely aid it on its way to becoming our second nature, or a habit, thus will make us prone to being angry more often rather than getting it off our chest (p3). The old outlook holds that once we have relived the old problem causing traumatic childhood repressions then the problems they will cause will be solved. There is a bit of truth-likeness here as when we see error, as error, we do automatically correct it, thus we do normally eliminate the errors as soon as we ever realise them as such, so we do not need to be told to do this, but the CBT reply is that we do not need to recall the past to see error but we can errors in our current thinking where they are usually not one whit repressed in any way but rather all too conscious, even if not yet seen as error. Our emotional problems arise from what we openly think currently, or in the very recent past, rather than from a merely imagined mythical Unconscious enemy within (p4) that was formed in early childhood.
The authors are a bit Politically Correct [PC] in that they prefer to say “she” to “he”, maybe on the PC grounds of making up for all those decades where authors, of both sexes, used to put “he” instead of “she” (p4ff]. PC usually offends whilst pretending to be out to dodge offence. It is usually intolerant under the guise of pretending to be tolerant.
The authors report that the media have not noticed this emergence of CBT to replace the old Freudian outlook (p5). Even authors like the late Thomas Szasz, whom we might have expected to be up to date in those things, tended, rather surprisingly, to overlook the rise of CBT almost completely (p7) despite continuing as an active psychotherapist. He never wrote about his practical ideas on therapy but he did once have a debate with Albert Ellis, so he certainly knew about CBT (p8). New leaders in pop psychology or management leadership, like Anthony Robbins, are more up to date, though a few, like Wayne Dyer have passed though CTB on his way into fashionable mysticism (p8) after plagiarising many of Ellis’s ideas (p227). Most of the media maybe overlook the rise of CBT owing to it being eclectic or mixed, or bity, that it arose very gradually over 60 years rather than there ever being a clean break (p9).
Though the authors hint early on that college psychology never did adopt Freud or even any psychotherapy, they do not explicitly say so till later on (p236). It would have been clearer to say it in the opening pages as it might have made things clearer.
This neglect of psychotherapy may well be because college psychology sees itself as a science rather than being anything that is applied in any way, so any form of therapy might look to be more like technology than like science proper. In its quest to be a proper science, college psychology has tended to latch onto biology about as much as it decently can do so. But the odd bod, like the late Hans Eysenck, did have a few ideas that they might classify as mainly new as he did tend to change current behaviour without worrying much about the Unconscious mind and his son, Michael, is listed as being in the new CBT outlook (p272).
The authors set out to explain why the old Freudian ideas were wrong whilst they rightly think that CTB is on roughly the right lines, though it maybe still needs to make more progress. They feel that the common idea that drugs are enough without any psychotherapy is mistaken too but they do not thereby rule out drugs entirely, as it is fashionable to do. Drugs will become ever better designed but so will CBT. However, the Unconscious mind does look to be quite false. If this is right then there has been some progress over the last 60 years as during that time CBT has been replacing the Freudian outlook (p10).
One contrast is that the client, or patent, who needs the psychotherapy never gets to clearly comprehend the Freudian outlook, especially the Unconscious mind that remains forever hidden, or mysterious, whereas CBT is simple and up front, so CBT tends to free the client whereas psycho-analysis tends to reinforce the client as a client in the pristine serf-like dependent sense (p12). The authors do adopt this word “client”, as do many companies, but have they looked it up in the dictionary? My dictionary says it means a vassal, a dependent, or a hanger on.
The old outlook, like the Bible, tends to distract the searcher for solutions of life problems with ideas tangential to their actual problems whereby the problems might vanish owing to the passing of time, or by being crowded out by new preoccupations, rather than by directly dealing with the problems, as the more germane CBT does. “Several years in therapy would be perfectly normal”(p26) but during that time many personal problems that we have will simply ebb away in any case. So a lot of credit will have been given to psychotherapy by the fallacy of post hoc ergo propter hoc.
As parts of the new CBT outlook has been adopted by nearly all surviving versions of psychotherapy, some of the success of even the very oldest surviving versions might be down to the bits of CBT that have been adopted (p17) say the authors, but it might also be down to displacement by other things or by the passing of time, as well as by sheer placebo, a faithful alley of all medicine.
Aspects of Buddhism do not seem alien to CBT but even more is it the case that CBT is rather like the old Stoic ideas of the Greeks, and their Roman epigones some 2000 years, or even more, back, especially Epictetus (p24). The Stoics were often slaves, so they were clients in the pristine sense, but they learnt that we had to solve our own problems (p25). One of them even became a Roman Emperor. There were a lot of such Stoic philosophers. Some of them were also pioneers in modern logic, not rediscovered until the nineteenth century by Frege. So CBT comes from a home of outstanding theoretical success.
CBT is not just a talking cure but requires what some Christians might call repentance, or reform of our habits or of our ways of thought too, or, as the authors put it, CBT also involves homework exercises for the client that can be done “by herself” away from the therapist (p25). They later add that it might be seen like maths training. Thought this reform may take a while it is not often, if ever, going to be years for usually it takes no more than about twelve forty-five-minute sessions (p28).
People often feel they should be upset, if they are to be normal at all, when bad things occur. If they suffer an ordeal they feel they might suffer from Post Traumatic Stress Disorder [PTSD] (p29) or when a beloved friend, or sibling, or parent dies then some even feel it shows that we never loved the departed at all if we do not openly demonstrate our emotions but this is a mere myth for it certainly does not follow. In such indulgence, we may merely just needlessly prolong our sorrow to no useful end for we cannot thereby aid the dead beloved (p31) Richard Kujoth, one of the authors, was thought to be inept when he suggested that we might be better to not be so disturbed by the death of a beloved person as it hardly aids anyone to indulge in such flamboyant emotion (p33). Emotion is not there inside people that can get pent up if it is not released but rather it is created by our current ideas as part of an experience rather than being completely dispositional or pent up.
The old idea of depression was to do with anger against oneself, so if it is released out then the depression will vanish, but this is not how anger is (p34). It is not stored up inside but rather exists only to the extent that it is felt or produced. We may be disposed to anger, just like we may be disposed to believe this or that, but both need some current activity to actually exist. Mere disposition can only be a factor in the final phenomenon. To be merely disposed to anger is not to be actually angry (p34). Anger flows from foolish current thought, that we overlook as such, (p35) such as when we think that things should not be as we can see that they actually are, but we may cool it, or prevent it, if we more realistically accept things as they are rather than protesting at things, especially thinking they just must be different, as if our anger were a useful form of magic, instead of more realistically doing something practical about it, even if it is not going to be very effective in the short run, or may risk failure even in the long run. Our expressing any emotion tends to reinforce it (p36). To cure anger, we need to see it as foolish. In nearly every case, it will be based on unrealistic ideas, a sort of magical thinking as if reality can respond to our angry wishes. If ever we think clearly, then our anger will dissolve. Clearer thought is likely to be more accurate in reflecting reality (p46).
The authors warn the reader of the book that merely reading about psychotherapy will no more allow one to benefit from it that will watching people exercising cause one to lose weight (p40) but it will aid an understanding of the different sorts of therapy. If the description given of CBT in the book is right then indulging in Stoic-like clear thinking will yield some of the benefits of it in the way that some physical exercise might aid us to lose a little weight. We may need to both shed our delusions on the one hand and develop skills that deal more realistically with our problems on the other (p46).
David Burns has two ideas of fortune telling, of assuming a known fixed future as well as mind reading, which tends to assume that others are thinking the worst about things. Both might be attempting to prematurely settle matters on the down side to gain a relief from more realistic uncertainty but clearer thought might get us to resolve the uncertainty by checking up instead (p52).
Viktor Frankl had the idea of paradoxical intention, where one might deliberately attempt to bring about a fault that may be feared, like a stammer, for in this deliberate attempt the fear we have of it might well diminish (p64). This looks like the inverse of the celebrated meme of the law of reversed effort, which holds that when the will and the imagination clash, the will tends to lose out, for if we wilfully reject something, like smoking or wilfully keep to a diet, then the imagination might aid us to see that smoking just the one cigarette or just the one slice of cake as very tempting. This is why diets with no limiting rules like the Atkins diet can do better as they remove this imaginative temptation.
A lot of rather foolish ideas that Feud adopted were also largely adopted by common sense in the conventional wisdom sense with the result that they do not seem as silly as they otherwise might (p69).
Freud did not invent the idea of the Unconscious mind (p72) for many authors, like Nietzsche had it and Schopenhauer had it before Freud was born, but those authors are greatly over-rated too, as truth finders, but like Freud they did not do so bad at producing literature, even if they failed as truth seekers. We are told that Freud added to the false ideas associated with the Unconscious mind and that may well be the case but the two authors that I cite here as forerunners did have very clearly false ideas about it. They are also two authors that Freud read, at least to some extent. Indeed, Freud wrote that Nietzsche’s premonitions and insights often agree in the most amazing manner with the laborious results of psychoanalysis. But the reader of this book will get an accurate account of how laborious Freud was in those pursuits.
Popular ideas are a bit more realistic for often people seem to assume a false but reasonably realistic idea, such that if we sleep on a problem, in mathematics, say, then it might well be clearer the next day or when we look at the problem again later (p72; also p207-8). This is because our brain is not completely unlike our muscles that we break down in heavy exercise but will rebuild stronger to cope with the task better after a day or two, usually to be strong enough to cope with the fresh work that we need to do. Similarly, a new tough problem in mathematics, especially when we are learning a well beaten track as school pupils do, might lead us to cut new dendrites in the brain, that, after a day or two, might well lead to a better trained mind that may well see the problem as way easier, or more familiar, but this will be a mindless physiological development rather than one in an unknown, or unaware, Unconscious mind. As Sartre said, the Unconscious mind looks to be intrinsically contradictory, but as the authors repeat, many developments in the brain are quite unconscious but not thereby to do with a mind of any sort. The brain itself is not a mind, though the working brain may well be what gives rise to consciousness.
The authors say that Freud changed his mind in 1897 from holding that all had sexual experiences in the first six years to the more realistic, if still false meme, that we all tended to merely imagine that something like that has happened to us but Freud never openly admitted to this amendment. It held that we all only wanted to be seduced in our first six years rather than his earlier idea that it actually happened (p73). This is far more realistic. It better fits the actual fact that such early sex only rarely happens. But even merely wanting it, according to Freud, was only in the Unconscious mind, so there no chance of us ever getting to know this without the benefit of prolonged rather expensive sessions in psychoanalysis.
The authors note a distinction between phantasy and fantasy such that the former is only of the Unconscious but the latter we will be quite aware of, even if others never are. This infant desire for sex is a phantasy that we cannot recall. Freud requires us all to begin with male minds such that we all suffer from the Oedipus complex, but girls later develop a female mind. This idea was made a sacred dogma of psychoanalysis such that anyone questioning it would be expelled as not a proper psychoanalyst (p73). The two sexes diverge at about the age of five when boys fear castration whilst girls experience, at least in the Unconscious, penis envy (p74). This tends to make girls feel inferior.
If ever a man says that he never wanted to kill his father to run off with his mother, he might say he prefers way younger females, for example, then he must be resisting the truth, so he must be in some sort of trouble (p74) in denial, indeed. But any conscious plans to replace the father as the mother’s lover that he might confess to, if ever he was that eccentric in life, would not relate to psychoanalysis at all, for it all needs not only to be only in the Unconscious mind but also to be a mere wish that we do not ever experience in an aware way even in our first six years of life (p75).
Psychoanalysis became very popular in the USA, though it was a country that Freud despised (p78). Popular movies like Alfred Hitchcock’s Spellbound (1945) helped to popularise it (p79). It became part of folklore or common cultural knowledge in the way that most know that vampires hate daylight. Any denial of this was evidence that Freud was right. Freud knew that all his female patents fell in love with him (p81) but, like Mandy Rice Davis, he fully expected that they would deny it if ever they were asked, for they would, wouldn’t they?
However, though psychoanalysis did well in psychiatry and in wider popular culture it never did so well in academic psychology (p83) that was dominated by behaviourism instead. It had a better run in the colleges in literature courses than in psychology courses, which is apt as Freud’s books are not so bad as literature. Similarly, Schopenhauer, who greatly influenced Freud, though greatly influenced by philosophers like Kant and Plato is way more like JRR Tolkien in his literary output, as is Freud too, than most philosophers, for he too tends to abandon the aim of truth.
As a method of treating depression psychoanalysis all too often gets things exactly wrong, such as with the idea that depression is pent up anger so the solution is to get the person to let the anger out. Depression is rather the idea that things are worthless whilst anger usually arises from things not going as smoothly as expected, so there is not likely to be any anger in the depressed person to let out (p83).
It is still common sense to look for agreement, but Karl Popper in the twentieth century (p91) saw that the mere passing of tests may not refute a theory even if it is false, but any number of ideas may seem to confirm almost any theory when way fewer might refute it. As refutation narrows the germane theory we would do better to attempt to refute. However, a failure to refute does not mean the theory is actually true so we always need to retain the rather odd Popperian duty to continue try to refute our pet theories, just in case they might be false, even after all their success in tests so far. This vital aspect of Popper is still alien to common sense.
Popper saw that Einstein had a distinct outlook from Freudism, Adlerism and Marxism in that he did not bother with mere confirmation but rather tested by attempted refutation. We would be more to the point to ask what difference it would make to the world if the theory were false rather than asking if we can see how it might be true (p92). Sidney Hook used to ask the psychoanalysis how we might know if a child lacked the Oedipus Complex. He put that question to them for over forty years that he paid attention them, or he asked what an adult who lacked the Unconscious desire in the first six years might be like (p95) but he got no answer on this over all that time. Instead of answering, the Freudians rather thought that Hook was a bit twisted for asking them that question (p96).
Whenever psychoanalysts disagreed with Freud they tended to be expelled from his movement. Soon both Adler and Jung were thrown out so each set up their own movement. Both retained the Unconscious mind but both revised ideas about it but both their conclusions seemed to be the same as if there was no Unconscious mind at all (p96). All three paradigms had plenty of confirmations but if any one of them were true then the other two would have to be false, as they did often contradict each other (p96), though all three might be false nevertheless. How would we know? It was not like in chemistry or physics where experiments needed to be reproduced by other psychoanalysts (p96). In science, an experiment gets nowhere near a physics textbook until it has been repeated many times (p97). But the free association of psychoanalysis can lead to any number of different results (p98) as it is all rather arbitrary. It is the input of the psychoanalyst that determines the conclusion rather that the discovered congruence of the assumptions made with the external world.
Freud set the emerging psychotherapy movement back with his 1909 visit with Jung and Ferenczi for the likes of William James and Josiah Royce were developing a form of psychotherapy that was way ahead of psychoanalysis in being germane to anyone’s actual problems (p114). Freud began a fashion that wasted some fifty years in the normal progress in psychotherapy with his wild goose chase into his revised version of Greek mythology but mainly with his bogus idea of the Unconscious mind, that alone allowed the wild goose chase to go unchecked or even unnoticed.
Freud tended to be cultish in that he fell out with those who disagreed with him. He began with Dr Josef Breuer who would not agree with the sexual basis of neurosis that Freud had assumed. He rejected Breuer for not agreeing, only to take up with Dr Wilhelm Fliess instead. But he soon rejected Fliess for not fully agreeing too but in each case he retained many of the ideas that the rejected men had contributed as part of their joint outlook (p115). In addition to rejecting his former friends Freud also held that they were mentally ill as well, so he did not need to deal with them seriously afterwards, or even speak to them at all. He tended to do the same with later rejected followers, saying that Adler had insane ambition (p117). Similarly with Wilhelm Sketel too (p118) from whom he retained some ideas on dream interpretation (p119).
For years, Carl Jung was due to take over after Freud, but gradually he developed his own ideas, one of which was that the mind was the collective unconscious (p121) external to the body, rather as Plato held before rejecting it in his old age along with the meme of the soul and even his Forms, and Jung also took an interest in Gnosticism, which is also a rather Platonic paradigm. Jung’s version of depth psychology is today more successful than Freud’s outlook, but no more useful as a technical psychotherapy (p123). Adler is the most realistic of the big three as he alone took notice of what the patents said (p117), an odd thing for the rest of the Freudian fad to ignore but the hallmark of psychoanalysis to always do so nevertheless. Indeed, Adler was maybe never a complete Freudian (p124). He went on to reject the basic myth of the Unconscious mind entirely but he retained the major idea of Freud of the vital importance of early childhood.
Recent studies, such as those of Judith Rich Harris, have suggested that how we are brought up does not matter very much to how we turn out as adults (p135). Our peer groups in our pre-teens and teens seem to be a bigger influence than do our parents (p135). In any case, we soon very often feel to be different from when we were young, but even if we do not, the influence of experience from decades ago are not likely to restrict our fresh thought today. We are free to re-think. Any influence we have from earlier decades will be to do with our recent quite conscious affirmations of it rather than it relating to our infancy and the non- experience of our Unconscious mind back then, as Freud oddly held and as he attempted to superimpose onto his patients.
In 1923, Freud innovated the id, the ego and the superego where all three were held to have both conscious and Unconscious aspects (p130). This new theory was more realistic, as it related to experience sometimes for we often do feel that others feel the same as we do for example (p131).
Carl Rogers has a person centred therapy (p136) but shuns saying anything by way of instruction (p137) but rather, in the spirit of Socrates who insisted that he knew nothing, leaves it to the patients to sort things out for themselves, as he merely aims to draw the ideas of the patient out, or to assist in self actualisation (p138). The authors say it could be the nearest thing in psychotherapy to a placebo (p138) but all medicine is aided by that phenomenon.
The authors say that with existentialist psychotherapy there is a flat contradiction between the notion of no prior essence and self actualisation (p140) which is the case if we follow Sartre but not with Heidegger or Japers, that Sartre did think he was at one with, but whom both disowned the idea of existence precedes essence in the immediate wake of Sartre’s 1845 lecture. Heidegger, in particular, thought there was a set authentic self that we should seek out if ever we are to truly care, but if we shun that task then we will be inauthentic.
The authors note academic psychology never adopted psychoanalysis as they had instead adopted behaviourism so they looked rather at conditioned learning (p145) as well as linking up with biology so it might be accepted as a science better, as Pavlov was accepted physiological science, even by winning the Noble Prize. Conditioned learning uses aversion therapy that associates the pleasure we might be indulging in too much, like alcohol, with an electric shock to discourage it, or maybe more humanely by just asking the patient to imagine an unpleasant thing that might thereby be associated with it (p146) which might be seen as less sadistic than the shocking alternative. The authors say that it has not been very effective, so is not now often used.
Joseph Wolpe, a medical officer in the South African army, found that just talking about the phobias they had rarely got affected soldiers to shed them. He favoured behaviour therapy so he attempted to get the patients to relax whilst, by degrees, thinking of things similar to the phobias then finally the phobias thus learning to be more relaxed about things they had earlier feared in the future (p146). This showed that the pristine experience of the phobias did not need to be recalled or that the Unconscious mind was involved (p146). Learning a new association was enough. But it did involve the conscious cognitive mind that involved the patient’s imagination. It worked well for phobias, but less well for depression, as it still tended to ignore the beliefs of the patients, but by the 1950s, many were converging from the failure of earlier therapy to pay more attention to what the patient thought was the case (p147). Both within and without psychoanalysis, there was a tendency for critics and reformers towards looking at how the patients felt at the moment or currently. Therapy was ready for a breakthrough.
Since the1970s, many have began to think that Freud might be dishonest such that we now know that he was habitually inventive in both his research and his reporting of those laboriously earned case results (p149). Some critics have blamed this habit of dishonesty onto the use of cocaine that Freud also recommended to his fiancée as well as to his patients (p152). Freud had first thought that the best idea was that all neurotics had experienced sexual encounters in childhood but he later realised that it was better to hold that such instances were merely imagined in the Unconscious wishes in all people but that the neurotics had not quite repressed them as normal people did.
This change from actual experience of neurotics to imagined experience by all that was made by Freud to his ideas in 1897 was important as it lead to psychoanalysis (p153). Jeffrey Masson in his book The Assault on Truth (1984) held that Freud was thereby covering up the near universal fact of the molestation of children, to the delight of many feminists, but he was just as hopelessly wrong as Freud was (p153). Freud was merely assuming both of those ideas for the sake of his developing theory (p154) but he never held that it was the parents who thus abused their children. He even had this theory of infantile sex before he thought up the Oedipus Complex (p154). On the old idea that Freud was honesty reporting cases that he had laboriously worked on, this change in the patients testimony occurring neatly in 1897, such that all reported abuse beforehand but none afterwards might seem a bit odd (p155). But Freud was interpreting the patient all along in terms of his theory rather than ever paying too much attention to what they actually said, so this change of theory never was based on what they ever said to him. That the cases he reported were ever clinical, or discovered at the bedside, is quite false (p156).
How far was Freud deluded (p157) rather than being just a liar? The authors feel he must have known what he said was false in the mundane sense (p158) but they tend to overlook that with ideas of truth, like Nietzsche’s, that Freud was so keen on, that the truth is not so much the vulgar everyday honesty. Rather truth is to do with the superior myths that we find useful, that work for us or merely cheer us up [somewhat similar to the pragmatists of the USA]. So Freud could be proud of his will to power. He would not see that as backward, or corrupt, no more than Nietzsche did, but quite the contrary. The fact that psychoanalysis was not vulgar, or not using the mundane idea of the truth that relates only to mere facts, as the rabble do, was hardly something that a superior person, like Freud, would ever be ashamed about.
We are not aware of many things that go on in the brain but we are always aware of our mind, for the mind is just the name we give to what we are aware of. We can call anything that we are not aware of, that goes on in our body, unconscious but it is not likely to ever be a rival agent. Oddly, Freud’s idea fits the pristine schizophrenia idea of being in two mind with the Unconscious mind as a hostile second agent but nowadays most books on that topic of schizophrenia disown the two minds idea in the opening pages. As Szasz rightly says, the psychiatrists retain the term as a blanket term for many different symptoms. They are fond of it for some reason or other. They do not say we have two minds.
The authors feel that most of our habitual or skilled behaviour is unconscious (p185) but that looks a bit exaggerated to me. We do monitor our skilled or habitual behaviour. It is almost automatic but never quite so. It needs some mindful input or attention. But we can focus on other things when walking, or working at tasks we are stilled in, but such tasks are never automatic, like breathing, or any other function of the autonomic nervous system [ANS] normally is. However, the authors write at length as if they feel it is.
This idea that we type without thinking at all once we have mastered touch-typing (p186) is somewhat similar to thinking that we dream unconsciously simply because we cannot recall our dreams later. There always is a conscious input.
The authors similarly conflate knowledge with belief. Knowledge is in the disposition but belief simply needs some current conscious affirmation, which always constitutes some revision or a loose tacit testing. We are disposed to believe this or that but we only finally believe whatever we do believe because at the current time we think it is true and that can only last a moment before the next belief or some slight revision. Beliefs are used up about as rapidly as we use up an intake of fresh air. We then need to make a fresh assumption, even if we retain the earlier content almost entirely, or even entirely, in the aftermath. Our idea of how things are now needs to complement any disposition, or mere bias, that we may have. “We all know many thousands of facts that we are not currently thinking about” (p187) but we have no such beliefs out of our consciousness or outside our minds. It may seem that we store facts in our memory like old photos but with memories, if not quite with beliefs, the authors realise that is a delusion. But they fail to realise that beliefs, like recall, need current fresh inputs.
Freud uses the idea that all we know that cannot be recalled is in the Unconscious mind to get this idea home as a clear reality. He makes a distinction between the Unconscious mind and the preconscious for the latter is in the vastly bigger Unconscious mind that we mostly have no access to at all but we can recall this preconscious subset (p187) even if we often have mental blocks with it. Repression causes both, holds Freud (p188). It may not be linked to anything unpleasant that we can see, but that we cannot see the cause will be owing to repression too. Freud held that most ideas were Unconscious (p189) but otherwise the Unconscious ideas were like the conscious ideas that we are aware that we have.
Some people might suppose that a modern calculator contains the answers we get out of it whenever we use it, instead of it producing them in response to the keys that we press. They might think it is rather that the machine locates the answer in memory (p190). Similarly, when we recall that Paris is the capital of France, but no sooner, we will then reproduce, or become aware that Paris is the capital of France. Oddly, the authors say after this about the calculator: “Knowledge, like belief, is a disposition” (p190). Neither seems to be quite the case, as the calculator example tends to suggest that what is displayed depends on current input rather than mere disposition. So what complements the disposition decides what is displayed. Fresh stimulus matters more to any actual belief than the latent capacity of the person concerned. Moreover, with memory it is common to take time to recall, though we nearly always have a rough idea of what we are attempting to recall, and we more often do recall immediately, but beliefs, by contrast, are always immediate. They are basically a check up our immediate environment as regards to its safety and the like at the current moment. Belief is always some reconsideration or a check on reality.
Paris has been the capital of France for decades but English speakers have altered Peking to Beijing relatively recently, and few people will miss that change of name if you ask them what is the capital of China is today. The normal human mind revises, or even errs, way more than any normal calculator ever will. But then the authors know that the mind is not like a calculator (p191). They know that belief and memory both require current input, which is what the calculator example is used to emphasise. What is cognitive is never a simple repetition, as we often get with the ANS, that is usually unconscious, and not one whit of the mind but certainly of the brain, most of which seems to be free of ideas: indeed there are no unconscious ideas (p192). But all beliefs are to do with currently thought ideas too, but the authors do not seem to realise that fact.
Fresh data is always sought whenever we think, be this in recall or in what we think is the case (p192) but we often feel, as when we think that Paris is still the capital of France, that there is no fresh relevant data in many particular cases. Sometimes that is right. To revise is not thereby to amend the contents. But it is to seek to amend them. To think at all involves some revision of what the world is like, even if it is only our immediate world. To believe is to slightly test. It is to come to a slightly fresh conclusion. Thus when we say we have believed things for ages that is not literally true, no more than one breath of air can last for more than a moment so no actual physical belief can either, but, on the contrary, it suggests that what we say the content of what we believe has past many such momentary tests provided by the production of actually fresh beliefs, tests done about as often as we take in fresh air. The belief is the idea that the content is true, not the mere reproduction of the content itself. We can reproduce the mere content just as well once we feel sure that it is false.
Dreams are quite conscious (p194) though we usually forget them rather rapidly, as they do not relate to real objects as well as do waking experiences, so they lack natural mnemonics that aids most of what we usually recall, as most of what we recall is by recognition. As we tend to forget most dreams we tend to underestimate how aware we are whenever we do experience a dream. We similarly forget most of our off-focus thinking in what we habitually do but, contrary to what the authors argue in their faulty accounts of habit, we are presumably still quite aware at the time when we act. Habit may well require less attention but it does require some attention.
“We do have unconscious dispositions to have thoughts, memories, and emotions” (p195) say the authors. But experience needs to complement them to become ideas, though they do, for some reason, want to deny that beliefs need to be ideas or current automatic aware assumptions.
The authors adopt an idea of logic as relating only to language rather than also to viable options when they say that logic “alone doesn’t give us any information about what may or may not happen (p197) but logic is about valid options as well as about inferences between propositions. If we can prove that something is impossible then we are not merely on about language, or what we can coherently say, but rather about realistic options. Logic is sometimes called proof theory.
One of Freud’s ideas is the common one that people cannot stand too much reality. But “there is no such thing as repression” (p198). This ideal that people cannot tolerate reality seems to be the opposite of the truth that what most persons find hard to stand much of is what they think to be stupidity. Many people openly tell u that they just cannot tolerate fools. Reality is automatically sought after by our belief system but what looks to people to be stupid is thereby automatically rejected, even by the more tolerant people who want to be kind to fools and even if it is actually very worthy paradoxical science. We do believe the most unwelcome news, like the death of beloved friends, near relatives or parents, in a jiffy, though we may lament the news for decades. We do not usually repress such bad news, if any of us ever at all. The sentence “I can’t believe it!” usually, ironically, reports that we plainly do believe it.
The book only considers declarative long-term memory, as that is the only kind that involves the Unconscious mind meme. It does not thereby deny other kinds of memory (p203). There maybe a Pavlovian association that affects us unwittingly that we have forgotten (p204) but the authors say that is not an indication of an unconscious mind. Most such associations soon fade, of course. Training can result in associations that soon ebb. The saying use it or lose it is often applied to such past training. Anyway, what is truly unconscious has no mind (p205). But the authors do not deny that future word usage might take a lot of the clearness out of Sartre’s repeated statement that the Unconscious mind is a contradiction in terms, but they also note that it has not happened yet; despite the popularity of the Freudian outlook over the last hundred years or so. Current usage still makes Sartre’s criticism look pertinent.
The chief reformer of psychotherapy in the last sixty or so years is Albert Ellis, suggest the authors (p211). He realised that if you face up to what you fear then usually the fear will often ebb. He found this to be the case as a young man with both his shyness with females and with public speaking too (p213). The more he tried facing up to the fear, by taking to the females or attempting to speak, the more it ebbed. He had a degree in business administration (212) but found he enjoyed helping people solve their personal problems so he took an MA in clinical psychology at Columbia University in 1941. Then he began a five-year PhD course in psychology (p214). He then joined psychoanalysis so he was analysed by Richard Hulbeck. He applied ideas he found in the books of Carl Rogers but thought that more rather than less direction was needed, so Ellis was contrary to Rogers in that (p214). By 1953, he set out to reform psychoanalysis but this eventually ended up by his abandoning it instead (p216). The new ideas were called Rational Emotive Behaviour Therapy [REBT] (p220) after beginning as Rational Emotive Therapy (p219), the behaviour addition emphasising the need to act, or reform, as well as just to think in order to solve problems. He learnt quite a bit from philosophy, especially from the Stoics, who tacitly held a version of Hume’s later explicit is/ought distinction, as they saw that we had some choice in response to what we did about any factual situation. The mere facts could not dictate what we ought to do.
Ellis also took a somewhat pragmatic idea of the facts, questioning whether the analysis was factual if our ideas did not work for us (p216). He did not give a proper theoretical account of REBT, despite writing 85 books (p217). He adopted the idea of Epictetus that “What upsets people is not things themselves but their judgement about things” (p218). But he thought we had an innate tendency to adopt unrealistic expectations of what we feel we just must do, that tends to cause emotional problems for us whenever our expectations are seen to be unrealistic, regardless of any childhood experience that we might ever have, or have lacked (p220). Ellis lived to see that the books of David Rowe and Judith Harris, that seriously challenged the traditional psychoanalytic paradigm about childhood in the 1990s (p221).
The ABC causation that Ellis saw emotional problems emerge is in the activating event [A] the belief or value [B] that has the problem as a consequence [C] (p221). To solve the problem we need to dispute the belief or value [D] attempt to find a more effective value or to eliminate the false belief, if it is false [E], that should lead to a new feeling or behaviour [F] (p222). Ellis realised that how we feel depends on what we are thinking, or were recently thinking. Life may not be what we make it, or things may never be as we might ideally wish, but despite that, reasonable satisfaction, or general contentment, seemed to him to be within the reach of nearly all of us, or even all of us, by just sheer clear thinking. I think he got it basically right there. As Spinoza once said, to understand all is to forgive all, for if we think clearly we will usually not want to reject the world.
That is not to deny that, in a few cases suicide, or truly rejecting the world, might be the best option, such as if we face prolonged unavoidable painful cancer with unsatisfactory chemotherapy, for example. But such examples are not very common. Even if we decide on suicide today, we still may make the best of our last few hours.
The authors criticise positive thinking (p224) and self esteem (p225). To say things are good, when they seem to be bad, looks futile. Albert Ellis opposed the recently fashionable self esteem movement that similarly attempted to boost only esteem rather than building it up by performance but Ellis held that it was an error to even attempt to rate yourself anyway. It is almost like searching for a likely disappointment. We need to accept ourselves as we are, but that is not quite unconditionally, though Ellis says that it is. It is rather just a bias towards oneself. Similarly, the mother who says she loves her son unconditionally has already stated the condition that he is her son. Unconditional love is a myth.
High self esteem can lead people into being thugs (p227) People can become impatient with those they think are inferior if they do not get the respect that is thought to be their due and they may then feel that they have a right to rob those inferior others. Psychoanalysis has held this to be really, or secretly, low esteem but independent researchers have not seen much sign of this behind the appearance of high esteem, say the authors. Instead, the high self esteem of the thugs looks like one of the causes that have lead them to abuse other people (p227).
Aaron Beck tended to follow in the steps of Ellis after a common start in psychoanalysis, though his books tend to be a bit more academic (p229) but there is one thing he has not adopted. He tends to be a bit less inclined to instruct than does Ellis, who mainly sees the adoption of the idea that we must do this or that as a major, if not the main cause, of emotional problems. Ellis even calls such ideas “musts”. His advice is to drop them. We need to replace the “musts” with the milder idea that we would ideally like to do this or that but we always need to drop the idea that we must do it.
This “must” fault is the idea that we have a God-like power to say what reality should be like, with hubris expectations that reality will obey us, as it might obey the thought of God if ever he existed but with humans it often leads to a nemesis of emotional problems when reality fails to conform to what we feel must be done. We need to dodge any “must” meme, but if we do drift into such expectations then we need to cut our loses by accepting ourselves as we are and things as they are rather than clinging on to the hubris “must” meme. Beck tends not to adopt that “must” idea (p233). Instead, Beck tended to look at the whole of the persons outlook rather than targeting only the unrealistic demands around “must” (p234). This tends to make therapy with REBT shorter and more to the point than is the therapy of Beck.
Psychology and psychotherapy have been distinct, as are science and technology, but there has been a rise in cognitive ideas in both since about 1950 and Martin Seligman is unusual in playing a part in both, against behaviourism in the colleges and against psychoanalysis in psychotherapy (p237). In working with dogs in 1965, Seligman noticed they unusually gave up rather than learnt along behaviourist lines, but other trainers then just found other dogs. Seligman saw that some humans also similarly learn to give up. Pessimists see poor results as permanent whilst optimists see them as a temporary hitch (p238). He began his own paradigm of positive psychology and also of positive psychotherapy too, with the aim of looking at how things go right rather than at how they go wrong, that he thought there was more than enough of already (p239).
CBT therapists in general hold that they can aid people to eliminate errors or dysfunctional behaviour that gives rise to emotional problems without affecting their normal outlook and beliefs apart from a few beliefs they have relating to the problem. This is a bit like losing weight or training to solve maths problems (p244).
The authors give a good exposition of Popper’s philosophy in the appendix (p255ff).
I think the authors are right when they, more or less, say that the Unconscious mind is a complete myth.