What does CBT have to say about emotions?

I’ve spent the day at Christine Padesky’s conference in London. An expert in her field, Aaron Becks Californian-based prodigy pretty much wrote the book on CBT.

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Listening to her today reminded me of what always fails to surprise me about CBT; the almost complete denial of past events and how they may be contributing to someone’s symptoms. CBT will work with what it calls core beliefs in longer term therapy, however as CBT is generally offered short term (especially in the NHS) the majority of the work is based on intervening at the level of the presenting symptoms, such as lack of activity, negative thoughts, etc.

I have written about the efficacy of CBT elsewhere. It is sufficient to say that there is no one size fits all approach to distress and a lot of people have greatly benefited from a practical skills based approach to therapy.

Attempting to answer the question posed by this post is a difficult one, the answer appears to be “not much”. Today we were given examples of current stressful events in a case study, these were cited as “environmental” causes or triggers for the emotion that was being experienced. The focus was primarily on what changes needed to be made by either changing negative thoughts or targeting behaviour that may be maintaining the particular emotion that the person has come into therapy for.

I wonder if CBT is doing itself (and the people who have no choice other than to accept it) a disservice by substantially ignoring the individual and collective causes that lead people to suffer in the first place.

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