The Philosophical Foundations of Cognitive Behavioral Therapy: Stoicism, Buddhism, Taoism, and Existentialism

In this study, we examine the philosophical bases of one of the leading clinical psychological methods of therapy for anxiety, anger, and depression, Cognitive Behavioral Therapy (CBT). Although the broad philosophical bases of CBT include the philosophies of Heraclitus, Stoicism, Epicureanism, Hedonism, Buddhism, Taoism, Existentialism, yogic philosophy, Baruch Spinoza, and Immanuel Kant (Ellis, 1997 p.5), our intent is to trace this method back to its philosophical roots in the Stoic, Buddhist, Taoist, and Existentialist philosophical traditions. We focus on these four schools of thought given that Ellis references Epictetus as the primary influence for his development of CBT. Taoism and Buddhism both are helpful to explain the process metaphysics that underlies the problems with categorizations that often lead us to become emotionally disturbed. Existentialism emphasizes choice and responsibility as possibilities for living an authentic life.We begin by discussing the tenets of CBT, and then we expand on the philosophical traditions that ground this approach. Given that CBT has had a clinically measured positive effect on the psychological well-being of individuals (Antonuccio, Danton and DeNelsky 1995; Dobson 1989; Robinson, Berman and Neimeyer 1990) it becomes important to study the philosophical foundations on which this therapy is based.Cognitive Behavioral TherapyExtensive research supports CBT as an effective non-pharmaceutical treatment for mood disorders, and we focus on the works of key scholars in CBT, Albert Ellis (1956; 1958; [1988]1990; 2007), and David Burns ([1980] 1999; 2009). Ellis, an originator of what has come to be known as CBT, ultimately named his particular approach, Rational Emotive Behavioral Therapy (REBT). He proposed an "ABC" model of cognitive behavioral disturbance (e.g., Ellis, [1988] 1990:52-7) marked by dysfunctional moods that diminished life satisfaction and happiness. In his theoretical model, the letter "A" stands for an activating event, "B" refers to a belief system, and "C" stands for the consequences of A through B. Although activating events cannot be changed, a change in the perception of A causes a change of B, and this, in turn, results in a change in consequences, that is, of C. The moods of individuals, then, the C's in the ABC model, can be transformed from dysfunctional affects such as depression, to functional ones such as moderate sadness, through a change in how activating events are perceived. A schema of Ellis' ABC theory of cognitive disturbance is as follows:Individuals' beliefs concerning the events they experience, the "B" in the model, can be considered their philosophical approach to life conditions. Ellis (1997; 2007) attributed his ABC model primarily to Stoic philosophy and to the Stoics, Epictetus and Marcus Aurelius in particular, although as we indicate in this study, there are other philosophical schools of thought that influenced CBT as well. According to Epictetus ([125 C.E.] 1991), it is not what happens to individuals, but rather how individuals perceive what happens to them, that determines their affect. Epictetus states, "Men are disturbed not by the things which happen, but by their opinions about the things."Ellis (2007) summarized his findings by stating that there are three fundamental sources of cognitive disturbance which he labeled "IB's" or "irrational beliefs," beliefs that caused individuals to react in dysfunctional ways to events in their lives. These three are: 1) "I must be successful," 2) "Others must treat me well" and 3) "Conditions under which I live must be agreeable to me." The "musts" are emphasized here because Ellis believed that simple concern does not lead to dysfunctionality among individuals. A "must" belief, on the other hand, does lead to psychological disturbance.It follows then, that according to Ellis, one of the main, if not the main, cause of human misery is grandiosity, that is, our taking ourselves too seriously. …