The Buddha's teachings compared to Cognitive Behavioural Therapy (CBT)
According to Wikipedia:
Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, and disorders such as PTSD and anxiety disorders. This therapy focuses on challenging unhelpful and irrational negative thoughts and beliefs, referred to as ‘self-talk’ and replacing them with more rational positive self-talk. This alteration in a person’s thinking produces less anxiety and depression. It was developed by psychoanalyst Aaron Beck in the 1950’s.
The Buddha’s phenomenological framework, definition of dukkha (“suffering”), and the subsequent path to liberation is consistent with the principles of CBT. According to dependent origination, our negative experience of dukkha is a form of cognitive distortion - our craving for pleasure and permanence, as well as our fear and loathing of physical pain, sickness, aging and death are mental constructs, and moreover we are ignorant of the ephemeral and constructed nature of our consciousness. In “reality”, living beings arising and dying are the result of natural processes, and the notion of “self” is a generated mental construct that is impermanent, perennially changing and unstable. Once that is understood, there is no necessity to crave for what we cannot have, or fear what is inevitable. By controlling and curating our mental constructions, we can achieve an optimal living experience devoid of dukkha.
The main assumptions of cognitive therapy used in CBT 1 aligns well with dependent origination, the four realisations and the structure of the saṅgha:
| Cognitive Behavioural Therapy assumptions | The Buddha’s Teachings |
|---|---|
| Human emotions are primarily caused by people’s thoughts and perceptions rather than events. | Dependent origination |
| Events, thoughts, emotions, behaviors, and physiological reactions influence each other. | Dependent origination |
| Dysfunctional emotions are typically caused by unrealistic thoughts. Reducing dysfunctional emotions requires becoming aware of irrational thoughts and changing them. | The second realisation (noble truth) concerning the origin of dukkha |
| Human beings have an innate tendency to develop irrational thoughts. This tendency is reinforced by their environment. | Dependent origination, and also the first realisation (noble truth) |
| People are largely responsible for their own dysfunctional emotions, as they maintain and reinforce their own beliefs. | Dependent origination, and also the first and second realisations (noble truths) |
| Sustained effort is necessary to modify dysfunctional thoughts, emotions, and behaviors. | third and fourth realisation (eightfold path) |
| Rational thinking usually causes a decrease in the frequency, intensity, and duration of dysfunctional emotions, rather than an absence of affect or feelings. | third and fourth realisation (eightfold path) |
| A positive therapeutic relationship is essential to successful cognitive therapy. | the Saṅgha |
| Cognitive therapy is based on a teacher-student relationship, where the therapist educates the client. | the preceptor-novice relationship in the Saṅgha |
| Cognitive therapy uses Socratic questioning to challenge cognitive distortions. | uposatha confessions in the Saṅgha |
| Homework is an essential aspect of cognitive therapy. It consolidates the skills learned in therapy. | fourth realisation (eightfold path) and also the basis for the vinaya or rules underpinning the Saṅgha |
| The cognitive approach is active, directed, and structured. | fourth realisation (eightfold path) and also the basis for the vinaya or rules underpinning the Saṅgha |
| Cognitive therapy is generally short. | although renunciation and ordination are seen as lifelong commitments, the Khandhaka generally describes liberation as something that is achievable in a relatively short period of time, certainly within a lifetime |
| Cognitive therapy is based on predictable steps. | fourth realisation (eightfold path) |
Typical phases of CBT 2 also align well with the eightfold path:
| Phases of Cognitive Behavioural Therapy | Eightfold path |
|---|---|
| Assessment or psychological assessment | Right Awareness (sammāsati) |
| Reconceptualization | Right View (sammādiṭṭhi) Right Intention (sammāsaṅkappa) |
| Skills acquisition | Right Speech (sammāvācā) Right Action (sammākammanta) |
| Skills consolidation and application training | Right Effort (sammāvāyāma) |
| Generalization and maintenance | Right Way of Living (sammāājīva) |
| Post-treatment assessment follow-up | Right Focus (sammāsamādhi) |
Although the above alignment could seem artificial or even contrived, the two approaches are clearly different articulations of the same fundamental principles. The Buddha’s teachings are more comprehensive and holistic, and the eightfold path is a more structured approach to achieving liberation. CBT is a more pragmatic approach to achieving mental well-being, and is more focused on specific techniques and strategies.
Footnotes
Section titled “Footnotes”-
Chaloult L. (2008). La thérapie cognitivo-comportementale: théorie et pratique (pp. 68–80). Gaëtan Morin. ↩
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Gatchel RJ, R. K. (2008). Evidence-informed management of chronic low back pain with cognitive behavioral therapy. The Spine Journal, 8(1), 40–44. https://doi.org/10.1016/j.spinee.2007.10.007 ↩