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Apologia Report 12:17
May 4, 2007
Subject: CBT overtakes Freudian psychotherapy
In this issue:
PSYCHOLOGY - new therapy now more common than psychoanalysis
SOCIOLOGY OF RELIGION - entire field summarized as "debunking"
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PSYCHOLOGY
"Patient, Fix Thyself" by Robert Langreth -- profiles cognitive behavioral therapy (CBT), which has dislodged preferences for Freudian psychotherapy by America's mental-health counseling professionals. Langreth calls CBT (which sprang from the separate efforts of Albert Ellis and Aaron Beck) "a startling revolution in psychological counseling that has taken four decades to unfold - and which now is spreading to the farthest reaches of American medicine." One patient boasts that CBT "'saved my life and gave me an entirely new worldview.'
"And that is the essence of CBT; Depression, anxiety and other ills aren't the cause of a cascade of debilitating thoughts and self-loathing - they are, instead, a result of the same. Eliminate bad thoughts and you can short-circuit bad feelings."
CBT, a term that first appeared in medical journals in 1980, "aims to push patients out of the shrink's office after only 10 to 25 visits, in sharp contrast to traditional psychotherapy that can run on for many years. ...
"In dozens of small patient trials staged over three decades, cognitive behavioral therapy has been shown to be surprisingly effective in quelling an ever expanding array of mental maladies...."
As you might expect, many traditional Freudian therapists are not so enthusiastic. "CBT is 'a simplistic method of treatment,' it is 'being oversold,' and it appeals to health plans simply because it ends so quickly, says Charles Benner, a psychoanalyst in New York and past president of the American Psychoanalytic Association.
"He practiced analysis for 60 years before retiring in 2001, seeing most patients four to five times a week for two to five years (and sometimes far longer). ...
"Yet CBT, in numerous trials, has been shown to be as effective in treating depression and anxiety as some of the pricey pills that have defined (and soothed) a generation...." Langreth reports that CBT is "at least as effective as drugs for virtually any nonpsychotic disorder."
"Among psychologists, CBT now has almost twice as many adherents as old-guard psychoanalysis, according to a survey by University of Scranton psychologist John Norcross. ...
"In 2004, 10 million Americans saw therapists, for a total of 84 million sessions, at a cost of close to $9 billion, up 40% in seven years, the U.S. Agency for Healthcare Research & Quality says. Cognitive therapy likely reaped a large share of that growth." More statistical and historical background is included. Cover story. Forbes, Apr 9 '07, pp80-86.
Counterpoint from AR consulting editor Mark Hartwig, who doesn't think the Forbes story is really all that significant: "Freudian psychoanalysis was already on the ropes when I was an undergrad psych major in the mid-seventies. That may not have been true of psychaitrists, but I think it was true of psychology as a whole - at least I think so. It was dealt a major blow by behaviorism and then another by the Third-Force psychologies of Abraham Maslow, Carl Rogers, Fritz Perls, Rollo May, Viktor Frankl, et al. I'd also heard of cognitive behavioral therapies, but the figure associated with that in my behavioral therapy class was Albert Bandura. Ellis was a pretty big name, too, but I don't think I encountered him in that context."
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SOCIOLOGY OF RELIGION
Invitation to the Sociology of Religion, by Phil Zuckerman [1] -- reviewer Thomas Robbins confirms a few ideas that many interested outsiders may have questioned at one time or another. "Zuckerman affirms that sociology is intrinsically 'debunking.' As 'intellectual investigators,' sociologists of religion seek 'to understand how it is that people can believe that which lacks reasonable evidence,' an example being Mormon doctrinal claims about Native Americans being descended from Middle Eastern Jews. Sociologists of religion study religious systems because, 'we yearn to understand how it is that our fellow human beings can join groups' and become committed to belief systems which necessarily appear to outside observers as 'unusual, counterintuitive or in outright contradiction to what we know of reality.'
"This conception of sociological inquiry into religion might appear to imply that the sociology of religion presupposes a more or less secular culture, and moreover, it should be primarily concerned with offbeat minority faiths which appear weird and esoteric to nonbelievers, to whom their beliefs will seem counterintuitive. From this standpoint it might not be possible to have sociology of religion in a deeply religious society, or in a society with a single dominant religion. ...
"'What makes religions distinct from other social collectivities: they are often based upon and centered on a body of explicitly extraordinary and often fantastic truth claims.' It is religion's 'unbelievable, fantastical, and unreasonable claims that makes religion a compelling topic for ... analysis and inquiry.' Sociologists of religion, such as this author, seek to comprehend 'why and how people can believe the manifestly unbelievable.' ...
"The proper sociologist of religion will necessarily possess a secular and skeptical orientation, since only a skeptical rationalist will be fascinated by and find problematic the persistence of the 'fantastical' beliefs of religion in modern society. For this reason the issue of the truth or falsity of religion cannot be avoided by sociologists of religion."
For Zuckerman, these "incredible beliefs ... cannot generally be attributed to psychopathology or brainwashing. ... [F]rom Zuckerman's skeptical, rationalist standpoint, all religions are essentially deviant cults with fantastic, unbelievable beliefs. Thus, 'explaining how millions of sound, reasonable people can believe the manifestly unbelievable is an unavoidable dilemma for the social scientist.'
"The problem with this interesting volume is that it doesn't really go very far in terms of sociologically explaining religious commitment or the development of religions." Robbins concludes: "Zuckerman's volume is really an introduction to religion from a sociological viewpoint, which may not be exactly the same thing as an introduction to the sociology of religion. But introductory sociology students could probably do a lot worse." Nova Religio, 10:3 - 2007, pp135-138.
POSTSCRIPT (Jan 16 '20): Also consider The Sacred Project of American Sociology, by Christian Smith of which the publisher says: "Counter to popular perceptions, contemporary American sociology is and promotes a profoundly sacred project at heart. Sociology today is in fact animated by sacred impulses, driven by sacred commitments, and serves a sacred project.
"Sociology appears on the surface to be a secular, scientific enterprise--its founding fathers were mostly atheists. Its basic operating premises are secular and naturalistic. Sociologists today are disproportionately not religious, compared to all Americans, and often irreligious.
"The Sacred Project of American Sociology shows, counter-intuitively, that the secular enterprise that everyday sociology appears to be pursuing is actually not what is really going on at sociology's deepest level. Christian Smith conducts a self-reflexive, tables-turning, cultural and institutional sociology of the profession of American sociology itself, showing that this allegedly secular discipline ironically expresses Emile Durkheim's inescapable sacred, exemplifies its own versions of Marxist false consciousness, and generates a spirited reaction against Max Weber's melancholically observed disenchantment of the world.
"American sociology does not escape the analytical net that it casts over the rest of the ordinary world. Sociology itself is a part of that very human, very social, often very sacred and spiritual world. And sociology's ironic mis-recognition of its own sacred project leads to a variety of arguably self-destructive and distorting tendencies. This book re-asserts a vision for what sociology is most important for, in contrast with its current commitments, and calls sociologists back to a more honest, fair, and healthy vision of its purpose."
Amazon includes: "'What, one might ask, could possess a well-established and well-known sociologist to write an account of his discipline as a sacred project while at the same time exposing its close-minded outlook? The answer Christian Smith provides is both bracing and sad, bracing in its thoroughness and originality, and sad in the very necessity to shine such a light on a discipline that is largely blind to the unintended consequences of its lopsided claims about the nature of social reality. Smith's observations are a carefully assembled, empirical confirmation that sociology still has important insights and ideas to convey to both students and the public, but that it has failed decisively in its efforts to account for life beyond the very narrow confines of its own expectations about what is right and wrong with that life.' - Jonathan B. Imber, Jean Glasscock Professor of Sociology and Editor-in-Chief of Society"
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Sources, Monographs:
1 - Invitation to the Sociology of Religion, by Phil Zuckerman (Routledge, 2003, paperback, 192 pages)
<http://www.amazon.com/exec/obidos/ASIN/0415941261/apologiareport>
2 - The Sacred Project of American Sociology, by Christian Smith (Oxford Univ Prs, 2014, hardcover, 224 pages) <www.amzn.to/2G84z77>
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