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Good Mood: The New Psychology
of Overcoming Depression

Relationship of Self-Comparison Analysis To Other Theory

cont.

appendb 88-150 December 12, 1989

Professional readers, both researchers and practicing therapists, will wish to compare the theory and methods offered here--which I call Self-Comparisons Analysis--with the cognitive therapies of Beck and of Ellis, behavioral therapy, the Inter- personal Therapy of Klerman and Weissman, Seligman's prescriptions about the sense of helplessness, and other views of depression. They will want to know what is new about the ideas and practices presented here. This Postscript responds to that question, and takes up some other matters of interest to the professional reader.

Before discussing differences, however, I would like to emphasize the key element in common: From Beck and Ellis I gained the central insight that particular modes of "cognitive" thinking cause people to be depressed. This implies the cardinal therapeutic principle that people can change their modes of thinking by a combination of learning and will-power in such fashion as to overcome depression. For this I am indebted to them not only intellectually but also for my own welfare. And now to the differences and novelties.

Beck has properly claimed as an advantage of his Cognitive Therapy over previous work that "the therapy is largely dictated by the theory."13 This book offers a more comprehensive theory of depression than has been offered heretofore, theory which includes the others as elements in it. The therapeutic approaches suggested here are dictated even more clearly by the specificity of the theory given here, and more possibilities are suggested by it, than any of the previous approaches alone. Even folk wisdom nicely takes its place within Self-Comparisons Analysis, as for example the dimension-shifting common sense of counting your blessings, living one day at a time, and devoting yourself to helping others rather than rehearsing your own woes.

Some Specific Differences

This section barely dips into the vast literature on depression; a thorough review would not be appropriate here, and the works mentioned below contain comprehensive review. I have merely selected some major themes for discussion.

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In reading the following discussion of differences between Self-comparisons Analysis and other approaches, please notice this in particular: Beck focuses on distortion of the actual- state numerator, and loss is his central analytical concept. Ellis focuses on absolutising the bench-mark-state denominator, using "ought's" and "must's" as his central analytical concept. Self-comparisons Analysis embraces both of these approaches by pointing out that either the numerator or the denominator can be the root of a Rotten Mood Ratio, and the comparison of the two (in the context of belief that one is helpless to make changes) causes sadness and depression. Hence, Self-comparisons Analysis reconciles and integrates Beck's and Ellis's approaches, and at the same time the self-comparisons construct points to many additional points of therapeutic intervention in the depression system.

Aaron Beck's Cognitive Therapy

Beck's original version of Cognitive Therapy has the sufferer "Start by Building Self-Esteem" (title of Chapter 4 of Burns, 1980). Excellent advice, but not very systematic. Neither "self-esteem" nor "negative thought" is a precise theoretical term. Focusing on your negative self-comparisons is a better method --clear-cut and systematic - for achieving the aim Beck sets. But there are also other paths to overcoming depression that are part of the overall approach given here.

Beck et. al. focus on the depressive's actual state of affairs, and her distorted perceptions of that actual state. Self-comparisons Analysis agrees that such distortions--which lead to negative self-comparisons and a rotten Mood Ratio--are (together with a sense of helplessness) a frequent cause of sadness and depression. But Beck et. al.s exclusive focus on distortion keeps them from seeing the deductively-consistent inner logic of many depressives, and accepting as valid such issues as which goals should be chosen.4 It also has focused them away from the role of helplessness in disabling the purposive activities which sufferers might otherwise undertake to change the actual state and thereby avoid the negative self- comparisons.

4In some later work, e. g. Beck et. al. (1979, p. 35) widen the concept to "patient's misinterpretations, self-defeating behavior, and dysfunctional attitudes". But the latter new elements border on the tautologous, being approximately equal to "thoughts that cause depression", and hence contain no guidance to their nature and treatment.

Beck's view of depression as "paradoxical" (1967, p. 3; 1987, p. 28) is not helpful, I believe. Underlying this view is a comparison of the depressed person to a perfectly-logical individual with full information about the present and future of the person's external and mental situation -- like the model of the perfectly-rational consumer in economics. A better model for therapeutic purposes is an individual with limited analytic capacity, only partial information, and a set of conflicting desires. Given these inescapable constraints, it is inevitable that the person's mental behavior will not take full advantage of all opportunities for personal welfare, and will proceed in a manner which is quite dysfunctional with respect to some goals. With this view of the individual, we may try to help the individual reach a higher level of satisfying (Herbert Simm's concept) as judged by the individual, but recognizing that this is done by means of trade-offs as well as improvements in thinking processes. Seen this way, there are no paradoxes.

Burns nicely summarizes Beck's approach (which he espouses) as follows: "The first principle of cognitive therapy is that all your moods are created by your `cognitions'" (1980, p. 11). Well said (though a bit over-stated; anger at being hit by a stray snowball is something other than cognitive). Self- comparisons Analysis makes this proposition more specific: Moods are caused by a particular type of cognition, self- comparisons, in conjunction with such general attitudes as (for example, in the case of depression) feeling helpless.

Burns says the "The second principle is that when you are feeling depressed, your thoughts are dominated by a pervasive negativity". (p. 12). Self-Comparisons Analysis also makes this proposition more specific: it replaces "negativity" with negative self-comparisons, in conjunction with feeling helpless.

According to Burns, "The third principle is ...that the negative thoughts ...nearly always contain gross distortions" (p. 12, itals. in original). Below I argue at some length that depressed thinking is not always best characterized as distorted.

Another difference between Beck's and my point of view is that he makes the concept of loss central to his theory of depression. It is true, as he says, that "many life situations can be interpreted as a loss" (1976, p. 58), and that loss and negative self-comparisons often can be logically translated one into the other without too much conceptual strain. But many sadness-causing situations must be bent and massaged in order to be interpreted as losses; consider, for example, the tennis player who again and again seeks matches with better players and then is pained at the outcome. It seems to me that most situations can be interpreted more naturally and more fruitfully as negative self-comparisons. Furthermore, this concept points more clearly to a variety of ways that one's thinking can change to overcome depression than does the more limited concept of loss.

It also is relevant that the concept of comparison is fundamental in perception and in the production of new thoughts. It therefore is more likely to link up logically with other branches of theory (see discussion below of decision-making theory) than is a less basic concept. Hence this more basic concept would seem preferable on the grounds of potential fruitfulness.

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