Good Mood:
The New Psychology
of Overcoming Depression
RELATIONSHIP
OF SELF-COMPARISONS
ANALYSIS
TO OTHER THEORY
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.
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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