Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-25T19:39:49.991Z Has data issue: false hasContentIssue false
  • English
  • Français

Does the cognitive therapy of depression rest on a mistake?

Published online by Cambridge University Press:  02 January 2018

Richard G. T. Gipps
Richard G. T. Gipps*
Affiliation:
Oxford University, UK
*
richard.gipps@admin.ox.ac.uk
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Cognitive therapy for depression is common practice in today's National Health Service, yet it does not work well. Aaron Beck developed it after becoming disillusioned with the psychoanalytic theory and therapy he espoused and practised. But Beck's understanding of psychoanalysis appears to have been seriously flawed. Understood rightly, the psychoanalytic approach offers a cogent theory and therapy for depression which, unlike the cognitive approach, takes us to its emotional-motivational roots. A clinically successful therapy can afford to eschew theory and rest on its pragmatic laurels. This is not the case for cognitive therapy. The time is right to re-examine the psychoanalytic theory and treatment of depression.

Type
Special Articles
Information
BJPsych Bulletin , Volume 41 , Issue 5 , October 2017 , pp. 267 - 271
Check for updates
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2017 The Authors

Footnotes

Declaration of interest

None.

References

1 Robinson, LA, Berman, JS, Neimeyer, RA. Psychotherapy for the treatment of depression: a comprehensive review of controlled outcome research. Psychol Bull 1990; 108: 30–49.Google Scholar
2 Cuijpers, P, Andersson, G, Donker, T, van Straten, A. Psychological treatment of depression: results of a series of meta-analyses. Nord J Psychiatry 2011; 65: 354–64.Google Scholar
3 Kirsch, I. Antidepressants and the placebo effect. Zeitschr Psychologie 2014; 222: 128–34.Google Scholar
4 Shea, MT, Elkin, I, Imber, SD, Sotsky, SM, Watkins, JT, Collins, JF, et al. Course of depressive symptoms over follow-up. Findings from the National Institute of Mental Health treatment of depression collaborative research program. Arch Gen Psychiatry 1992; 49: 782–7.CrossRefGoogle ScholarPubMed
5 Steinert, C, Hofmann, M, Kruse, J, Leichsenring, F. Relapse rates after psychotherapy for depression - stable long-term effects? A meta-analysis. J Affect Disord 2014; 168: 107–18.CrossRefGoogle ScholarPubMed
6 Otte, C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci 2011; 13: 413–21.Google Scholar
7 Beck, AT, Rush, AJ, Shaw, BF, Emery, G. Cognitive Therapy of Depression. Guilford Press, 1979.Google Scholar
8 Lubbe, T. Object Relations in Depression: A Return to Theory. Routledge, 2011.Google Scholar
9 Freud, S. Mourning and Melancholia. Standard Edition, vol. 14 (ed. J Strachey): 239–58. Hogarth Press, 1917.Google Scholar
10 Busch, FN. Anger and depression. Adv Psychiatr Treat 2009; 15: 271–8.Google Scholar
11 Beck, AT, Hurvich, MS. Psychological correlates of depression: 1. Frequency of “masochistic” dream content in a private practice sample. Psychosom Med 1959; 21: 50–5.Google Scholar
12 Beck, AT, Ward, CH. Dreams of depressed patients: characteristic themes in manifest content. Arch Gen Psychiatry 1961; 5: 462–7.CrossRefGoogle ScholarPubMed
13 Beck, AT. Depression: Clinical, Experimental, and Theoretical Aspects. University of Pennsylvania Press, 1967.Google Scholar
14 Clark, DA, Beck, AT, Alford, BA. Scientific Foundations of Cognitive Theory and Therapy of Depression. John Wiley & Sons, 1999.Google Scholar
15 Beck, AT, Beck, J. Aaron T. Beck, M.D. interviewed by Judith S. Beck, Ph.D. [video]. Beck Institute for Cognitive Behavior Therapy, 2012. Available: at https://www.youtube.com/watch?v=7BZp7ZiAE3c (accessed 23 August 2015).?Google Scholar
16 Barrett, D, Loeffler, M. Comparison of dream content of depressed vs non-depressed dreamers. Psychol Reports 1992; 70: 403–6.CrossRefGoogle Scholar
17 Freud, S. The Interpretation of Dreams. Macmillan, 1913.Google Scholar
18 Fried, D, Crits-Christoph, P, Luborsky, L. The first empirical demonstration of transference in psychotherapy. J Nerv Ment Dis 1992; 180: 326–31.Google Scholar
19 Andersen, SM, Chen, S. The relational self: an interpersonal social-cognitive theory. Psychol Rev 2002; 109: 619–45.Google Scholar
20 Ellis, A. Reason and Emotion in Psychotherapy. Lyle Stuart, 1962.Google Scholar
21 Beck, AT. Cognitive Therapy of Depression: A Personal Reflection. Scottish Cultural Press, 1993.Google Scholar
22 Lear, J. Integrating the non-rational soul. Proceedings Aristotelian Soc 2014; 114: 75–101.Google Scholar
23 Frederickson, J. Psychodynamic Psychotherapy. Brunner/Mazel, 1999.Google Scholar
24 Beck, JS. Cognitive Behavior Therapy: Myths and Realities. Huff Post 2010; 7 November [updated 17 Nov 2011]. Available at http://www.huffingtonpost.com/judith-s-beck-phd/cognitive-behavior-therap_b_638396.html (accessed 11 September 2015).Google Scholar
25 Shedler, J. The therapy relationship in psychodynamic therapy versus CBT [blog]. Psychol Minded 2015; 18 March (https://www.psychologytoday.com/blog/psychologically-minded/201503/the-therapy-relationship-in-psychodynamic-therapy-versus-cbt). Accessed 11 September 2015.Google Scholar
26 Cuijpers, P, van Straten, A, Andersson, G, van Oppen, P. Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. J Consult Clin Psychol 2008; 76: 909–22.Google Scholar
27 Mundera, T, Briitscha, O, Leonhartc, R, Gergera, H, Bartha, J. Researcher allegiance in psychotherapy outcome research: an overview of reviews. Clin Psychol Rev 2013; 33: 501–11.Google Scholar
28 Kim, D, Wampold, BE, Bolt, DM. Therapist effects in psychotherapy: a random-effects modeling of the National Institute of Mental Health Treatment of Depression Collaborative Research Program data. Psychother Res 2006; 16: 161–72.Google Scholar
29 Ablon, JS, Jones, EE. How expert clinicians' prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavioral therapy. Psychother Res 1998; 8: 71–83.CrossRefGoogle Scholar
30 Salkovskis, PM. Cognitive therapy and Aaron T. Beck. In Frontiers of Cognitive Therapy (ed P Salkovskis): 531–9. Guilford Press, 1996.Google Scholar
31 Hans, E, Hiller, W. Effectiveness of and dropout from outpatient cognitive behavioral therapy for adult unipolar depression: a meta-analysis of nonrandomized effectiveness studies. J Consult Clin Psychol 2013; 81: 75–88.Google Scholar
32 Hobson, RP. Brief Psychoanalytic Therapy. Oxford University Press, 2016.Google Scholar
33 Abbass, A. Intensive short-term dynamic psychotherapy of treatment-resistant depression: a pilot study. Depress Anxiety 2006; 23: 449–52.Google Scholar
34 Fonagy, P, Rost, F, Carlyle, J, McPherson, S, Thomas, R, Pasco Fearon, RM, et al. Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry 2015; 14: 312–21.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.