I count three women as the most important people in my life: My mother, my best friend of twenty years and my therapist, Doctor Ruth Greenberg.

Ruth was one of the first students of Aaron Beck, a brilliant man, who started a movement that we now call “Cognitive Therapy”.

When I first met her, she had me take an evaluation, that figured out where my views about myself and my world were skewed. Among my “negative schema’s” were extreme shame, guilt and low self-esteem.

Diagnosed as Bipolar II, with Borderline traits, which the latter I believe was due to my serious self-injury, I learned and continue to learn in my weekly sessions with Ruth.

I am able to express my emotions after a life-time of repressing them. I can even at times take pride in myself, ignoring the inner voice whispering “Pride comes before a fall.” I can believe now, that not everything is my fault, which is a demented form of hubris.

When my mind becomes too twisted to understand this, and I’m seeing things that are not of this world, it is then that this therapy fails. For my meds have failed me, which in turn, fails my hope.

Dr. G,

CBT and RET certainly have something valuable to contribute, but taken too far the notion that thoughts, beliefs, and expectations come first, then cause or drive feelings and emotions — this strikes me as WAY too simplistic. Forget about the difficulties involved in trying to define thoughts and beliefs as things, separate from these other things called feelings, then “causing” processes to happen, like a table of billiard balls. It’s easy to get bogged down in philosophy though, and the bottom line is that CBT and RET
techniques do help many people effectively deal with many issues. But we all have experiences on a daily basis, do we not, when it seems more the case that feelings come first, then the thoughts, like when an attractive person gets our hearts beating, or when we get frightened by a wild animal.

P.S. I greatly appreciate what you do here. I have long considered you the finest psychology blogger on the web. Rock on!

this is excellent news. now i can be an asshole guilt-free and when someone complains that i’m hurting them, i’ll respond with: “actually, you’re hurting yourself; get over it.”

The most difficult part of this process is identifying your negative thoughts, which are so ingrained that a depressive hardly ever notices them and just starts feeling awful about what is happening in their lives. Once you identify the thoughts you can work toward challenging them.

Wendy Aron, author of Hide & Seek: How I Laughed at Depression, Conquered My Fears and Found Happiness
Now On Sale at Amazon!

Hello,

I am wondering why cognitivists despise psychoanalytical therapies so much. I’ve been through a psychoanalytical therapy and came up with (partly) the same conclusion about feelings and thinking that cognitive therapies are stating. I belive it’s just a stupid theoretical war that therapist who care about people don’t take in consideration (because you cannot be doctrine-religious and a good therapist)

The thing with a book like “3 minutes therapy” is I would never buy it because of the title (sounds like all self help bullshit), and because of ideas like - change your mind, change your feelings. But my mind and my feelings is myself, it’s self insulting to hear this statement.

This is just not true. This flies in the face of our current understanding about how the brain works. Thoughts do not drive emotions. Emotions come first, especially intense ones. That said, CBT can and does help some people, but often people who are less distressed and whose problems are not long-standing. The practice and theory of CBT does have an empathy problem. There’s no way of getting around it. If empathy were central, then the therapy would be more relational and client-centered.

CBT can also be offensive to those whose problems have been foisted on them somehow but manifest symptoms that the therapist then tries to treat with CBT. CBT labels all but the most optimistic thoughts distorted or irrational.

Its astounding to me how this therapy has gained such a footing in our mental health system (despite the obvious reasons why). And its proponents continuously over-represent the evidence base for this therapy. It is almost literally perceived as a panacea, being studied for things like Chronic Fatigue Syndrome, which is actually a medical disorder.

I cringe every time I hear someone say that thoughts drive emotions. Its is ridiculously simple and is not even rational. A perfect example is a previous commenters post above. (See above)

Taking responsibility for our feelings is not just a therapy intervention issue. It also is the key factor in my work teaching brain-based coping skills in schools and community education programs. As an Emotional Health Educator, the programs I’ve developed are preventative and asset-development focused. I have collected pre- and post-project self-assessments evaluating education projects with kids that shows incredible gains in coping confidence and self-acceptance. Our six-year demonstration and research program promotes self-discipline using less than 3-hrs. of classroom time. This educational approach has been evaluated by aggregating results by age, class and gender.

Why teach healthy coping skills and brain function literacy to 700 pre-teens (grades 4-6)? Taking responsibility for one’s feelings (and behavior) is part of strengthening one’s self-management of common stressful and upsetting emotional experiences. These are LIFE SKILLS that once learn become imbedded brain patterns that strengthen emotional resilience and self-acceptance throughout life. My book on this process, “Emotional Honesty & Self-Acceptance: Education Strategies for Preventing Violence” advocates emotional health education approaches in which we learn the relationship between “emotions” and “feelings.” This is a critical distinction that informs us about what we can change and what we can’t.

I have come to believe that “Feelings are the subjective interpretation of our emotional experiences.” Emotions originating in the brain limbic system are interpreted by our reasoning and thinking neocortex. These are two distinct types of brain functions. That’s why we teach brain-function literacy so students as young as 9-yrs. old can begin building brain-based coping competence that enables them to deal with their coming teenage years ruled by brain and behavior changes about which most kids, their teachers and parents have little familiarity. It is through education that we can give our children the tools to regulate brain impulses that help them “honor” and take responsibility for their feelings. Once they understand these processes they will use them to diminish the inevitable torment and angst during adolescence.

I’m obviously not as educated as you all & have no book to sell, but I have been under treatment with a combo of medications for bipolar I disorder for 10 years & am thankful for the new medications available. My mother also had bipolar & committed suicide when I was a teenager.

I had several attempts myself but with medication & individual therapy & dialectical behavioral therapy I am trying to treat BOTH sides of the equation: the biochemical & emotional/psychological issues I have that are impairing my ability to enjoy & function to the fullest extent possible (though having that higher quality of life is definitely my goal).

I beg to differ with the previous poster who stated that thoughts do not drive emotions–that emotions occur first. In my case–JUST THE OPPOSITE. I have thoughts (& have had delusional thoughts that have been alleviated with medication) that lead to emotions but the “normal” range of emotions don’t stay with me. The emotions escalate very quickly into intense, overwhelming feelings which lead me to doing irrational acts (such as overdoses) to try to alleviate the emotional pain. Through the DBT therapy/classes I am learning techniques to pause, institute mindfulness & breathing techniques & try to employ rational thinking instead of automatically jumping to my natural emotional response to “triggers.”

I am 54 years old & just beginning to learn how to manage my emotional turmoil but I have hope with the medications that have helped with the paranoia & delusional thinking & now with the DBT to help judge whether my thoughts (which lead to the incredible emotions) are rational or not.

I have not had a suicide attempt in 2 years. I hate to say it, but in my case that is “successful.”

So many theories just seem to use different words for similar things. I do agree that CBT often is lacking in empathy and the experiential component. I believe there needs to be both, and I sometimes pull more from either one side or the other but seek for a balance. If someone doesn’t think I am trying to understand them, they aren’t going to be very open to any feedback I offer. Taking on such a process is hard work and people are making themselves vulnerable to me asking for help. That deserves a certain amount of gentleness and seeking to help them feel “safe” to talk about these things.

No matter what a person has been through, though, I am generally very pro responsibility and no one “makes you” anything. I want people to not give away their power and to realize they have more choice than they think. This is because I do care and want them healthier. I talk a lot with people about boundaries and protecting what is theirs emotionally by not letting themselves get all confused and involved in what is someone else’s emotional junk.

Emotions are important, though. God gave them to us for a reason or two. One of the things I always appreciated about Murray Bowen was that he never said he wanted people to be so able to work from a place of clear thinking and never have feelings. He simply said he wanted people not to be ruled by their feelings and react based on feelings. I love DBT because it allows for feelings while still saying we can choose how to manage them. This chicken or thing is not as relevant to me as helping people understand they don’t have to be controlled by feelings.

I read an article recently that presented this same idea in slightly different language. The point was that, whether we have an instant physical or emotional reaction or not, we can choose how to behave and that this choice will largely be based on how we make meaning of something. The article is by David Steele, MFT and relationship coach. He used the example of fact vs interpretation. “The sky is blue” is fact. “The sky is pretty and it is a beautiful day” is a judgment based on the fact. Our judgments of, or interpretations of, facts, get us in trouble. If we stick to the fact and consider the range of possible reasons or meanings, we are more able to suspend judgment and not automatically jump to anger or hurt feelings. People decide what they think something means and act on that assumption.

I love the idea of teaching classes for pre teens. So many of the adolescents I work with don’t have skills for managing their emotions. I wish they’d had some ability to learn these things before the hyperemotionality and raging hormones took over. Adults in their lives often don’t handle their emotions well either. We could all do a better job with this stuff, I guess.

I don’t understand the idea that we’re responsible for how we feel. What about when I’m doing something or voicing an opinion&someone else jumps all over my case because I’m not thinking exactly as they do. I was raised to believe that I wasn’t allowed to feel angry, sad, or frustrated. Well, I feel those things when someone jumps on my back&attacks me emotionally-why is what I’m feeling-when it’s negative-my fault/problem when someone else is attacking me? I didn’t ask for them to say or do cruel, mean things to me, so why is it my fault? Am I supposed to ignore it when someone treats me poorly? Why are there no repercussions for their behavior? For instance the guy who said “Now I can be an asshole&blame the hurt on the person I’m being an asshole to because how they feel is their fault.” I just don’t get this whole “You’re to blame for how you feel,” when there are people who act like the guy I mentioned does. Does this mean being an asshole&picking on people is OK?

The point is, if we actually believe that someone else controls whether we feel upset then we are at their mercy emotionally. On the other hand, if we believe that even though we may initially feel a pang of anger or hurt when some attacks us, that we ourselves, alone have the power to keep it from really bothering us, then we are at no one’s mercy and have way more control in life. This way of thinking does not make it “okay” in a moral sense for people to mistreat others, but what is okay doesn’t really have to do with this concept. Of course, one hopes that most people will be kind and think is is not right to blatantly mistreat others. Hopefully most will treat others in a golden rule fashion because it is a fact that you tend to get what you give in dealing with other peope. However, it is a reality that some people will mistreat us and then we have to deal with it. They could very well just say “Well, if you don’t like what I say that is your problem” and sadly, as far as our emotional reaction goes, they would be right. We cannot control anyone else. That is when we have to decide whether we will allow that person’s comment, action etc. to bother us because we attach a greater meaning to it, such as “If this person is criticizing me, then I should take their opinion of me very seriously and feel insecure about myself”.
Now no one is saying one cannot tell the offending person that you will not tolerate being treated with disrespect and establish consequences for them, should they continue to act in the way we disapprove of, such as reporting them to a boss or leaving them if we are in relationship. That makes them responsible for making their choice and dealing with what happens as a result. But the point is, the emotional reaction is our own problem to deal with. If we don’t allow something someone else says or does to have so much weight and meaning for us, we cannot feel insulted or hurt, etc. The only way we can keep from feeling bad when others inevitably act rude, is to believe we alone can control whether we give it meaning and have a reaction to it or not.