Friday, 29 October 2021

The Epistemic Relevance of CBT

Chloe Bamboulis, a PhD student at the University of Birmingham, works on the relationship between classic philosophical views and cognitive-behavioural therapy (CBT). In this video, she talks for three minutes about self-knowledge in Plato and in CBT. In today's post she summarises a commentary co-authored with Lisa Bortolotti on the utility of CBT, forthcoming in Philosophy, Psychiatry, and Psychology.


Chloe Bamboulis


A common idea about CBT is that it does not contribute to the person's understanding of reality (validity) but encourages ways of thinking that boost the person's wellbeing (utility). In our brief commentary, we argue that CBT can also contribute to some of the person's epistemic goals.


Suppose James comes to believe that he will not be offered his dream job, the one he is going to be interviewed for. James arrives at this self-prediction by accepting a negative automatic thought about himself as someone who does not perform well at job interviews. Accepting that things will go badly due to negative biases may give rise to the correct prediction, but this does not mean that the prediction reflects  a careful consideration of the factors that are likely to contribute to the future outcome. 

 

By inviting James to think about his past performance during interviews and getting him to realise that he actually did get a few jobs, CBT might make additional explanations for James's negative perception of himself over and beyond the thought that “he is rubbish”. What if some of the job he interviewed for in the past were extremely competitive? What if James had not shone in previous interviews because he was tired or stressed? If there is evidence against the view that James "is rubbish" at job interviews, this evidence should be taken into account. 

The mere consideration of additional evidence and alternative hypotheses enables James to imagine another reality. A reality in which not getting the next job is not the only outcome. This has implications for the discussion of the aims of CBT: the epistemic relevance of a therapeutic approach does not merely depend on whether it increases the overall number of accurate representations and correct hypotheses, but in whether it encourages grounding representations and hypotheses on experience and evidence.

 

An epistemic goal has been served by a therapeutic approach that helps James resist the power of a negative bias. If CBT can habituate people to adopt a thinking style where hypotheses are not accepted blindly, but explored and weighed up against alternatives before being accepted, this suggests a significant epistemic progress. It leads people to become more sensitive to evidence.

 

We all find obstacles on the way to pursuing our goals. When we overestimate our talents and how rosy our future will be, we are less likely to give up pursuing our goals at the first setback. We are motivated to persevere, and more likely to achieve our goals than if we had given up earlier. Some of these relevant goals may be epistemic and contribute to our exchanging information more effectively within our social environment, and gaining a better understanding of ourselves and the world. 

Finally, James's self-predictions can become self-fulfilling. If he is convinced that he will not get the job, he might not even be motivated to prepare for it. But if he thinks he has a chance, he might do his best to perform well. CBT seems to have an important role in the process of learning how to develop effective strategies to sustain future motivation.

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