This article traces current and emerging themes from Buddhist philosophy and psychology that have increasingly appeared in western cognitive psychotherapeutic practices. We argue that this interest has occurred within the context of post-modernist, relativistic thinking patterns first exemplified by the constructivistic movement within cognitive psychotherapy. This in turn has arisen from a world-wide clash of cultures in which western cognitive psychotherapies have been forced to reconsider some of their own tacit assumptions. Ideas for the future development of cognitive psychotherapies using Buddhist and Eastern ways of thinking are presented.
Key words: cognitive-behavior therapy, Buddhism.
The purpose of this article is to trace the development of cognitive psychotherapy as it has increasingly incorporated constructivistist and relativistic themes which are based in part on Eastern ways of thinking. First, we examine the role that Culture - our own and that of others - plays in the cognitive psychotherapy process. Second, we examine the theoretical and practical influence of Buddhist concepts on Western cognitive psychotherapy, and end with some recommendations for further incorporation of Buddhist concepts and practices.
INTEGRATIONS OF COGNITIVE THERAPIES AND BUDDHISM
The Role of Culture in Cognitive Psychotherapy
Cognitive psychotherapy, like other forms of therapy, is deeply embedded in the culture in which it has developed and uses existing cultural metaphors to explain its interventions and anticipated outcomes. Because these metaphors were developed within Western ways of thinking, they included certain cultural tacit assumptions and concepts and excluded others. The great error in the creation of all systems of therapy has been to postulate universals where there are really cultural specifics. Thus Freud's world view was a product of the 19th century Central European culture with its suppression and channeling of sexual activities, and its use of the principles of hydraulics and mechanics in developing such concepts as drive reduction and symptom substitution. Later, Carl Rogers's (1961) client-centered therapy can be seen as reflecting two powerful cultural aspects of mid-20th century American life: the increasing egalitarianism that reduced the exalted status of the therapist and the increasing affluence in material goods as well as the reduced hours of work that permitted the leisurely exploration of the client's inner mental life. Heinz Kohut (1985), who developed self psychology, thought the ideal type of individual identity was the autonomous self, characterized by self-esteem and self-confidence. Cushman (1995) refers to this as the creation of the "masterful, bounded, feeling Self" of the post-World War II Western era. The central role of the therapist for Kohut was building, maintaining, and enhancing the patient's self-identity, separate from that of others. But Cushman sees this as an "empty self" that must be filled by consuming material possessions.
Behavior therapy's guiding metaphor can be seen as that of the machine and a mechanized view of therapy, with one early article even referring to the behavior therapist as a "reinforcement machine." Early cognitive psychotherapy (broadly considered) appears to have been based on an information processing metaphor, with the tacit assumption that reality is fixed and the objective of therapy is to change dysfunctional, unrealistic cognitions into more adaptive, realistic ones. With the exception of client-centered therapy, there is little room in these cultural assumptions for such Buddhist concepts as compassion except at the most basic level of trying to help people. The therapist is a change agent, not a caring agent.
Tacit cultural assumptions change, sometimes rapidly, when a culture comes in close contact with, and often in opposition to, another culture. This has been especially true in recent years with increasingly rapid communication and transportation around the world. …