Academic journal article Journal of Cognitive Psychotherapy

Maimonides and the Origins of Cognitive-Behavioral Therapy

Academic journal article Journal of Cognitive Psychotherapy

Maimonides and the Origins of Cognitive-Behavioral Therapy

Article excerpt

The philosophical roots of cognitive-behavioral therapy (CBT) have usually been traced to the rationalist and stoic philosophers, but not to the 12th century physician-theologian, Maimonides. This paper argues that CBT has startling affinities with Maimonides's clinical methods of dealing with emotional disturbances, and that both Maimonides and practitioners of CBT drew inspiration from similar philosophical traditions. While CBT did not evolve directly from Maimonides, many of its tenets were prefigured in his writing. By comparing the specific methods of CBT with the teachings of Maimonides, a nexus between the two is established. The more theocentric aspects of Maimonides's views, though not directly transferable to CBT, open a path toward the fusion of cognitive-behavioral and existential therapies.

Cognitive-Behavioral Therapy (CBT) is a therapeutic method that emphasizes the role of irrational ideas and self-defeating behavior in both the origin and persistence of psychopathology (Beck, Rush, Shaw, & Emery, 1979; Ellis & Harper, 1961). In essence, CBT holds that when we are severely anxious or depressed, it is due to our holding various distorted ideas, and to the chronic reinforcement we receive when behaving in accordance with these ideas. Thus, the individual who believes, "I must be loved by everyone, or I'm a terrible failure in life," will undoubtedly become depressed when the hoped-for love is not forthcoming. Furthermore, when this individual becomes socially withdrawn for fear of rejection by others, the consequent reduction in anxiety 'reinforces' the withdrawal, as predicted by operant conditioning theory. While this account is vastly oversimplified, it is essentially the basis for CBT as described by Beck (Beck et al., 1979) and for 'rational emotive therapy' as developed by Ellis (Ellis & Harper, 1961). More purely 'behavioral' approaches have been developed by Wolpe and others, but in clinical practice, cognitive and behavioral elements of treatment are usually combined (Hollen & Najarits, 1986).

Practitioners of cognitive therapy trace its roots to the Stoic philosophers Epictetus and Marcus Aurelius, and to the 'rationalist' philosopher, Spinoza (Ellis & Harper, 1961). Rush and Nowels-both physician practitioners of cognitive therapy-also link cognitive therapy to 'the Stoic philosophers of Greece,' but conceptualize these thinkers as forerunners of phenomenological psychology (Rush & Nowels, 1994).

Curiously, neither the cognitive nor the behavioral practitioners of CBT seem to recognize the affinity between their techniques and the teachings of Maimonides, the great Jewish physician-philosopher-theologian who flourished in the 12th century (1135-1204). As I hope to demonstrate, Maimonides managed to synthesize rationalism, empiricism, and stoicism into a clinically useful approach to the disturbed patient. (We shall clarify the meanings of these terms later.) Indeed, the burden of this paper is to show that Maimonides is arguably the 'father' of cognitive-behavioral therapy; and further, that he propounded specific therapeutic techniques that bear an uncanny resemblance to those of modern-day CBT. I shall proceed by summarizing (1) the formative philosophical influences on Maimonides' s views; (2) the essential components of CBT; and (3) the manifold connections between Maimonides's philosophy and our modern-day construct of CBT. I shall then argue (4) that these connections are neither the result of 'coincidence,' nor of an unbroken historical chain linking Maimonides to his present-day counterparts. Rather, the affinity between Maimonides and CBT stems from the specific philosophical-conceptual traditions drawn upon by Maimonides and the practitioners of CBT, over vast and discontinuous stretches of historical time. Finally, I shall present some thoughts on the fate of Maimonides's views; their relevance for modern practitioners of CBT; and some possibilities for the integration of CBT with existential psychiatry, following Maimonides's principles. …

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