Top positive review
129 people found this helpful
Valuable insights, but misrepresents CBT
on 28 August 2005
I manage a supported housing project for people with mental health problems, and I have found a number of useful insights in the Human Givens approach.
Most compelling, I believe, is the excellent work the authors have done on studying the role of sleep in our emotional lives, particularly the vicious circle of excessive rumination, exhausting amounts of REM sleep, lack of energy and motivation, and so on.
The authors' undogmatic approach is welcome - taking whatever appears to be most effective from various therapies. This is not new, however. For example, Arnold Lazarus has for many years done similar work with his 'Multimodal' model of therapy (Stephen Palmer has written about this approach in the UK).
The book is also refreshingly unafraid to point out the failings of much theory and practice of therapies that simply encourage rumination on the past, to the exclusion of finding practical ways to feel better in the present. Many authors have, I feel, trodden too carefully around this area, being almost apologetic in pointing out the harm that such approaches can do. Griffin & Tyrrell should be applauded for their honesty here. Those who would dogmatically reject this book because it criticises such approaches might ask themselves whether they are more interested in being right than in doing what works for their clients.
I think there are, however, a couple of areas where the book lets itself down. Firstly, the references, though they exist, are not thorough or detailed enough for my liking. Often they simply refer to a book, without any further detail of the evidence it is supposed to contain.
Also, the tone of the book is that the Human Givens approach is revolutionary, and that it is uniquely in tune with 'human nature'. Here, one gets suspicious that the authors have been encouraged to present their (valuable) insights as a dramatic new way of doing therapy, simply in order, perhaps, to make people take notice.
Their main points are presented as revolutionary, but as I see it are for the most part uncontroversial and well understood. As others here have pointed out, the three main points are (paraphrasing):
1. The brain is a pattern-matching machine.
2. Emotion comes before thought.
3. The more emotional we are, the more difficult it is to think reasonably.
Points 1 and 3 are self-evident as far as I can see. Useful to bear in mind, but hardly revolutionary.
But my main issue is with point 2, and what I regard as the authors' misrepresentation of Cognitive Behaviour Therapy (CBT). Their contention is that CBT says thought comes before emotion, and that that is wrong. They take CBT's ABC model of emotional disturbance (Activating event, Belief, Consequent emotion) and replace it with their APET model (Activating event, Perception, Emotion, Thought).
But it seems that these two models are saying essentially the same thing. The 'Perception' part of the APET model is what CBT calls an 'automatic thought' - completely out of our conscious control. The authors here have assumed that in CBT terms a thought must be 'conscious'. But CBT doesn't do that at all. CBT's main point is to discover what our 'automatic' thoughts are, examine them for their truth, logic or helpfulness, and repeatedly rehearse more helpful thoughts until THOSE thoughts become automatic. It is revealing that the authors don't even mention the CBT concept of 'automatic thoughts' - a glaring omission that suggests they may have been equally unscholarly elsewhere.
The authors describe the Perception part of the APET model(p194): "Information... taken in through the senses is first pattern-matched by the mind to innate knowledge and past learnings... which in turn gives rise to an emotion, E." A more perfect description of 'automatic thoughts' you could not wish for. Sensory information filtered through "past learnings" - or in CBT terms: "underlying/ core beliefs". The difference between the APET model and the ABC model is purely semantic as far as I can see.
Where I do have some sympathy with the authors on this point is that CBT often doesn't make clear enough the distinction between automatic and conscious thinking. In my own work I call the distinction "automatic versus deliberate thoughts". Griffin and Tyrrell get round the potential confusion of talking about two types of "thoughts" by calling one of them a Perception. This may indeed be an easier way for some clients to understand the model. But I think in future editions the authors should acknowledge that this model's contribution is a useful semantic one, otherwise clients who come across CBT may get stuck in unnecessary chicken-and-egg confusion about what came first, the thought or the emotion?
In all, I'd highly recommend the book, mostly for its insights into the crucial role of sleep in our emotions, and its ability to cut through a great deal of psychobabble and talk about what actually works to help people feel better.