All or Nothing Thinking

Although I have criticised Cognitive BehaviouralTherapy (CBT), it has some fantastic tools that allow one to challenge your thinking.  Briefly, CBT is based on the idea that much of our suffering is due to distorted thinking and faulty logic.  As you know, I believe that it is not enough to address faulty logic without also addressing relationships.  However, let's assume that you are taking care of that side of things, and look at one distorted thought process, namely "All or Nothing" thinking, which is also called "Black and White" thinking.

All  or nothing thinking happens when an individual characterises an object, the self or others as either totally wonderful or completely evil, without recognising that all things and people exist on continua that vary according to:

 (a) context;

(b)  stages of a process/development

(c) energy/resource availability;

(d) short term and long term needs;

(e) insight and knowledge.

In general,  nothing is perfect or imperfect because, as the Buddhists say, everything is in a constant state of flux; everything is changing; and everything that exists is in process. The notion of perfection or imperfection is a human construct which assumes that there is some pre-existing and overarching standard or pattern, separate from the human collective consciousness, against which things and people can be tested.  

This assumption is probably rooted in our primitive instincts.  As a newborn, we are only able to experience the absolute joy of having our needs met (nursing); or being utterly overwhelmed by our immediate needs being unmet (crying for the breast).  These ideas were first put forward by Melanie Klein, an English psychoanalytic theorist in the early 20th Century, who is credited as being the first children's psychotherapist and who wrote on the topic of "object relations". She wrote about how the reflexive infant splits experiences into a good breast or a bad breast.  This splitting results in the infant existing in binary states and in which they are either experiencing either total joy or total suffering.  Thus both the part representation of the mother (breast) and the self are split into two.  

Crying in response to hunger holds survival value because it signals need.  However, as time passes,  the infant who has his needs met learns that the breast sometimes provides and sometimes withholds;  and the developing personality learns to trust the process of life.  Freud said that depending on the quality of care, people carry with them into adulthood either a hostile or idealised infantile prototype.  In other words he noticed that individuals exist on a continuum that ranges from a tendency to project an ideal onto other people, or they project hostility (evil) onto others.  

Some people switch suddenly between these extremes, without integrating people or situations into their grey in-betweens which depend, I believe, on the factors I mentioned in the list above.  

Therefore, awareness of all or nothing thinking challenges us to see things in a balanced way.  In order to be whole,happy and Integrated we need to be able to see things in and people as wholes and in constant process.  By avoiding black and white thinking, we are better able to respond to things as they really are, rather than what we believe they should or should not be.  This requires the nurturing of gentleness and kindness towards ourselves and to others.

A critique of Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT), is a type of psychotherapy in which the therapist helps the client to idientify their distorted thoughts, evaluate how these thoughts impact on the individual's life, and then helps the individual make changes to their behaviours by challenging their thought patterns.  This is a laudable goal and is a method of psychotherapy that has proven success and for this reason, medical insurance is likely to cover it as part of a medical plan.  Being a skeptic myself, I believe that medical insurances would cover this kind of therapy because it is usually completed in about ten sessions.  People's behaviours change, and they seem to cope better with their lives.  This stands in opposition to other forms of psychotherapy which take much longer.  For example, integrative psychotherapy might involve years of therapy, as might psychodynamic psychotherapy and many of the more traditional forms of therapy.  This isn't good news for health insurers, because it does not satisfy their needs for quick, medical types of treatments for problems such as depression, anxiety, phobias and various types of neuroses.  It kind of fits into a neat model of healing in which a specific cause has a specific effect on the individual; and if this cause can be identified and rooted out, then a cure can be found.  This presupposes a very mechanistic understanding of the human mind.  Don't get me wrong, I am not against CBT at all.  In fact, it has helped me a great deal at times. But I am nearly certain that it is actually the positive relationship between the therapist and the client that actually promotes healing; or at least allows the client to actually take the content of the therapy half-way seriously.
What I find fascinating about psychotherapy in general is that there are hundreds of flavours of it, and when they do efficacy studies on these hundreds of therapies, they all seem to work, regardless of the model of intervention.  It is astounding that they all seem to have a positive impact on the individual who attends for them.  Yet each therapy will inevitably doggedly insists that its own particular theory  or brand of approach is the causative agent in the healing process.  But if you look at what is common to all these verbal psychotherapies, you will see that it is in fact a relationship with a sanctioned healer.  In order to heal, people need a positive relationship with someone.  And in my opinion, that means the following:
(a) someone who will give the individual their full attention
(b) someone who provide the client with positive social signals (such as listening)
(c) someone who will validate the client's experience of suffering, the client's thoughts, the client's feelings
(d) someone who expresses belief in the client's goodness

and does all of these things in a manner which is believable to the client.   This is strengthened if the therapist has a high social ranking, such as a title like Dr. or Prof.

Although I do believe that working with irrational thoughts with a client may be useful, the therapist/clinician is invariably telling the client: "there is something wrong in your thinking; you need to think in this correct, rational way."  I don't think this is really possible unless underlying relational issues are tackled.  If the therapist is stern, non-emotional and acts as a teacher, giving these rational thoughts to the client, they will not be taken up.  If the therapist has the qualities I have mentioned above, then the client might pay attention to the method and get better, regardless of the new thought patterns.