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Buddhism and Cognitive-Behavioral Therapy (CBT)

“In the words of the Buddha, … ’We are what we think. All that we are arises with our thoughts. With our thoughts we make the world.’ It’s an idea that’s in line with current thinking in psychology. In fact, this simple philosophy – that changing the way we think can change the way we feel – underpins the very practice of Cognitive Behavior Therapy (CBT), an approach widely used in clinical psychology and counseling, as well as stress management programs.” So writes Kathy Graham, in a thoughtful article on Buddhism and happiness, which can be found here.

The radical and powerful notion that our thoughts make up our realities may seem silly at first, especially when we think of how important circumstances can be in our lives. Even the word “reality” itself is often used in such a way as to connote external circumstances; for example, the phrases “back to reality,” “harsh reality,” or “the real world” usually refer to external circumstances, not our own thoughts. A typical example of how someone might describe their “reality” would include the facts that they are a single mother, 42 years old, working as a project manager at a big company, and making mortgage payments on a condominium. But are these facts enough to explain our experience? This question deserves some thought; on one hand, this is how we usually define our “reality,” but on the other, it’s easy to imagine how two people in these same circumstances could have quite different experiences. One person might be more optimistic and cheerful, enjoying each day, whereas someone else might be more pessimistic and anxious, and enjoy life less.

But what is it that makes one person anxious and other person optimistic? We each have our tendencies toward different thought patterns. We can call these tendencies by various names: personality traits, temperaments, reactions to formative experiences, genetic predispositions, or what have you. However we understand these tendencies, their moment-by-moment impact on us happens via our thoughts.

One of the most important aspects of cognitive therapy is the idea that we can change the content of our thoughts, and thus impact how we feel. Many of us have tried to change the way we think about something, with varying degrees of success. A common example would be the ex-boyfriend or ex-girlfriend, trying to resist temptation to reunite with their ex, that resolves to think only of their negative qualities or to convince themselves their ex is a horrible person. This is not the focus of cognitive therapy, where the therapist focuses on helping you understand how certain thought patterns are

1) contributing to making you more depressed or anxious, and
2) not necessarily based on sound reasoning.

For example, someone who is depressed may tend to have more thoughts like “I can’t do anything right,” or “No wonder he doesn’t like me, I’m a loser” than someone who is not depressed. Someone who tends to be anxious, on the other hand, may tend to have thoughts like “This is going to be a disaster,” or “Why hasn’t she called? She must have been in accident.” For whatever reason, we have a tendency to believe these thoughts a bit more than they deserve. Looking at the examples above, it’s not hard to see how a close examination might show that the statements the thoughts may be exaggerations or false predictions based on insufficient evidence. Even though on some level we know this, we often have difficulty extricating ourselves from the sadness and anxiety such thoughts can bring on. This is where cognitive therapy can help.

To return to the quote excerpted in the Kathy Graham article, “We are what we think. All that we are arises with our thoughts. With our thoughts we make the world,” it seems that the third idea, ‘with our thoughts we make the world’ seems most consistent with cognitive therapy. At least, the notion that with our thoughts we influence our mood and anxiety is quite consistent with cognitive therapy. But let’s look at what the quote is really getting at. The quote is a statement about something deeper than just mood or anxiety, it’s talking about reality. The idea that “we are what we think” may sound like a cute maxim suitable for getting a laugh at cocktail parties, but it refers to the Buddhist notion of anatman, the idea that at the core of our beings, there is no individual self. Rather, what we mistakenly identify with as a “self” is a combination of a physical body, sensations, emotions, and bundles of thoughts. The Buddha would suggest that if any of us were to closely inspect this “self” through meditation, we would realize that it has no inherent nature or existence; that it is an illusion of sorts.

Cognitive therapy focuses not only on thoughts that contribute to depression and anxiety, but also on beliefs that serve the same function. The difference between thoughts and beliefs is that thoughts are events in time lasting only for a moment, whereas beliefs are more stable and long-lasting. Beliefs can range from the specific, e.g., “I’m no good at bowling, I’ve never been any good at bowling” to the global, e.g., “I’m unlikeable,” or “I am really good at everything.” We all have lots of beliefs like these, covering the full range from the specific to the global. These beliefs span wide ranges of accuracy, helpfulness, and healthiness. Cognitive therapy considers these beliefs to be relevant, sometimes, to why we experience depression, anxiety, or other problems. From the perspective of Buddhist psychology, these beliefs begin to comprise what we think of as the self. Consider the example of a 68-year-old male, recently retired from a successful career as a bussinessman in New York. Several months after retirement, he began to become depressed and tried to re-enter the business world. His involvement was not as welcomed as he had hoped, and his mood became more depressed as he realized he would not be able to resume his career. Eventually he sought treatment for depression. This man identified with his career to such an extent that once it was over, he was unsure how to think of himself. A cognitive therapist might contend that he could no longer rest on his beliefs about himself as an effective businessman, and depression followed. Buddhist philosophy might suggest that the man had relied on an illusory conception of himself; the illusion was that of stability and permanence. This leads us to the phrase quoted from the Buddha, that “all that we are arises with our thoughts.”

We have a tendency to want to believe that something about ourselves is permanent. We would like to think that many things about us are not subject to change. One of the fundamental concepts of Buddhism is anicca (flux, or impermanence). This is the idea that everything that comes into existence will eventually cease to exist. This applies to everything from the Roman Empire to a blade of grass. It applies to people too; for the retired businessman mentioned above, he relied on an identity as a successful businessman in such a way that he didn’t really think it would end. When it did, the effect was similar to a rug being pulled out from under him. When considering the Buddha’s quote, “all that we are arises with our thoughts,” we need to remember the importance of anicca. According to Buddhism, there is nothing permanent in what we regard as the self. Just as all things are subject to continual change, each of us is constantly changing. So if we pin our identity on one aspect of our lives, like the retired businessman did, eventually we will be left in a bit of a crisis. In saying that we are nothing more than our thoughts, the Buddha is saying that not only is there nothing solid in our existence, but that what we think of as ourselves is generated by our own minds.

While this philosophy is clearly a further-reaching model than that described by cognitive therapy, we can see that the two are more consistent with one another than one might think.

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