GETTING TO THE HEART OF THINGS COGNITIONS—> MEANINGS

Working in his residency in psychiatry at the University of Pennsylvania, David Burns began research on the theory that “a chemical imbalance in the brain, specifically that patients with depression have a serotonin deficiency, and patients with mania have an excess.” But he couldn’t find any evidence!

Later he was given the prestigious A.E. Bennett Award for his research on brain serotonin metabolism. That was for the double-bind research on the theory whereby two groups of patients, each given a milkshake daily, but one milkshake was laced with 20 grams of L-tryptophan, a massive dose of an amino acid that goes directly from the stomach into the blood and into the brain. Measuring the depression levels of both groups, “there were absolutely no differences.” This was published in Archives of General Psychiatry in 1975 which led him and others to conclude that it was not clear at all why people were proposing the brain chemistry theory.

The theory was now in question. So David Burns asked his advisor. At the time, he was one of the world’s top three psycho-pharmacologists. He responded: “Well David, to tell you the truth, a number of years ago, several of us got together to try to start the field of biological psychiatry. We know there are thousands of substances in the human brain, but the first one we learned how to measure with an assay, was serotonin. So, kind of tongue and check, we made up this theory that depression is due to too little serotonin and mania is due to too much. We just wanted to get the field of biological psychiatry going so we could submit grants to NIMH and get funding and start brain research.”

He felt that “as a basis for a dominant theory” that was ridiculous. Yet to that, the advisor said: “Don’t rock the boat. I could get you started testing antidepressants for drug companies. You’ll make millions every year. You’re already becoming world famous. Don’t challenge the system.”

He refused. I like this guy! In the face of the ridiculous assertion that antidepressions can “cure 85% of patients with depression” he said, “that’s baloney!” Having clinical experience with depressive clients, he said most were not getting better and many were deteriorating. That was back in the mid- 1970s. And that led him to discover and using Aaron Beck’s Cognitive Therapy. But at first he resisted. Why? He asked in disbelief: “Negative thinking causes depression? Change the way people think and you can change the way they feel?”

It seemed too simplistic, too Dale Carnegie or Norman Vincent Peale! But he gave it a try. Later he had patients who were starting to say, “Hey this stuff really helps. This is great. Do you have more techniques?” And with that he wrote, “It was the patients who really sold me on it.”

“I am deeply indebted to Albert Ellis and Aaron Beck, pioneers who changed the history of psychotherapy. They were brilliant clinicians and they gave us incredible gifts...”

Noting that they did not have all the answers he described how important the factors of motivation and resistance play a great role in our cognitions and perceptions. In therapy, one has to have some way to melt a patient’s resistance and then “the patient becomes a powerful collaborator with the therapist.”

All of this is in the interview with David Burns in the current edition of The Milton H. Erickson Foundation Newsletter (Summer/Fall 2014). Then in a tone that sounds like NLP, Burns says, “when we deal with resistance we try to make patients proud of their depression, and show they why they possibly should not give it up” (p. 23).

If you can do that in a skillful way, the paradox is that the moment that you sell the patient on the fact that they shouldn’t change, suddenly their resistance disappears and they’re quite hungry to change.”

I met Albert Ellis for the first time in 1979 along with Rolla May and others during a Conference in ST. Louis. That led me into Cognitive Psychology. And with David Burn published Feeling Good: The New Mood Therapy in 1985 it bought it immediately and began putting the processes (“techniques”) that he had created into action. Later I visited, interviewed and modeled Albert Ellis at work in his New York clinic and that is the background for using the Cognitive Distortions in Meta-Coaching.

All of that background also prepared me for NLP in 1986. What NLP did for me was flesh out the details of the Cognitive Psychology model. And no wonder—the two founders of Cognitive Psychology, George Miller and Noam Chomsky were key influences on NLP. John Grinder did his dissertation on Chomsky’s Transformational Grammar model and then the early NLP group used Miller’s work of his TOTE model in The Structure of Behavior (1960) for creating the NLP Strategy Model.

How does all of this help with “therapy?” To heal a person, to facilitate the person to become okay, empowered to face reality, and to come into the now— the problem is always at the level of cognitions, and more specifically, meanings. Yes, brain chemistry changes and reflects the problem. And yes, emotions are symptomatic of the problem and can amplify the problem. And yes, behaviors can be dysfunctions and hurtful. Yet they are symptoms. The cause of the problem always goes to how the person is thinking— processing information, constructing meaning, and interpreting the experiences of life. Change that and the person changes— and so do the symptoms.

Why is this? Because “the map is not the territory.” The mental mapping of the person which is trying to comprehend and deal with the territory determines appropriateness and effectiveness. If the map is wrong, then so will be the biochemistry, the emotions, the behaviors, the ways of relating, etc.