Spiritual Cognitive Therapy: Modifying Core Beliefs (Detailed Notes)

Tom G. Stevens PhD ,  California State University, Long Beach

Sherry Bene' Stevens MFT,  California State University, Fullerton

(Presentation to California Association of Marriage and Family Therapists, CAMFT, May 3, 1998)

For complete AUDIO presentation,  go to: Download_SCT_AUDIO.htm

I. INTRODUCTION                                           

1.1 more anxious first time + about working together, had to give ourselves SCT to “Rise above” our feelings. Fell into garbage.

1.2 Tom’s story: I was raised by my dad to believe that success and being no. 1 were the most important things in life. 

Yet at age 16, I could see that there was something wrong with that philosophy, dad had lived by that and wasn’t happy, so had I.  Hap->God, Min->Psy, Book    1.3 Sherry’s story:

 

AUDIENCE SURVEY: Sherry–see overhead:   How many?  Raise your hands

If anyone has conversion experience like to talk about, tell us after wkshop.

 

OBJECTIVES TODAY: Overview and cover a few issues, lots of information, can’t go into detail, go to book.

We have modified the original outline, can get new materials at website or sign-up afterward for mailing.

 

II. WHAT IS MISSING FROM TRADITIONAL THERAPIES (Tom)

In order to illustrate what is missing from traditional therapies, I’ll tell you about my own changes in therapy approaches over a 25 year period. My own habit-> spiritual therapy changes,  (Behavioral/habit->skills->motiv/cog->deeper/spiritual, 2nd renewal w/Sherry to current approach->book, today. (Beh->spiritual is up the cog hierarch)      

            Variety of symptoms–is there a common cause?   Start w/ Linda eg?

Martin Seligman, new APA president wants Psy to put new focus on optimism and positive mental health, said,

“Science has managed to ignore the fact that undesirable events

often produce extraordinary strength, growth, and creativity.”

            Use Higher Self (HS) diagram: (but clarify that HS may not be in top position as in diagram). Also leader-group analogy.

                        1. Relation of cognitive/personality hierarchical level to psychological treatments.  

1.1 Simple Habits–changing frequencies,   health habits,    Eg. Behavior Therapy, shaping, reinforcement/punishment

1.2 Lower cognitive   speech habits, simple interpersonal skills, simple stress-management skills

1.3 Middle level cognitive complex skills–interpersonal, self-motivation, decision-making, etc

        1.4 Personal knowledge and history client’s history and conclusions about it.  Issues related to particular people, events, etc in one’s life.

1.5 General knowledge “university in head” psych, math, history, political, etc.  Eg. Clients who are psychologically sophisticated versus not.

1.6 Central belief systems philosophy/personal philosophy, world view, self view, life values, themes, roles, goals, plans.  Eg. Therapy to help develop positive self-view and world views, new life themes roles, goals, plans.  Some areas traditionally OK–others NOT (eg. Views of God, Truth, Direction of History, What is morally right? ETC) Traditional church-state separation–esp in state-supported programs.

                        1.6 a. Core belief systems. Ultimate concerns, Higher Self, “Faith,” core identity, etc.

                        OMIT as separate 2. How are the different levels related to each other and to psychological problems?                                    

3. Don’t therapies already deal with the core issues?  What they do and don’t deal with. Better at self-esteem issues.  But usually don’t deal with issues regarded as phil of life, religious, value-issues. (Cover later)

                       

III. LET’S GET A CLUE (to what really changes people)

S-1. Religions–millions of believers, “personal redemption/conversion/salvation” emphasis related to high growth and radical change in values, life-style, etc. Harvey Cox’s new book, Fire from Heaven worldwide spiritual movements.         

–p183, David Myers, series of questions, “highly spiritual’ who agree with statements like, “God loves me even though I might no always please him,” “My religious faith is the most important thing in my life” twice as likely to say they are “very happy.” In US, church attenders less likely to become delinquent, abuse drugs/alcohol, divorce or be unhappily married, or commit suicide.  They tend to be physically healthier and live longer.

S-2. Self-help movements (12-step programs, etc) Every client who ex-subst abuser except 2 active in 12-step programs which all emphasize belief in a Higher Power.  One believed in a Bus.

T-3. Personal (non-group) “conversion experiences.”

            *Gautama, the Buddha (was rich prince w/ family, but unhappy, life meaningless, gave up to seek happiness

            *Apostle Paul most responsible for spread of Christianity=classic road to Damascus,

            His insight that changed his life, view God NOT as punative, autocratic father that demanded obedience to every tiny rule, or would be severly punished, but God as a God of love and forgiveness who wanted people to be happy.

If I have the gift of prophecy and can fathom all mysteries and all knowledge,

and if I have a faith that can move mountains, but have not love, I am nothing.

If I give all I possess to the poor and surrender my body to the flames, but have not love,  I gain nothing.

Love is patient, love is kind.  It does not envy, it does not boast,   (omit? it is not proud. It is not rude, it is not self-seeking, it is not easily angered,)

 it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. 

(LOVE always protects, always trusts, always hopes, always perseveres. . . 

And now these three remain: faith, hope, and love.  But the greatest of these is love.         * John Wesley, founded UMC;

            *I have interviewed several women who weighed >300lbs and lost, UC decision, best friend/food

T-4. What do these all have in common that works? Fundamental shift in world view, values, goals. Yes, but what else is important?  What kind of a shift?  What are the qualities of values, goals,  or world views that work work?

            *Tillich’s idea of UC, little gods, choice gives it power over personality. STOP              [25 minutes]

 

WHAT IS “SPIRITUAL COGNITIVE THERAPY”?

 

S-What do the words “spirit” and “spiritual” mean?  The words “spirit” or “spiritual” refer to humankind’s highest mental phenomena and related information. Questions about ultimate reality and values and any issue related to these more ultimate questions could be called spiritual in so far as they relate to those ultimate questions.  The words “spirit” and “spiritual” do not in themselves refer to--or imply--anything supernatural or unnatural.

           

S-What is “Spiritual Cognitive Therapy”? READ, our definition is: “It is therapy that helps people discover, examine, choose, and apply their core ultimate concerns, identity, and related cognitions. “

 

T-How does the concept “ultimate concern” relate to the concept of one’s “faith”?  Tillich’s concept of ultimate concern  is exactly equivalent to what he and others traditionally call one’s  “faith.”  A non-religious person’s faith might be in his/her nation, the laws of the universe, in the family or in himself or herself.  But whatever it is they have faith in something or some things–it can be fragmented.

 

T-How does the role of a psychological “spiritual cognitive therapist differ from what a preacher, prophet, or priest in helping people deal with faith/spiritual issues? The psychologist/therapist is not concerned with any PARTICULAR religion or faith.  The psy is concerned with the more philosophical and scientific questions about how a person’s core or faith affects their personality, their emotions, their behavior, and other aspects of their lives (and vice-versa).

 *The therapist’s main concern is the welfare of the client and the agreed goals of therapy.

 The preacher/priest is a believer in a PARTICULAR faith.  He is concerned about the concrete content of a person’s faith and it’s related teachings, symbols, historical events, church community, etc. The priest usually has a concern about the person accepting and fulfilling the particular religion that the priest represents.  In addition the preacher/priest is concerned about the ULTIMATE TRUTHS behind the cognitions.

If client asks, “Does God exist?”  A priest might try to convince the person that God does exist. 

*A therapist might reply, “You have to decide for yourself.” If it relates to the person’s problem, the therapist could also say, “There is research evidence that people who believe in God are happier.” OR

*I had a client “Fear being alone at nights, I want someone to comfort me when I’m afraid.”  I have said, “Some people find relief in a belief that they can talk to God. One client even said that she imagined God giving her a big hug.  Those people tell me that it takes away their fears and comforts them.  They feel loved, and no one can take that away from them.”

 

T-How is spiritual cognitive therapy different from regular cognitive therapy?  Spiritual cognitive therapy self-consciously deals with cognitions that have traditionally been labeled “spiritual,” traditional cognitive therapy may occasionally deal with matters of one’s core ultimate concerns or faith, but not self-consciously.  Many cognitive therapists shy away from deeper value issues and especially from theological or religious issues.

*However, when cognitive, or humanistic therapists assert that people need to value themselves unconditionally to overcome self-esteem-related anxiety, they are dealing with core concerns.

 

OMIT-WHAT IS “SPIRITUAL” PSYCHOTHERAPY?

                1. Targets the core or top beliefs and skills in the cognitive hierarchy.

                2. Needs to define a set of its own values, methodology, etc.

2.1 Assumed values include:  truth, health, happiness, harmony between people, the rights of clients to choose their own beliefs and values,

2.2 Assumed methods include: scientific method, human reason, direct and phenomenological observation, philosophical inquiry, etc.

3. Relationship to religious systems.  Overlaps in some issues, but does not give particular preference to any religion and lacks the thematic material.

                                3.1 Examples.

                4. How can we identify and treat the core issues without getting into the “value problem”?

 

[5 minutes]

 

IV. SAMPLE CORE ISSUES FOR SPIRITUAL COGNITIVE THERAPY?

            Note: Under most areas a number of specific alternatives will be discussed in the workshop.  These issues are discussed in Tom’s book, You Can Choose To Be Happy: “Rise Above” Anxiety, Anger, and Depression.  We will contrast ways we can “Choose To Be Happy” with ways we can “Choose To Be Miserable” and connect these to common psychological disorders such as depression, anxiety disorders, low assertiveness, low self-esteem, relationship problems, anger/aggression, addictions, etc.  We will also describe or list some how some traditional philosophical or theological issues are related to these psychological issues (often the other side of the coin).                            [note: U= choose to be unhappy OH on screen]

S- Introduction

1. Ultimate Concerns .  Clients’ “ultimate concern” or top value/goal in life and other top values (eg. Maslow, Kohlberg, Western versus Eastern, etc.).

One of the greatest Buddhist insights and insights of Paul Tillich was as soon as make anything a goal, it simultaneously becomes a source of anxiety.  And if we make something our UC, it becomes our ultimate source power over our lives and our ultimate source of anxiety.  Eg.  If I make money or success No. 1, I will do anything to get money, lie, rob, cheat, kill, because I will do anything for money.  That’s what an UC is. 

*Always a source of worry.  If I don’t have money/success, then I worry about getting it.  If I do have, worry about losing it.

* Becomes our little god–power

One of the biggest differences in UC is whether they are primarily EXTERNAL or INTERNAL. 

            Issue is CONTROL.  Little control over money, success, approval, find someone who will love us, etc.=>Constant ANX

What else can we make UC that will partially solve this problem of constant underlying worry and anxiety?

            * Spiritual, mental values like such as happiness, love, growth, truth, creativity, beauty, etc.

Can’t be taken away so easily (INTERNAL-PROCESS vs. EXTERNAL-OUTCOME goals.

            * Eg one of my worst fears, lose Sherry, but know can still be happy.  Affect daily worries, Every time late on freeway

 

1.1 What do great religious leaders and philosophers  say our ultimate concern should be?

            1.Hinduism, unity with God, state of Nirvana.

            2.Guatama the Buddha, happiness–gave up riches & family, tried Hindu self-denial first.

            3.Aristotle, quote from book.

Happiness, then, is at once the best and noblest and pleasantest thing in the world...

we always choose it for itself and never for the sake of something else.

            4.Jesus, the great commandment (Overhead of it from Ch-1?)

            5.Judaism, 10 commandments, great commandment.

            6.Islam, similar I believe, but more rule-oriented

            7.Kant, Happiness for all

            8.Bertrand Russell, happiness for all

            9.Kohlberg, Justice, but Others criticize, want to add higher stage of empathy/love.

            10.Modern Humanism (Maslow), Self-Actualization/mental health, peak experiences/happiness,

            METAVALUES such as truth, love, beauty, wholeness, goodness, simplicity,  uniqueness, playfulness, and self-sufficiency

 

1.2 My emphasis on SPIRITUAL, HIGHER MENTAL VALUES >> EXTERNALLY-TIED            [UH-Only happy if]

What does making God, love, happiness, or other higher spiritual/mental values do for psychological well-being?

We can use them to help us rise above difficult situations. Can help us reframe difficult situations. We can get a positive point of view from higher beliefs that help us overcome difficult situations.

* Egs POW who reframed/new point of view situation (I’m in control/host)[omit mental golf = overall meaning + mean/HF mom-to-moment.]   * Genevieve or Frankl–read quote:                                                                   

 

Slow-> Only the men the men who allowed their inner hold on their moral and spiritual values to subside

eventually fell victim to the camp’s degenerating influences. . . 

Instead of taking the camp's difficulties as a test of their inner strength,

they did not take their life seriously and despised it as something of no consequence. . .

Yet in reality, there was an opportunity and a challenge.  One could make a victory of those experiences,

 turning life into an inner triumph, or one could ignore the challenge and simply vegetate, as did a majority of the prisoners. . .

 

 

1.3 Desirable qualities of one’s ultimate concern(s): Overhead

            Ultimate. Highest value/goal in one’s life.  Will be chosen above all other (secondary) values. Tillich

            Unconditional. Is primary under any condition.Tillich

Simple and elegant.  Ideally, it would be a relatively simple statement–easily understood by many–that is at the same time so powerful that it can explain or encompass all life events.

**Comprehensive.  Is at least tangentially relevant to any situation in life.

Unifying.  Is able to successfully resolve differences in conflicts between two or more competing lower values. Tillich.

Truthful. Represents the true state of affairs in the universe–(not usually evaluated by therapist?) Tillich

It should no conflict with any other type of valid knowledge or truth (eg. Scientific knowledge, historical knowledge, personal knowledge, etc).  This is a murky area for therapists.

High unconditional value of oneself and all others. All people’s health, happiness, and general welfare are highly valued.

High unconditional value for the environment and to some degree the entire universe.

Universality. Kant’s cat imperative “act as if the maxim of your action were to become through your will a universal law of nature.”

Adaptable.  Through it’s nature is able to adequately deal with all possible changing conditions and conditions of life in ways that meet the other criteria.

**Growing more elaborate and integrated over time. (INTEGRITY of personality over time, & Self-Act people)  It should become increasingly complex and integrated within itself and with the rest of the personality over time from interacting with many particular life events.  Each new event should become integrated with the core. 

* Poor choices for UCs lead to Growing fragmentation, repression, or conflict within parts of the personality, becuse the core is inadequate and can’t deal with important aspects of life or reality.

Source of Security. Trusting in this principle, being, whatever provides ultimate security for person.

Clear, Prescriptive.  It should include extremely general, implied  guidelines for evaluating or recommending almost any behavior. Like one’s personal supreme court.

 

1.4 Common ultimate concern problems

1. Poorly developed HS and phil of life=>lack meaning to life, depression, narcissism, addictions, dependency/external control. *RECALL Frankl quote. (Meaning to suffering) Logotherapy=>depression

                        * Let me read of another kind o f poorly developed UC that leads to dispair and depression.

                          It is a common a afliction of the Educated.        

                        Bertrand Russell in The Conquest of Happiness, (p. 12) called it “Byronic Unhappiness” (title of chapter II):

It is common in our day...to suppose that those among us who are wise

have seen through all the enthusiasms of earlier times     and have become aware that there is nothing left to live for. 

The men who hold this view are genuinely unhappy,   but they are proud of their unhappiness,

which they attribute to the nature of the universe    and consider it to be the only rational view for an enlightened man.

[omit...The truth is that they are unhappy for some reason of which they are not aware, and this unhappiness leads them to dwell

upon the less agreeable characteristics of the world in which they live. The wise man will be as happy as his circumstances permit,

and if he finds the contemplation of the universe painful beyond a point, he will contemplate something else instead.]

            2. Fragmented UC=> Inner conflict, anxiety, indecisiveness.  Sherry will discuss later. [Eg workaholic who runs out of gas]

            3. Sample of common poor choices of UC: (See Kohlberg’s stages, but he lacks top stage of love/empathy).

According to Tillich, anything we pick as an UC that does not fully deserve to be UC will cause serious life problems. One of my more recent hypotheses, is that I believe they are at the heart of many psychological disorders.

                        (Coordinate this with OH–which is different say power, obedience closely related)

                        * Self-pleasure, now: childlike selfishness, lack empathy, narcissim, sociopathic/anit-social “gimme”, addictions.

* Another person, family, or everyone (love, parent, acceptance) as god.  Dependency/ external control, codependency, addictive relationships, self-deprivation.To be loved and accepted by all.

[U-success]        * Achievement/success or over-identify with a role: Workaholic, feels worthless without success, may lead to depression, anxiety. May be aggressive, lack empathy, manipulative. Physical health problems. Unhappy.

* Power, status, recognition, respect, pride. “I am important” Manipulative, ruthless, conceited, self-serving decisions, status symbols.  Fears:being weak, rejected, looked down on by others,

                                    * Nation, Church or other group or institution: Must go to church and obey all rules or go to hell. Us vs Them.

                        * Blind obedience to God or a Set of Rules==> “Rule bound” leads to OCD-like behavior.

                        * Health.  Hypochondriac.

            4. As said earlier, soon as pick X as UC=>source of greatest anxiety and fear.     [U-worst fears]

                        *Worst fears as flip-side of UC.

                        *Explore and resolve worst fears (and deepest assocs) one of most powerful techniques

                                    PLUS it is way of identifying and exploring highest values/UCs.                         [next U-avoid change]

            5. Repress doubt (Freud/Tillich)=>fanaticism, extreme beliefs, disbelievers threatening/punish.. [Also,  Cults]

            People with inflexible UC s will fear change, therefore sensitive to criticism.  If value growth/progress, welcome it.

OMIT 1.5 Relationship of ultimate concern/faith issues to common psychological problems

(Omit? 1.6 How can you assess what a person’s UC is? 

(1) Cuts across many situations.  Eg. Puts relationship ahead of self, even when partner abusive,

(2) Situations where values conflict and asking them to choose.

Kohlberg’s Moral dilemmas.  Dave’s choice of family and quality of life> high admin position/status/success.

                Choice between *permanent separation from family OR personal unhappiness & psych dysfunction.

                *telling the truth and losing a friend OR lying and keeping the friend. *DO MORE??  –end omit?)                      [25-30 minutes]

 

2. Our natural “Higher Self.” (Sherry)Head full of little people. A natural cognitive system that can be our inner guide, conflict-resolver, and hero. How dysfunctional belief systems can overwhelm the Higher Self and leave one in a miserable state with no apparent way out.  Ways to strengthen the Higher Self, the importance of cognitive integrity, how to let the Higher Self create psychological integrity, relation to Maslow’s self-actualization, etc. * Differences betw UC and HS. *Conductor *Healing, Dawn

                                                                        [20 minutes]

3. World view issues (SEE BELOW). (Tom) Clients’ world view issues (how we view basic forces in the world, human nature, basic expectations from life, the importance of cognitively overcoming our worst fears, etc.   

4. Self view issues. (Tom) Two major issues, most of you familiar with it.  Two major issues include:

1. Unconditional love of self   and    2. how to  accept even the worst parts of ourselves, our histories, and our past “sins.”

                                                                        [5-8 minutes]

5. External versus Internal Control. (Sherry) Core issues related to dependency, codependency, non-assertiveness, aggressiveness, etc.  How to gain more internal control.

 

6. Harmonious Functioning Model: (OVERHEAD) Important insight that relates higher mental/spiritual values to biological basis.

Assumes highest motive of higher brain is to process info effectively, maximally learn and get mental control of body and environment. 

==>Even in deep depressions or high anxiety, if can get focused on totally mentally involving activity, temporarily rise above emotion.  POW golf, Frankl fantasy of wife,   Relate back to UC

(OMIT)     7. Issues related to knowledge levels, skill levels, and effectiveness in meeting our general values and goals.  The importance of key life skills in areas like thinking, self-management,  interpersonal, leisure, and career.

                                   

V. HOW TO DEAL WITH SENSITIVE RELIGIOUS AND VALUE ISSUES–  SPIRITUAL COGNITIVE THERAPY (SCT) PROCESS

 A general THERAPY PROCESS for dealing with sensitive value issues: self-exploration, observation, description of alternatives, etc. (Similar to any good therapy). (Tom) (overhead) 

            1. Explore presenting problem

            2. Find underlying highest level issues. (See chapter 2)

            3. Clarify inner conflicts-- between inner subparts, values, or with external sources. (See chapter 2-3)

            4. Reframe with HS-related values. Get client in touch with HS: REFRAME, DIF POINTS OF VIEW (from HS, etc)(Ch 3)

                        a. Start with presenting problem and help client REFRAME also:

                        Eg. Upset about failure, reframe to what can learn, grow, new opportunities/new chapter.

                        Never fail to learn=> UC=Peoples’s inner growth, spiritual devel more important than achievement.

                        b. Other ways of reframing:

                        Above eg. Growth> success; Bigger perspective (time, people, life areas,);

                        *Things beyond control: Trust in God etc;

                        * Losses, Negative, UNFAIR events (poverty, illness, death)=> Zero exp, Abundance;

Depression, opportunity to reassess life, depress provides motivation to change, look back see major periods of growth during or following depression.

            5. Clarify deep issue choices. HS>other parts, esp dysfunctional parts and negative external influences.(Ch 3)

            6. Align self with benefit to client and client’s HS-related values.

7.  Avoid role of preacher/priest.  But can say, “Some clients from your faith have tried xxx” or other informational help that you remain “neutral” in.  Or suggest they talk with preacher/priest.

            8. Help client see how they can apply higher values to daily thoughts and actions

 

Types of situations and sample solutions: Sherry (overhead)

1. Non-value-related presenting problem. Presenting problem appears to be non-value-related, but self-exploration leads to value issues that affect the presenting problem.

2. Non-religious, value-related. Presenting problem is value-related, but not connected to any religion.

3. Implicitly religion-related. Presenting problem is value-related, but implicitly related to their religious views or history.

4. Explicitly religion-related. Presenting problem is explicitly related to their religious views or history. CASES

VI. SUMMARY, REFERENCES, AND QUESTIONS–play HERO from CD. Put OH with words up.

Note: For additional materials related to program, visit Tom’s web site, leave your name, email us, or write.

Handout:

 

Sample World View Issues Affecting Psychological Functioning:

Issues for Cognitive Therapy and Personal Growth 

                       

 

  Ok fail, poor, alone, sinful, sick,?                                     Does he just want me to obey rules and reward me only     

–Rule-bound, Paul from Pharasee->empathy/love Read Cor if I obey and punish me if I don’t?

 I Corinthians 13,

 *ex about receive * I am entitled to a good job, etc Life owes me...

if not get it bitter, victim, owe me,  

I was born of no merit of own, etc.  (If time) Zero exp-> abundance/appreciation-> happy.

When anxiety or depression, always look for underlying expectations/goals. For what GIVE and RECEIVE.

If life gives me lemons make lemonade.  

Look at Christopher Reeves  – On top of world, could have been bitter.  From Superman to Super man.