Book Review: Developing Resilience: A Cognitive-Behavioural Approach
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In this issue the books reviewed are a good indicator of the breadth and inclusiveness of the existential perspective. CBT often provokes a polarised debate and we start with a review of a recent book about CBT. One of the reviewer's points is that it has come a long way in a comparatively short time and warrants more notice now than it once did. This is followed by a necessarily long and in-depth analysis of the overlaps between existentialism and eastern thought. Necessarily long because commentators on the connections rarely have a solid knowledge of both fields, unlike our current reviewer. It would be a great loss if existentialism was to stay within the confines of philosophy and therapy and the next book is a relatively mass market book that tries to reach beyond without dumbing down. A skill indeed. The debate about the origins of the differences, such as they are, between men and women will probably never die down and the next book looks at the issue of men's particular therapeutic needs and how they may be addressed in therapy. Until recently existential writing in the UK has been largely dominated by two writers who were placed unfortunately and too simplistically by their readers in opposition to one another with a consequent loss to debate. The next review of four books together establishes three other writers with additional perspectives with respect to the practice of existential therapy. This can only be a good thing. Following this is a book on the connections between psychoanalysis and existentialism. Considering that death and spirituality are central ideas, they are curiously underrepresented in the literature. The next book from major figures in the field redresses this imbalance. Because they deal with basic developmental issues of life and death and are less abstract and more experience-near, formal existential education could draw far more than it does on works of fiction and we finish this issue with reviews of two impressive books that draw on the value of fiction in understanding and interpreting the nature of existence.
Developing Resilience: A Cognitive-Behavioural Approach.
Michael Neenan. (2009). Routledge, London & New York 2009
Developing Resilience was first published in 2009 simultaneously in the UK, USA and Canada, which perhaps comes as no surprise since a lot of research on resilience has been published in the previous years in North America by reputable cognitive practitioners such as Padesky (2008) or Coutou (2003).
Cognitive-behavioural (CB) therapists have shown a growing interest in the area of individual resilience and inner strengths since the 1980s and this book is a natural and obvious development by one of our own, very experienced UK based (CBT) therapist Michael Neenan, a co-director at the Centre Management for Stress in Kent and a colleague of Windy Dryden¹ In the UK, clinicians had traditionally focused on symptoms management however, impressive work in the area of individual resilience has been revealed by various authors of the 'Overcoming' series² (cognitive-behavioural, self-help guides). Even though each overcoming (self-help) guide has a specific focus such as, low self-esteem (Fennell, 1999) or relationship problems (Crowe, 2005) many of the strategies suggested are aimed at helping individuals build their self-beliefs and resilience. Thus it appears that CBT had started to pay close attention to the domain of individual resilience some time ago, both in the UK and across the ocean and Neenan's work is a good example of how clinicians' understanding of individuals' (therapeutic) needs had evolved over the years.
The author therefore, approaches a relevant subject and draws not only on his own clinical experiences but on the work of other authors with similar interests, to successfully deliver 10 chapters on a subject that most therapists ought to know something about. The book is practical and has the quality of a self-help guide. Even though it stays within the CBT tradition, the material is not constrained by typical psychiatric or psychological jargon. The book's 10 chapters (listed below) hide no surprises and clearly indicate toward the content; each chapter has an introduction and several subheadings aimed at answering the questions raised in each chapter's title.
- What is resilience?
- Attitude: the heart of resilience
- Attitudes that undermine resilience building
- Making yourself more resilient
- Strengths underpinning resilience
- Resilience in workplace
- Resilience in relationships
- Resilience in dealing with difficult people
- Maintaining resilience
- An overview of resilience
The book starts with an attempt to define what resilience means for the author and his reputable colleague Windy Dryden; and from there on it continues with a description of different methods of building individual's inner strength and dealing with various obstacles one might encounter in building resilience, in a pure cognitive and behavioural manner and language. Most of the theory is backed by a range of practical examples and case studies. Some of the areas covered are, managing unhelpful emotions and thoughts, learning from past experiences, developing self-beliefs, maintaining a resilient outlook, being realistic as well as other emotional regulation techniques (or what in the book is referred to as frustration tolerance).
The author quotes Epictetus³ (Greek philosopher more than 2,000 years ago) and mentions the ancient Stoic philosophers' view of resilience, in the first chapter. To the reader who is unfamiliar with CBT this may seem an unusual opening but philosophical ideas and traditions, even Buddhism and Hinduism, are often quoted by CBT researchers in an effort to bridge and bring depth to scientific constructs. Indeed more recently, third-wave therapies⁴ are offering a new philosophical dimension to this otherwise, very scientific approach.
Having said that, Developing Resilience is far from being a philosophical paper, it does not take on a humanistic or existential stance and therefore it should not be read with those views in mind. On the contrary, the book defines resilience using clear psycho-social terms and outlines a range of traditional cognitive and behavioural techniques, such as ABC (see Chapter 2, page 22) used here to explain how one might raise awareness and manage negative thoughts when faced with difficult situations, thoughts and emotions. Existential views of anxiety for instance are not taken into account since only pathological anxiety is discussed, and by the same token sadness is viewed much more as a symptom of depression rather than a standalone, necessary condition of human existence.
On the other hand some overlap with the existential thinking is inevitable and a good example is the subchapter on 'self-acceptance' (see Chapter 5, page 76); the reader might be surprised to discover that cognitive-behavioural therapists are also viewing acceptance as an essential part of the therapeutic process. The author views self-acceptance as 'the acknowledgement of yourself as a fallible (imperfect), complex and untreatable human being' and this view had been already noted in a previous CB manual by Neenan and Dryden (2004).
To describe in detail each chapter, would turn this brief article into a detailed synopsis rather than a review, and it will almost be too revealing since the book is so well structured and efficiently organised. Therefore, I would just conclude that, Developing Resilience is a well-written, engaging manual packed with many practical examples that aim to enhance knowledge, ability and skill in the complex and unquantifiable area of human resilience. It does not make the slightest attempt to put other forms of therapy down or try to show that cognitive therapy is somehow the knowledgeable authority in this field.
Although some philosophical concepts are briefly discussed as already mentioned earlier, to some, existential-phenomenology would not have been given sufficient credit in spite of the obvious contributions, such as, the understanding of being-in-the-world (Heidegger, 1962); therefore this book might leave some readers feeling that they have just attended a coaching workshop.
Michael Neenan's work is nonetheless a testimony to the nature of CBT. If in the 1960s this modality was merely a treatment protocol for depression, 50 years later practitioners talk about a family of cognitive and behavioural therapies; this approach has developed like no other to the extent that it has incorporated neuroscience as well as philosophy (Hickes and Mirea, 2012); thus an expansion in the area of individual's inner strengths and resilience is yet another obvious development for the cognitive-behavioural psychotherapist. This book I feel will help improve the image of cognitive and behaviour therapies, which a lot of schools would still describe as emotionally detached, too intellectual and technique driven. The book was published at a time when third wave therapies were still in its infancy and other therapeutic modalities still believed that CBT's success is largely due to its cost effectiveness as a short-term therapy. Neenan is yet another respected author and an experienced therapist who is showing his readers that some myths about CBT could not be further from the truth.
Notes
¹ Windy Dryden is one of the leading practitioners and trainers in the UK in the Cognitive Behaviour Therapy (CBT) tradition of psychotherapy. He is best known for his work in Rational-Emotive Cognitive Behaviour Therapy (RECBT), a leading CBT approach. He has been working in the field of counselling and psychotherapy since 1975 and was one of the first people in Britain to be trained in CBT. He has published over 185 books and has trained therapists all over the world, in as diverse places as the UK, the USA, South Africa, Turkey and Israel. He is currently Professor of Psychotherapeutic Studies at Goldsmiths, University of London.
² Overcoming self-help series offer courses of highly effective CBT in book form. CBT is recommended by the NHS for the treatment of many emotional and psychological problems. The authors are among the leading and best-qualified mental health experts in their field and our books are recommended to thousands of people by NHS psychologists. http://www.overcoming.co.uk/single.htm?ipg=4795
³ Epictetus, Stoic philosopher and patron of the resilient (AD 55-135) 'people are not disturbed by events but by the view they take of them' highlights one of the basic most fundamentals theories in the CBT approach.
⁴ Third wave (CB) Therapies was introduced at the CBT World Congress in 2005 Gothenberg and it refers to the latest developments that are based on Eastern philosophy and tradition (Hayes et al., 2004).
References
Coutou, D. (2003). How Resilience Works. In Harvard Business Review on Building Personal and Organizational Resilience. Boston, MA: Harvard Business School Press.
Crowe, M. (2005). Overcoming Relationship Problems: A self-help guide using Cognitive Behavioural Techniques. London: Robinson.
Fennell, M. (1999). Overcoming Low Self-Esteem: A self-help guide using Cognitive Behavioural Techniques. London: Robinson.
Heidegger, M. (1962). Being and Time. Blackwell Publishing, Oxford, England.
Hickes, M. and Mirea, D. (2012). Cognitive Behavioural Therapy and Existential-Phenomenological Psychotherapy: Rival Paradigms or Fertile Ground for Therapeutic Synthesis? Journal of Existential Analysis, 23(1): pp 15-31.
Neenan, M. and Dryden, W. (2004). Cognitive Therapy: 100 Key Points and Techniques. Hove, UK: Brunner-Routledge.
Padesky, C. (2008). 'Uncover Strengths and Build Resilience with CBT: a four-step model'. Workshop, London, 12-13 May 2008.
Daniel Mirea
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