Varga_Cognition%2C+Mental+Repr.s+_+Embodied+Emotions+_rec+09+13_

7/27/2019 Varga_Cognition%2C+Mental+Repr.s+_+Embodied+Emotions+_rec+09+13_

1/26

Cognition, Representations and Embodied Emotions:

Investigating Cognitive Theory

Somogy Varga

Received: 20 July 2012 / Accepted: 27 March 2013 Springer Science+Business Media Dordrecht 2013

Abstract Cognitive theory (CT) is currently the most widely acknowledged

framework used to describe the psychological processes in affective disorders like

depression. The purpose of this paper is to assess the philosophical assumptions

upon which CT rests. It is argued that CT must be revised due to significant flaws in

many of these philosophical assumptions. The paper contains suggestions as to how

these problems could be overcome in a manner that would secure philosophical

accuracy, while also providing an account that is better suited to explaining some ofthe cognitive, emotional, and bodily manifestations of affective disorders.

1 Introduction

In recent years there has been a reawakened philosophical interest in the topic of

emotion and its relationship to cognition and mental representation. While this

interest has resulted in the emergence of a dynamic field that is characterized by

interdisciplinary research, relatively little philosophical attention has been devotedto the conditions in which emotions are disordered. Nevertheless, such attention

could result in a mutual enrichment. Relevant knowledge from psychopathology

could inform and correct philosophical inquiry, while psychological and psychiatric

theories could benefit from a philosophical assessment of some of their core

assumptions (Varga2011,2012).

In this paper, an attempt will be made to work towards such a mutual enrichment

by assessing the foundations of the influential cognitive theory (CT) as defended by

Beck et al. CT is probably the most commonly used theoretical approach to

understanding the psychological processes involved in affective disorders and toconceptualize the adequate psychotherapy. Alford and Beck (1997, 4142) claim

S. Varga (&)

Department of Philosophy, University of Memphis, 327 Clement Hall, Memphis, TN 38152, USA

e-mail: [email protected]

1 3

Erkenn

DOI 10.1007/s10670-013-9484-x


2/26

CT is of both practical and explanatory value: The purpose of cognitive theory is

to provide conceptual tools for effective action or practice in such clinical contexts.

It also explicates the factors or processes responsible for the development,

maintenance, correction, and prevention of psychopathology. I should note that

what I outline here is the most influential and canonical version of CT, as espousedby founding fathers like Beck and others. There are of course approaches to CT that

deviate from the canonical version and it is therefore possible that some of these

might not subscribe to all of the assumptions that I deal with. Consequently, the

critique and corrections I put forward have broad applicability, although there might

be versions of CT that will not be vulnerable to all of the concerns that I raise.

In CT, emotional disturbances like those in depression are thought to be a result

of an inaccurate cognitive mind-set or an inadequate way ofthinkingabout self and

world (Beck 1967; Beck and Alford 2009; Wells 2008, 2), as a matter of faulty

information processing or distorted and dysfunctional beliefs (Bracken andThomas2008, 86). Maladaptive cognition is thus given a causal role in depression

(Kuyken et al.2005, 114; DeRubeis et al.2008). CT is the theoretical foundation of

so-called Cognitive Therapy,1 which is promoted as the therapy of choice for many

emotional disturbances and constitutes the predominant paradigm of psychotherapy

in the treatment of depression (Epp and Dobson2010; Holmes2001; Ghaemi2007).

In CT-informed therapy, the aim is to alter depressive cognitive styles by

challenging and modifying irrational and dysfunctional thought.

Of course, a proponent of CT could respond to the first aim of this paperto

philosophically evaluate CTby saying that, instead of philosophical assumptions,it is firmly based on scientific principles (Padesky and Beck 2003; Dryden et al.

2010, 226277 in Dobson 2010, 262).2 Such a proponent may remind us that CT-

based therapy is currently the first-option treatment for diverse conditions because it

has been successfully formalized in comprehensive therapeutic manuals and has

been positively evaluated in randomized controlled trials (Epp and Dobson 2010;

Hollon and Beck 2004; Roth and Fonagy 2005).3 However, there might be an

epistemological misconstruction in such a strategy that neglects the fact that in

many cases the boundary between scientific and philosophical issues cannot be

drawn sharply. While generating numerous testable hypotheses, scientific theories

emerge in paradigms that always involve untestable or circular assumptions.

Consequently, it is unproblematic to say that empirical studies can prove that people

suffering from, or vulnerable to, depression have a propensity to assess themselves,

the situations they encounter, and their relations to other people in a certain way.

Also, it is equally unproblematic to hold that empirical studies can help to evaluate

1 Cognitive therapy is the application of cognitive theory to the individual (Beck and Alford 2009,

300). Also: we do not believe that the therapy could be applied effectively without knowledge of the

theory (Beck et al. 1979, 4).

2 Indeed, Padesky and Beck have critiqued other approaches (for example, Ellis rational emotivebehavior therapy REBT) for representing a more philosophical approach, while pointing out the more

scientific base of CT (Padesky and Beck2003).3 In recent years, however, there has been an increase in discussion about the effectiveness of such an

approach, especially in terms of clinical improvement and protection against relapse (Brewin2006; Roth

and Fonagy2005).

S. Varga

1 3


3/26

the effectiveness of the treatment process (McEachrane 2003, 82). However, it is

problematic (and circular) to hold that empirical studies can provide satisfactory

evaluation of all the underlying key assumptions.

Philosophy can indeed make a valuable contribution here because, as will be

made clear, CT rests on certain philosophical assumptions (McEachrane 2003;Lacewing2004; Whiting2006a) that have a long history (Butera 2011). This paper

will assess these philosophical assumptions and argue that due to several flaws, CT

must be revised. In the final section of the paper, a way will be sketched in which

these flaws could be corrected in a manner that would not only secure philosophical

accuracy but also result in an account that is better suited to explaining some of the

cognitive, emotional, and bodily characteristics in affective disorders. Furthermore,

the conceptual adjustment might lead to improvements in the treatment protocols

and the empirical testing of the protocols.

2 The Philosophy of CT

The two primary historical factors that led to the emergence of CT were the

cognitive revolution in psychology, on the one hand, and the growing dissatis-

faction with both stimulusresponse psychology and psychoanalysis on the other

(Dobson and Dozois 2010). At the same time, theoretical psychology began to

acknowledge the existence of inner mental maps (Holmes 2010; Westen 2005).

Partly due to these factors, the 1950s and early 1960s saw an increasing emphasis onthe role of cognitive processes in psychiatric disorders (Beck and Alford 2009, 232).

Albert Ellisconsidered by many to be, along with Aaron Beck, the father of CT

presented a theory of emotional dysfunction in the 1950s that has become an

important premise of CT. The so-called ABC model of emotional disturbance was

meant to describe how cognitive processing (as opposed to the environment)

influenced emotional and behavioral reactions. While CT underwent numerous

modifications over the ensuing four decades, its general point remains that mental

disorder is intrinsically linked to cognitive disturbance.4

From this outlook, depression is conceptualized as a disorder of thought (Beck

and Alford 2009, 208, 239) and the pathological affective disturbance can be

regarded as the consequence of the way individuals view themselves and their

environments (Ibid., 231). The primary causal factor in the development of

depression is the activation of idiosyncratic cognitive patterns that divert thinking

into specific channels that deviate from reality (Beck and Alford2009, 243; Wells

2000, 34). A central claim is that depression is characterized by inaccuracies in

information processing that therapy aims to correct (Beck and Alford 2009; Clark

4 The idea of an underlying cognitive disturbance serves as a point of departure for many other and less

widespread approaches like Ellis rational emotive behavior therapy (REBT), and, to a lesser degree, for

the more recent acceptance and commitment therapy (ACT) and for some of the so-called third wave

approaches (Dobson and Dozois 2010). Also, other directions that either place greater emphasis on

metacognitive interventions or attempt to insert positive distortions into cognitive processes to a certain

degree still remain within the cognitive paradigm.

Cognition, Representations and Embodied Emotions

1 3


4/26

et al. 1999). As Judith Beck (1995, 2), one of the currently most influential

proponents of this approach, notes:

The therapist seeks in a variety of ways to produce cognitive changechange

in the patients thinking and belief systemin order to bring about enduringemotional and behavioral change.

Additionally, Aaron Becks cognitive-content specificity hypothesis postulates

that depression has a distinctive cognitive profile that is characterized by thoughts

focused on incompetence, failure, or worthlessness (Clark et al. 1989, 1990;

Szentagotai et al. 2008). As we shall see in the next section, these negatively

distorted thoughts and beliefs emerge from the activation of negative and more

fundamental belief-systems that are stored in long-term memory.

2.1 Schemas and Automatic Thoughts

A central characteristic of CT is a distinction between fundamental beliefs or

schemas and something like second-order thoughts called automatic thoughts

that emerge on the basis of schemas. These schemas begin developing in childhood

and they contain beliefs which are understandings that are so fundamental and

deep that [patients] often do not articulate them, even to themselves (Beck1995,

16). Schemas are depicted as stored bodies of knowledge containing fundamental

beliefs which are regarded by the person as absolute truths, just the way things

are (Ibid.) Schemas interact with incoming information and help shapeexperience (Beck and Alford2009, 255; Williams et al. 1997).

Dysfunctional schemas are thought to be causative elements in the development,

maintenance, and recurrence of a variety of mental disorders such as depression.

The schemas of depression-prone individuals are considered to be dysfunctional

because they contain beliefs about self and world that are rigid and unrealistically

negative (Kovacs and Beck 1978; Beck 1983; Hammen 1997; Epp and Dobson

2010; Blatt 2004). CT maintains that depressed individuals possess negatively

biased cognitive schemas that reflect past experiences, and organize and structure

new experiences. In the case of numerous and significant early negative

experiences, negatively biased schemas (Im vulnerable, I am worthless, or

the world is dangerous) may develop which influence the preferential processing

of information. Over time, these schemas often become unconditionally acknowl-

edged as truths (Wells 2000), in the sense that they are not seen as contingent

construals to which alternatives are possible. It is on the background of such aspects

that Charland (2006) has argued that depression assumes the character of a

cognitive module.5

5

This hypothesis has been put forward by Charland (2006), who argues that a good theoreticalformulation and defence of this hypothesis can be found in Aaron Becks well-known cognitive theory of

depression (2006, 221). Charlands point that the emotional system is marked by a susceptibility to

develop a modular structure (Ibid., 225) may be right, but it is unclear whether this can in any way further

our understanding of emotional disturbances. We would still have to explain why emotional systems in

some individuals and not others are afflicted. CT provides an explanation for this, but one that does not

clearly sustain the modularity hypothesis.

S. Varga

1 3


5/26

Cognitive theory maintains that while schemas are mostly not readily accessible to

consciousness, they are both expressed in and activated by automatic thoughts (Alford

and Beck1997, 1617). Schemas become apparent to both the patient and therapist as

they identify the consistencies or themes that run through the automatic thoughts.

Cognitive training is supposed to make people able to catch the automatic thoughtsthat follow an event and trigger the emotional response (Beck1976, 26; Beck and

Alford 2009). Beck (1995, 14) notes that when reading her book on cognitive therapy,

such automatic thoughts could be: This is just too hard. Im so dumb. Ill never

make it as a therapist. Automatic thoughts are the situation specific actual words or

images that go through a persons mind (Beck1995, 16). The most emotion-eliciting

automatic thoughts are thought to consist of some kind of mental representation

involving actual words; the authors also note that mental imagery can elicit the same

effect. But importantly, such mental imagery is also thought of as being conceptually

structured (e.g., Beck and Alford2009, 26, 3738).Overall, the relationship between core beliefs, automatic thoughts, and emotional

distress is viewed in the following way: experience is interpreted within the framework

of schemas, which lead to specific automatic thoughts that, in turn, generate specific

emotions. Consequently, therapy seeks to determine the content of such maladaptive

information processing strategies. The aim is to capture automatic thoughts that

allegedly elicit emotions in the moment and, on that basis, to explore the underlying,

general belief-schemas that these thoughts express. Then the attempt is made to

change the semantic information that such emotion-eliciting thoughts contain and

modify the content of basic schemas (Beck et al.1979; Beck and Alford2009). Thepatient is encouraged to logically challenge and test thoughts against reality, both in

session and as in-between-sessions homework (Milton 2008, 104), and to create

substitute representations that help restore positive mood states. In this framework,

once the correction is achieved and consistency with intersubjectively valid standards

is attained, these schemas can no longer trigger the unpleasant emotional disturbances.

3 Assessing the Underlying Assumptions of CT

After this brief outline, I want to isolate underlying assumptions on which CT is

based. These assumptions can be categorized into two groups, relating to

philosophical issues of mental representation and introspection on the one hand

(3.13.3) and emotion and cognition on the other (3.43.5). The assumptions are as

follows: Thoughts are mentally represented (3.1), words are the vehicles of thought

(3.2), we have direct access to our thoughts (3.3), cognition constitutes/causes

emotions (3.4), and schemas constitute the fundament of our thinking (3.5). In the

following, they will be tested one by one.

3.1 Thinking that P. Non-representational, Explanatory, Expressive

and Transparent Uses

In the CT literature, cognition is depicted as essentially involving internal

conversations and inner speech, in which we constantly talk silently to


1 3


6/26

ourselves (Sheldon 1995, 150151). Accordingly, the automatic thoughts that

accompany experience are described as on-going automatic self-statements

(Hollon and Kendall1980; Freeman et al.1989,2005), cognitive self-talk (Safren

et al. 2000, 328), internal exclamations (Newman 2006, 212), or as a running

commentary (Mulhern et al., 38). While the talk of statements, exclamations,speech, or commentary indicate that in CT, thinking implies the representation

of propositional content, other authors spell this out more explicitly. In their recent

book on CT and depression, Gilson et al. (2009), 128) speak of automatically arising

thoughts as self-talk sentences. Riskind (2006, 63) maintains that automatic

thoughts are consciously accessible verbal thoughts and pictorial images. Beck

(1995, 16) concurs, arguing that automatic thoughts are actual words or images

that go through a persons mind and that the therapist should aim to capture (Ibid.,

88).6

As these examples demonstrate, CT posits a very strong conceptual link betweencognitive events and mental representations andakin to the Representational

Theory of Mind (Sterelny1990) from the philosophy of cognitive scienceregards

representations as the vehicles that drive our thinking and carry mental content.

However, CT also maintains that there is a representation of propositional content

involved. In a concrete therapeutic encounter, this means that the report of the

patient in the form of I thought that P is understood as entailing the representation

of propositional content, which the patient can catch. In other words, there is a

general assumption that thought involves conscious mental representation and a

more specific assumption that mental representations are speech-like, that is,structurally isomorphic with spoken language (words are the vehicles of thought). I

shall first deal with the more general assumption.

As the following conceptual examination shall make clear, the general

assumption that thought involves conscious mental representation is flawed and

potentially damaging to a precise understanding of the patients self-reporting. I

shall introduce a couple of conceptual distinctions and argue that the formula I

think/thought that P can convey different meanings depending on whether it is used

in a non-representational (3.1.1), explanatory (3.1.2), expressive (3.1.3), or

transparent(3.1.3) manner.

(3.1.1) In order to demonstrate a non-representational use, I want to draw

attention to the crucial distinction between thinking and having thoughts (see

McEachrane 2003; Malcolm 1972; Davidson 1987).7 The fact that we sometimes

use the verb think in a transitive manner and, thus, imply that it has a propositional

object seems to mislead the CT to think that thinking involves the representation

of a propositional content. However, in everyday language, saying that a person

6 To avoid misunderstandings, it is important to recall that mental imagery is also thought to be

conceptually structured (e.g., Beck and Alford 2009, 26, 3738).7 Several of Malcolms connecting ideas have been contested (for instance by Davidson), but the aspect

that I emphasize here is not really controversial. For instance, while Davidson (2001, 97100) criticizes

specific aspects and implications of Malcolms idea (specifically the question of attributing of thinking

to animals), he similarly argues that we should not conceive of thinking as having representations before

the minds eye and urges us to give up the idea that thoughts require mental objects (Davidson

1987, 456).

S. Varga

1 3


7/26

thought that P does not imply that he thought of P, or that P occurred to him in his

thoughts. Let us look at some examples. When I enter my sons classroom to pick

him up, it sometimes takes a while until I spot him among the many children

wearing the same uniform. When I finally do, I am surely aware of my seeing him,

but in general, the thought that is my son does not occur in my thoughts. Thisobservation is also valid from a third-person perspective. When a cab driver stops

his car at an intersection because the light is red, he is cognitively aware of the light

being red, but the thought the light is red does not necessarily occur in his mind. In

other words, our speaking of thinking does not necessarily entail that we represent

propositional content: he thought that p does not entail the formula, the thought

that p occurred to him. Regarding having thoughts as the prototype of thinking

is bought at the expense of mistakenly taking grammatical form to be the index of

psychological reality.

If this is right, if he thought that P can mean something different than theformula the thought that P occurred to him then there is a risk that the CT

informed practitioner will misinterpret the patient. However, the picture is even

more complex, as there are yet other intelligible uses of the formula I thought that

P that carry different meanings.

(3.1.2.) It is perfectly intelligible to use the sentence I thought that P in an

explanatoryway, which not only does not involve mental representations, but which

cannot even be considered as involving reporting on actually occurred thoughts. As

noted, when we say that the cab driver thinks that the light is red, this need not

involve positing that there is a particular representation going through his mind.Rather, we attribute thoughts to him and use the term thinking to describe and

explain the situation in question in a way that makes sense of his actions. In other

words, when we attribute the thought to the cab driver we do not necessarily

designate some mentally represented entity, but rather the situation that he is in. As

Dan Hutto (2008, 433) notes, we use such sentences to fill in the content clause,

but this is only a convenient way of denoting the situation that it is directed at non-

contentfully. Also, when asked to explain why he stopped, the cab driver may

simply tell us I thought the light was red. But in that case, he would not be

reporting on words or images represented in his mind, rather, he would be

explaininghis experience of the situation and his reaction in a particular way, which

involves some kind of awareness of the light being red. When listening to his

explanation, unless we are given further information, under normal circumstances

we cannot assume that he is reporting on thoughts that actually occurred to him.

(3.1.3.) There is in our everyday language yet another non-representational way

in which it is entirely intelligible to use the sentence I thought that P. We may use

it an expressive way, which is neither about reporting on thoughts or explaining

actions, but about expressing emotions. In order to see this, let us imagine that

Malcolms car driver is involved in a serious car accident right after stopping at the

red light. When a concerned friend or therapist later asks him what went through his

head in that life-threatening situation, he may very well reply, I thought I was going

to die. But what does his answer mean? It is rather unlikely that he means that the

thought I thought I was going to die or a particular image with the same content

passed through his mind. Instead, his utterance might very well convey the manner


1 3


8/26

in which he experienced being in the dangerous situation, feeling frightened and

passive. In other words, in this case his utterance I thought I was going to die is not

explaining (or at least not only explaining) but expressing the terrifying emotional

experience that he underwent. Thus, his voiced thought might very well have been

the first time these words actually occurred to him.(3.1.4.) The last meaning connected to the formula I thought that P that I want

to mention can be referred to as the transparentuse. Recall that in CT, it is assumed

that the proper answer to the question of the therapist Do you think that P?

involves an introspective process that aims to detect pre-existing thoughts.

However, it is perfectly intelligible to attribute thoughts to ourselves without

turning inward at all. Indeed, in many cases where we think that we arrive at a

certain self-ascription of a mental entity by inwardly attending (introspection), we

are in fact attending outward to those aspects of the world that our mental states

are about. That is, sometimes we simply acquire knowledge about our minds andarrive at self-ascriptions by looking outward. The question Do you think that P?

may be transparent to a corresponding question about the world, which can be

answered by considering reasons that count for or against P itself (Evans 1982;

Moran 2001). It is perfectly intelligible to attribute thoughts to ourselves without

turning inward at all. Given the CT framework, the therapist may easily mistake this

utterance as a direct, introspectively achieved report about the patients inner life.

The analysis provided so far has established a couple of interlinked points. It

became clear that when somebody uses the formula I thought that P, we are not

warranted in assuming that the relevant thought was mentally represented to him orher. Further complicating matters, we have established that using this formula does

not even necessarily entail that the person is reporting on thoughts at all. He may

just as well be explaining actions, expressing emotions (see also section (e)) or

forming beliefs. If the points made here are correct, then the CT-informed therapist

might in numerous cases wrongly infer the existence of a corresponding internally

represented propositional content and severely misunderstand the meaning of the

patients report. At least in some situations, the excessive focus on thoughts as

mental representations and the neglect of situational and bodily dimensions may

preclude a precise understanding of what the patient is saying.

Importantly, what I have said in this section entails no knock-down argument

against the general idea that thinking may involve mental representations. The

points I have put forward are compatible with the view that in some cases mental

representations are indeed constitutive of our thinking.8 But they also show that in

8 For additional support for the arguments made here we could draw on recent discussions in the

philosophy of cognitive science, where non-representationalist approaches to cognition are increasingly

popular (Keijzer1998; Hutto1999; Wheeler2005; Gallagher2005; Dreyfus2004; Varga in press). Non-

representationalist arguments often draw on continental phenomenology and find support by empirical,

cognitive-scientific cognition. But we might also consider a possible objection the CT theorist might use,inspired by representationalist replies to the non-representationalist challenge. Could the CT theorist not

relax her main claim and argue that CT merely provides inferences to the best explanation about

subpersonal phenomena? To see why this strategy is not available for the CT theorist, we have to recall

that CT is not merely explanation oriented, but aims to change cognitive and emotional phenomena.

Therefore, CT has to assume that automatic thoughts and schemas are not subpersonal, but accessible to

consciousness.

S. Varga

1 3


9/26

order to secure a precise understanding of the report of the patient, the CT

assumption that automatic thoughts are internally represented in a way that we can

catch them must be corrected. In order to see whether this is possible, we need to

ask: is it the case that CT needs to (is logically compelled to) assume the view?

Does CT need maintain that all thinking is reducible to having thoughts? Inshort, nothing of what I have said implies that CT is logically compelled to

subscribe to such hard-nosed representational view. Thus, CT could in principle

choose to relax this view significantly, maintaining that only thinking only

sometimes involves the representation of propositional content. However, without

further arguments, this move would also render CT question begging. If the CT-

informed therapist cannot assume that thoughts involve the representation of

propositional content, then more needs to be said as to how she would pick out the

right automatic thoughts. At this point, I can only gesture towards a solution,

which I see as connected to more focus on interpretation. What the formula I think/thought that P really means, whether it involves representation of propositional

content, and whether thinking is applied in an expressive, explanatory, or

transparent manner will to a large extent first become intelligible if the whole

communicative situation, the context, the tone of voice, and bodily language is

taken into account. In other words, accommodating the criticism would require that

CT put more emphasis on interpretation.

3.2 Words are the Vehicles of Thought

Different versions of the idea that thinkingoccurs in a kind of inner speech involving

words are not unfamiliar in philosophy.9 In CT, the claim that thinking involves

representations is paired with the idea that that symbols like words and propositions are

the vehicles of a persons thought. Recall that in CT, cognition is understood in terms of

an ongoing internal conversation, inner speech, or as a running commentary to

experience (see 3.1). Thoughts are described as involving self-talk sentences that are

consciously accessible (Gilson et al.2009; Riskind2006). It is on such a background

assumption that CT-theorists instruct practitioners to convey to their patients that it is of

utmost importance to recognize and capture the precise wording of their automatic

thoughts (Beck and Alford2009, 311; Beck1995, 16 and 88).

In order to assess the accuracy of the assumption that all thinking involves words,

we may draw on several sources. First, we may draw on empirical findings to

counter the phenomenological claim in CT about actual words or images that go

through a thinking persons mind. In several studies, Hurlburt and Heavey (Hurlburt

1990,1993; Heavey and Hurlburt2008; Hurlburt and Heavey2002;2004; Hurlburt

and Akhter2008) demonstrate that we frequently think in an unsymbolized manner,

9

For instance, Gilbert Ryle refers to thinking as internal monologue or silent soliloquy (Ryle1949,28), while Plato writes that the soul when thinking appears to me to be just talkingasking questions of

herself and answering them, affirming and denying. I say, then, that to form an opinion is to speak, and

opinion is a word spoken, - I mean, to oneself and in silence, not aloud or to another Recently,

Carruthers (1996, 5051,2009) has subscribed to a related view maintaining both that thoughts occur in

the form of imaged conversations and that we have introspective access to them. However, in his

account, Carruthers also reserves a place for the so-called mentalese.


1 3


10/26

entertaining thoughts that do not include words or propositions.10 This is further

sustained by ontogenetic considerations about, on the one hand, the acquisition of

concepts and words, and thinking on the other. It seems relatively straightforward

that in order to learn a language, the young child must be able to reflect on and

hypothesize about the meanings and correct applications of the words that she hears.To be able to achieve this, however, the child needs to be able to possess certain

concepts and entertain thoughts. This conceptual point is supported by empirical

evidence showing that thinking and the possession of concepts precede the

acquisition and mastery of words (Hespos and Spelke 2004; Bloom2000a,b).

Still, a CT theorist could counter this in several ways. One way would be to argue

that these mainly phenomenologically-based findings miss the target because

positing that words are the vehicles of thoughts is a theoretical matter about

subpersonal phenomena. But this objection would fail, because CT needs to assume

that the relevant mechanisms are available for conscious thought.A second, and more successful, way would be to argue that these empirical

results are in principle compatible with CT. CT could simply relax its claim, and

maintain that not all, but in a good deal of cases, words are involved in our thinking.

This move would as such not be devastating for CT, but it would introduce further

insecurities. CT would have to specify whether and why automatic thoughts belong

to the realm of thinking that involves representing propositional content. Also, given

that CT maintains that patients have to learn to identify automatic thoughts, it would

have to be clarified how the patient would identify thoughts that involve words and

further distinguish between automatic and non-automatic ones. However, there isanother critical problem that is more damaging to CT. I want to argue that even if

we assume that the patient reliably identifies automatic thoughts involving words,

we need to distinguish between those cases in which these words have a constitutive

or merely an accompanying role. As I will show in the following, while the

constitutive story is very difficult to establish, it is nevertheless the one that CTboth

assumes and needs to assume.

3.2.1 Words: Constitutive or Accompanying Role?

Consider the following example. Our cab driver is a rather unorganized man, who

often forgets to lock the door of his car in spite of knowing that the city he lives in

has exceptionally high rates of car theft. Both his employer and his wife have

unsuccessfully warned him several times that if he continues his forgetful habit, it is

only a matter of time until he will have his car stolen. One day, returning to the car

10 In these studies, normal subjects wore a paging device, which would randomly beep throughout the

day. Somewhat similar to patients in a CT informed therapy session, the subjects participating in these

studies were asked to stop and record the thoughts that they had during the activation of the device. What

subjects report is that besides inner speech and visual imagery, they also experience unsymbolized butdeterminate thoughts - such as wondering whether or not to purchase a particular item in a supermarket -

in the absence of any visual imagery or inner speech (Heavey and Hurlburt 2008, 802). Moreover, the

authors have detected a significant negative correlation between inner speech and unsymbolized thinking.

This means that individuals have a relatively stable propensity towards different thinking patterns. Those

who report frequent cognitive activity in which words and proposition constitute the vehicles of their

thoughts have at the same time relatively few instances of unsymbolized thinking.

S. Varga

1 3


11/26

park from his lunch break, the unlocked car is gone. The first thought that comes to

his mind is, I had that coming.

Now, the first issue I want to demonstrate with this example is that it is difficult

to tell whether the proposition involved (the resounding words I had that coming)

can be said to constitute the cab drivers thinking. When the thought resounds, hemay likely be imagining telling the episode to his wife or employer. In that case, it is

questionable whether the resounding words I had that coming are the indispensible

vehicles of his thought. But in case he is imagining himself speaking, then the

resounding words have an accompanying role, simply adding a meta-level to his

thinking (see Davies 1998). This would be both consistent with the conceptual

analysis presented earlier (3.1) and also with the view that words and language are

not necessary for thought, but only for meta-level thought (Smith 1998, 407). The

point is that without further evidence, there is no obvious reason to assume that the

resounding words constitute his thinking.In support of this, one may make a stronger argument: when the cab driver

hears himself inwardly uttering I had that coming we cannot even securely

assume that he is aware of a genuinemental episode of thinking. Byrne (2011, 115)

compares inwardly and outwardly uttered sentences and argues that the outer

utterance is not itself an episode of thinking, but something produced by such an

episode; likewise, if there were () an inner utterance it wouldnt be an episode of

thinking either. Thus, using Byrnes idea, we could argue that what the cab driver

is really aware of when he hears himself inwardly uttering I had that coming is

not the thinking process itself, but rather its product. Byrnes reflections usefullycomplement the arguments presented earlier, but his position is stronger than the

one I am trying to defend. While he subscribes to the view that inwardly-uttered

words cannot be taken to constitute the vehicles of thought, Byrne seems to deny

that they can be parts of the thinking itself. My suggestion is more modest,

maintaining that at least in some of those cases in which words resound in our

heads, the words inquestion only play an accompanying role in our thinking, rather

than constituting it.11 Also, I am not claiming that it cannot be clarified whether a

resounding thought has an accompanying or constitutive role. Rather, the point is

that it would take exactly the kind of (not insignificant) interpretative effort that CT

wants to avoid (see more on direct versus interpretative retrieval in3.3).

A CT theorist might reply that it does not really matter whether the resounding

thought constitutes or merely accompanies thinking. She might remind us that what

really matters is that these thoughts are generated by a (negative) schema and that

they can be used to detect that schema. Nonetheless, this objection is not entirely

convincing. If one assumes that the resounding thought in question merely

accompanies thinking, then it is doubtful whether it would necessarily or even just

reliably reveal underlying schemas. Here is why.

11 The view that thinking does not necessarily involve words is less bold than the idea that not all

thinking may involve concepts. The latter view has been put forward by Bermudez (2003), emphasizing

non-conceptual processes of representation that are not constrained by the range of concepts possessed by

the cognitive agent. Similarly, Evans (1982) has written about the possibility that cognitive activity may

involve non-conceptual content.


1 3


12/26

Let us imagine that our cab driver felt depressed and consulted a CT-informed

therapist. When talking about the episode when his car was stolen, the therapist asks

him What went through your mind? He replies: I had that coming. Now let us

assume that the words in question (we are now assuming that they resound) play a

merely accompanying and not constitutive role. The difficulty we then face is asfollows: If the resounding thought only accompanies thinking, for example, if he is

thinking by imagining himself speaking about the episode, then it is an instantiation

of thinking that is located at a higher level of thought, and the connection to an

underlying schema becomes more uncertain. Put differently, it then becomes

implausible to think that the thought necessarily (or even reliably) reveals or reflects

an underlying schema. So in order to avoid potential misunderstandings, and to

maximize the reliability of the CT therapists judgment, it is safer if the therapist

only infers an underlying schema in cases in which the resounding thought has a

constitutive role.

3.3 We have Direct Access to our Thoughts

Besides the CT conjecture about the vehicles of thought, the idea that patients can

catch (Beck; JS Beck) the precise wording of their automatic thoughts relies on

an additional assumption. That is, the assumption about a vehicle of thought is

complemented by an assumption about access to our thoughts. Recall that the

patient is instructed not to interpret, but to simply observe introspectively and report

the actual words that go through her mind. This is something that patients usuallyhave to get used to: Until they have learned to recognize these thoughts, many

patients report interpretations, which may or may not reflect the actual thoughts

(Beck1995, 88 emphasis in original). This, however, relies on the assumption that

we must have direct (unmediated, non-interpretative) introspective access to our

thoughts. If the claims and recommendations of CT are coherent, then CT has to

rely on the assumption that by introspection we can bring our thoughts into

awarenessdirectlythat is, unaltered, unpolluted by any process of interpretation.

To be clear, the point is not that CT assumes that there are completely unpolluted

thoughts. Evidently, CT maintains that thoughts are polluted, namely by the

underlying schemas. My point is, rather, that CT assumes that the introspective

retrieval brings thoughts into awareness unpolluted by any additional process of

interpretation.

One major flaw in the assumption of direct access is that it neglects the authority

and agency that we entertain towards our mental states. When we bring aspects of

our mental life to consciousness, we are not merely something like an expert witness

of our mental states. Rather, the identity of a given inner entity depends on our

interpreting it by applying conceptual and descriptive resourcesa process that

involves a stance of agency (Moran 2001, 4; 42). Bringing into play both the

issue of the constituting agency of the person and the dynamic relation between

first-person reflection and mental life, Moran (2001, 28) shows that acquiring

knowledge of our inner life is not a perception-like and relatively neutral epistemic

undertaking of an expert witness, but a process that has specific, formative

consequences for the object of introspective retrieval. In such a process, we do not

S. Varga

1 3


13/26

merely report, but, rather, shape (pollute) and sometimes co-constitute the state in

question. Thus, in those cases in which answering the question Do you think that

P? involves an introspective process, the introspection shapes and alters the content

in question (Moran 2001, 40).12 Mental states are far from being independent and

stable entities that await introspective discovery. Rather, they are polluted byintrospection as mental states are dynamically intertwined with our first-personal

agency.13

The CT theorist might object that I am attributing a view to CT that is stronger

than what it needs to assume.14 She could relax the claim and concede that there is

always some kind of interpretation involved. She could argue that CT only needs to

assume that introspective reports of the patient can sometimes, or in principle

truthfully reflecthow the patient feels. However, this would be too imprecise. Recall

that according to CT, affective states (how the patient feels) do not necessarily

reflect the underlying schemas. While it is important to know how the patient feels,bear in mind that in CT, it is not so much the way the person is feeling that is taken

to reveal insight about the schemas. Rather, and crucially, CT maintains that it isthe

automatic thoughts(which cause the emotions) that really offer the relevant insight.

Therefore, the CT theorist must embrace more than the simple and trivial claim that

introspective reports can sometimes accurately reflect how a person is feeling.

There is, however, another way in which the CT theorist could acknowledge the

role of interpretation and relax the relevant claim. She could argue that CT only

needs to assume that introspective reports of the patient can sometimes, or in

principle, truthfully reflect the patients automatic thoughts. There is somethingright about this objection. Surely, some reports are more accurate than others. But

this is also a quite substantial concession that introduces significant uncertainties

into the therapeutic setting. How is the patient or the therapist to decide whether a

report is more direct in the sense of involving a minimal amount of interpretation?

Given such insecurities, under what circumstances is it warranted to infer an

underlying schema? Thus, while it is in principle possible for the CT theorist to

concede the role of interpretation and relax the relevant claim, this would be bought

at relatively high price.

12 It should be noted that Morans view of first-personal agency is weaker than constitutivist views, such

as the one defended by Crispin Wright.13 Of course, this goes for both symbolized and unsymbolized thought. But it is even more

straightforward that we cannot be said to have direct access to our unsymbolized thoughts. Carruthers

(2009) has criticised Hulburts understanding, suggesting that when prompted by the beep, subjects turn

their mindreading systems on their own behavior and circumstances , often enough interpreting

themselves as entertaining a specific thought. The point that Carruthers tries to convey is that

unsymbolized thoughts are in the periphery of our awareness in a way that making sense of them

necessarily involves some kind of self-interpretation. But independent of Carruthers pointwhich

depends on a certain conceptualization of the mindit does seem rather unproblematic to hold that since

neither the content nor the vehicles of unsymbolized thinking are of propositional nature, ourcommunicating their content will always be indirect, involving some kind of translation into words and

propositions. Of course, none of this commits me to the idea that we do not have a direct or unmediated

understanding of our unsymbolized thoughts. The point so far is merely that our communicating their

content will always be indirect.14 I thank an anonymous reviewer for putting forward this objection.


1 3


14/26

3.4 Cognitions Cause and/or Constitute Emotions

After having considered the assumptions of CT that relate to the topics of cognition,

mental representation and introspection, the focus of the remaining part of this

section will be on cognition and emotions. The first point that I shall make is thatCT subscribes to a general cognitivist view of emotions, which explains the emotion

by attitudes directed at a proposition, while bodily feelings are in no way essential

(see de Sousa2010). A central assumption of CT is that emotional disturbances like

feelings of guilt, anxiety, and despair in depression can be traced back to a specific

constellation of thoughts and beliefs. Within the general view of depression as a

disorder of thought (Beck and Alford2009, 208, 239), it is possible to identify in

CT both the claim (a) that thoughts, beliefs, or judgments cause emotions and

(b) that they constitute emotions.

(a) As to the causal claim, Beck and Alford explicitly maintain that the affectivedisturbance, in such forms as low mood and anxiety is the consequence of

cognitive activity (Ibid., 231): the typical depressive affects are evoked by the

erroneous conceptualizations (Ibid., 209). In all, there is primarily a disorder of

thought with resultant disturbance affect and behaviour in consonance with the

cognitive distortions (Beck and Alford2009, 208). While it is indisputably the case

that sometimes emotions are caused by cognitive activity, the CT picture on

causation is too crude. First, we must remember that non-cognitive causal factors

can trigger emotions. For instance, anxiousness can be caused by an excessive

consumption of beverages that are rich in caffeine, just as feeling sad may be theoutcome of consuming alcohol or fatigue (Prinz2004). Second, given the enormous

amount and variety of processes covered by the term cognition, it is rather obvious

that not every token cognitive activity is necessarily efficacious. It is possible to

hold a relevant belief or judgment while not being in the matching emotive state

(Robinson 2005, 26). The cab driver may believe that leaving the car unlocked is

dangerous, while not fearing that the car might be stolen. Third, even in the case of

causally efficacious cognitive activity, the picture is much more complex than what

is depicted in CT. For instance, the same judgment with the same propositional

content may sometimes generate anger, but sometimes anxiety or sorrow, or even a

dispassionate shrug of the shoulders. In all, the CT claim that affective disturbances

are caused by cognitive activity is very problematic.

(b) A CT defender may object and argue that CT does not really need the causal

account for its aims. Instead, it only has to claim that emotions are constituted by

thoughts, beliefs, or judgments. According to the view that emotions are constituted

by thoughts, beliefs, or judgments, the anger I feel toward a friend of mine simply is

the judgment that he has wronged me, while my embarrassment is identical with my

judgment of being in an awkward situation (Solomon 1976, 187; Neu 2000;

Nussbaum 2001; Marks 1982).15 Subscribing to the constitutional view, the CT

theorist may claim that if emotions are constituted by thoughts, beliefs, or

15 Of course, some positions are slightly more complicated. For instance, in order to be able to attribute

emotions to infants and animals, Nussbaum (2001) allows for some propositions to be preverbal.

However, this redefinition may result in a very vague concept of propositions (de Sousa 2004).

S. Varga

1 3


15/26

judgments, then modification in the judgment will ipso facto generate a change of

emotion.16 The CT theorist could argue that the constitution view would be

consistent with the CT idea that clients should be corrected when describing their

experiences by using I feel Beck et al. (1979), 37). Therapists are instructed to

help patients translate I feel into I think or I believe (Beck et al. 1979; Beck1995; Beck and Alford2009). For example, the patient might say: So, during the

course of the day, driving into work, being at work, I was just in a nervous state. Not

in extreme panic, but just in a nervous state. A feeling of, like, I dont know if I

want to stay here or if I want to go (Scott et al. 1991, 18). The therapist answers

and translates the patients report into a cognitive vocabulary: You had automatic

thoughts like I dont know if I want to go or stay at work? (Ibid., 18).

There are several ways in which the CT theorist could flesh out a constitutive

view (see Debes 2009). The strongest version holds that emotions both are

evaluative judgments (reductive identity) and that they are type-identifiable by thecontent of those judgments or beliefs. Slightly less strong, she could claim that

emotions are both essentially constituted (though not exhausted) by evaluative

judgments or beliefs and type-identifiable by the content of those judgments or

beliefs. In the weakest version, she could claim that emotions are essentially

constituted (though not exhausted) by evaluative judgments or beliefs, though

without being differentiated by their cognitive contents.

As I see it, CT only needs to assume the weakest version of the constitution

viewa move that would save it from a great deal of problems. CT may thus grant

that emotions are not necessarily type-identifiable by the evaluative, propositionalcomponent involved, or that the emotion is identical with or exhausted by the

evaluative component (for a critique see Ben-Zeev 2004; Goldie2000). Nonethe-

less, the weakest view is also vulnerable to severe criticism. One very simple

problem for this view is that possessing particular judgments is neither necessary

nor sufficient for having an emotional state (Stocker and Hegeman 1992; Tappolet

2003).17 In other words, it is possible to be in an emotional state without holding the

relevant judgment. For instance, feelings of fear toward some object do not

necessarily involve assenting to the object being dangerous (Goldie 2000; Ben-

Zeev 2000; Elster 2003). In addition, the body of work on affect programs by

psychologists like P. Ekman and R.B. Zajonc and philosophers like DeLancey

16 Matthew Ratcliffe has righty pointed out (personal communication) that CT does not actually need to

commit to the strong cognitivist view that beliefs precede emotions and that emotions are themselves

cognitive states. Instead, it could maintain that emotions entail evaluations, but resist the final assumption

that these evaluations are judgments (or beliefs involving propositional content), and settle with the view

that changes in beliefcan influence emotions. However, while this would indeed be an alternative, it is

nevertheless not endorsed in CT. A speculative answer as to why, could be that it would weaken the

positions of CT. But also, even if CT theorists would take this option, CT would still be susceptible to the

rest of the criticism in this paper.17 Additionally, research in neuroscience indicates that affective responses can and do operate prior to

and without the involvement of cognitive processing. Emotions can be experienced without cognitive

processing and they actively influence such processes (LeDoux 1996; Damasio1994/2006;1999). In this

context, cognition is taken to denote thinking activity, and not merely simply any processing of

information about the world (which would include perception). Such evidence is in contradiction with the

assumption of a cognitivist view of emotions in which changes in belief precede emotional changes.


1 3


16/26

(2002), DArms and Jacobson (2003) and Prinz (2004) contains substantial evidence

about the automated and non-cognitive nature of emotional response systems. Thus,

even the weakest notion of the constitution view is susceptible to substantial

criticism.

The issues raised in (a) and (b) have implications for our context. For instance, aclient reports about her horrible day at work where she suffered feelings of

inferiority and constantly felt outperformed by her co-workers. When asked what

she was thinking, her answer is I felt so stupid and worthless. Typically, the

therapist would correct her, and encourage her to say instead I thought I was stupid

and worthless, either because this thought is regarded as causing or as constituting

the emotional experience.18 However, given that thoughts need not necessarily stand

in either causal or constitutional relation to emotional states, this patients emotional

experience does not have to involve her thinking that she is stupid and worthless.

But if this is right, the strategy might be misleading and lastly ineffective. First, itmay be misleading to persuade the patient to switch to using cognitive vocabulary.

For example, it may very well be that the utterance I felt so stupid and worthless is

expressive (in the sense defined in 3.1 and thus not a report) and conveys a

confusing emotional experience that she underwent. In that case, her original

description is the more accurate one, and the correction may take her further away

from the original experience. Second, in cases of this type, the translation into a

cognitive vocabulary and the attempt to neutralize the relevant thought is unlikely to

be effective and result in relief.

It is important to emphasize that nothing I have said entails denying thatcognitions may cause or constitute certain emotions and emotions disturbances.

Sometimes this may very well be the case. However, in order to make out whether

this is the case, it is of utmost importance to provide a more profound interpretation

of the reports, taking into account a variety of contextual elements. This adds to the

complexity of the interpretational task as (very roughly) laid out in Sect. 3.1.

3.5 Cognitive Schemas Constitute the Fundament of our Thinking

Cognitive theory rightly maintains that experience does not take place in a world

that is neutrally disclosed, but in one where we always already are anchored by our

cognitive schemasstored bodies of fundamental, background beliefs that interact

with the incoming information and shape and frame experience (Beck and Alford

2009, 255; Williams et al. 1997). The schemas constitute the tacit background of

experience and the framework of intentional experience. What CT also says is that

in depression-prone individuals this interpretive framework is unrealistically

negatively biased, resulting in catastrophic interpretations of an occurring situation.

At the same time, the relevant schema rationalizes the catastrophic interpretation.

Thus far, this idea calls into mind Wittgensteins work on certainty and hinge-

propositions (Wittgenstein1969). He famously argued that at the fundament of our

18 Beck (et al.1979, 37) specifically emphasizes that clients should be corrected when describing their

experiences by using I feel. Rather, therapists are instructed to help patients translate I feel into I

think or I believe (Beck et al. 1979; Beck1995; Beck and Alford2009).

S. Varga

1 3


17/26

world-relation, there are certain types of beliefs (hinge-propositions), which make

up a rather permanent backdrop of certainty (Ibid., 115, 150, 283, 472477) that

even skeptics must rely on. What is special about these beliefs is that they do not

always rely on justification by other beliefs: they are immediately warranted,

epistemically basic, and the certainty we connect to them does not stem from theirrole within our framework of beliefs.

However, discussing Wittgensteins use of the term hinge-proposition also

sheds light on some of the challenges that the idea of cognitive schemas face.

Looking closer on Wittgensteins hinge-propositions reveals that these are not

clearly propositional and belief-like as other beliefs,19 and, therefore, some argue

that hinge-propositions are linked to and embedded in practice (Moyal-Sharrock

2003; Varga 2012). The background that frames everyday experience and the

realness that usually characterizes experience is not merely grounded in beliefs but,

rather, in our practical relation to the world revealed in our patterns of actions.While hinge-propositions on this interpretation are themselves embedded in

something more fundamental, we might start suspecting an analogous case with

cognitive schemas. While the level of practice is undoubtedly a part of the

background of experience and thinking, what I want to add here is that cognitive

schemas are also embedded in tacit background emotions. As we shall see, for an

adequate understanding of the activation pattern of cognitive schemas, we need to

take into account this embeddedness.

3.5.1 Background Emotions

Very roughly, background emotions are inconspicuous background states that are

less intense then what we usually consider as moods (Damasio1999, 341; Lane and

Nadel 2000; Ratcliffe 2005; 2008).20 As with being in a mood, we only have a

subtle awareness of a background emotion, but when prompted, we are usually able

to report on its quality instantly. Matthew Ratcliffe has provided an excellent

phenomenological study of such subtle emotions that include the feeling of being

on top of things, being strong and full of energy, being in danger, or being

distant and cut off from the world (Ratcliffe 2005,2008,2010).

These emotions not only colour our experience, but have far more important roles

to play. Similar to the way in which Martin Heidegger has famously described

moods, they disclose to us our Being-in-the-world as a whole and create

frameworks of significance that structure our experience and make it possible for us

to direct ourselves towards something (Heidegger 1963, 172). Such tacit

background states bestow the world with a sense of practical significance. Roughly,

one may say that these fundamental emotions frame experience and provide an

affective background orientation by constituting a space of significant possibilities

that afford certain actions. For instance, the subtle feelings of being on top of

19 Some of his examples are not propositional, like the certainty of the sense of ownership of body parts.20 As Damasio (1994/2006) has expressed it, a background feeling is not the Verdi of grand emotion,

nor the Stravinsky of intellectualized emotion but rather a minimalist in tone and beat, the feeling of life

itself, the sense of being.


1 3


18/26

things, or being in danger may have us in its grip to the extent that it permeates

the cognitive and evaluative aspects of our experience (Ratcliffe2005,2008). Such

background emotions structure the pool of meaningful possibilities and shape

practical comportment. Somebody feeling on top of things will have a propensity

towards holding certain beliefs about herself and the world, for instance, seeingherself invincible and the world as a place in which her plans can be effortlessly

realized. But in addition to such an orienting role, Damasio (1994) points out that

background emotions also enable the proper functioning of cognitive and

deliberative skills. He draws on neurological phenomena that cannot be fully

explained within the traditional framework that assigns primacy to cognitive

approaches. One of Damasios conclusions is that background emotions constitute

something like the context in which cognition takes place.

Drawing on Damasios work, Matthew Ratcliffe has argued that background

emotions are essentially embodied, which also means that the way the body feelsand how the world is experienced (as the inhabited space of possibilities) are not

two different things, but rather two inextricable aspects of the same experiential

structure (Ratcliffe2005, 49; also Drummond2004, 115).21 The space of possibility

for experience is constituted by bodily potentialities, so that an altered feeling in the

body is at the same time a change in the space of possibility.22 For instance, the

background emotion feeling low is both characterized by the way in which the

world appears, namely as lacking attractive affordances, and the way the body

feels: slow and heavy. Meier and Robinson (2005) have found empirical evidence

that supports such a view. On the basis of these results, referencing a study of simplevertical selective attention tasks, they argue that emotional states like feeling

down are intrinsically linked to specific bodily postures (like looking down).23

The most important point emerging here is that embodied background emotions

are not just adding some emotional color to objects that are already present through

21 At this point we depart from Damasios theoryone that only acknowledges the role of the body in

the form of somatic markers. Many have critiqued this view for thinking in dualistic terms and separating

mental and somatic aspects, and for envisaging emotions as representational events taking place in the

brain (Spackman and Miller 2008; Gallagher2005).22

Phenomenologists (and more recently enactivist approaches to cognition [Noe 2004]) haveemphasized that the lived body is not just an object of experience, it also has a decisive role in

structuring experience and the range of possibilities that we perceive. For instance, integral to

experiencing an object, there is a perceived range of salient possibilities. When looking at the laptop in

front of me, it appears as something that could be worked on and manipulated in certain ways. Such

clusters of experiential possibilities make up the horizons of objects, which are not only perceived

visually but above all feel like bodily potentialities. In the perception of an object, there is a bodily sense

of being able to reveal hidden features of the object and to be able to act upon it in various ways. So the

body is not only the matching part of ordered horizons, but also indissociable from such horizons. At the

same time, the body is of central relevance to background emotions. Its role is not exhausted by its

relation to specific horizons of possibilities of particular entities; it also relates to the world-horizon of

pre-givenness that, for Husserl, allows individual entities to appear in the first place (Husserl, Hua VI,

146, 267).23 Some additional supporting evidence can be found in the work of Lakoff and Johnson (1999) and

Johnson (1987), who suggest that emotional experiences are usually expressed by employing bodily and

spatial metaphors. It is easy to see that positive emotions typically refer to high vertical positions. When

experiencing positive emotions we tend to speak of feeling up or high, while we speak of feeling

down or low when undergoing negative emotion.

S. Varga

1 3


19/26

cognition. Rather, they fundamentally shape cognition and tacitly structure and co-

constitute experience. Taking this seriously, we may argue that this also means that

background emotions to a certain extent constitute the framework in which the

cognitive schemas occur. This view can be additionally supported by phenomeno-

logical and empirical arguments. Let us see how.First, this view squares easily with the relevant phenomenology. For instance,

having a background emotion that is characterized by general anxiousness towards

the world usually comes with a propensity towards holding certain basic beliefs

about oneself and the world, as vulnerable to dangers that one tends to see

everywhere. Or, more moderately, we can say that such a background emotion

amplifies those past experiences in which such vulnerability to dangers has been

confirmed. At the same time, when having such a background emotion, one is

specifically susceptible to feelings of fear that one otherwise would be able to

regulate and to hinder from guiding action. Additional evidence for the embedd-edness of beliefs and schemas in background emotions comes from psychopathol-

ogy. Ratcliffe (2005, 2008) has argued that pathologically altered background

emotions that lack certain qualities may lead to delusional beliefs.

If this is right, then it is plausible that the background beliefs or schemas that CT

considers to cause the pathological emotional episodes are not simply there as

brute facts regulating our inner life at the fundament of our world-relation. Instead,

their presence and impact are themselves dependent on the background emotions

that frame them. This view is additionally confirmed by the work of Teasdale and

Barnard (1993). These authors note that one problem with the CT assumption thatvulnerability to depression depends on individuals underlying dysfunctional

background beliefs is that it has not been demonstrated that vulnerableindividuals

remain committed to these beliefs once their depression has remitted.24 Thus, once

the patients no longer suffer from the affective disturbances in depression, the

relevant negative or dysfunctional background beliefs cease to be active or existent.

Therefore, the evidence shows that rather than being enduring characteristics of

vulnerable individuals, such beliefs are habitually mood-state dependent (Teasdale

1993; Teasdale and Barnard1993).

If it is correct that schemas are themselves embedded in background emotions,

than this has serious consequences that CT needs to take into account. For instance,

it needs to be taken into consideration that schemas in depression may in themselves

not be dysfunctional, but rather intelligibly embedded in a particular (dysfunctional)

background emotion. In other words, their dysfunctional nature may stem from their

being embedded in a particular background emotion. But then, CT needs to

accommodate that the adequate explanation of the dysfunctional response patterns

must take into account such non-cognitive aspects.25 In addition, another

24 For a philosophical critique of their account see Charles2004paper Emotion, Cognition and Action.25 Whiting (2006a, b) has rightly argued that there are some cases in which the explanation of

dysfunctional response patterns must be non-cognitive. He has noted that sometimes our thoughts depict

or represent the world accurately, but our emotional response is inappropriate or out of control, in which

case it may be inadequate to aim at cognitive alterations. I am making a related point here, but note that

the point of departure is very different. In each case that Whiting depicts, experience starts with

representations that then elicit certain evaluations and/or emotional responses. The view that I am


1 3


20/26

consequence is that the therapeutic alteration of such patterns and the alleviation of

the emotional disturbance may consist in working with the (background) emotions

themselves instead of focusing on cognitions. Of course, the identification of

cognitive schemas is an important step toward mapping the cognitive landscape of

the patient, itself a vital instrument of psycho-education. However, its value issomewhat limited if the role of background emotions is not taken into consideration.

4 Towards a More Precise CT

So far, this paper has mainly been concerned with testing the underlying

philosophical assumptions of CT, but it has also pointed out where CT needs

revision and what such revision should best entail. Such revision is likely to be

extensive. On the one hand, it would involve correcting assumptions about cognitiveprocesses, mental state attributions, mental representations, and background

emotions. On the other hand, it would involve paying less attention to the content

of mental representations and more to the role of interpretation. Such revision will

not only secure philosophical accuracy, but may also help provide an account that is

better suited to explain some of the cognitive, emotional, and bodily manifestations

in affective disorders. Furthermore, the revised account could still count as sort of

CT, since none of the arguments presented here deny that beliefs have an important

role to play in depressive states. Indeed, beliefs can and do contribute to sustaining

background emotions, and the fact that fundamental beliefs arise in the context ofbackground emotion does not mean that they cannot affect them.

In the remainder of the paper, given the constraints of space, I will make

admittedly tentative suggestions of how a corrected CT would have several

advantages and could provide the basis for a more precise understanding of patients

utterances in a therapeutic encounter. First, upon such a correction, the bodily

aspects of depression could be accounted for in a more adequate and direct manner

(a). Second, some of the described problems that CT runs into could be avoided (b

and c). Let us see how.

(a) As noted earlier, CT is in striking contradiction with the embodied nature of

background emotions, since it regards the bodily aspects of emotions and affective

disturbances, like somatisation and motor retardation, as (at best) secondary

compared to automatic thoughts and fundamental beliefs (Beck and Alford 2009,

244). However, the bodily experience is not only an inextricable part of the emotion

itself, but sometimes it is the most salient feature of it. In that case, focusing on the

bodily changes may help reveal the background emotion that one is going through.

For instance, parallel to low moods, depressive patients often complain about motor

retardation and about general states of all-encompassing bodily uneasiness in which

the body feels object-like and conspicuous (Fuchs 2003,2005; Ratcliffe2009). An

Footnote 25 continued

stressing is different in that I take representation to already be imbued with an embodied background

emotion. Such a point of departure leads into a different explanation, but one that is compatible with

Whitings account.

S. Varga

1 3


21/26

advantage of such a changed view is that complaints about motor retardation or

bodily conspicuousness, and the tacit quality of the low emotional experience,

need neither be understood as distinct phenomena, nor in causal terms. The

background low emotion in which everything is permeated by a sense of

meaninglessness and lack of possibilities, and the object-like and conspicuous senseof the body (through which we usually actualise those possibilities), may simply be

different sides of the same experience.

In the corrected view, such bodily feelings need not be distinguished from altered

experiences, and we need not say that it is beliefs formed on the basis of experiences

that slow down the body. If we understand the changed bodily feeling as a part of

the altered experience, then in some cases the emotional experience of being

irrevocably disconnected, cut off and alienated can become more conscious by

focusing on the bodily side of the experience. This may specifically apply to patients

that are more comfortable with talking about bodily disturbances rather thanemotional ones.

(b) On the background of several points throughout the paper, it seems clear that

a correction of CT would also have to involve allocating a different position for

automatic thoughts. First, as seen in Sect.3.1., the flawed general assumption must

be abandoned that thought always involves conscious mental representation.

Besides this general point, special attention should be paid to the fact that a thought

or a belief need not be constitutive of an emotion but might simply be expressiveof

it. Automatic thoughts could, in such a changed picture, be understood as

expressions of a negatively altered background emotion that makes the horizon ofpossible experiences shrink into a locked atmosphere, characterized by a loss of

meaningful practical possibilities. In this case, it is clear that if the therapist seeks to

change the vocabulary and reduce the utterance of the patient I feel worthless to

some kind of belief, then important aspects of a complex experience are lost. I feel

worthless might harbour a much more complex relation to self and world than

certain beliefs about the state of things. Referring to feelings might just be the most

adequate means of expression of the transformation in the overall sense of being in

the world rather than a change in belief. We have to keep in mind that such

alteration encompasses a range of subtly different predicaments and it might be

extremely difficult to convey it in terms of concrete differences in how things look.

So while CT would attempt reduce I feel worthless to a distorted belief, in the

corrected view, the same utterance might figure as a useful characterization of the

altered background structure of experience. It may express that the world no longer

offers the usual possibilities for activity, in the sense that possibilities for interaction

that are inaccessible to the self, appear easily accessible to others. It may express

alterations in the space of possibilities that involve feelings and thoughts of

irrevocable isolation. A correct and nuanced understanding of such utterances may

also be the first step towards working with the background emotions themselves

instead of focusing on cognitions.

(c) Besides this loss, we have also seen how CTs intention to identify automatic

thoughts and to correct and translate affective utterances in a cognitive vocabulary

can lead to a variety of severe misunderstandings, which can be assumed to have a

negative impact on the therapeutic outcome. A common problem is that if a patient


1 3


22/26

is unable to identify explicit automatic thoughts resounding in her mind, the

conclusion of CT is typically that they are simply not conscious enough. This

conclusion is in striking contradiction to the patients awareness of her distress,

which may then lead her to seek even harder, thus increasing the chance of a false

recollection. It is already the case that due to the specific way of questioning and thepower of the therapeutic encounter, clients do at times falsely recollect automatic

thoughts (Power 2002, 2009). However, if some of the assumptions of CT are

revised in the way indicated in this paper, then the problem of falsely recollected

automatic thoughts might be reduced to a minimum.

5 Conclusion

Undeniably, the cognitive conceptualization of emotions and affective disorders has

led to a variety of theoretical, empirical, and therapeutic advances. However, given

that CT constitutes the predominant paradigm in the understanding of affective

disorders and psychotherapy, and given that the therapist more or less explicitly

educates the patient to consent to this theory (psycho-education), it is important to

assess the philosophical assumptions on which it is based. Therefore, this paper

contained the identification and the assessment of basic assumptions, relating to

philosophical issues of mental representation and introspection on the one hand

(3.13.3), and emotion and cognition on the other (3.43.5). The general conclusion

was that the philosophical basis of CT needs to be revised, and over the last pages

the attempt was undertaken to briefly sketch how this could be achieved and whatadvantages a corrected view would hold. Of course, much further work is needed.

One interesting possibility to make progress would be to explore how my

suggestions could be combined with models that work with multi-level accounts of

emotion such as in Power (2009) and Power and Dalgleish (1999). In any case, the

hope is that some of these thoughts may contribute to providing a clinically useful

framework with which the emotional disorders can be understood.

Acknowledgments I would like to thank Matthew Ratcliffe, Daniel D. Hutto, George Graham, Achim

Stephan, Stephan Blatti, Remy Debes, Luvell Anderson, Shaun Gallagher, Jennifer Radden and ananonymous referee for valuable comments and criticism.

References

Alford, A., & Beck, A. T. (1997).The integrative power of cognitive therapy. New York: Guilford Press.

Beck, A. T. (1967). Depression: Clinical, experimental and theoretical aspects. New York: Hoeber.

Beck, A. T. (1976).Cognitive therapy and the emotional disorders. New York: International Universities

Press.

Beck, A. T. (1983). Cognitive therapy of depression: New perspectives. In P. J. Clayton & J. E. Barrett

(Eds.), Treatment of depression: Old controversies and new approaches (pp. 265284). New York:

Raven Press.Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.

Beck, A. T., & Alford, B. A. (2009). Depression: Causes and treatments (2nd ed.). Philadelphia:

University of Pennsylvania Press.

Beck, A. T., Rush, A. J., Shaw, B. F., et al. (1979). Cognitive therapy of depression. New York: Guilford

Press.

S. Varga

1 3


23/26

Ben-Zeev, A. (2000). The subtlety of emotions. Cambridge: MIT Press.

Ben-Zeev, A. (2004). Emotions are not mere judgments. Philosophy and Phenomenological Research

LXVIII, 2, 450457.

Blatt, S. J. (2004). Experiences of depression: Theoretical, clinical, and research perspectives.

Washington, DC: American Psychological Association.

Bloom, P. (2000a). How children learn the meanings of words. Cambridge: MIT Press.Bloom, P. (2000b). Children think before they speak. Nature, 430, 410411.

Bracken, P., & Thomas, P. (2008). Cognitive therapy, cartesianism, and the moral order. In R. House &

D. Lowenthal (Eds.),Against and for CBT. Towards a constructive dialogue? (pp. 86100). PCCC:

Hereforshire.

Brewin, C. R. (2006). Understanding cognitive behaviour therapy: A retrieval competition account.

Behaviour Research and Therapy, 44, 765784.

Byrne, A. (2011). Knowing that I am thinking. In A. Hatzimoysis (Ed.), Self-Knowledge (pp. 105124).

Oxford: OUP.

Butera, G. (2011). Thomas aquinas and cognitive therapy: An exploration of the promise of the thomistic

psychology.Philosophy, Psychiatry, and Psychology, 17(4), 347366.

Carruthers, P. (1996). Language, thought and consciousness: An essay in philosophical psychology.

Cambridge: Cambridge University Press.

Carruthers, P. (2009). How we know our own minds: The relationship between mindreading and

metacognition.Behavioral and Brain Sciences, 32(2), 121138.

Charland, L. C. (2006). The cognitive modularity of emotions. Canadian Journal of Philosophy 32,

213228 (Eds. L. Faucher, & C. Tappolet).

Charles, David. (2004). Emotion, cognition and action. Royal Institute of Philosophy Supplement, 55,

105136.

Clark, D. A., Beck, A. T., & Alford, B. A. (1999). Scientific foundations of cognitive theory and therapy

of depression. New York: Wiley.

Clark, D. A., Beck, A. T., & Brown, G. (1989). Cognitive mediation in general psychiatric outpatients: A

test of the cognitive content-specificity hypothesis. Journal of Personality and Social Psychology,

56, 958964.Clark, D. A., Beck, A. T., & Stewart, B. (1990). Cognitive specificity and positive-negative affectivity:

Complementary or contradictory views on anxiety and depression? Journal of Abnormal

Psychology, 99, 148155.

DArms, J., & Jacobson, D. (2003). The significance of recalcitrant emotions (or, anti-quasijudgmen-

talism). Philosophy, 52, 127145.

Damasio, A. (1994/2006). Descartes error: Emotion, reason, and the human brain. New York: G.P.

Putnams Sons.

Damasio, A. (1999).The feeling of what happens: Body and emotion in the making of consciousness. New

York: Harcourt Brace and Co.

Davidson, D. (1987). Knowing ones own mind. Proceedings and Addresses of the American

Philosophical Association, 60(3), 441458.

Davies, M. (1998). Language, thought, and the language of thought (Auntys own argument revisited). InP. Carruthers & J. Boucher (Eds.), Language and thought (pp. 226247). Cambridge: Cambridge

University Press.

de Sousa, R. (2004). Sex, drugs and Mahler. Reflections on Martha Nussbaums. Upheavals of Thought.

Rretrieved on March 2013 from http://homes.chass.utoronto.ca/*sousa/UPHEAVALS-APA.pdf.

de Sousa, R. (2010). Emotion. In E. N. Zalta (Ed.), The stanford encyclopedia of philosophy. URL

http://plato.stanford.edu/archives/spr2010/entries/emotion/.

Debes, R. (2009). Neither here nor there: The cognitive nature of emotion. Philosophical Studies, 146(1),

127.

DeLancey, C. (2002). Passionate engines. New York: Oxford University Press.

DeRubeis, R. J., Siegle, G. J., & Hollon, S. D. (2008). Cognitive therapy versus medications for depression:

Treatment outcomes and neural mechanisms.Nature Reviews Neuroscience, 9

, 788796.Dobson, K. S. (Ed.). (2010). Handbook of cognitive behavioural therapies. NY: Guilford Press.

Dobson, K. S., & Do

Varga_Cognition%2C+Mental+Repr.s+_+Embodied+Emotions+_rec+09+13_

Documents

Transcript of Varga_Cognition%2C+Mental+Repr.s+_+Embodied+Emotions+_rec+09+13_