You can borrow this book from Archive.org for free, although I think its entirely worth the regular $10 Kindle price on Amazon. I bought a copy in a used bookstore about 12 years ago. Recently I picked this book up again. In re-reading this book I was pleased to see that the acknowledgments section credits Abraham Low, and Recovery as one of the earliest forms of Cognitive Therapy. Dr. Burns writes:
"The development of cognitive therapy has been a team effort involving many talented individuals. In the 1930s, Dr. Abraham Low, a physician, began a free-of-charge self-help movement for individuals with emotional difficulties, called "Recovery Incorporated," which is still in existence today. Dr. Low was one of the first health professionals to emphasize the important role of our thoughts and attitudes on our feelings and behavior. Although many people are not aware of his work, Dr. Low deserves a great deal of credit for pioneering many of the ideas that are still in vogue today."
Recovery is sometimes described as Cognitive Behavioural Therapy (or CBT), and we say that largely because this phrase is familiar sounding to a lot of people these days. Some clarification is in order though, since this phrase didn't exist when Dr. Low wrote his books.
Cognitive Behavioural Therapy, or as Dr. Burns writes Cognitive Therapy, has its origins as a term in the 1960s. The focus of Cognitive Therapy is to address the depressed patient's negative view of the world and the future and help them to change these thinking patterns.
While certainly this is something that we talk about in Recovery meetings, Cognitive Therapy was originally designed as a tool or method that a therapist would use to work with a patient. As a peer support group we don't diagnose one another, we aren't therapists.
Having said that, there are a lot of interesting parallels between Dr. Burns' book and what you will find in Dr. Low's best known book Mental Health through Will Training, as well as some differences. On the surface the styles are extremely dissimilar. Some people are put off by Dr. Low's writing, it is a little bit stiff in places, somewhat dated, and is really written from the perspective of a medical professional (Dr. Low) addressing a patient (the reader). Dr. Burns book is written in the 1980s, and is entirely different in tone. It is friendly, much of it written in a conversational style that avoids sounding clinical or academic, but at the same time isn't patronizing, but is rather supportive and patient.
Both of these books describe themselves as self-help-books. Both books are written by medical professionals describing methods refined through years of practical work with patients. Both books explain their ideas without using overly technical terms, instead often through anecdotal stories where they describe real individuals and the specific troubles that those individuals faced.
In Recovery meetings we focus on a technique that Low calls "spotting". The idea is that we learn to observe our own behavior when we are at a crisis point, what Dr. Low calls being in temper, and we use that point as a time to be extra careful in how we proceed. We apply tools to these situations. Tools are effectively a list of common mistakes that people make, and are reminders of simple ways to side step those problems.
Dr. Burns describes cognitive distortions in the first part of his book (Chapter 3). While we discuss these in Recovery as well, when I first read Dr. Burns' book I found these to be a tough starting point. It made sense to me that each of the items on the following list was an example of bad thinking, I simply had a hard time understanding how to use this list to make myself feel better. Dr. Burns' list is as follows:
- All-or-Nothing Thinking: Anything less than perfection is a failure.
- Overgeneralization: One bad day this week means the rest will be bad.
- Mental Filter: I focus on a flaw in a house repair, ignoring the rest of the good work.
- Disqualifying the Positive: If something good happens, it was an accident.
- Jumping to Conclusions: My friend was late, therefore she doesn't care about me.
- Magnification (Catastrophizing): I will get fired because I missed a day at work.
- Emotional Reasoning: I feel like my driving test went badly, therefore I will fail.
- Should Statements: I should go on a diet, I should read more books and get more exercise.
- Labelling and Mislabelling: I'm a bad person.
- Personalisation: I'm the reason my parents split up.
The trouble with this list and the made up examples that I included to illustrate the ideas is that while *these* examples are clearly instances of flawed thinking, *my* thinking seems fine, and doesn't exhibit these problems. That is at least the trouble that I had when I first read Dr. Burns' book. In an intellectual way I understood that bad ideas probably caused bad feelings, but how was I to know which of my ideas were the bad ones? I seemed perfectly reasonable to me.
These are tough questions.
My first experience at reading Dr. Low's book was similar. I understood the words, and the details made sense to me, but it wasn't clear to me how to translate this into a strategy for being well.
The psychiatrist that I met in the late 1990s was certainly a very talented man, but he only mentioned these methods in passing. His primary method of treating me was in the form of prescriptions, yearly blood tests, an occasional ECG, and listening. He was very nice to me, and expressed a lot of concern, and gave basic life advice when it was appropriate or when I asked for it. For a depressed person, having someone patiently accept your situation and talk to you about it means a lot.
My biggest trouble with seeing a psychiatrist focused on a medical treatment of my depression was that it was an entirely passive approach. I met with him periodically, I took the medication he prescribed, and that made my symptoms less intense. While the treatment helped, aside from attending periodic appointments and taking pills, I wasn't doing anything.
When I started reading more about Cognitive Therapies, and actually attending Recovery meetings and talking to other people who had used these methods to change their lives it gave me something to do. It gave me agency in my own getting well process. Ultimately I believe that agency has made a huge difference.
While I didn't fully understand Dr. Burns' book the first time I looked at it, it was a good starting point. In re-reading it I think there are a lot of good ideas in his book and I'm enjoying revisiting this material. In Recovery meetings we keep our focus fairly narrow and stick to Dr. Low's work, but I think its important to know a little bit about how Dr. Low's books fit in with more recent therapy methods. It continues to surprise me how universal the ideas in Dr. Low's books are.
We meet every week and we talk about Dr. Low's method and discuss chapters from his book Mental Health through Will Training. You are welcome to join us.
You can find us at:
Tuesday 7:30pm - 9pm
Binkley United Church,
1570 Main Street West,
Hamilton Ontario
