Re:Response to Jim Pretzer's Comments

Jeff, you’ve raised a number of points, I’ll try to address as many as possible.

I was not being at all disingenuous when I said that I was not interested in criticizing your approach. However, it would have been more accurate to say “I am not particularly interested in criticizing Jeff’s approach at this time.” There have been other occasions on which I have critiqued your approach. This has generally happened when I have been asked to review cognitive behavioral approaches to the treatment of personality disorders. When I do that, I critique each of the major approaches including yours. (I’ve even been known to critique my own approach on occasion). On other occasions, I have challenged individuals who were asserting that Schema Therapy is clearly superior to Cognitive Therapy as a treatment for personality disorders. As far as I can remember, I have not asserted that CT is superior to ST but I have argued that there is stronger empirical support fot CT than for ST. However, in the current discussion I was not interested in criticizing your approach, I was responding to a query from someone who was asking about critiques of Schema Therapy.

You write “Although you often phrase criticisms under the guise that you are merely repeating the opinions of others, I would say that this is irresponsible, unless you believe the criticisms yourself and are prepared to defend them.” I guess we have a major difference of opinion here. First of all, I do NOT phrase criticisms under the guise that I am repeating the opinions of others, when I have a criticism to make I express it openly, when I say I am discussing the opinions of others, I am discussing the opinions of others. Perhaps it has been long enough since we have worked together that you do not remember this about me. Second, if someone asks whether I know of any critiques of a given topic, it seems to me that it is completely legitimate to discuss all the criticisms I know of, not just the ones I agree with. For example, when there was a query regarding crtiques of Cognitive Therapy I posted some criticisms of CT by psychodynamic authors even though I did not agree with those views.

I understand that you do not agree with my posting items which express a broad range of opinion and would prefer for me to only post my own opinions. However, as moderator of this forum I feel I have a responsibility to present a range of opinion. This forum is a discussion of CT and CBT, not a discussion of Jim Pretzer’s views.

You ask why I wrote “... Jeff’s approach risks ...” If you refer back to the post in which I said that, you will see that I started by saying “I can’t think of any critiques of Schema Therapy except for a few published in obscure newsletters which you would have a hard time locating so I’ll list a few criticisms which I’ve encountered (these comments do not all represent my own views):” and then went on to list a series of criticisms. This was a criticism which I had heard and which I decided to include. I also openly acknowledged that I have my own biases regarding Schema Therapy, pointed out that you and I disagree on a number of points, and encouraged others to contribute to the discussion.

You seem to wonder why I did not assert that this criticism is invalid. There are two reasons. First, I was listing criticisms of Schema Therapy, not listing defenses of Schema Therapy. Second, my understanding of Schema Therapy may not be as comprehensive as you think. I did not realize that you advocate using Schema Therapy only after using CT to deal with the Axis I problems. I thought you advocated Schema Therapy as a free-standing approach for treating individuals with personality disorders and was under the impression that you started addressing schemas earlier in therapy than is typical in Beck’s approach.

You also say that you believe that I exaggerate the degree to which empirical evidence supports CT for personality disorders. I will post my 1998 review of the empirical evidence in this forum as soon as I have a chance and readers can form their own opinion. Please note that I did not say that there is a small body of well-controlled outcome studies, in my reviews of the literature I include single-case experimental studies and uncontrolled clinical trials as well as controlled clinical trials. You may have different standards than I do regarding what counts as empirical support.

I am not a good person to estimate how influential your ideas have been. I know that my own ideas developed independently of yours and will let others comment on the extent to which they have been influenced by your work if they care to do so.

I am glad that your new book will contrast Schema Therapy with Cognitive Therapy for Personality Disorders and will look forward to reading it. It may not have been intentional, but some of your previous discussions of the way in which Schema Therapy compares with Cognitive Therapy in the treatment of personality disorders made it sound as though Cognitive therapists would attempt to use Cognitive Therapy for Depression as a treatment for personality disorders and made it sound as though no one had figured out how to use Cognitive Therapy with personality disorders.

I agree that these disagreements are healthy and help advance the field. I will continue to try to be objective about ST, CT, and the other topics I discuss. I will continue to post material that reflects a range of opinions, not just my own, but I will make more of an effort to make clear which comments reflect my own opinion and which reflect the opinions of others.

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