good storytellers

Despite Jim's disclaimer in class last week, I really enjoyed this week's readings and they went by quickly. I was particularly interested by Jacobson, Martell, and Dimidjian's 2001 article on behavioral activation treatment for depression. Their focus on action, rather than cognition, intrigued me. "One of the primary goals of presenting the BA model," they state, "is to dispel the myth that changes in mood need to occur before changes in behavior" (p. 260). I put a little exclamation point next to this statement on my paper copy, because in making this claim, Jacobson et al. draw upon a large body of social psychology research that supports the notion that behaviors have the ability to change cognitions just as much as, if not more than, cognitions have the ability to change behaviors. If forced, for example, to choose between two equally appealing alternatives, we later devalue the one we did not choose and increase our evaluation of the one we did choose. A study I particularly like that illustrates our behaviors' ability to drive our judgment is one in which participants were asked to engage in an excruciatingly boring task for a long period of time. (For the life of me, I cannot remember who did this study!) Once the task had been completed, researchers either offered the participants $1 or $15 to tell the future participants that the task had been interesting. Participants who received $15 did so, but later rated the study as boring. Participants who received $1 also told others the study was interesting, but when privately rating the study, said they had actually found it interesting. Presumably, they could not justify lying about the study for just $1, and so explained their behavior by coming to believe that they had actually found the repetitive task interesting! This and other similar studies suggest that while we don't always know the reason for our behaviors, we're very good at coming up with plausible explanations after the fact.

Although we would like to believe that we are perfectly rational creatures, oftentimes our self-stories are used not to guide our behaviors but to make sense of what we do. By encouraging depressed individuals to engage in personally reinforcing activities, BA uses behaviors as a guide to change cognitions (i.e., "if I am choosing to get out of bed and engage in this activity, then I must be feeling more energetic"). I doubt that this would work if goals were not worked out collaboratively; if the therapist were more active-directive, I imagine that the client would then be able to attribute their actions to the "orders" of the therapist, and would consequently not derive as much benefit. I therefore see the program's emphasis on helping the client to select activities that they personally find reinforcing to be a plus. Getting the client to make choices about goals and carry them out independently as homework drives them to ascribe their positive behaviors to their own internal states rather than to the dictates of the therapist.

Overall, I found theirs to be an intriguing and potentially very useful perspective on the treatment of depression. Looking forward to hearing from everyone else on this!