The very best critique of cognitive therapy (and I have already drawn upon some good ones) was written a century ago by William James in The Varieties of Religious Experience (1902). James, the father of American psychology and a sufferer from severe recurrent (and occasionally, psychotic) depression, took on modern cognitive therapy's direct ancestor, the mindcure movement of the 19th century (which also begat Christian Science). He conceded:
Diverting one's attention from evil is splendid as long as it will work. It will work with many persons, and within the sphere of its successful operation there is nothing to be said against it. But it breaks down impotently as soon as melancholy comes … The only relief that healthy-mindedness can give is by saying: 'Stuff and nonsense! Cheer up old fellow, you'll be alright erelong, if you will only drop your morbidness!'
Mincing no words, James called this "religion of healthy-mindedness" "unspeakably blind and shallow."
For the common-sense remedies of cognitive therapy to work, two unexamined and truly incorrect core schemata must be maintained. First is that the social status quo is essentially fair and just, with fulfilling possibilities available to all who keep an open mind. As Fancher (1995) puts it, "People can fit, if they just think straight."
Indeed, it would be both comforting and therapeutic to believe that our society gives everyone a fair shake. Social alienation has a proven negative effect on mental and physical health. The problem is patients who are depressed often have plenty of real-life evidence that society isn't fair or safe. In the name of rationality, cognitive therapy invalidates their experience and the most reasonable inferences to be drawn from it.
The second schema is that bad things are never really final. James (1902) again: "Systematic healthy-mindedness fails to accord sorrow, pain and death any positive and active attention whatever." In other words, the tragic view of life is a cognitive distortion, and those hapless souls who hold it--many of our culture's most creative people-are in error.
Carl Jung once wrote that the most important problems in life are never solved, only outgrown. Pain, loss, alienation from the larger culture, frustrated loves, ambitions that won't go away--such things we do not solve; at best we come to terms with them.
But that process, while often lengthy and painful, yields rewards undreamed of in cognitive therapy's socially adaptive outcomes. For, to finish with James (1902):