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The role of the Emotive and

Developmental Components
in Cognitive Therapy in Italy
G.M. Ruggiero, S. Sassaroli
Studi Cognitivi Cognitive Psychotherapy School
Foro Buonaparte 57
20121 Milano Italy
Cognitive therapy in Italy: merging
constructivism and rationalism
A starting point for a reflection about the
cultural aspects behind the adoption of
cognitive therapy in Italy is a short history of
the problems that Italian therapists
historically met when dealing with the more
rationalistic aspects of cognitive therapy
Cognitive therapy in Italy: merging
constructivism and rationalism
Two main features distinguished the
cognitive movement in Italy from the
beginning:
The direct and strong contact with the
theory and clinical practice of Ellis rational
emotive behavior therapy (REBT)
Its integration with a cognitive -
constructivist movement that arose in Italy in
the same period.
Cognitive therapy in Italy: merging
constructivism and rationalism
The Italian therapists who brought REBT to
Italy in the 1980s and 1990s (i.e., Cesare De
Silvestri, Carola Schimmelpfennig, Franco
Baldini, and Mario Di Pietro) had to find a
compromise between REBT and the
constructivist viewpoint dominant in Italy
(Ruggiero et al. 2014).
Cognitive therapy in Italy: merging
constructivism and rationalism
In the 70s and 80s the major Italian
cognitively based clinicians and researchers,
such as Vittorio Guidano, Gianni Liotti, Sandra
Sassaroli, Antonio Semerari and Francesco
Mancini merged the REBT paradigm with
constructivist and developmental models that
gave more room to emotions and personal
experience than to cognitive schemata
Problems with the rationalistic aspects of
cognitive therapy: Science or Culture?
Italian therapists perceived the disputing
(Ellis, 1962) phase of REBT to be a too
rationalistic and directive intervention.
Did this depend only on their constructivist
training or also on a cultural trademark?
Italian radical Constructivism
The success of the constructivist approach in
Italy was largely due to the influential work of
Vittorio Guidano and Gianni Liotti, authors of an
internationally successful clinical model that
combined cognitive, behavioral, constructivist
and evolutionary elements (Guidano & Liotti,
1983; Guidano, 1987, 1991).
Italian radical Constructivism
Guidano and Liotti (1983)
devalued the concept of a shared, objective and
external truth
expressed doubts about the efficacy of real
rational disputing as a therapeutic intervention
usable in therapy.
Italian radical Constructivism
Deep down, Guidano and Liotti did not think
that rational thinking could affect emotional
states and behaviors (Guidano & Liotti, 1983).
The interest in clients personal development in
Italian Constructivism
In addition, Guidano and Liotti (1983), and later Liotti
alone (2001), focused on the developmental roots of
biased beliefs.
In clinical terms, this meant paying more attention to
the exploration of clients personal histories, how they
developed and in what situations and with what
relational patterns they learnt their biased beliefs.
Difficult relationships were thought to be predisposing
factors paving the way for a cognitive vulnerability to
emotional disorders.
Italian cognitive therapy: more narrative and
relational and less directive
Consequently, Liotti (2001)
conceived therapy mainly as a sort
of compensative relationship that
provided the client with the warmly
accepting environment that he or
she had missed during childhood
Italian cognitive therapy: constructivism,
metacognition and interest in clients personal
narratives
Also other Italian authors developed constructivist aspects and
metacognitive models all focused on clients emotions and personal
development
Francesco Mancini interest about guilt in obsessive compulsive disorder
Antonio Semerari focused on emotionally shared moments in therapy
Giancarlo Dimaggio interested in personal narratives
Sandra Sassaroli and Roberto Lorenzini who merged Kellys constructivism,
Bowlby attachment theory and REBT
Is there a cultural aspect in Italian
constructivism?
We can also, however, wonder
whether this distrust of REBT
disputation might also depend
on general cultural factors not
reducible to Italian therapists
constructivist background.
Is there a cultural aspect in Italian
constructivism?
Furthermore, even the Italian preference for
the constructivist approach may be partially
due to cultural influences.

Is there a cultural aspect in Italian
constructivism?
Are there any significant features in Italian culture
to justify the preference of Italian cognitive
therapists for:
the less rationalistic -and more constructivist-
aspects of cognitive therapy
their tendency to combine REBT with a deeper
analysis of clients personal development and of the
history of their significant relationships with
affective figures during childhood and adolescence
the higher importance given to the emotive and
behavioral aspects of REBT
Defining culture
Defining a countrys culture is an extremely
difficult and not frequently rewarding task
However, we cannot deny that differences
among cultures do exist and may affect social
behaviors, including clinical practice
We choose of running the risk of unavoidable
oversimplifications and stereotypes
Method
We chose two different strategies
for exploring the features of Italian
culture that could account for the
obstacles to the acceptance of
rationalistic and directive aspects
of cognitive therapy
Italian philosophical tradition as a tool to
understand Italian therapists mentality
The first strategy is an analysis of certain
aspects of Italian philosophical thought
It is, of course, debatable whether a history of
the philosophical thought of a country can be
used as a tool for understanding its culture
Italian philosophical tradition as a tool to
understand Italian therapists mentality
However, in this work we explore the
intellectual behavior of a selected population:
a highly educated segment of the population
plausibly both directly and indirectly
influenced by the philosophical tradition of
their home country
Italian philosophical tradition as a tool to understand
Italian therapists mentality
Plausibly, this philosophical tradition was able
to affect the choices and preferences either
thoughtful or idiosyncratic- of the population
in question, and, consequently, the way they
adopted cognitive therapy

Italian philosophical tradition as a tool to
understand Italian therapists mentality
Actually, there are remarkable
similarities between some specific
features of Italian philosophy and
the way Italian cognitive therapists
adopted cognitive therapy and
particularly REBT
Method: how we explored Italian
philospphical thought
We refer to the three most recent and
comprehensive collective anthologies of
Italian philosophers published in English
(Borradori, 1988; Hardt & Virno, 1996; Chiesa
& Toscano, 2009) and the brilliant review by
Roberto Esposito in Italian (2010, 2012)
Italian philosophical and cultural distrust in the
rational handling of emotions
In the founding fathers of Italian thought, namely Niccol
Machiavelli (1469-1527), Giordano Bruno (1548-1600), and
Giambattista Vico (1688-1744), there is the same lack of confidence
in the possibility of tackling emotions using rationality that
distinguishes the Italian approach to cognitive therapy.
Italian philosophical and cultural distrust in the
rational handling of emotions
These three philosophers did not believe in the possibility
of a rational order ruling or at least managing politics
(Machiavelli, 1532), human history (Vico, 1725, 1730, 1744)
or even the structure of universe (Bruno, 1584)

Comparison between
Machiavelli and Hobbes
A comparison between Machiavelli with
Thomas Hobbes -a non-Italian counterpart- is
particularly enlightening
Comparison between Machiavelli and Hobbes
Both Machiavelli and Hobbes theorized a pessimistic and violent
vision of mankind, implying that is only the organized violence of
the Prince (Machiavelli) and of the Modern State, the so-called
Leviathan (Hobbes), that establishes social life under the rule of
law.
Comparison between Machiavelli and
Hobbes
However, in Machiavelli there is no trace of
the uncompromising contrast portrayed by
Hobbes between the emotional life of people
in the wilderness and the moral and rational
order established by the State/Leviathan.
On the contrary, in Machiavelli this tendency
towards conflict is deeply emotional and
cannot be repressed by rationality.
Comparison between Machiavelli and
Hobbes
In Machiavelli the rational handling of conflict is
always temporary and never separated from
emotional life, and, moreover, it derives totally
from emotional conflict.
Any attempt to build a perfect separation
between rational thought and passioni, i.e. the
motivational drive coming from emotions, is
doomed to a sterile loss of life (Esposito, pp. 45-
57).

Giordano Bruno
Bruno proposed an astonishingly brave model of the Universe in
which there was no center (for Bruno not only the Earth, but also
the Sun was not the center), in which Space is infinite and human
reason (not coincidentally without capital letters) is not the ruling
law of the Universe but only a transient function of a particular and
transient living form: human race.
Giambattista Vico
Giambattista Vicos thought provides one of
the foundations for modern anthropology and
history.
He debunked the power of rational thinking
and described human thought as stemming
from an emotional and affective appraisal of
reality that assumes the non-rational form of
mythology, religion, poetry or any imaginative
thinking.
Giambattista Vico
Moreover, Vico even attempted to imagine the mental
experience of pre-human beasts (bestioni) in which
psychic life was totally buried under bodily perceptions.
It is from this pre-linguistic experience that human reason
stems.
According to Vico, rational thinking is not a structural
feature of mankind, but only a recent and acquired
product of mental activity, a mere function produced by
cultural evolution and lacking any particular structural
role

Giambattista Vico: Poetic wisdom as New
Science
Giambattista Vicos New Science begins with an
image, a frontispiece which Vico placed there so that
the reader could recollect, at a glance, the whole
opus.
Mankind needs poetic wisdom (represented by
Homer receiving the light of providence as reflected
by metaphysics).
Without poetic wisdom the mankind cannot ascend
to Truth.

Other Italian thinkers
Similar themes are present in other Italian thinkers:
the historian Vincenzo Cuoco (1770-1823);
the novelist Alessandro Manzoni (1785-1873), particularly in the tragic report of a case
of injustice Storia della Colonna Infame (History of the Infamous Column);
the poet Giacomo Leopardi (1798-1837) in whose marvelous little book Operette
Morali ("Small Moral Works") (1830-1979) this pessimistic conception probably reaches
the most perfect expression;
the idealistic philosophers Benedetto Croce (1866-1952) and Giovanni Gentile (1875-
1944);
the political thinker Antonio Gramsci (1891-1937);
the philosophers Gianni Vattimo (1936-) and Emanuele Severino (1929-);
Italian culture as defined by its
social life
Although it is admittedly possible to ascribe a
particular character to Italian philosophy, it remains
unclear how much these philosophical features are
also present among the Italian people.
Generalizations are always difficult, given not least the
great cultural differences between Italian regions.

Italian culture as defined by its social life
Using Hofstedes multi-factorial model of cultural studies
(Hofstede, 2002), we can find in Italian society:
distrust toward impersonal procedures;
confidence in emotional and relational bounds;
tendency to conceive conflicts as an unavoidable aspect of
social life;
Italian culture as defined by its
social life
In addition, any anthropological study about individualism
and familiar culture in Italy shows the risk to be clouded by
stereotypes: to call Italy the empire of stereotypes is no
exaggeration (Casillo, 2006, p. 83).
Anyway, if we accept some unavoidable
oversimplifications, it is possible to ascribe some common
cultural features to the general Italian population.
Italian culture and cognitive therapy: bridges,
not only walls
We think that all the above-mentioned
aspects of Italian philosophical thought and
social culture help explain the way cognitive
therapy, and particularly REBT, was adopted
and disseminated among the Italian
cognitive-behavioral therapist community
The contribution of the Italian
cognitive movement
However, in this final section we
pose the question whether Italian
culture not only created obstacles
but have encouraged a particular
attention to REBTs constructivist
and meta-emotional aspects.

The contribution of the Italian cognitive
movement
In response to suggestions by Mahoney (1974,
1995, 2003) and by Guidano and Liotti (1983) Ellis
stressed that the REBT model was far from being
a purely rationalistic model and also had a
constructivist and emotional facet (Ellis, 1990)
aimed at promoting increased acceptance and
tolerance of emotional suffering.

The contribution of the Italian cognitive
movement
It is also true that Italian therapists keenly appreciated REBTs
meta-emotional aspects.
In REBT this meta-level is generally called secondary problem.
This secondary problem is a vicious circle in which the client has a
biased negative belief towards his or her own mental states.
Many Italian cognitive clinicians and theorists think that all
emotional disorders are, in fact, always generated by a secondary
process (Lorenzini & Sassaroli, 1987; De Silvestri, 1989; Mancini,
1990).
The contribution of the Italian
cognitive movement
We can see a parallel with the historical distrust of Italian thought
and culture in the capacity of the mind to handle emotional life
using the tool of rational thinking.
Consequently, the only available instrument is a meta-cognitive
level in which emotions are recognized and regulated but never
really directly controlled (Caselli, 2013).
It is not concidental that Dryden (an important REBT theorist)
called the secondary problem meta-emotional problem (2011, p.
70).
Italian americans and Italian
culture
Although my knowledge of the work
of Italian americans colleagues is still
beginning, I would suggest that also
in some american colleagues of Italian
ascendancy we can find the same
interest towards emotional life and
interpersonal conflicts.
Italian americans
Raymond DiGiuseppes studies about anger
Bernardo Carduccis researches about shyness
Philip Zimbardo work about the social roots of
evil
Anthony Sciolis studies on hope
Ralph Piedmont studies about spirituality
Elisabeth Messinas reflections on social
stigma

the Battle of Anghiari by Leonardo da Vinci symbolizes
the Italian scientific passion for exploring emotions

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