Anderson Cooper 360 Degrees
Interview with Jeffrey Young

CNN, January 14, 2004

COOPER: Well, tonight we continue our special series, "Conquering depression." Last night we talked about antidepressant medication. Tonight, talk therapy.

In a moment, you're going to hear about a particular kind of therapy that has become increasingly popular. But first, let's look back, a brief analysis of our own on how far we've come since Dr. Freud.

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COOPER (voice-over): Today's therapy is part of American culture. You see it in movies and on TV.

BILLY CRYSTAL, ACTOR, "ANALYZE THIS": Have you been under a lot of stress lately?

ROBERT DE NIRO, ACTOR, "ANALYZE THIS": Like to see your best friend murdered?

CRYSTAL: That would qualify.

DE NIRO: Yes, I've got a lot of stress.

COOPER: But long before there was Frasier there was Freud. The father of psychoanalysis gave us the talking cure, tracing adult psychological problems to repressed childhood experiences, particularly sexual desires. You might even say Freud gave us Woody Allen, who highlighted neuroses in his films.

WOODY ALLEN, ACTOR, "BANANAS": I was a nervous child. I was a bed wetter when I was younger. I used to sleep with an electric blanket and I was constantly electrocuting myself.

COOPER: Freud had apostles who rejected his emphasis on sex as the basis for neuroses. They formed their own schools of analytic thought.

Alfred Adler started individual psychology. He coined the term "inferiority complex." Carl Jung's analytical psychology emphasized symbolism, focusing on the inner self in touch with a collective unconscious.

Karen Horney rebelled against Freud's view of femininity. Penis envy? Not a chance. She created the idea of basic anxiety, the feeling of being small and insignificant, helpless and endangered.

Behavioral therapy evolved from the insights of B.F. Skinner, who believed we're all products of our own environment.

Now, there's cognitive therapy, a more active approach to change, focusing more on the present instead of the past. And, of course, today, most popular of all, there is TV. You might call it couch potato therapy. Not very effective, but free psychological advice on almost every channel. DR. PHIL: You need to stop indulging yourself and get back in the game.

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COOPER: You need to stop doing that.

There are a lot of treatment options out there, of course, if you're depressed. But new research suggests that cognitive behavioral therapy may be among the most effective forms of talk therapy for people fighting depression.

Just a short time ago, I spoke with Jeffrey Young, noted psychologist and director of the Cognitive Therapy Center in New York. I started by asking him how cognitive therapy is different than other kinds of therapy.

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DR. JEFFREY YOUNG, DIRECTOR, COGNITIVE THERAPY CENTER, NEW YORK: We're teaching self-help skills the patient can use to get better on their own. And most therapies, they try to provide insight, understanding, but they don't actually give the patient tools they can use to actually get out of the depression.

COOPER: So you are not talking about dream analysis and what happened in your childhood. You're talking more about sort of skill sets for every day living now?

YOUNG: Right. Like how to change the way you're thinking about things, how to change your actual behavior right now. Not where did it come from, not why you're doing it. But just let's -- here are some techniques for change.

COOPER: Don't you have to know some of what happened in the past and why you might be doing something in order to change it now?

YOUNG: If you deal with chronic depression, which are people who have been depressed most of their lives, the therapy has to be altered. And it is very helpful then to look back in the past.

COOPER: I understand you actually give homework assignments to your patients. How does that work? Give me an example.

YOUNG: Right. Well, typically, the most common one, a daily mood log. Whenever they start feeling upset, sad, anxious, they take the sheet out. And it has different columns on it.

And at first, they fill out what was the event. Like, say, it might be a female patient, where her boyfriend didn't call her that night even though he was supposed to. Then the next column she writes down what she's feeling when he doesn't call her. So she might say, sad and anxious.

Then in the next column, we say, what are your automatic thoughts? What are you thinking to yourself? And she might say, he doesn't love me anymore. He wants to break up with me.

Then in the last column, they have to come up with a healthy answer, which is what the therapist helps them to do. Something like, my boyfriend hasn't called many times before. He always stays with me. He loves me.

I have no other signs. And for me to jump to this conclusion is just part of my depression.

COOPER: I've read some of the research, and the results seem pretty encouraging. I mean, there was just an article in the "Wall Street Journal" about a new study that was done. I guess it was published just last week in which the relapse rate of patients who were on antidepressant medication was 60 to 80 percent, I believe. If they stopped within a year, they might relapse into depression.

But with cognitive therapy, the relapse rate was only something like 25, 30 percent, was it?

YOUNG: Exactly. That's right, Anderson. And I think that's a very important difference, because a lot of people, they go only for medication because they know they can get better quickly. But what they don't realize is, when they go off the medication, the chances are, as you just said, 75 to 80 percent that within a year they will become depressed again.

So, basically, the medication doesn't in any way prevent future depressions. Whereas with cognitive therapy, we're actually teaching them skills, which even when the therapy is over, like those homework assignments, they can keep doing them. So when they start to get depressed again, they can start using the same skills and start doing...

COOPER: So it's not necessarily therapy that takes years and years and years?

YOUNG: No. Typically, it is 15 to 20 sessions of therapy. So it's actually a very short-term therapy.

COOPER: All right. Jeff, thanks very much.

YOUNG: Thank you, Anderson.

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