Italian American Heritage Month: A Cognitive Behavioral Therapy Lesson in A Bronx Tale
By Ferdinando “Ferd” Palumbo, MSW, LCSW, Founder and Director, Chief Italian American Officer, Northern NJ CBT
For anyone unaware, October is Italian Heritage Month in the United States. This month has been busy but very fun, filled with celebrating Italian Heritage and the impacts Italian Americans have had on the United States. I playfully referred to myself as the Chief Italian American Officer of Northern NJ CBT, but I do proudly trace all my roots to Italy. Like so many others, my grandparents came to the United States from Italy for a better life. I decided to write a blog about Cognitive Behavioral Therapy about the classic Italian American film and one of my all-time favorites, A Bronx Tale.
Let’s start with the clip! For reference, I often use this clip in my therapy sessions (warning profane language is used in this clip):
What we call Cognitive Behavioral Therapy or CBT today evolved from the work of two individuals who, unbeknownst to each other, were arriving at the same conceptualizations about the causes of mental distress within a few years of each other. The first clinician who arrived at this conceptualization was Psychologist Albert Ellis in New York City, who called his therapy Rational Therapy. Ellis was influenced by the stoic philosophers and, in particular, Epictetus, who was credited with saying, “Men are disturbed not by things, but by the views which they take of things.” Not very far away, in Philadelphia, Psychiatrist Aaron T. Beck was coming to similar conclusions about what creates suffering in humans based on his research that suggested individuals suffering from depression had certain types of thinking biases, which he termed “cognitive distortions” that lead them toward depression rather than a more adaptive emotional response.
It’s not the circumstances, events, or other things in and of themselves that lead to a particular emotion. Instead, it is the meaning and interpretation of those circumstances, events, and things that lead to a feeling. This premise underlies all CBT therapy. It can sometimes be caricatured as an idea that the circumstances, events, and things are unimportant or play no role in the formation of emotions. This notion is inaccurate in the CBT perspective. These circumstances, events, and things are an activating event that absolutely matters in the sequence. However, whether a person looks at these events clearly or through the lens of a cognitive distortion will influence whether that person has an emotional reaction that is functional or dysfunctional for their particular goals.
My clients with OCD are not experiencing anxiety because of the number of people who touch doorknobs; otherwise, everyone who sees doorknobs would share that same anxiety. Instead, they experience that distress because there is a story they are constructing about how disgusting or dangerous that doorknob is because many people touch it. Similarly, people with panic disorder aren’t experiencing distress because of the bodily sensations they are experiencing. Instead, there is an interpretation of those sensations, which is usually catastrophic in nature, that leads them toward distress. If physical sensations caused panic disorder, we would then expect everyone who experiences these sensations to develop panic disorder—but that isn’t the case. The children and adults I work with who have problematic anger might be tempted to say it was something not going their way that led them to anger, but it’s not that simple. Does this happen literally every time they don’t get their way? Unlikely. It’s an interpretation that, in that particular situation, it was a grave injustice they didn’t get their way that would lead them toward anger. It follows then, that if we could change the thought or belief we should be able to change the feeling.
Now, what does any of this have to do? A Bronx Tale. Well, when you’re a CBT nerd like me, you tend to connect things to CBT. If we weren’t careful, we would say the main character, Calogero, who goes by “C,” is experiencing anger because someone owes him $20 (it’s hard to tell what year this takes place, but it is closer to $200 in contemporary value). But we can think back to Epictetus, Ellis, and Beck! It’s not the money owed that generated the anger. It’s the interpretation of that fact that led C toward rage. Your guess is as good as mine as to what interpretation C made that led him to anger and wanting to beat up Louie Dumps over the money. He may have been creating a story of how others in the neighborhood would take advantage of him because Louie has an unpaid debt (that would be the cognitive distortion of “fortune telling”). He may have believed that debts must be paid back, or this is some grave injustice (the distortion of “should statements”). We see in the clip, though, that the meaning of the debt matters more than the debt itself. Sonny, the local gangster who is the envy of all the neighborhood boys, offers an alternative narrative that C could adopt. After asking C if he likes Louie, which C doesn’t like, Sonny offers that for $20 he no longer has to interact with Louie, which might be the best $20 he spent.
The debt is the same $20 in both scenarios. Interestingly, one narrative leads to anger and a desire for violence. The other narrative leads to very different emotional and behavioral consequences. Maybe his emotion was disappointment that he was ripped off mixed with relief that he no longer must deal with Louie.
What Sonny did in the above clip is something in CBT we call “cognitive restructuring.” We work with the clients to examine their beliefs/thoughts/inferences for their usefulness in meeting their goals and the general truthfulness of the particular thought or belief. In the above clip, Sonny focuses more on the utility of clinging to the belief that he must get paid back. Is that belief generally helpful to C, who is liable to end up injured or in prison trying to collect that debt? Is that something worth it for C? Not every thought or belief we have is helpful to our overall goals. Instead, Sonny poses an alternative way of looking at the same activating event of being owed $20 that likely is more useful in the goals C has.
Here is an image of some common cognitive distortions or thinking traps that, in CBT, we would argue, can lead people toward suffering:
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