Socratic Questioning in Psychotherapy: What is it Good For?
Socratic questioning is a central aspect of cognitive behavioral therapy (CBT) (Beck, 1985, 167) which derives its name from the 5th century BCE philosopher Socrates. Socratic questioning entails asking questions intended to help the client reflect on distressing thoughts or experiences in order to re-evaluate those thoughts and experiences.
As Socratic questioning is most commonly associated with CBT, I will primarily focus here on how it relates to CBT. It is important to note, however, that Socratic questioning can be implemented in any therapy modality (Padesky and Kennerly, 2021, 2).
What is cognitive behavioral therapy (CBT)?
CBT is an evidence-based therapeutic treatment modality. The central tenet of CBT is that the way we think has a causal influence on the way we feel and behave. Therefore, changing the way we think can improve the way we feel and behave (Beck, 1979, 3–4, 35).
Of all the thoughts we may have, there is a subset of thoughts that are the most important for Socratic questioning: appraisals or evaluations, or thoughts and beliefs about what is good and bad. The two “fathers” of CBT, Albert Ellis and Aaron Beck, both theorize that emotion is simply a strong appraisal accompanied by a physiological change (Ellis, 1962, 44–45; Beck, 1979, 56–57). For example, when we feel anxiety, we may be appraising something as dangerous while experiencing a concurrent physiological change, such as muscle tension, increased heart rate, etc.
According to CBT, our appraisals are generated by deeply held convictions, or core beliefs, about what is good or bad, or right and wrong (Beck, 1979, 41–42). The aim of the CBT therapist is to help the client to trace their appraisals to these underlying core beliefs, and then to determine whether these core beliefs are adaptive or maladaptive. If they are maladaptive, the CBT therapist helps the client to reject and replace those core beliefs for more adaptive ones (Beck, 1979).
What is Socratic questioning in CBT?
Socratic questioning is one of the primary methods utilized by CBT to explore, challenge, and ultimately to replace maladaptive core beliefs with more adaptive ones (Clark and Egan, 2017).
This means that Socratic questioning is ultimately aimed toward eliciting the client’s evaluative beliefs, or thoughts and beliefs about good and bad, and then reflecting on those beliefs to determine whether to keep them or replace them.
Waltman et al. (2021, 68–81) identify four core stages of Socratic questioning: focusing, phenomenological understanding, collaborative curiosity, summary and synthesis, which are a slight reworking of Padesky’s (1993) model. Below I will provide a loose synthesis of both:
Focusing
Focusing is the process of determining which issues or beliefs to focus on. In order to help the client most effectively and efficiently, there simply isn’t enough time to focus on every distressing thought or belief. The therapist works to identify those thoughts and beliefs that are most distressing. This usually involves asking informational questions to help the client hone in on the most distressing cognitions.
Examples of Socratic questions for focusing:
- What would you say is the most distressing part of this situation for you?
- Which part of this scenario do you think is most important to focus on first?
- What do you think is the aspect of this situation that gets closest to the heart of the matter?
Phenomenological understanding
Phenomenological understanding is the process in which the therapist works to understand exactly why the client thinks the way they do about the topic of focus (phenomenology is the study of consciousness from a lived, first-person perspective). Without this understanding, it will be much harder for the therapist to be of help to the client in exploring and expanding these perspectives.
This process involves a lot of listening on the part of the therapist, not only to the words the client speaks but for strong emotional reactions, particular phrases, or other unique elements that may help the therapist to gain insight into the client’s experience.
Examples of Socratic questions for phenomenological understanding:
- When you mentioned your father a minute ago, I noticed that your voice got quieter. Am I reading into that too much or could there be some significance to that?
- I want to make sure I understand. – can you tell me a little bit more about what that was like for you?
- When we get to the topic of work, it seems like your language becomes a bit harsher and more aggressive. Am I picking up on some anger there?
Collaborative curiosity
Collaborative curiosity is the process of expanding the client’s perspective, helping the client to explore other possible perspectives, to identify blind spots in their current perspectives. This involves both asking questions and providing summaries of the clients’ own perspective to help the client to explore their perspectives from a new angle.
Examples of Socratic questions for collaborative curiosity:
- You said your boyfriend was angry with you when you told him you wanted to have some space the other night. Can you think of any other possible reasons he had that reaction?
- We’ve been talking about the worries you have about going to this party on Friday. As a thought experiment, what do you think is the reasonable best-case scenario if you go to the party?
- Have you always thought this way or have your thoughts about this changed over time?
Summary and synthesis
The summary and synthesis stage is the process in which the therapist helps the client to integrate newer perspectives into their belief system that have been gained throughout the prior stages.
Examples of Socratic questions for summary and synthesis:
- How does this fit with the way you understand yourself?
- Can we try to summarize this discussion to see what we have covered so far?
- Is there anything you’ve been surprised to hear yourself say during this conversation?
There is no “cookbook” for Socratic dialogue
It is important to note that while the above model can provide a helpful roadmap for how a Socratic dialogue may progress in therapy, this model is only that – a roadmap, not a rulebook (Padesky and Kennerly 2023; Brickhouse and Smith, 1994, 10). Socratic questioning is a form of dialogue, and for a dialogue to be genuine, it must be unscripted. That is, a true dialogue is an interaction between two or more people in which each person is open and responsive to the other. Prioritizing the adherence to a particular model, or script, or set of rules above true responsiveness to the other person will be counterproductive to the aims of true understanding and connection.
The origin of Socratic questioning in CBT
Finally, I want to place Socratic questioning in CBT into its historical context. Socratic questioning gets its name from the ancient Greek philosopher Socrates, particularly as he is depicted in the dialogues of his follower Plato. In these dialogues Socrates is portrayed as a brilliant questioner who helps his conversational partners to reevaluate their beliefs.
While Plato’s dialogues are highly philosophical, they are also rooted in practical problems. For example, in one quintessential Socratic dialogue, the Laches, two parents discuss whether a new form of military training will make their children more courageous. This is a very practical question, grounded in the ordinary concerns of life. What parent, after all, doesn’t want to raise courageous children? These parents ask two prominent Athenian generals – seeming experts on the subject of courage – and they in turn ask Socrates, who they know to be interested in these sorts of questions.
But rather than giving them an answer, Socrates leads the generals through a series of questions, beginning with the question, “What is courage?” He notes that if they want to determine whether the training would make their children more courageous, they would first need to know what courage is so that they will have a basis for measuring the effectiveness of the training. But it turns out that courage is a very difficult thing to define. After numerous failed attempts at such a definition, the generals admit that they don’t know what courage is!
By the end of the dialogue, the conversation has shifted from the initial question of whether a specific training will increase courage, to a new question: how to go about discovering what courage is in the first place!
While this resolution may seem more abstract than practical, it is in fact a practical resolution as well: no one in the dialogue has been able to justify spending the time, money, and effort to learn this new training. This is particularly relevant for the general Nicias, who had argued that the training would effectively increase courage. He was therefore able to loosen a previously held belief.
How “Socratic” is Socratic questioning in CBT?
Some have argued that Socratic questioning in CBT is a misnomer on account of the different aims of CBT and Socratic philosophy (Waltman et al., 2021).
While it is true that the goal of CBT is therapeutic, that is, it is a negative goal of reducing emotional distress (Beck, 1979), and the goal of Socratic philosophy is positive in that it is concerned with human flourishing (Bobonich, 2010), in my view these can be thought of as different targets on the same spectrum rather than as incompatible goals altogether. Each targets evaluative beliefs (beliefs about things good and bad) and explores their validity through Socratic questioning with the aim of improving the quality of that person’s life.
So, what is Socratic questioning good for?
To get back to the question posed in the article title, what is Socratic questioning good for? For examining our beliefs about what is good!
References
Beck, A. (1979). Cognitive therapy and the emotional disorders. Meridian.
Beck, A., Emery, G., Greenberg, R. (1985). Anxiety disorders and phobias: A cognitive perspective. Basic Books.
Bobonich, C. (2010). Socrates and eudaimonia. In D. R. Morrison (Ed.), The Cambridge companion to Socrates (pp. 293–332). Cambridge University Press. https://doi.org/10.1017/CCOL9780521833424
Brickhouse, T. & Smith, N. (1994). Plato’s Socrates. Oxford University Press.
https://doi.org/10.1093/oso/9780195081756.001.0001
Clark, G. I., Egan, S. J. (2018). Clarifying the role of the Socratic method in CBT: A survey of
expert opinion. Journal of Cognitive Therapy 11, 184–199. https://doi.org/10.1007/s41811-018-0016-y
Ellis, A. (1962). Reason and emotion in psychotherapy. Stuart.
Padesky, C. (1993, September 24). Socratic questioning: Changing minds or guiding discovery? [Invited address]. European Congress of Behavioural and Cognitive Therapies, London, England.
Padesky, C. A. & Kennerley, H. (2023). Dialogues for discovery: Improving psychotherapy’s
Effectiveness. Oxford University Press. https://doi.org/10.1093/oso/9780199586981.001.0001
Waltman, S. H., Codd, III, R.T., & McFarr, L.M., Moore, B. A. (2021). Socratic questioning for
therapists and counselors: Learn how to think and intervene like a cognitive behavior
therapist. Routledge. https://doi.org/10.4324/9780429320392
Photos
- Photo by Vitaly Gariev on Unsplash
- Photo of Socrates licensed under Creative Commons zero.
