Cognitive therapies have shifted clinical explanation away from motiva
tional formulations of disorder which employ both belief (cognitive) a
nd desire (conative) concepts towards a purely cognitive and motivatio
nless one. However, cognitivist explanation, when taken with the const
ructivist metatheory which usually accompanies it, (a) is incomplete w
ithout a conative principle - and attempts to use a self-concept fail
to redress this incompleteness, and lead only to explanatory regress;
(b) leaves beliefs ontologically uncertain and confused; and (c) assum
es, but does not explain, rationality. In contrast Freud's metapsychol
ogy - regardless of its theoretical problems - provides a metatheory u
ntroubled by these criticisms.