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Cognitive therapies have shifted clinical explanation away from motivational formulations of disorder which employ both belief (cognitive) and desire (conative) concepts towards a purely cognitive and motivationless one. However, cognitivist explanation, when taken with the constructivist metatheory which usually accompanies it, (a) is incomplete without 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) assumes, but does not explain, rationality. In contrast Freud's metapsychology—regardless of its theoretical problems—provides a metatheory untroubled by these criticisms.