Nature: Psychological treatments: A call for mental-health science

[alex3619]

There is one case of a thought (not mental) disorder. Its based on irrational and unsubstantiated beliefs. I am talking about people who are brainwashed. They have a thought disorder. It doesn't matter if this is done by tyrannical governments, religious cults, or the more rogue CBT practitioners. Its still a thought disorder.

CBT is a tool that can have good value in improving coping mechanisms. What CBT is used for is critical. When its used to support unproven fantasy views of reality its dangerous.

People can also be mistaken about things. I am dead sure most of us have experienced an idea about what CFS is or is not, or about what ME is or is not, that seemed reasonable at the time, but which we now reject. I know I have.

 

[WillowJ]

No, CBT is a coping strategy. I provided a theory which introduced the actual mechanism at the root of the continuous stress response, which causes the complete imbalance of the body.

http://forums.phoenixrising.me/index.php?threads/my-understanding-of-cfs-me-and-how-to-heal.31393/

This theory is based on my experiences. Skepticism is necessary, but so is open mindedness.

But you didn't explain it as a coping strategy (which I have no problem with). You explained it as a cure (this claim requires proof, such as Alex explained).

Even now you are claiming both coping strategy and that it is a central disease process, which are contradictory claims.

(Also not everyone is a fan of the "allostatic load" theory; there are other theories, and we can like others better for various reasons.)

 

[cmt12]

But you didn't explain it as a coping strategy. You explained it as a cure.

Right. What I'm doing to heal is not CBT. CBT focuses on the conscious mind similar to mindfulness. The problem is with the subconscious mind, which we cannot control. That is why I said CBT is a coping strategy, or symptom management.

 

[alex3619]

I had practiced meditation for most of a decade. As my CFS got worse, my capacity to do so declined then disappeared, I haven't gone back to it in maybe twenty years. I recall in 1985 I could hold my breath for 5 minutes before even starting to feel uncomfortable ... a lot of what I did (not all of it) was breath meditation (Japanese), but I used other styles too. Not at any point did it look like a cure. I have no doubt at all that some people will benefit from meditation, and some of those will benefit a lot. Some however cannot do it. Others find it makes them worse. Alternative and new techniques to address this have yet to be proven in any way recognized in science. Basic meditation does produce health benefits, but there are plenty of practicing meditators who get sick.

As a funny anecdote, I recall meditating in a break at work in about 1983, when I knew I was sick and had no idea why, and about six years before I was diagnosed. People used to come up to me and wave their hands in front of my face. It was all I could do to maintain meditation, as I had the urge to laugh.

In the 80s I also tried Chinese herbal medicine, homeopathy, acupuncture, naturopathy, affirmations, and yes, even GET and CBT. None delivered on promises for me. This was my decade of looking for alternatives, when I realized that doctors had no idea at all. and before I found my first knowledgeable doc on CFS or ME. In the 90s I also did some alternative approaches, including lactovegetarianism (yoghurt as the only dairy).

I did find CBT useful as a tool for improved coping. However I was already aware of most of what I was taught. Many CBT practices have their roots in meditation and Buddhist philosophy.

 

[alex3619]

It occurs to me that digging out subconscious thoughts to achieve recovery is yet another variant of Freudian psychoanalysis. Thousands of times this has been proposed, if not more. Not once has it stood up to testing. Indeed, such claims have been made about diseases as diverse as epilepsy to diabetes, gastric ulcers to cancer. I would like to see even one paper showing clearly that any of these claims, even one, is right. Every paper is vague enough for the data to be accounted for in many other ways.

 

[alex3619]

"Subconscious thoughts" covers just about everything. Conscious thought is different. Do be aware that many of us are trained in things like mind-body, psychology, neuroscience, medicine etc. I am trained in aspects of mind-body philosophy, systems theory, and biochemistry. I was working on a neural systems modelling tool with my PhD candidacy.

If the argument is about biochemical stress mechanisms, however, then those mechanisms need to be testable.

We are a difficult audience to convince if the evidence and argument are not there.

The first thing that needs to happen to advance arguments like these is clearly separate hypothesis from technique. Even if the technique appears to work, the hypothesis can still be invalid.

 

[adreno]

I had practiced meditation for most of a decade. As my CFS got worse, my capacity to do so declined then disappeared, I haven't gone back to it in maybe twenty years. I recall in 1985 I could hold my breath for 5 minutes before even starting to feel uncomfortable ... a lot of what I did (not all of it) was breath meditation (Japanese), but I used other styles too. Not at any point did it look like a cure. I have no doubt at all that some people will benefit from meditation, and some of those will benefit a lot. Some however cannot do it. Others find it makes them worse. Alternative and new techniques to address this have yet to be proven in any way recognized in science. Basic meditation does produce health benefits, but there are plenty of practicing meditators who get sick.

Not claiming meditation as a cure for ME/CFS, but it might have its merits:

Psychoneuroendocrinology. 2013 Mar;38(3):348-55. doi: 10.1016/j.psyneuen.2012.06.011. Epub 2012 Jul 15.
Yogic meditation reverses NF-κB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial.
Black DS1, Cole SW, Irwin MR, Breen E, St Cyr NM, Nazarian N, Khalsa DS, Lavretsky H.
Author information

Abstract
BACKGROUND:
Although yoga and meditation have been used for stress reduction with reported improvement in inflammation, little is known about the biological mechanisms mediating such effects. The present study examined if a yogic meditation might alter the activity of inflammatory and antiviral transcription control pathways that shape immune cell gene expression.

METHODS:
Forty-five family dementia caregivers were randomized to either Kirtan Kriya Meditation (KKM) or Relaxing Music (RM) listening for 12 min daily for 8 weeks and 39 caregivers completed the study. Genome-wide transcriptional profiles were collected from peripheral blood leukocytes sampled at baseline and 8-week follow-up. Promoter-based bioinformatics analyses tested the hypothesis that observed transcriptional alterations were structured by reduced activity of the pro-inflammatory nuclear factor (NF)-κB family of transcription factors and increased activity of Interferon Response Factors (IRFs; i.e., reversal of patterns previously linked to stress).

RESULTS:
In response to KKM treatment, 68 genes were found to be differentially expressed (19 up-regulated, 49 down-regulated) after adjusting for potentially confounded differences in sex, illness burden, and BMI. Up-regulated genes included immunoglobulin-related transcripts. Down-regulated transcripts included pro-inflammatory cytokines and activation-related immediate-early genes. Transcript origin analyses identified plasmacytoid dendritic cells and B lymphocytes as the primary cellular context of these transcriptional alterations (both p<.001). Promoter-based bioinformatic analysis implicated reduced NF-κB signaling and increased activity of IRF1 in structuring those effects (both p<.05).

CONCLUSION:
A brief daily yogic meditation intervention may reverse the pattern of increased NF-κB-related transcription of pro-inflammatory cytokines and decreased IRF1-related transcription of innate antiviral response genes previously observed in healthy individuals confronting a significant life stressor.

 

[chipmunk1]

In the video recently from Stanford even Komaroff was saying CBT helped patients - though some patients didn't want to hear it. That was based on reports back from his patients. He said it helped reduce their symptoms.

either this shows that some can be helped with CBT or that some find any random crap that you throw at them helpful. From my personal experiences i suspect it's the latter.

 

[Cheshire]

either this shows that some can be helped with CBT or that some find any random crap that you throw at them helpful. From my personal experiences i suspect it's the latter.

I'm not at all a supporter of CBT as a cure for ME, but I think that, as a coping strategy, psychological support may really help some people.

Some of us experience a worsening of symptoms with stress, psychological support can help reducing stress, some have difficulties accepting being sick, and overdo, psychological support can bring acceptance, and thus lead to reducing of activities.

But all this is not a cure.


Living well with this disease is a real challenge. Maybe you are lucky enough to be able to cope without any help, you have a comprehensive environment, and so on, but for those who feel isolated and frightened or that experience psychiatric issues, saying that they

find any random crap that you throw at them helpful

is somewhat dismissive.


And I don't buy at all this unresolved trauma stuff which is guilt sharing post freudian new age crap.

 

[chipmunk1]

I'm not at all a supporter of CBT as a cure for ME, but I think that, as a coping strategy, psychological support may reallyhelp some people.

i agree but i don't think CBT is genuine psychological/emotional support it's just a nice way of brainwashing. Real support is listening/supporting and understanding the patient not artificially forcing certain thought patterns. CBT implies that our behaviour and thought patterns need to be changed because they are inappropriate or faulty.

 

[Cheshire]

i agree but i don't think CBT is psychological/emotional support it's just a nice way of brainwashing. Real support is listening/supporting and understanding the patient not artificially forcing certain thought patterns. CBT implies that our behaviour and thought patterns need to be changed because they are inappropriate or faulty.

It really depends on the therapist you meet. A narrow and mean interpretation of CBT theory with a rigid employment of CBT pattern (like the thougtless transposition of the phobia pattern to our supposed kinesiphobia) is a direct way to disaster.

But I don't think all the CBT tools should be thrown away with the baby's bath water. A good therapist should use available tools (CBT or others) at the right moment.

 

[Valentijn]

In the video recently from Stanford even Komaroff was saying CBT helped patients - though some patients didn't want to hear it. That was based on reports back from his patients. He said it helped reduce their symptoms.

That was coping-based CBT, which can help as it should support the concept of pacing. CBT to cure disease, which is what is being discussed in this thread, isn't even remotely the same treatment.

 

[adreno]

That was coping-based CBT, which can help as it should support the concept of pacing. CBT to cure disease, which is what is being discussed in this thread, isn't even remotely the same treatment.

No, the thread is about making psychological treatments more science-based, not about CBT curing disease.

 

[chipmunk1]

Well some thought patterns are more productive than others..

yes but usually an adult with some common sense will be well aware of the consequences of his actions and beliefs and could figure out easily if there are problematic beliefs. The idea that you need a trained professional to help you with everyday problem solving is ludicrous.

 

[Valentijn]

No, the thread is about making psychological treatments more science-based, not about CBT curing disease.

Nonetheless, the CBT being discussed in that context is CBT as a cure for ME.

 

[Cheshire]

yes but usually an adult with some common sense will be well aware of the consequences of his actions and beliefs and could figure out easily if there are problematic beliefs. The idea that you need a trained professional to help you with everyday problem solving is ludicrous.

Well, you may be some kind of superman, or wonder woman! Which I am not.


After a horrible meeting with an hematologist, I was so lost that I took an appointment with a CBT therapist I had yet met. Intellectually I was conscious that the 'all in your mind' despising talk of that doctor was untrue, but emotionally that deeply hurt me and I needed help. That CBT therapist (who didn't know CFS, but is convinced fibromyalgia is an organic disease) helped me fight unhelpful thoughts (feeling guilty for having an imaginary illness), and helped analyze rationally this disastrous meeting.


Because, yes, at that point I wasn't emotionally able to use common sense and ordinary problem solving skills. An hour long meeting helped me, and that was it. I don't feel weak to have had the need of that therapist, and I think I would still qualify as "an adult with common sense". The common sense in that situation was acknowledging I needed help.

 

[chipmunk1]

Well then I guess we should just tell all those people seeking therapy to use their common sense. Sounds very scientific. And helpful.

Because, yes, at that point I wasn't emotionally able to use common sense and ordinary problem solving skills. An hour long meeting helped me, and that was it. I don't feel weak to have had the need of that therapist, and I think I would still qualify as "an adult with common sense". The common sense in that situation was acknowledging I needed help.

CBT isn't a magic insight in the human mind or a revolutionary technique. People seek therapy because they are unable to cope. The "science" of CBT itself offers not more than common sense could provide but having a therapist can help you when you are overwhelmed. I am not saying that no one ever needs a therapist or something like that.Emotional support can help.

 

[adreno]

Yes it's my belief based on my personal interpretation. I think it's another over-hyped scam, that follows psychoanalysis, alien abduction therapy, repressed memory therapy, primal scream therapy etc.

I see no point in arguing this matter any further with you.

And for your information, CBT is based on behaviorism, which was a movement in psychology that strongly rejected freudianism.

 

[adreno]

CBT isn't a magic insight in the human mind or a revolutionary technique. People seek therapy because they are unable to cope. The "science" of CBT itself offers not more than common sense could provide but having a therapist can help you when you are overwhelmed. I am not saying that no one ever needs a therapist or something like that.Emotional support can help.

There is nothing magic (or perfect) about CBT, but it offers a standardised system that makes it testable, and also avoids the arbitrariness of individual therapists. Without a standardised system, therapy becomes random, inconsistent, untestable, and impossible to adjust and improve over time. These are the advantages. Without a system it's just "talk".

 

[chipmunk1]

And for your information, CBT is based on behaviorism, which was a movement in psychology that strongly rejected freudianism.

I know what it is based on. And i think behaviorism is as nutty as freudianism just the other side of the coin.

What i wanted to say was that there have been a lot of questionable therapies on the market and sooner or later all of them turned to be out to be based on hype and wishful thinking. In my opinion CBT will be no different.