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Psych watch: rumblings of discontent over CBT. Guardian feature on psych wars

Messages
15,786
I just think it's hilarious that Chalder is giving the example of helping someone deal with the effects of abuse. Especially since the type of CBT she uses far more closely resembles that abuse than it resembles a supportive therapy.

Downplaying what the victim is going through? Check.
Invalidating the experiences of the victim? Check.
Cutting the victim off from social support? Check.
Keeping the victim away from medical services? Check.
Keeping the victim away from other survivors of abuse? Check.
Telling the victim that there's something wrong with her perceptions? Check.
Blaming the victim for failing to fulfill excessive expectations? Check.

Trudie Chalder is just as sick as the rest of them.
 

cigana

Senior Member
Messages
1,095
Location
UK
I just think it's hilarious that Chalder is giving the example of helping someone deal with the effects of abuse. Especially since the type of CBT she uses far more closely resembles that abuse than it resembles a supportive therapy.

Downplaying what the victim is going through? Check.
Invalidating the experiences of the victim? Check.
Cutting the victim off from social support? Check.
Keeping the victim away from medical services? Check.
Keeping the victim away from other survivors of abuse? Check.
Telling the victim that there's something wrong with her perceptions? Check.
Blaming the victim for failing to fulfill excessive expectations? Check.

Trudie Chalder is just as sick as the rest of them.
So true!
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
I like to utilize CBT to let go of anger about injustice of our position....

There's a lot of effort to convince people that some feelings are "bad", especially anger. I find that anger motivates me to take action - action to protect myself and others from the immense harm caused by the psychobabblers who claim CBT to be some kind of magic cure-all for whatever ails us.

We now have the situation where the psychobabblers want to convince us that our struggle to end the inappropriate use of CBT is prima facia evidence of mental illness, which must be treated with CBT, of course.
 

Chrisb

Senior Member
Messages
1,051
We now have the situation where the psychobabblers want to convince us that our struggle to end the inappropriate use of CBT is prima facia evidence of mental illness, which must be treated with CBT, of course.

It is interesting to note that Catch 22 was based on the unwillingness of authorities to recognise combat stress. Just keep the planes flying. The individual counts for nothing. Unless, of course, he is a very important individual.

Who said something recently about "the moral equivalent of war?"
 

chipmunk1

Senior Member
Messages
765
I think the main problem with CBT is its theoretical frame. And I'm not talking only of CFS/CBT. The belief that mental illness are caused by unhelpful thoughts and maladaptive behaviors and can be cured by fixing them is just simplistic. Mental illnesses are a complex result of multifactorial causes. And I also think this model mixes up causes and consequences.

That being said, there are really helpful psychotherapeutic tools (including CBT techniques) that can help cope with illness (be it "organic" or "mental"). But that's what they are: coping tools, no more no less. And in some cases, alleviating the stress caused by mental symptoms can be curative.

if CBT was promoted like this there would be no problem with it. In practice, many CBT promoters simply take it too far. We are seeing CBT as a Primary treatment for MS fatigue or "Chemo Brain."

CBT does also blame the patient usually.

A few quotes from Albert Ellis, the father of CBT:

“The best years of your life are the ones in which you decide your problems are your own. You do not blame them on your mother, ecology, or the president. You realize that you control your own destiny.”
― Albert Ellis

You largely constructed your depression. It wasn't given to you. Therefore, you can deconstruct it.
Albert Ellis

http://depressiongenetics.stanford.edu/mddandgenes.html

“Men are not disturbed by things, but by the views which they take of them”
― Albert Ellis, Rational Emotive Behavior Therapy

If i get cancer it is only disturbing because i think it is?

So to sum it up:

Anything bad that happens in your life is caused by you and you need to accept that.
 

xrayspex

Senior Member
Messages
1,111
Location
u.s.a.
this is a great thread, a lot of thought provoking stuff
I love that about Catch 22, didn't remember that
and I didn't know this Chalder woman is isolating victims like that, just awful
It does seem like in England there is a whole other more systematic denial thing going on in yr medical system, it really has made me wonder over the years as I have learned from you all who live there and what they have done with ME.....its pretty scary. Not to say that it can't be awful here in US, but it doesn't seem as well orchestrated but more willy nilly here. You don't know what you will get when you go to a doctor in US, its so situational, some run every test and try many remedies and take you seriously, others could refer you right to therapy only.....crap shoot

I also have mixed feelings about therapy like CBT and MI......there are different methods of it and like I mentioned I am a fan of DAvid Burns, I think he offers some tools to help talk to other people when its complicated and ways to think about things that aren't denying our feelings but avoiding being self-destructive,; as sometimes worry or anger can only hurt us--I know that is oversimplistic but for me anyway it boils down to that
Its like I am paranoid and they ARE out to get me lol but my issue is I am sensitive and it bothers me, and I want to keep working on blowing off caring what a doctor or neighbor etc thinks if it doesn't help me move forward

but yea, the part I question with CBT and MI is that in theory, a skilled, wise practitioner would say definitely all our feelings are ok, and we want to experience full range of them, but just find ways so they don't hurt us or other people--but in practice not every counselor works that way.

like one study out of Harvard said to write down everything that makes us mad, every day, embellish it even, swear, hate etc and then rip it up, that research shows that the tactile act of emotion to writing to ripping signals to brain etc a sort of letting go. David Hanscom a neurosurgeon who had chronic pain writes a lot about this technique at his website, he tells his client to do the writing practice every day and he feels it helps over time and needs to be done indefinitely to be on safe side. He remedied a lot of his own spinal issues thru dealing with anger and other emotions. I think a lot of his ideas are helpful....however, where I part ways with him, and therapists that seem to think this way--is when they say and believe that everyone can be free of pain (or illness etc) if they just practice these methods accurately and religiously....and if it doesn't work for you--well then its on you. That part really bothers me, as I know, from personal experience, you just know in your gut, when something is really broken and its not going to get you back to the baseline of your satisfaction thru mere journaling or happy thoughts....yea that is a huge insult. Obviously people who believe that do because it worked for them--Hanscom supposedly cured his own back pain thru therapy etc but that seems very ego centered to assume that because something worked for you it will work for everyone and to think they are failing if it doesn't. That said though I do think its worth doing all that sort of inner work while one searches for other medical treatments and during taking them....because I do think the mind-body connection plays a role, the degree is quite variable of course for all of us. I guess there is nothing to lose. But I know that being mad all the time isn't helping me either. I am trying to find that edge of keeping my awareness about the injustices and allowing any anger about it but at same time trying to get more zen or whatever so I can be more clear to take care of my business and also maybe help other parts of my body by not increasing the tension of resentment. I definitely do not have it all figured out for myself.........work in progress....

I also think its like dark humor, how MI (motivational interviewing) could be used by medical people or bankers or anyone to have circular discussions with people to try to fluff them and get them out the door before they realize they left with nothing.

I am intrigued the last several years as i read about more and more illnesses, ones that are accepted as real like cancer or diabetes, about research that suggests people should do mindfulness and have improved outcomes....I can't think of an example right now but its sort of mindblowing at times, like they will say psych therapy has better outcome than medicine. I wonder if its partly because a lot of medicines really are toxic and you rob Peter to pay Paul (that has happened to me a lot over the years, and you think of how a lot of people at this forum got sick because of antibiotics or other medical treatments in the first place) so are some researchers and practitioners turned off by the toxic aspects of medicine so pushing mindfulness or CBT because its less invasive and for some people a spa away from stress of modern life does help their health---or is it driven by insurance companies not wanting to pay for medicine and procedures? I would guess its a tangled mess and that not one institution is driving it in an organized way....maybe that is niave.

Oh I will add though in regard to neuro Hanscom, caveat, he does allow that some people have spinal issue that can't be healed thru working just with neuroplasticity--he thinks those cases are rare--so he does retain the physical science part. He focuses on spinal pain and I happen to have one of the spinal exceptions he would allow that cause chronic pain without intervention of some sort (severe stenosis etc) however what I disagree with him on there is that he thinks some of his spinal patients who are in chronic pain who don't meet criteria per MRI etc of having the exceptional spinal issue that would call for more than journaling--he thinks they need to just do more inner therapy work to get out of pain---that tells me he doesn't understand how things like ME could be undiagnosed in a spinal patient and still cause awful pain in head or spine that isn't going to be cured by journaling alone. I think its a dangerous position he takes to assume he can ascertain the cause in every case of someone's pain and to assume that we are currently advanced enough scientifically to know all the causes.
 
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alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
I think the problem arises at two levels. First, CBT is probably OK as a skill for dealing with quality of life issues, its only a huge problem when its being used as attempted cure or therapy for physical issues. Second, the adopted methodology typically measures attitude and not objective outcomes. There are so many layers of bias there that the entire methodology is severely suspect. Every claim that CBT has a positive effect on physical issues needs to be looked at with great scepticism.
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
I would guess its a tangled mess and that not one institution is driving it in an organized way

The Wessely School has been promoting psychobabble for ME in a very organized way. There are boatloads of documented conflicts of interest and connections between the psychobabblers, insurance industry, mass media (via the Science Media Centre), medical journals, and government agencies on both sides of the Atlantic.

Tuller, Coyne, the IOM, and others have succeeded in documenting that we have been hit by a bus. Now we need a real investigation, followed by a trial of the facts in a court of law, to determine exactly who is driving the bus that keeps running over us.
 

Snowdrop

Rebel without a biscuit
Messages
2,933
And if all you want from CBT is help with some unhelpful thinking that is causing you problems then there are some good and free videos on youtube that can probably work as well as a therapist given that therapists just follow a script and aren't trained to know anything else to add value to that.
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
there are some good and free videos on youtube that can probably work as well as a therapist

All the effort to have more and more illness "treated" by CBT is moving towards eventually replacing most (all?) therapists with a computer program. Any script followed by a human can be followed by software, at least in theory. Whether any of it works (therapy by people, video, or software) is irrelevant, as long as it saves money.
 

Old Bones

Senior Member
Messages
808
First, CBT is probably OK as a skill for dealing with quality of life issues, . . .

I agree. When first ill, my company's Chief Medical Officer recommended I see a psychologist to help me come to terms with the impact of a life-altering illness -- at least that's what I was told. Attendance was voluntary, although I'll never know if that was actually the case since I agreed with no reservations. Perhaps it was a good thing that nothing was being reported about ME during those days. I had no exposure to the horrors other people were experiencing with presumed psychiatric causation and forced exercise, CBT, etc. Otherwise, I may have approached my appointments with suspicion.

Fortunately for me, the CMO chose a psychologist with an accurate understanding of ME. I learned more from him about the physical aspects than from my GP, and when he realized my doctor wanted to report me as being depressed (which he knew I wasn't), he stated "she's not going to do you any good", and recommended I switch to a doctor he felt would be a better fit. He was right.

Although I didn't realize it at the time, the psychologist was slyly fitting cognitive and psychological tests into my appointments -- the type typically given during independent medical examinations required by insurance companies. He became one of my biggest allies. When he realized he had no more to teach me, he initiated the end to our sessions. So, there are some honest and helpful psychologists out there. And, isn't it refreshing I was introduced to mine by the CMO of the company that would have benefited from my being denied insurance coverage.
 

worldbackwards

Senior Member
Messages
2,051
Just read through this. Feel thoroughly vindicated in my instinctive, non-ME related loathing of behaviourism, another attempt to reduce the complexities of humanity to numbers on a spread sheet.

Reminds me of neo-classical economics and the idea that all human interaction is predictable by simple calculations about gains and losses, as if anyone can truly know what people really feel about everything around them and reduce it to a formula. That isn't turning out too well either.
Perhaps the only undeniable truth to emerge from disputes among therapists is that we still don’t have much of a clue how minds work. When it comes to easing mental suffering, “it’s like we’ve got a hammer, a saw, a nail-gun and a loo brush, and this box that doesn’t always work properly, so we just keep hitting the box with each of these tools to see what works,” said Jules Evans, policy director for the Centre for the History of Emotions at Queen Mary, University of London.
AMEN.
 
Messages
3,263
I think the main problem with CBT is its theoretical frame. And I'm not talking only of CFS/CBT. The belief that mental illness are caused by unhelpful thoughts and maladaptive behaviors and can be cured by fixing them is just simplistic. Mental illnesses are a complex result of multifactorial causes. And I also think this model mixes up causes and consequences.
I agree, @Cheshire. Although I think the "B" in CBT might be effective for some problems (e.g. phobias), I have a problem with the "C". The underlying assumption that thoughts drive our feelings seems to me to be ass backwards. For example, there is a huge literature on how "rumination" causes depression (e.g. excessively thinking the same negative thoughts). And although I'm sure there is a small space for thoughts to have an influence on feelings. most of the relationship is probably in the opposite direction (that is, depression causes the rumination).
 
Messages
3,263
I am intrigued the last several years as i read about more and more illnesses, ones that are accepted as real like cancer or diabetes, about research that suggests people should do mindfulness and have improved outcomes....I can't think of an example right now but its sort of mindblowing at times, like they will say psych therapy has better outcome than medicine
@xrayspex, I think that's largely because the methods used to demonstrate effectiveness of mindfulness, CBT, whatever, are very loose and its much easier to get a false positive result from a study than it is for, say, a drug study.
 

xrayspex

Senior Member
Messages
1,111
Location
u.s.a.
The Wessely School has been promoting psychobabble for ME in a very organized way. There are boatloads of documented conflicts of interest and connections between the psychobabblers, insurance industry, mass media (via the Science Media Centre), medical journals, and government agencies on both sides of the Atlantic.

Tuller, Coyne, the IOM, and others have succeeded in documenting that we have been hit by a bus. Now we need a real investigation, followed by a trial of the facts in a court of law, to determine exactly who is driving the bus that keeps running over us.
I forget about that, sorry, I recall people telling me that during all the engaged discourse here during xmrv days--that is obviously the worst situation......very kafkaesque and worse, sorry........I wonder if it is because of medicine being more socialized there that the UK got a jump on trying to get out out of paying for extensive testing and treatment...altho it sounded like some of their therapy stuff was extensive and sometimes in home if I recall...couldnt have been cheap either....but maybe part of it is not wanting to admit to the masses that there is some scary virus that is easily caught that can lead to lots of problems....I wonder that about lymes in US, why the system has been so invested in denying it
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
I wonder if it is because of medicine being more socialized there that the UK got a jump on trying to get out out of paying for extensive testing and treatment

I view it as a group effort: it was a 1987 CDC workshop that coined "chronic fatigue syndrome". Sir Simon Wesseley shows up as early as 1991 as a keynote speaker at an NIAID & NIMH conference. Sir Simon and Michael Sharpe both participated in creating the Fukuda definition in 1994. The disability insurers are trans-national corporations with lackeys everywhere. It's an effective strategy: if "everyone" is guilty, then "nobody" is guilty.
 

xrayspex

Senior Member
Messages
1,111
Location
u.s.a.
I view it as a group effort: it was a 1987 CDC workshop that coined "chronic fatigue syndrome". Sir Simon Wesseley shows up as early as 1991 as a keynote speaker at an NIAID & NIMH conference. Sir Simon and Michael Sharpe both participated in creating the Fukuda definition in 1994. The disability insurers are trans-national corporations with lackeys everywhere. It's an effective strategy: if "everyone" is guilty, then "nobody" is guilty.
true enough.....many corrupt things happened here too....I have my copy of Osler's Web!