Why I hate CBT
I don’t hate it, actually, I think it can be very useful for some people and would be even more useful if properly applied. That is, whether it has been empirically proven or not (and usually I’m empiricism’s biggest fan), the curative property of therapy lies in the interpersonal relationship between the therapist and the client. If a therapist thinks that cognitive-behavioral therapy is an exercise in filling out record sheets and setting goals, then that might work for some people but it doesn’t work for me.
So on a recent entry I receive comment which is rather spam-like but could be well intentioned. The comment consists of a single link to the MoodGYM training program, hosted by the Australian National University. This is a slick website that runs you through a course in CBT. You take quizzes to determine your “warpy” thoughts. (Oh, if only they knew — my warpy thoughts don’t even appear on their radar screen). I assume you are then led to change these thoughts and let a smile be your umbrella. Avatars with various emotional quirks are used as examples.
I say “assume” because I just couldn’t bring myself to continue with the program. After about the fifth time you’re asked if you tend to underplay your achievements or if you’re too sensitive to criticism (why yes, I am, damn you for asking), it’s just too obvious where all this is going. It’s the same simple-minded stuff David Burns sells in his Feeling Good manuals.
My problem is that hardcore cynicism is part and parcel of my depression and who knows, probably my personality as well. If I were capable of accepting the reality that my sad, bad, mad, scared thoughts were irrational, well, I wouldn’t be depressed, would I? But more power to those who find that it works. Sorry to rain on your parade. Let a smile be your umbrella!
I’m not a huge fan of CBT. It has its place in the therapy world. For me, my issues are bigger and deeper than distorted thought patterns.
That’s not to say that I haven’t found some of the CBT skills useful. But I don’t think it’s the be all and end all of therapy.
For me, the most effective therapist is able to tailor a treatment plan to the individual client. And if that means using multiple therapeutic styles, then that’s what should be done. I really can’t stand therapists who are wedded to one style of treatment. Been there, done that, got the tee-shirt. I hated the one person who tried to treat me with CBT and just CBT. It was a waste of my time and money.
The best therapist I’ve ever had used a combination of psychoanalysis, CBT, DBT and a bit of Jungian stuff thrown in for fun. I enjoyed working with this guy. I won’t say that work was easy or enjoyable, but I liked working with him because he was flexible enough to help me tackle my issues in whatever way worked.
Hmmmm… I think that’s enough parade raining for one day.
If a therapist is able to respond that flexibly to anything that comes up, then I say he/she is really being present to what you’re saying and bringing a full toolbox of skills to the work. I admire that.
I really did admire him. He took the time to continue to educate himself on the different therapeutic techniques and experimented with different ideas with me.
I do think he was a bit more flexible with me than he might have been with his other patients. I was a psychology grad student at the time. I was doing my MA in developmental but was interested in developmental delays and psychopathology in children.
If I were ever to move back to that city (which I hope I’ll be able to some day) I’d look him up again if I thought I needed to be in therapy.
My current therapist is pretty flexible as well. I haven’t really worked with her long enough to form any real opinions yet.
I agree with much of your post–in fact maybe you don’t even go far enough. This isn’t to say that CBT doesn’t work–I’m sure it does for some people–but David Burns seems to have a very broad and simplistic way of categorising negative ways of thinking. More importantly, he doesn’t properly address the possibility that there IS potential merit or rationality to certain negative thoughts. One CBT technique is to ask yourself “socratic questions” such as “What are the odds of this really happening?” In my response, I honestly and uncynically answered that the odds are high and I knew the reasons why it was high were rational. And man, most therapists do NOT like being challenged…
I agree with you. CBT isn’t the be all and end all of treatments – even though I use it as a therapist myself. I find it works best when it’s combined with other techniques such as hypnosis, EFT and NLP. Everyone’s individual and so, whilst there are some things that work with a lot of people, no one thing will work with everyone and all of them will need to be tailored for the best results.
I agree with this post wholeheartedly. And with Eric. Most therapist’s do not like being challenged and attribute doubts about cbt to irrational thinking and resistance to change. Using CBT I remained in abusive family relations far too long. As if I could just think about them the right way they wouldn’t be damaging. Sorry, I know I’m not very articulate. Thanks for the post.
Really interesting post, I actually like using CBT but I tend to use it at the start of my treatment with a client as it helps establish the main thinking styles and on a conscious level helps the client to gain insight into their thinking. You are absolutely right about using CBT and nothing else, this is a very limiting way to treat a client, a more effective approach is to use a mix of interventions rather than consistently plodding with cbt week after week but saying that it certainly has its place and is very effective if used well!