Posted by Blue Cheer 1 on January 25, 2002, at 5:39:48
In reply to Re: David Burns, posted by Emme on January 24, 2002, at 16:10:59
> Hi Folks,
> Funny this thread should come up. I'm partway through the book. I personally find a lot that's objectionable and a lot that's good (besides the thorough medicine listing at the end). First of all, I don't think we should disregard the usefulness of CBT. *Every* human being, mood disordered or not, can use a reality check now and then. To me, CBT is just a formalized system of being aware of how your thoughts and reactions relate to what may or may not actually be going on. When I look at his descriptions of cognitive distortions, I see myself so clearly in some of them. While I'm not big into writing it all down, it doesn't hurt to have my awareness raised. My therapists have used some aspects of CBT (though not in the rigid cultlike manner as Burns prescribes). Although it's certainly not enough to manage my illness without meds, I can't say it hasn't been helpful.
> Do I think CBT has or can "cure" my serious mood disorder? No! I *know* that I need careful psychopharmacologic management. Do I think there's a genetic component to my illness? My family history says absolutely. And I can't process any CBT while severly depressed - the meds have to bring me up a bit. I suspect my illness is more "biologically" based than "psychologically" (if we're gonna draw a line between the brain and the mind). But hey, any adjunct tool that can help me manage better can't hurt. I just don't expect CBT to be the magic key.
> On the negative side: I do agree the book and techniques have an almost cultlike feel to them. I totally agree that it's ridiculous that he says bipolar is genetic and depression is not. It also sounds a bit hard to believe when he says he has cured suicidal patients in incredibly short periods of time. And that he's rarely had a patient need onoging drug treatment beyond a year or so. I also worry that all his glowing stories might make people who've had CBT feel like failures if they haven't had resounding success with CBT. I worry that the book might encourage folks to abandon their medicine without appropriate discussions and oversight from their doctors, or to not recognize when they need to really think about starting meds. Yeah, I know he puts in caveats about when to call in a professional and all that. But I think his anti-drug stance poses possible dangers.
> Oh, and the guy's way too long winded (unlike this post :) He could've made his points in a quarter of the space and his writing style irritates me - he writes as if his audience is a bunch of third-graders. How annoying.
I see Dr. Burn's as more of an opportunist than anything else. Essentially, he took the ideas of Aaron Beck, M.D. (father of congitive therapy) and ran with them. He did his psychiatry residency at the Philadelphia VAMC and gave the hospital an undeserved black eye when he described (in his preface if memory serves me) a patient he passed on the elevator there who was returning from his 18th shock treatment, and was yelling "I want to die." I haven't looked at Feeling Good since it was first published, but I think he claimed that it was at this point when he decided there 'must be another way' (to treat depression). In any case, I know psychiatrists who remember him well, and he routinely used drugs in his practice.
I don't care about his drug recommendations since he's not a psychopharmacologist.
I've tried manualized CT/CBT before, but it's of no value if you're in a state of depression that makes it impossible to carry out the "homework assignments" that are part of the therapy. For those who are experiencing mild to moderate depression, I think it's an excellent adjunct to medications.
poster:Blue Cheer 1