Posted by sid on January 31, 2002, at 0:21:58
In reply to Re: assumptions « elizabeth, posted by Dr. Bob on January 30, 2002, at 19:01:29
In response to Elizabeth...
> > But CBT is *not* a cure for any disease. Just about everybody has some bad attitudes or habits that they could stand to unlearn. I think that most of us understand that that's not the same as a mood or anxiety disorder.
Right, but depression distorts our thoughts and possibly our behavior too, as a consequence of distorted thoughts. So CBT can help realize that and actively work on changing those. I think that's what happened in my case. I was sooo incredibly irrationally negative. CBT did help with that.
> > > But some people are not open to learning.
> >
> > This is where some people start feeling like they're being put on the defensive: the implication, whether intended or not, is that when people say that CBT didn't work for them, it's because they're not open to learning. (Ironically, rigidity and lack of openness are among the "bad attitudes" that CBT is supposed to correct.)
> >
> > The "blame the patient" strategy is sometimes invoked in order to rationalize the failure of medication, too. This is done by changing the diagnosis to "personality disorder" (or adding a personality disorder diagnosis). Indeed, there are some psychiatrists who seem to equate treatment resistance with personality disorder, regardless of the symptomatic presentation!Well, I've seen it mentioned on PB and PSB many times. I personally did not feel guilty. I just wanted to get better and worked at it every way I felt comfortable with, one being CBT. I did learn things that helped and stil do in my everyday life. When I get stressed, I have a tendency to have negative thoughts. I catch them immediately and move on to better things. Had I not learned about CBT, I would be in danger or sliding towards another major episode every time my stress level is high. I don't think there should be any guilt. Guilt is one of the symptoms of depression, that may be why so many people seem to be feeling it in relation to therapy. I had lots of guilt, about other stuff.
> > > I think it's another tool that can help, and I don't see why people don't use it more.
> >
> > I think that many people try it, but some find that it doesn't live up to its claims. As you say, it's a tool that *can* help. That's no guarantee that it will help everybody. (The above applies to medication too, of course.) It also doesn't mean that people who aren't helped by it simply aren't trying, or that they're lazy and expect the meds to do everything for them without any effort on their part (as you seem to imply -- again, perhaps unintentionally).I seemed to imply that because that's the impression I sometimes have from reading different posts. My impression may be wrong. On thing I did notice is that people insist on the diabetes-insulin example to explain, rationalize, justify (to themselves and their loved ones) taking meds for depression. But I never read about exercise and diet against diabetes being similar to therapy, relaxation techniques, etc... To me, IME, it becomes a better analogy when all is included. But again, my experience, and the fact that many things have worked for me, is what generates this opinion.
> > > I am not sure if different CBT techniques could help, I just got tired of making efforts and decided to rely on meds at this time. CBT does require efforts indeed, that's the downside: no free lunch.
> >
> > Again, this is the kind of attitude that can make people feel bad or defensive if they aren't helped by talk therapy. Many people assume that people who don't find talk therapy helpful are simply not trying hard enough. This is probably true in some cases, but I see no reason to assume that it is always (or usually) the case. I also think that the idea that people who take medication are not putting forth effort is mistaken: medications have side effects that need to be endured or managed. Many people are willing to endure these side effects because their response to medication is rapid and dramatic (let's not forget that many people need medication simply to function). For a lot of people, talk therapy produces little benefit rapidly enough to permit them to continue with their lives uninterrupted, and the effects, when they do finally begin to show, aren't that impressive. I suspect that there are people who might be helped a little bit by CBT or other talk therapy, but not enough for it to be worth the time and expense to them. Self-help books like Burns's are useful for people who can't afford to see a therapist, but this approach isn't useful for people whose problems require therapies that are more complicated and can't be written into a manual like CBT can.Right. No guilt or juggment form me on that. I preferred not to take meds for the longest time, but therapy was not working for the dysthymia, and I had spent a lot of time on it, needed to work more and spend less time trying to get better. I am still making efforts (side effect: it's 1AM and I can't sleep, so I am writing instead; have to be at the office at 8AM tomorrow), but spending less time on it. I work a lot more now and I don't think about the depression so much. I write and read about it here, but my day otherwise is depresion-free. Stressful, but depression-free. Cross my fingers.
> > > However, it does help for the rest of your life, even if it is not a panacea.
> >
> > CBT advocates have for some time been trying to prove that it has lasting effects. To date, these efforts haven't shown much success.Well, for me, as I explained above, it helps. I see some situations (high stress) that could lead to another episode and I have managed to avoid them so far, using what I learned in therapy, mostly CBT.
I have not read many studies overall since I do research in another field for a living (that's enough reading studies and writing them for me), but that's what my experience has been so far.
> > There is no panacea for mood and anxiety disorders; we just have to do whatever we can. And we're all individuals -- there's a *lot* of variation among human brains -- so making generalizations doesn't pay off (generally :-) ).
Indeed.
> > BTW, "johnhill"'s post expresses, better than you or I ever could :-), the extremist (and unsupported) attitudes and assumptions that some people have about psych meds and talk therapy.
> >
> > -elizabeth- Sid
poster:sid
thread:17202
URL: http://www.dr-bob.org/babble/social/20020125/msgs/17584.html