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Dr. Bob is Robert Hsiung, MD,
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Posted by badhaircut on November 6, 2003, at 18:02:22
The NYT Magazine (Nov 2 '03 -- http://www.nytimes.com/2003/11/02/magazine/02FEAR.html --registration req'd) had an article on David Barlow's anxiety treatments. He's a psychologist at Boston University. His technique is basically flooding with the twist that he PROHIBITS both relaxation techniques and CBT-style cognitive challenges.
He's trying to expand the treatment to depression also. From the article:
-snip-
Barlow is currently working on taking his treatment to those suffering from everything from depression to substance abuse. "It's far too early to tell if this will work," he says. But he has begun treating a small group of depressed patients by teaching them to accept, and even seek out, their sadness. According to Barlow, attempts to suppress painful emotion lie at the heart of most pathology; the struggle involved in suppression only tightens the noose on an already vulnerable neck. So first sit still, Barlow says. Second, begin to act exactly counter to how you feel. ... Third, and most controversial, court the causes of your depression as a means of desensitizing yourself to them. "When you fight your own internal censors, you're giving them too much power," says Reid Wilson, who employs Barlow's methods in his practice. "You're saying they're worth the fight. Guess what? They aren't. There are some limitations to cognitive restructuring, because it's just like teaching relaxation. It sends the message that negative thoughts are bad, can even kill you. We practice the provocative approach of getting a person to confront repeatedly what they fear until they're so used to it that it ceases to mean a thing."
-snip-The suggestion that depressives could try to "accept and even SEEK OUT their sadness" is intriguing to me. Anyone have experience with Barlow's methods?
-bhc
Posted by Tabitha on November 6, 2003, at 19:52:44
In reply to Barlow - new depression treatment?, posted by badhaircut on November 6, 2003, at 18:02:22
Sounds like one of those ideas where, if it works, it's obviously great, but what do you do with people who just can't manage to force themselves to ACT counter to their depressed thoughts? Those types of ideas always have a lot of appeal to me-- but I haven't been able to get much practical use from them. I used to love a book called "Playing Ball on Running Water" which was a similar idea-- just ignore your inner dialogue and do what needs to be done. It didn't actually get me to change at all-- I'd just read it and dream of a day where I'd finally take charge of my depressed procrastinating self and just function.
I understand the impulse to abandon cognitive techniques. After all, you can spend your whole life sorting out the tangle of your inner dialogue, challenging it, replacing parts of it with new thoughts, and never actually change your life much at all.
Posted by mattdds on November 7, 2003, at 15:37:35
In reply to Barlow - new depression treatment?, posted by badhaircut on November 6, 2003, at 18:02:22
Hey Badhaircut,
This treatment is very interesting to me, because I feel like I sort of reinvented his wheel.
When I used to feel depressed, I would fight the feelings so hard, doing nearly anything to feel better. But this is basically "escape" behavior, and it sends the message to your brain that these feelings are dangerous and deserve further attention - thus magnifying them in importance. But we all know that pathological feelings are of really no particular relevance, and trying to "figure them out" is pointless.
Only once I completely accepted the horrible feelings and dealt with the prospect of having to live with them did I start to recover.
I think this is the way CBT will evolve...away from traditional cognitive restructuring and journaling, and toward acceptance and desensitization.
Great post. Thanks!
Matt
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