7 ms·

Hmmm... I'm pretty skeptical of the premise that "All therapy books start with a claim that their form of therapy will change everything." My wife practices Co

Hmmm... I'm pretty skeptical of the premise that "All therapy books start with a claim that their form of therapy will change everything." My wife practices Cognitive Behavioral Therapy (CBT), and the foundation of her approach and all CBT books on her bookshelf is that CBT in fact doesn't change anything at all. You will still have symptoms (depression, anxiety, etc.) after CBT, but the goal of CBT is to help you manage those symptoms and live a meaningful life despite those symptoms. It's reasonable to doubt that such an approach can work, but Scott's article entirely misses that this approach can even exist. I suspect that this is a latent bias due to his psychiatrist training. (Psychiatrists are trained to use medicine to reduce/eliminate symptoms, and that is their primary measure of success; psychologists use therapy, and the reduction/elimination of symptoms is not necessarily their primary measure of success.) I just did a quick search on amazon for CBT books, however, and found that most results are things like "CBT for Dummies" and "Teach yourself CBT in 7 weeks". These are not books for doctors, but books for laymen that are merely self-help books with a veneer of science/therapy to help the book sell. Who knows what sort of crap is in these books.

jrsdav 7y ago
For those interested in learning more about CBT, "Feeling Good, The New Mood Therapy" by David Burns is probably the most recommended book out there. https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380810336 https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380... There is also a handy CBT app called Quirk that I'd also recommend checking out https://www.quirk.fyi/ https://www.quirk.fyi/
- OscarCunningham 7y ago
  Claim that their form of therapy will change everything: >The good news is that anxiety, guilt, pessimism, procrastination, low self-esteem, and other "black holes" of depression can be cured without drugs. In Feeling Good, eminent psychiatrist, David D. Burns, M.D., outlines the remarkable, scientifically proven techniques that will immediately lift your spirits and help you develop a positive outlook on life.
  - Rerarom 7y ago
    Ok, this is a premier example of Poe's Law
- deleted 7y ago
  [deleted]
shantly 7y ago
This seems to rely on a specific take on the phrase "change everything" that doesn't square with how I'd have read it, followed by the odd claim that CBT doesn't change anything, but then a description of things it changes. [EDIT] in fact despite looking superficially like a fairly sober and complete post, I believe the parent might be a poster child for "shallow dismissal".
whiddershins 7y ago
The author writes from the perspective of a working psychiatrist. In this linked essay, he refers to specific quotes regarding CBT that touted it as a nearly miraculous therapy, when it was first introduced. https://slatestarcodex.com/2015/07/16/cbt-in-the-water-supply/ https://slatestarcodex.com/2015/07/16/cbt-in-the-water-suppl...
polymathemagics 7y ago
For what it's worth, CBT was hugely helpful for me. I read The Feeling Good Handbook (kind of the CBT bible, a new edition of Feeling Good). CBT is definitely a tool that you want on your tool belt if you're struggling with anxiety/depression. It may not be the be all end all, but I like that it puts control and responsibility into the person's hands, namely the thesis that thoughts precede emotion. It's helped me reframe my mind to give me more control over what I think and feel, to separate the true reality of life ("that person and I didn't talk for long", "I haven't heard from a friend in 24 hours", "I'm not currently doing anything on this saturday night") from the normative, subjective spins your mind can put on reality ("that person didn't like me", "I have no friends", "I'm a loser with nothing to do"). There's definitely a discussion about whether CBT should always be the therapy of choice. Personally, I think you need to be at the right spot for CBT to be effective. For me, I was a functional person who could somewhat identify what I didn't like about my mental state and was very open to trying to improve. I'm guessing CBT is probably not as effective if you're experiencing severe mental health problems or breaks in reality, or if you have milder symptoms but don't want help/change. Sometimes when I'm really down, CBT essentially feels like "you're sad because you're too stupid to be happy!" At the same time, I imagine every therapy works better if a person is at an okay spot and open to change. And CBT can probably help people all over the spectrum to various degrees. If you're experiencing mental health problems, give The Feeling Good Handbook a try! It's a large workbook where you read and work through written exercises. Very helpful to me so I try to evangelize it when I can (and give out copies to people I know who struggle). I never tried in person therapy but that'd also be immensely helpful too. The great thing about CBT is how simple it is though, so reading a book (aka bibliotherapy) for a self-motivated patient can do the trick. Indeed, he spends the first chapter reviewing studies that claim bibliotherapy is just as successful as in person therapy. (Not sure what I think of that... I imagine book readers are more self-motivated than the average in-person patient but they were experimental studies so I'm sure that's already controlled for... nevertheless, bibliotherapy was good for me. About me: I lost my dad in high school, my mom in college, and my sister to suicide after graduating. Pair that with an interesting childhood (alcoholic mom, bipolar sister) albeit a financially comfortable childhood. It was (and still can be) an incredibly hard stretch of time. At the same time, I was exceptionally gifted at school and really looked up to my teachers so I was and am very lucky and traditionally successful. If you're struggling, get help! Take responsibility! Your mind CAN change in small but subtle ways in how you frame your life and the daily happenings of it.
dominotw 7y ago
> You will still have symptoms (depression, anxiety, etc.) how can a human being not have these. Even my cat has these from time to time.
- kingkawn 7y ago
  Part of the damage of depression and other mental health problems is that all normal sadness and anxiety becomes associated with illness. The work to heal is doomed if the person aims to never feel these things.
kelnos 7y ago
> CBT in fact doesn't change anything at all > CBT [...] help[s] you manage those symptoms and live a meaningful life despite those symptoms So... it... does actually change things? I'll be explicit rather than flippant: giving someone tools to manage symptoms and live a full life can be a huge change.
- jackpirate 7y ago
  That was my point. From a psychiatrist's perspective, "change things" means reduce/eliminate symptoms. From a psychologists perspective, however, the goal is to manage symptoms rather than reduce symptoms. This distinction is often lost in resources that are not aimed at the clinical audience.
xelxebar 7y ago
> I'm pretty skeptical of the premise that "All therapy books start with a claim that their form of therapy will change everything." Nicely spotted. This is certainly a good point to question. The article reads to me as (intentionally) hyperbolic, in a dry humor kind of way. Perhaps the author is frustrated with the state of things. Anyway, I feel like "change everything" can be considered a stand in for "effect any change more than other therapeutic methodology." With that reading, the main point that stands out to my eye is that CBT or any methodology is no more effective than the next. They are all the same basic process, just with different dressings. As an extreme example, even far-field woo like Dianetics can boast the kind of therapeutic help you describe. This makes it seem like the particulars of CBT are mere detail and the thing that is working is mostly the patient's earnest work toward some form of "better."
jdietrich 7y ago
>all CBT books on her bookshelf is that CBT in fact doesn't change anything at all. You will still have symptoms (depression, anxiety, etc.) after CBT, but the goal of CBT is to help you manage those symptoms and live a meaningful life despite those symptoms You're describing Acceptance and Commitment Therapy, not CBT. https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy https://en.wikipedia.org/wiki/Acceptance_and_commitment_ther... >psychologists use therapy, and the reduction/elimination of symptoms is not necessarily their primary measure of success Aaron T. Beck invented both CBT and the most widely used instruments for measuring the severity of depression and anxiety symptoms (the Beck Depression and Anxiety Inventories). CBT was the first psychotherapy to a) explicitly make the reduction of symptoms the primary goal and b) measure the success of therapy using standardised questionnaires to quantify symptomatic reduction. Using a repeatable psychotherapeutic model to measurably reduce the symptoms of psychiatric illness is pretty much the raison d'etre of CBT. Beck's work is by no means immune from the "eureka" anecdote of a patient suddenly entering remission thanks to the acute insights of $theoreticalModel. https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy >found that most results are things like "CBT for Dummies" and "Teach yourself CBT in 7 weeks". These are not books for doctors, but books for laymen that are merely self-help books with a veneer of science/therapy to help the book sell. Who knows what sort of crap is in these books. Both CBT for Dummies and Cognitive Behavioural Therapy: Teach Yourself were written by qualified and accredited psychotherapists.

jrsdav 7y ago

For those interested in learning more about CBT, "Feeling Good, The New Mood Therapy" by David Burns is probably the most recommended book out there. https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380810336 https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380... There is also a handy CBT app called Quirk that I'd also recommend checking out https://www.quirk.fyi/ https://www.quirk.fyi/

OscarCunningham 7y ago
Claim that their form of therapy will change everything: >The good news is that anxiety, guilt, pessimism, procrastination, low self-esteem, and other "black holes" of depression can be cured without drugs. In Feeling Good, eminent psychiatrist, David D. Burns, M.D., outlines the remarkable, scientifically proven techniques that will immediately lift your spirits and help you develop a positive outlook on life.
- Rerarom 7y ago
  Ok, this is a premier example of Poe's Law
deleted 7y ago
[deleted]

shantly 7y ago

This seems to rely on a specific take on the phrase "change everything" that doesn't square with how I'd have read it, followed by the odd claim that CBT doesn't change anything, but then a description of things it changes. [EDIT] in fact despite looking superficially like a fairly sober and complete post, I believe the parent might be a poster child for "shallow dismissal".

whiddershins 7y ago

The author writes from the perspective of a working psychiatrist. In this linked essay, he refers to specific quotes regarding CBT that touted it as a nearly miraculous therapy, when it was first introduced. https://slatestarcodex.com/2015/07/16/cbt-in-the-water-supply/ https://slatestarcodex.com/2015/07/16/cbt-in-the-water-suppl...

polymathemagics 7y ago

For what it's worth, CBT was hugely helpful for me. I read The Feeling Good Handbook (kind of the CBT bible, a new edition of Feeling Good). CBT is definitely a tool that you want on your tool belt if you're struggling with anxiety/depression. It may not be the be all end all, but I like that it puts control and responsibility into the person's hands, namely the thesis that thoughts precede emotion. It's helped me reframe my mind to give me more control over what I think and feel, to separate the true reality of life ("that person and I didn't talk for long", "I haven't heard from a friend in 24 hours", "I'm not currently doing anything on this saturday night") from the normative, subjective spins your mind can put on reality ("that person didn't like me", "I have no friends", "I'm a loser with nothing to do"). There's definitely a discussion about whether CBT should always be the therapy of choice. Personally, I think you need to be at the right spot for CBT to be effective. For me, I was a functional person who could somewhat identify what I didn't like about my mental state and was very open to trying to improve. I'm guessing CBT is probably not as effective if you're experiencing severe mental health problems or breaks in reality, or if you have milder symptoms but don't want help/change. Sometimes when I'm really down, CBT essentially feels like "you're sad because you're too stupid to be happy!" At the same time, I imagine every therapy works better if a person is at an okay spot and open to change. And CBT can probably help people all over the spectrum to various degrees. If you're experiencing mental health problems, give The Feeling Good Handbook a try! It's a large workbook where you read and work through written exercises. Very helpful to me so I try to evangelize it when I can (and give out copies to people I know who struggle). I never tried in person therapy but that'd also be immensely helpful too. The great thing about CBT is how simple it is though, so reading a book (aka bibliotherapy) for a self-motivated patient can do the trick. Indeed, he spends the first chapter reviewing studies that claim bibliotherapy is just as successful as in person therapy. (Not sure what I think of that... I imagine book readers are more self-motivated than the average in-person patient but they were experimental studies so I'm sure that's already controlled for... nevertheless, bibliotherapy was good for me. About me: I lost my dad in high school, my mom in college, and my sister to suicide after graduating. Pair that with an interesting childhood (alcoholic mom, bipolar sister) albeit a financially comfortable childhood. It was (and still can be) an incredibly hard stretch of time. At the same time, I was exceptionally gifted at school and really looked up to my teachers so I was and am very lucky and traditionally successful. If you're struggling, get help! Take responsibility! Your mind CAN change in small but subtle ways in how you frame your life and the daily happenings of it.

dominotw 7y ago

> You will still have symptoms (depression, anxiety, etc.) how can a human being not have these. Even my cat has these from time to time.

kingkawn 7y ago
Part of the damage of depression and other mental health problems is that all normal sadness and anxiety becomes associated with illness. The work to heal is doomed if the person aims to never feel these things.

kelnos 7y ago

> CBT in fact doesn't change anything at all > CBT [...] help[s] you manage those symptoms and live a meaningful life despite those symptoms So... it... does actually change things? I'll be explicit rather than flippant: giving someone tools to manage symptoms and live a full life can be a huge change.

jackpirate 7y ago
That was my point. From a psychiatrist's perspective, "change things" means reduce/eliminate symptoms. From a psychologists perspective, however, the goal is to manage symptoms rather than reduce symptoms. This distinction is often lost in resources that are not aimed at the clinical audience.

xelxebar 7y ago

> I'm pretty skeptical of the premise that "All therapy books start with a claim that their form of therapy will change everything." Nicely spotted. This is certainly a good point to question. The article reads to me as (intentionally) hyperbolic, in a dry humor kind of way. Perhaps the author is frustrated with the state of things. Anyway, I feel like "change everything" can be considered a stand in for "effect any change more than other therapeutic methodology." With that reading, the main point that stands out to my eye is that CBT or any methodology is no more effective than the next. They are all the same basic process, just with different dressings. As an extreme example, even far-field woo like Dianetics can boast the kind of therapeutic help you describe. This makes it seem like the particulars of CBT are mere detail and the thing that is working is mostly the patient's earnest work toward some form of "better."

jdietrich 7y ago

>all CBT books on her bookshelf is that CBT in fact doesn't change anything at all. You will still have symptoms (depression, anxiety, etc.) after CBT, but the goal of CBT is to help you manage those symptoms and live a meaningful life despite those symptoms You're describing Acceptance and Commitment Therapy, not CBT. https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy https://en.wikipedia.org/wiki/Acceptance_and_commitment_ther... >psychologists use therapy, and the reduction/elimination of symptoms is not necessarily their primary measure of success Aaron T. Beck invented both CBT and the most widely used instruments for measuring the severity of depression and anxiety symptoms (the Beck Depression and Anxiety Inventories). CBT was the first psychotherapy to a) explicitly make the reduction of symptoms the primary goal and b) measure the success of therapy using standardised questionnaires to quantify symptomatic reduction. Using a repeatable psychotherapeutic model to measurably reduce the symptoms of psychiatric illness is pretty much the raison d'etre of CBT. Beck's work is by no means immune from the "eureka" anecdote of a patient suddenly entering remission thanks to the acute insights of $theoreticalModel. https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy >found that most results are things like "CBT for Dummies" and "Teach yourself CBT in 7 weeks". These are not books for doctors, but books for laymen that are merely self-help books with a veneer of science/therapy to help the book sell. Who knows what sort of crap is in these books. Both CBT for Dummies and Cognitive Behavioural Therapy: Teach Yourself were written by qualified and accredited psychotherapists.