
Cognitive behavioural therapy is falling out of favour - amelius
https://www.theguardian.com/lifeandstyle/2015/jul/03/why-cbt-is-falling-out-of-favour-oliver-burkeman
======
neilk
This article discards the boring, plausible thesis in the first paragraph. The
rest of the article is given over to speculation.

CBT requires a lot more work from both the patient and the therapist. I can
easily believe that as it's become more popular, it's being applied less well
or to populations where it's less appropriate.

Anecdotally, in my experience, there are enormous differences between
therapists. I have had very ineffective treatment which did seem a lot like
"just get happy, stop thinking bad thoughts". And I've had effective treatment
where a perceptive person cut straight through to reveal my self-defeating
patterns and gave me skills to do better. It's a constant battle but I'm glad
I did it this way.

CBT isn't for everyone or every problem. But I would be surprised if the main
insights were totally wrong.

~~~
tssva
I wish I could site the study, but I read it many years ago. It was one of the
major studies being touted at the time for showing the effectiveness of CBT.
They actually stopped the study at one point to retrain the therapists on CBT.
After retraining them they started the study from scratch and through the term
of the study constantly evaluated the therapists and provided additional
guidance to ensure they were properly applying CBT. What I gathered from the
study was that proper application of CBT in the wild was likely to be rare and
therefore the effectiveness of CBT in the wild would be limited.

------
ThrowMeAway314
I've had a severe double down depression for most of my life. It started at
around 10~11, after my father died and it peaked at 26 where I could not get
out of bed without extreme amounts of stress or sleep deprivation. This ruined
relationships, friendships and left me with practically all of my teenage
years and most of my twenties lost to self-hatred and self-denial.

Medication was the life preserver for me when I finally got myself to accept
that I would never be able to deal with this alone. Medication gave my brain
some well deserved rest, let me take stock from a more balanced point of view.

CBT was my ladder to climb out of hell. Without CBT I would be still where I
was those years ago, just less affected by it. Sitting in a room that was on
fire, but just not caring about it that much, that's still a shitty place to
be in.

The important thing about CBT was for me that it gave me tools to work with. A
chisel for my mind so to speak. It is not at all about talking oneself into
happiness, for me it was about NOT talking oneself into sadness. About giving
me the logical framework to force myself to see good things where they were,
instead of focusing on the bad things. It gave me ways to correctly
differentiate between tackling bad situations and just glooming about non-
issues.

I'm pretty sure without CBT my life would be nowhere where it is right now, so
i'm very glad for its existance and would recommend anyone in a similar
situation to try it with a GOOD therapist (mine was a guardian angel, battling
the worst parts of my reasoning when I wasn't strong enough to do so).

~~~
digler999
> for me it was about NOT talking oneself into sadness.

Exactly. one tool you learn is how your thoughts/feelings/actions interact:

You cannot control your feelings, but they do influence your thoughts. You can
control your actions, but they can influence at least some of your feelings.
You can control some of your thoughts, which will influence your feelings.

(I may not have stated this exactly correctly, but the gist is the same ). So
basically you learn that if you begin "investing" in healthier actions and
thoughts (i.e. not sulking or self-pity or rumination), it will slowly pay off
in less negative feelings.

No it doesnt' solve every single problem in your life, but a big part of
depression is "learned helplessness" [1], and learning about
thoughts/feelings/actions can be the first tool to counter this.

[1].
[https://www.youtube.com/watch?v=NOAgplgTxfc](https://www.youtube.com/watch?v=NOAgplgTxfc)

~~~
chillacy
I found this last week on HN, but there was a great book that's short and
hands-on called Learned Optimism:
[https://en.wikipedia.org/wiki/Learned_optimism](https://en.wikipedia.org/wiki/Learned_optimism)
which was written by one of the researchers on Learned Helplessness

------
stupidcar
Having experienced CBT as a patient, I thought it was a useful, but limited. I
had two specific critiques:

1\. If you're reasonably intelligent, it's easy to see how CBT "works" within
a few sessions, and afterwards you can fall into a trap of telling the
therapist what you "should" say according to CBT. Because there's a very
specific goal of avoiding negative thoughts and thinking patterns, it's easy
to exaggerate your level of success in order to "please" the therapist, rather
than admitting that you've not make any progress.

2\. My larger problem is that CBT puts a primacy on thoughts over emotions
that I'm not sure is warranted. The thesis is that you have a established
negative thought, such as "social situations make me nervous", which becomes a
self-fulfilling prophecy, and so you are always nervous in social situations.

However, I am not sure that this is truly the order of things, at least for
me. I observed that, even when I studiously avoided negative thoughts like
this, the underlying _emotions_ were still often present. Being confronted
with a social situation produced a physiological response that included
anxiety. I might consciously _rationalise_ that response with a thought like
"this is a social situation, and social situations make me nervous", but the
underlying response existed regardless.

Freudian psychotherapy has a lot of wacky ideas about unconscious desires and
whatnot, but it does at least acknowledge the idea that there _is_ something
within people beyond the rational, conscious mind, and that it it can be the
stronger force. In contrast, CBT seems to be a therapy born from the opposite
viewpoint: that the primal, subconscious, animal brain is entirely subordinate
to the rational, conscious mind. Perhaps that's true for the people who
developed the therapy, but it isn't true for me.

~~~
empath75
Right, but isn't it about coping with that response, not eliminating it? That
was the impression I had of what it is. The goal isn't to eliminate sadness or
anxiety, but to limit the negative impact it has on your life. So you don't
get into these cycles were depression prevents you from moving forward, which
makes you more depressed and so on. That's why it supposedly works so well
with people with bpd, right? Because bpd is all about fear of people leaving
you, while you behave in ways that absolutely ensure that people will.

~~~
morbidhawk
My wife has BPD. CBT never worked for her (and it never worked for me either),
her therapist switched from CBT to DBT & EMDR instead and it has better
results. The problem with CBT is that it tries re-frame situations using a
logical explanation to people who don't know how to talk in logical terms to
see things from a different perspective. The problem is that people with BPD
don't express things in logical terms, so it is easy to mis-diagnose or
misrepresent and cause an invalidating statement. Borderlines are great at
reading between the lines and trying to understand things in an emotional way.
They can easily misinterpret your re-framing to be invalidation. So instead,
DBT and a question-based approach that helps them to think through the problem
themselves is so much better. My CBT therapist told me to tell my wife "that
being out of town for her birthday wasn't abandonment", yeah right that'd go
over like hell. BPD requires deeper introspection and CBT therapy will usually
cause the client to feel invalidated

~~~
thrwy1287
>> "The problem with CBT is that it tries re-frame situations using a logical
explanation to people who don't know how to talk in logical terms to see
things from a different perspective."

Not BPD but my experience with CBT and anxiety was that I could see my
response was illogical but I didn't believe myself it at the same time. So
when the therapist asked about this assumption I had that influenced my
thinking he was able to show me it was illogical, I was able to say 'I know in
my head', but at the same time - I don't believe you in my gut. His solution
to this was exposure. If you are put in the situation and you personal
assumption is proven to be untrue or it's is sufficiently challenged enough
times then you can start to believe it's illogical.

------
tfgg
A doctor I spoke to about CBT said he thought CBT was effective for the
relatively intelligent, introspective people they might have had in early
trials. Rolling it out further beyond that group had lower success rates.

The additional the article raises about lower standards of training as it
scales is also an interesting one, and could possibly apply further to other
fashionable "therapies" in things such as fitness and project management.

~~~
thrwy1287
>> A doctor I spoke to about CBT said he thought CBT was effective for the
relatively intelligent, introspective people

That makes sense to me. From my experience you have to be willing to take
small events in your life and read into them/pull them apart in great detail.
If you can't understand the root issue (the reason you react to your
thoughts/feelings in a certain way) by examining your thoughts in that way
then you can't really put into practice the basic tenets of CBT. Maybe it
depends on the therapist but from my perspective it seemed like quite an
intellectual way of dealing with your problems.

------
dominotw
I read about how beneficial CBT is on HN only a couple days ago
[https://news.ycombinator.com/item?id=12298898](https://news.ycombinator.com/item?id=12298898)
(Disturbing trend of people with no medical experience making critical medical
recommendations.)

Anything that has been researched is immediately accepted as truth
[https://news.ycombinator.com/item?id=12300577](https://news.ycombinator.com/item?id=12300577)

~~~
baconner
> 1\. scientific method is not a good fit for 'mental health' research

What exactly is a good basis for mental health research then in your opinion?
twisi the scientific method is basically all you've got even if it doesn't
work as well as it does in other types of research. Yet what other options do
you have besides anecdotes and woo?

~~~
orblivion
Anecdotes and intuition got us through life until the scientific revolution. I
don't think you can conclude that it's entirely worthless.

~~~
baconner
I didn't say that though...

~~~
orblivion
"the scientific method is basically all you've got" \- I took that to mean
that other methods aren't of any use for learning truth.

~~~
baconner
Alright then let me clarify my opinion. I don't think anecdotes and intuition
are useless. They're appropriate for every day decision making where stopping
to do a controlled study isn't an option. When it comes to actually looking
for broader truth though all they can do is point you in potential directions
to study. Theres no better option than scientific method for that so far as I
know.

So if you want to know broadly of CBT works then science is your only
realistic option.

~~~
orblivion
I realized that I unnecessarily came off like I was getting on your case
specifically about this. It's just a concept that's crossed my mind in general
lately about people's views on the place of science.

~~~
baconner
no worries! i can see how what i said originally could be read that way and
suspect we may agree that there's a bit of an unhealthy tendency amongst some
of our peers to overstate how well science works and underestimate everyday
reasoning that we all must do. Science is messy too. The world we're measuring
is messy.

I say - use the best method that you reasonably can use and see where it gets
you. If that's science then great, but often you need to get by with a lesser
method and that is ok.

------
dougmccune
It's worth noting the study was specifically about CBT for depression, which
may not indicate similar effects for CBT for other disorders. As always it's
worth reading the actual study and not just the headlines. From the study:

"The present meta-analysis is not without limitations. First, this study only
included depression, thus, excluding CBT trials aimed at treating other
diagnosis, such as anxiety, posttraumatic stress, eating, schizophrenia, and
sleep disorders. There is no reason to expect the present findings to
generalize to these disorders. In particular, anxiety disorders, which include
a heterogeneous group of disorders that probably yield different time trends,
have been subjected to the CBT approach. The clinical presentations of, for
example, panic, obsessive– compulsive, and posttraumatic stress disorders are
very different, as are the CBT approaches used. A meta-analysis of five trials
comparing cognitive therapy with exposure therapy to treat obsessive–
compulsive disorder (Ougrin, 2011) did not indicate a decline for the newer
trials."

The paper (linked to in the article):
[https://uit.no/Content/418448/The%20effect%20of%20CBT%20is%2...](https://uit.no/Content/418448/The%20effect%20of%20CBT%20is%20falling.pdf)

------
privateersman
CBT is pretty much a scientific interpretation of stoicism. If you want it to
work, then you have to be dedicated to that mindset and lifestyle.

It's not a simple bandage over a cut. It's the sort of thing that a parent or
religion might teach to a child over years of growing up.

~~~
morbidhawk
I've heard about this correlation before as well. When I went through CBT
therapy I saw how logic could be used to re-frame issues to not assume the
worst in a situation, i.e.: my boss doesn't hate me, he very well could be
having a bad day today. However, I think CBT lacks the negative visualization
aspect of Stoicism where you think pessimistically about the future in order
to be prepared for the worst. This is definitely useful for someone strong
enough to handle that and not get depressed, but to the average person with
depression it probably won't help much if they aren't ready for it. I
personally feel like the Stoics were on to something that is more helpful as a
long-term solution rather than just getting by battling the current day's
depression.

------
slr555
Meta-analysis: the non-study, study that says, well, anything you want it to
say.

I am so tired of second rate journals running rehashes of other researcher's
work and pawning it off as a "ground breaking examination of the data". Anyone
in the field of medicine will tell you that meta-analysis is the least
credible form of "research".

I find the Guardian author's first hypothesis most credible. There are a lot
of bad therapists out there. It is well established in surgical studies that
results for a procedure will be less positive in study sites that are not
centers of excellence as the surgeons are less practiced and less skilled.
Surgeons and therapists are not stamped from a machine. As the commercial
says, "your mileage may vary". Put another way, what do they call the person
who graduates last in their class in med school? Doctor.

For any medical ailment of any consequence you might face you will be well
served to find the best and most experienced provider available to you.

~~~
force_reboot
On what basis do you say that meta-analysis is not credible? From my stats
background, (but without any direct experience in meta-analysis) I would say
that they could be problematic because the N is very small and so have a lot
less to work with, and more temptation to use fancy statistical techniques
with hidden assumptions. On the other hand, what do you do when you have 50
studies of varying quality, no one of which is has such a compelling
methodology as to eclipse the others? In that case it seems like meta-analysis
is the least bad option.

~~~
slr555
Your point is a good one but in medicine the issue tends to be that a lot of
studies with varying controls and endpoints are being lumped together and
presented as a coherent whole. In reality the distortions (and in some cases
biases of the researcher) that are introduced leave the data often untenable.
You are absolutely right that powering medical studies correctly is a critical
issue. It is also critical that when making pronouncements about important
treatment modalities that the research be of the highest quality.

Meta-analyses are often used in so creating so called evidence based medicine
standards which are sometimes cost cutting efforts dressed up like research.

As a trauma surgeon recently said to me recently, "They said they designed it
using evidence based medicine. They didn't say whose evidence".

------
andretti1977
I've tried cbt in conjunction with other mindfullness techniques: they
required me to work a lot on myself and my thoughts (but this is right: you,
the patient, is the one that does the work on itself, not the doctor) but it
was one of the greatest help and valuable resource i discovered in my life.
Really, can't even understand what they meant when they are talking about
placebo effect. There is no placebo effect in cbt.

------
Apocryphon
I once knew a clinical therapy student who was studying in the psychodynamic
school and heavily anti-CBT. Is that what the state of the field is really
like, there's a rivalry between the two schools?

~~~
mikkergimenez
Masters in Counseling Psych here. The short answer is yes.

Basically people who practice CBT think that people who practice
psychodynamic/existential-humanistic spend too much time analyzing things that
may not matter with less direct evidence that it works. The other half(myself
included) think that CBT is too much of a quick fix, and that yeah, you may
want to have 6 sessions of skill building to solve your problems, but that
will only provide a short term solution.

The reality is probably somewhere in the middle, and the skills taught by CBT
are probably important. And if you have poor coping mechanisms or antagonistic
thought patterns CBT is important, but it won't touch the underlying issues.

The funny thing about this article and the talk about the "placebo affect" is
that to a certain extent many types of therapy are about integrating
experiences: coming to an understanding about events in your life and the
context in which they take place. The other thing that is linked most highly
to success in therapy is the strength of the relationship between therapist
and client(with a few caveats. The research shows this relationship should
embody a few things and obviously it could be strog and unhealthy if there's
something unethical going on).

But basically, talking about the placebo affect in mental health is kind of a
funny thing. There are studies that look at placebo affects to certain
therapies, but in general, since the goal is to feel better, if you think it
worked and your supposed to feel better, should I come back and say don't feel
better?(barring concerns about it being a short term effect). When the goal is
to think you feel better, how(and why) do you suss out the difference. What
I've always wondered, is do we think about the placebo affect the wrong way?
Instead of seeing as something that disapproves efficacy, should we think
about it as a power we should try and harness?

~~~
Jonoco
> linked most highly to success in therapy is the strength of the relationship
> between therapist and client

Have there been many studies looking at how the client-therapist relationship
itself effects the client? Wouldn't having a non-judgmental person with whom
you can comfortably confide it, whom you know is making a concerted effort to
help you improve your well being, have some noticeable improvement on your
condition, regardless of whether they were a trained professional?

Or put another way, is there anyone who finds themselves in therapy largely
because they have no close friends?

------
stupidcar
It seems a like a different possible explanation is a variation in publication
bias (and perhaps researcher bias) over time in response to the changing
status of CBT.

Studies saying "this new thing works" have an obvious appeal, particularly in
a field searching for something beyond classic psychotherapy. So when CBT
first appeared, studies with strong, positive results may have been favoured.

Studies saying "the mainstream thing doesn't work", or "this mainstream thing
doesn't work as well as we thought" also have obvious appeal. Now that CBT is
mainstream, research showing that it is less effective that thought, or not
effective in particular types of cases, may be more likely to be published.

------
tssva
One if the issues I have with CBT is the same that I have with 12 step
programs. In both if they aren't effective often the person is blamed, "They
didn't do the process right." or "They weren't willing to do the hard work
needed.", allowing avoidance of questions regarding the limitations or flaws
of the therapy.

------
wodenokoto
Nobody in this thread (at time of writing) seems to have the slightest idea
about what CBT is.

It is not about denying thoughts. It is not about telling yourself that you
are happy, when you are not.

It can't treat severe depressions, but it can treat mild ones, and it can
lower the amount of medication needed to treat severe ones.

You can think about it as "good posture for your mind". Nobody wants a bad
posture, but lots of people have it, and some have it so bad, that they get
pains so severe they cannot work. Some people with back pain take pain
medication, and never solve the problem, but can go on with their lives.

For some people, there are external influences on their posture that cannot be
negated by exercise and they do need to change their environment.

Some do need an operation with everything that entails, but most just need to
fix their posture: Do the right exercises and stretches and they won't need
medication or operations.

If you are depressed because of your abusive boyfriend, then CBT's answer is
not "stop thinking about it" or "just think happy thoughts when you're being
beaten" it is "get the fuck out of it".

~~~
DanBC
> Nobody in this thread (at time of writing) seems to have the slightest idea
> about what CBT is.

I like to think that somewhere there's a discussion board for psychologists
and they're talking about, say, using R and how it sucks or not.

~~~
fsloth
Given how statistics seem to be an integral part of psychology research, I
hope there is.

~~~
DanBC
I hope their discussions about R aren't as pisspoor as our discussions about
psychotherapy.

~~~
surement
[http://www.smbc-comics.com/index.php?db=comics&id=2177](http://www.smbc-
comics.com/index.php?db=comics&id=2177)

------
SnacksOnAPlane
I feel like CBT can be counterproductive because it encourages you to ruminate
on negative thoughts instead of just not thinking them. You have to examine
them and put them into categories like "mindreading" or "catastrophizing", but
giving them time in your mind just reinforces that you should be thinking
them.

I much prefer mindfulness methods where you immediately think "is this thought
useful to me at all?" and if it isn't, you put it out of your mind. Meditation
helps with this, as it trains your brain to be able to let go of thoughts.

~~~
xlm1717
Ideally they won't be negative after working on them using CBT. In CBT, you
have to be aware of your thoughts too, but instead of thinking "is this
thought useful to me", you think "is this thought an accurate representation
of my current situation". You then work on changing your thoughts until it is
an accurate representation of your current situation. Categories like
"mindreading" and "catastrophizing" mean that you are assessing a situation
with incomplete information, and training your brain to not make snap
judgments can be immensely more helpful than training your brain to just
ignore those snap judgments. It does take a lot of work, but a lot of the time
the thoughts you need CBT or mindfulness to work through, you get because
there's an unresolved conflict in your life that you can't find a resolution
for. It's better to train your brain to find a resolution for problems than to
ignore them.

------
mettamage
"What’s going on? One theory is that, as any therapy grows more popular, the
proportion of inexperienced or incompetent therapists grows bigger. But the
paper raises a more intriguing idea: the placebo effect."

The placebo effect, and effects like it, happen everywhere. Everything given
with a good or bad attitude will have some beneficial or detrimental effect.
In that sense this article isn't that interesting.

What I think is more interesting is combining the interaction between
inexperienced therapists and the placebo effect. Well trained psychologists
have a stronger -- and I'd guess more nuanced -- belief of when CBT is useful
and how it is useful. Since they have that belief, it has the potential to
create a positive placebo. I always have to think of the Pygmallion effect and
similar effects.

People who treat patients CBT but are inexperienced do not have that
enthusiasm and have a weaker belief that it will work. Maybe they only think
intellectually that it would work, but don't feel an emotional tsunami of
conviction -- in particular cases -- that it will work. It's easier to have
that when you know that in 7 out of 10 particular cases it worked really well
(i.e., having experience).

That would be my guess anyways.

\---

Now I read a couple of comments with people giving the sentiment that they
think CBT is nonsense. Allow me to address that.

When I looked into CBT (@ 17/18 yo) and its pseudoscientific brother --
reframing in NLP -- I noticed that it was all about changing perspective.
Learning to see that multiple emotional perspectives can be equally true was
mind blowing for me. I came to the conclusion that I might as well pick the
most positive one. I learned a couple of nuances on the way. For example, for
some goals it's useful to hold multiple positive and negative perspectives at
the same time.

I used it even today, now that I think of it. I was learning Django and it
took me 4 hours to write simple custom email validation. I had a bug, a very
simple one if you know the framework, but I don't. I was pissed after 4 hours,
I felt like I wasted my time. I found the bug though :)

Since I didn't want to feel pissed I looked for a reframe. The reframe was:
it's the first time that I learned to debug in Python with pdb, read source
code from a framework so intensely, have a better understanding in
transferable skills since I have experience with gdb and have the guts to
debug the framework and understand it, for the first time. While I didn't
progress much in writing actual code, my confidence in tackling issues in
Python has grown tremendously. After thinking this I felt pretty good and
figured that tomorrow it would be another day. So yea, I didn't progress in my
initial goal (completing a tutorial) but I got something way more cooler for
it in return. Now, if I hadn't known CBT I would've stopped at my first
thought and stayed pissed, I'd then enter a lot of thought trains that would
go to destructive places.

So yes, changing perspectives works. I also call it 'simple CBT'.

And when heavy stuff happens, then it doesn't completely cure you (perhaps
reduces the pain by 5 to 20% IME, got no scientific sources). In many ways
that's because the pain from the problem does not only stem from cognitive
distortions -- e.g. generalizing the slightest thing to a negative epic scale
-- which is the main assumption that CBT makes. If you lose a person (breakup,
passing away, etc.), for example, you also need to be reconditioned since a
lot of habits are still there that are only applicable to the other person
which may trigger an immediate pain. You can't just think your way out of
that, and the "behavioral" part of CBT will take a longer time and may not
work (habit formation and destruction is a difficult topic).

Disclaimer: studied psych., I know a lot more about reframing than CBT (I
skimmed a couple of texts and was like "hey that looks like reframing"). So my
knowledge is _not_ a 100% sharp and may miss important details. I read a book
about ACT and compared that with CBT.

~~~
chillacy
Your story is spot on with my experiences dabbling with reframing lately (the
kind presented in Learned Optimism, where the practitioner is aware of their
beliefs and debates internally to install new beliefs. Negative things are
reframed to be temporary or impersonal while positives are permanent general
traits about the individual)

I've known some people who have seemingly indestructible self confidence,
bordering on delusional, and this seems to be how they do it. I don't
particularly want to be delusional, but I'd rather be happy than right.

~~~
mettamage
"but I'd rather be happy than right"

Me too, to add: I'd rather be both ;)

------
jrapdx3
This is completely unsurprising. Like all other disciplines, behavioral health
is subject to trends and the glitter of the "new things". We've seen this
regarding initial enthusiasm for new medical procedures or medications, after
practitioners gain experience with new tools the limitations prompt more sober
reanalysis, and the enthusiasm becomes more restrained.

Recent studies have called into question the initial reports of effectiveness
of psychotherapies, CBT included, or perhaps in particular. I won't go into
detail here, but in a phrase all kinds of established therapies tend to
eventually be observed to follow the classic "rule of thirds". More or less
about a third of the treatment cohort will get better, a third remain the same
and a third are worse. Proportions vary of course, but that's the idea.

What it comes down to is that CBT, interpersonal therapy, psychodynamic
therapy and a thousand variants can be helpful for certain problems, but quite
often a combination of approaches is needed for optimum outcome.

It's not unlike software development, a "team" of tools is necessary to
actually get from initial concept to production release. It's a complex non-
linear process, at least as much art as technology must be applied to get
there.

I can attest after decades in the trenches that treatment for behavioral
conditions runs in a parallel form, the art and science of applying relational
and medical tools is distinctly complex, as it's necessary to tailor the
approach to each individual. The salient point is no two people ever have the
same illness.

CBT can be no more effective than the skill and talent possessed by the
therapist and patient working as a team .

------
oldmanjay
Given the slightly less than rigorous reputation psychology has lately, what
are the chances the initial measurements that determined CBT were woo to begin
with? There are certainly enough incentives on the part of the practitioners
to give the benefit of the doubt to the efficacy of expensive new techniques.

~~~
DanBC
CBT is much cheaper than other forms of psychotherapy. It's a short form
therapy, that takes between 8 to 14 sessions, of about an hour each, as oppose
to the sometimes years long therapy of other systems.

EDIT: Its cheapness is one reason it's been pushed so heavily in the UK.

------
iiiggglll
There's the classic joke where someone goes to the doctor and says "it hurts
when I do this", and the doctor says "well don't do that then".

Cognitive behavioral therapy is basically the same thing but it boils down to:
"it feels bad when I think about this" / "well don't think about that then".

~~~
JoBrad
It's more like a thing gives a patient unbearable anxiety and makes them feel
like they have no control. CBT helps them put that thing in perspective, and
actively control how they respond to it before it winds out of control.

------
m-jones
People aren't depressed because they want to be, CBT relies upon the false
assumption that people are able to change their mood if they will it enough.

If we wish to treat depression, we should focus on life not being so
depressing to begin with, not persuading people that actually it isn't once
they have already spiraled into despair.

~~~
sweetdreamerit
It looks like you know nothing about cbt

~~~
m-jones
I have been through three courses of CBT. On the third I was dismissed after
six weeks because "I already knew it all" and the pediatrician thanked me as I
had helped them "gain a better understanding". I found that it was only after
receiving medication that I returned to mental stability.

I resent that you make a false assumption, having been through CBT so many
times I feel I might even have a better knowledge of it than professionals
whose only experience is from a text-book.

~~~
Bud
Now it's clear that in addition to knowing nothing about CBT, you also know
nothing about what it takes to become a licensed therapist. My fiancé just
became one, so I can help educate you: it goes far, far beyond textbook
learning. After you get your Masters, you have to accumulate 3000 hours of
supervised professional therapy under the guidance of another therapist who is
licensed, and then after that you must pass an ethics exam and a clinical exam
as well. Therapists are rigorously trained.

~~~
DanBC
You don't know what country m-jones is in.

