
Psychology's New God (a critique of Cognitive-Behavioral Therapy) - gnosis
http://hbmag.com/jungian-psychology-series-psychology’s-new-god/
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gohat
I've written a lot of articles in the health field (around 200), and, iirc,
the efficacy data for therapy of psychoanalysis and CBT is similar, actually,
again, now that I think about it, iirc, any psychological type of therapy
(within reason) is roughly as effective as the other.

As such, from the insurer's side, which is preferable: one that lasts
something like 12 weeks and has limited amount of sessions, or one that lasts
years and can have 4 sessions a week?

People need to feel listened to, cared for, important - in one form or
another.

~~~
steve-howard
4 sessions a week is always excessive. It's not that people don't need the
help -- it's just that you need more time to process information.

~~~
gnosis
I don't know about that. It's not like people aren't "processing information"
either during or after the therapy sessions.

And is 4 sessions a week really "excessive"?

Remember that most therapy sessions are only 1 hour long (sometimes as little
as 45 minutes, or even 30 minutes long).

It can feel very rushed to have to cram a description of and then a discussion
of everything significant that's happened to you in the course of a full week
in to just 1 hour of therapy, especially if you are going through a very rough
time where there's a lot going on (both external and internal).

That's why many therapists prefer "intensive therapy" (ie. more frequent or
perhaps longer sessions) for people going through a crisis, and then advise
less frequent sessions as their lives stabilize.

That said, I think 1 hour per week is the norm in most types of therapy. 4
hours per week is relatively unusual.

~~~
steve-howard
Not to tell too much about my life and the lives of those close to me, but two
hours a week is the crisis setting. If a therapist tells you anything of value
about the way you think or behave, it takes some time to think about what that
can mean for your life.

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william42
I'm not sure whether it's a good idea to trust any magazine that includes
articles on homeopathy:
[http://hbmag.com/category/6-holistic_therapies/homeopathic-n...](http://hbmag.com/category/6-holistic_therapies/homeopathic-
naturopathic/)

------
gnosis
Also very interesting:

    
    
      Post Qualification Training in Selective Ignorance
    

<http://www.midpsy.org/training_in_ignorance.doc>

Excerpts:

 _"the assumption .. [is] that [CBT] represents a lucid treatment framework,
founded upon a solid body of theory and research... [but] when this approach
is examined from a historical perspective, it is revealed as a self-
contradictory mishmash of psychiatric ideas, behavioural techniques, crude
clinical pragmatism and post hoc justifications from the academic discipline
of 'cognitive psychology' - or at least those bits of it that can be made to
fit with the claims of the therapists.

In other words, CBT is a 'tradition' rather than a distinct modality, owing
most of its success to its appeal to a superficial rationalism and to the
promise of delivering 'cheerful efficiency'"_

The papers presented in one of the conferences mentioned in the above report
are collected in this book:

<http://bjp.rcpsych.org/cgi/content/full/195/6/557>

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MaxGabriel
Another critique of CBT, this one from a psychoanalytic perspective

[http://www.guardian.co.uk/science/2008/sep/09/psychology.hum...](http://www.guardian.co.uk/science/2008/sep/09/psychology.humanbehaviour)

The Guardian article is theoretical or philosophical at best, but presents
some interesting ideas, such as criticisms of the methodology of CBT studies.
Specifically, the focus on solving one symptom while not taking into account
development of others.

------
ChrisMac
Another critique you can level against CBT comes from the thinking behind
Acceptance and Commitment Therapy (ACT). I've read books on ACT that argue
that trying to rationally challenge and control and manage your thoughts often
has the paradoxical effect of making them stronger, and making them more
prominent in your life. A common comparison is that a person trying not to
have negative, depressed thoughts is like someone trying not to think of a red
lion; you can't make yourself _not_ think something.

The ACT approach to negative thoughts and behaviors is more mindfulness based
and is about accepting the things that come from your mind without necessarily
getting sucked into them or being controlled by them. Personally I think bits
of several approaches can help.

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MarkPNeyer
i tried CBT when my life was a mess last year. it helped me accomplish some
goals for a while, but it didn't last.

now i'm going to analysis 5 times a week, and it's made a world of difference.

~~~
awakeasleep
How many hours a week do you spend in therapy? And what is the price to you?

Not trying to make a point in reference to CBT, I'm just curious about the
numbers, if you feel like sharing.

~~~
MarkPNeyer
i go to 5 one hour sessions each week. the therapy and medication cost me over
2 thousand dollars each month, but i credit them with totally turning my life
around. before this therapy i had zero emotionally intelligence; i would feel
things so intensely that i would be overwhelmed with the emotion and unable to
think about it rationally. now i am building the ability to step back and see
what is happening.

another really helpful move i took was to build the website
<https://www.thoughtplot.org>, which has been incredibly valuable for me in
understanding my mood.

at cbt, i told the guy that i sometimes become convinced that i am supposed to
trigger the singularity via a giant public sex orgy. instead of trying to
figure out why that is or what i could do about it, he was like "why dont you
make it a goal to eat vegetables today?" it actually helped, but it was
adressing the symptoms (psychosis) rather than the problem (a feeling of
lonliness and self hatred.)

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IANAP
I thought this was posted for it's comic value, but then I read the comments.

This is a critique of a therapy repeatedly proven empirically superior in it's
efficacy to other non-pharmacological approaches. And, amazingly, it's a
critique coming from what seems to be a Jungian nobody from Reno.

I say this as a huge advocate, and student of, Jung, Freud, Adler and the
rest. But come on, if something helps people who can't leave the house, hold a
job, or drive a car function again, without 10 years of 5 session a week
therapy, how can you ethically justify attacking it this way.

CBT attempts to change negative thoughts and maladaptive behavior by
addressing thoughts and behavior. Jungian therapy attempts to help people
integrate elements of their psyche carried over from previous lives, an
inherited collective psyche (yes Jung was a Nazi).

~~~
gnosis
_"This is a critique of a therapy repeatedly proven empirically superior in
it's efficacy to other non-pharmacological approaches."_

Well, that's the question isn't it? Has it really been proven to be superior,
or is it just scientistic, reductionist hype that is championed by insurers,
governments, and societies that values cheap, quick, superficial bandaids
instead of potentially more expensive approaches that might actually require a
long, hard look at the depths of your own self.

 _"I say this as a huge advocate, and student of, Jung, Freud, Adler and the
rest."_

I really wonder about that, considering your later mischaracterization of
Jungian therapy.

 _"But come on, if something helps people who can't leave the house, hold a
job, or drive a car function again, without 10 years of 5 session a week
therapy, how can you ethically justify attacking it this way."_

But does it help them? That is the key question. You clearly seem to think so.
Not everyone agrees.

 _"CBT attempts to change negative thoughts and maladaptive behavior by
addressing thoughts and behavior. Jungian therapy attempts to help people
integrate elements of their psyche carried over from previous lives, an
inherited collective psyche (yes Jung was a Nazi)."_

First, it's not like Jungian psychology does not "address thoughts and
behavior". It does. It just has a different understanding of what the causes
of these thoughts and behaviors are, what they mean, and how and when to
change them.

Second, to say that _"Jungian therapy attempts to help people integrate
elements of their psyche carried over from previous lives"_ makes it sound
like Jungian therapy is based on a belief in reincarnation. This is false.

 _"an inherited collective psyche"_

This is more accurate. Humans inherit certain instincts, such as the sucking
instinct a baby exhibits when presented with a nipple. Human brain structure
is partially an inherited characteristic. Jungians argue that there are
psychological instincts that are also inherited.

For instance, an image of a breast might trigger certain feelings and behavior
in an infant. The image of an infant might trigger certain feelings and
behavior in a mother.

The actual theory of such "archetypes" the "collective unconscious" is
actually much more complex. Entire books, in fact many, many books have been
written on these subjects. So the above should not be taken as even an
adequate summary, much less an exhaustive account of what they're about.

 _"Jung was a Nazi"_

This is troubling and problematic, but not really relevant to the question of
whether Jungian therapy works. It's even less relevant to the question of
whether CBT works.

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pnathan
"In addition, CBT has been enthusiastically embraced and promoted by insurance
companies because it is considered an effective, short-term therapy. Owing to
the hundreds of research studies documenting its efficacy in treatment for the
above illnesses, CBT is the quintessential 'evidence-based treatment."

If it's more effective, then it should be the program of first choice. Why is
this hard to accept? Can we not simply select the maximally effective
treatment?

I find the article an appeal to irrationality.

~~~
j_baker
I'd like to point out that the author doesn't say it _is_ more effective, only
that studies have shown it effective. The human mind is more complex than
traditional science is capable of handling. In particular, studies can only
show you how people behave on average. The problem lies in the fact that
there's no such thing as an "average" person. As Jung said, everyone is an
exception to the rule.

~~~
pnathan
What I've read of Jungian is pretty 'woo-woo' and does _not_ lead to any sort
of rational trust.

I'd rather go with statistics: statistically, 68% of people are pretty close
to the rule, and 95% are fairly close. People are all pretty much the same
wherever you go if you look past the superficial trappings.

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ZeroGravitas
Not really a critique, just some rather muddled FUD from a once fashionable
rival.

~~~
gwern
The real criticism, as it were, is in the final paragraphs where the author
points to the usual study of psychotherapies which found small advantages for
CBT. (I couldn't help but sarcastically think, 'and is 8% more effectiveness
not worthwhile?')

~~~
gnosis
Read that again. It didn't find an 8% advantage for CBT.

Here's the sentence that mentions 8%:

 _"Dr. Wampold found that the methods and techniques unique to a given therapy
account for only a modest portion (roughly 8 percent) of the overall treatment
effects._ "

Note that he's talking about _"a given therapy"_ , not CBT in particular.

Also, it's not clear from the summary whether 8% was within the margin of
error or not. And what kind of "effectiveness" are they measuring? Has the
"effectiveness" been shown over the long-term or just the short-term? How
large were the studies? Etc...

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j_baker
I think in a lot of ways, CBT is sort of psychology's OOP. Sure it's useful
and has its place, but that doesn't mean it should be used for everything.

