Cognitive Behavioural Therapy

Your scepticism is refreshing given how hegemonic CBT (and its bastard offspring, Mindfulness) has become in the NHS. William M. Epstein's 'Psychotherapy as Religion' looks critically at CBT and the supposed evidence of its efficacy. I'd recommend it. It's pricey at about £20, so get your library to order it.

I guess it depends on what you're using CBT for. My partner used to swear by CBT in general but found EMDR (Eye movement Desensitization and Reprocessing) to be the most effective remedy for her PTSD.

I thought that I did CBT but I didn't have a workbook or anything.

The idea of CBT, if I remember rightly is to look at your automatic reactions and try to identify them and try to counter them if they are having negative effects. I think it can help some people and not others.

I don't see anything wrong with being challenged, I hvaen't seen the books so they might be terrible, but the idea is not to tell you that you are wrong for feeling something, but more to help you to ask yourself why you are feeling a particular way and if you can do something to change that if it causing a problem.

It also depends on what is being treated, for example I don't think a lot of mental illnesses are behaviour, in that sense, so can't necessarily be treated in that way. To be honest I think it is something that works if you have a professional trying to help you, if they are just shoving one size fits all workbooks at you then it is not as likely to have an effect. Just being asked how you feel has a beneficial effect, they control for it in medical trials, because just the fact of filling in forms to say how you are improves mood etc.

You can also check out this, but I think you know about it already

CBT is a therapy reflecting current/social organisation.

1950's followed behaviourism and Psychoanalysis

Humanistic therapies reflected the 60's.

CBT is replete with long waiting lists, targets, tick boxes
and therapists who are not required to undergo their own therapy.

All therapy, whatever system it uses, depends on the quality of the therapist.

Humanistic therapies are still available.

It sounds like you should be in regular talk therapy where you can have more validation, empathy, and support for your pain and struggles. I do think it's important to be challenged, too, on your thoughts, beliefs, and emotions. So hopefully it's possible for you to do both CBT and talk therapy? Ideally there is a balance between validation and being challenged.

I’ve searched around before for leftist perspectives on counselling and a common criticism seem to be that it has an individualist outlook, ignoring the social context of mental health, blaming the individual for their mental health problems and making them fix themselves to better fit society, rather than changing society. I agree with these views, but at the same time there is kind of the risk of saying or coming to believe that mental health is all societies fault, therefore there is nothing I can do to help myself, and I don’t want to get stuck with that thought either.

This is a dilemma I have, too. It's so hard to find the right balance between these two ways of thinking. I don't think I'll ever stop being confused about it.

I try to take a practical approach to this dilemma. Even if it is mostly society's fault, I can't just change society to be a better mental health environment for me. Of course as libertarian-communists, we are trying to change society, but that ain't gonna happen soon enough. So when it comes to mental health, I focus on changing myself and my life since that's what I have more control over (even though it's not total control).

What are your experiences with CBT, have you found it useful and if not have you found something else that works for you?

I've not done CBT with a therapist but have used workbooks. I did find it somewhat useful in changing some of my negative self-talk. But like you say, though it may be easy to identify better ways of thinking, it's a lot harder to change your thought patterns. Constantly monitoring and adjusting your thoughts is tiring, and leaves you with less mental focus for learning or engaging in other activities.

Because of this, I don't keep up with CBT practice. However, learning CBT has left me with better mental habits than I had in the past. So although I'm not rigorous about it, I generally have healthier thought patterns than before, even though they can still be pretty fucked up. Also, if I get into a particularly fucked up place mentally, I'm somewhat better equipped to find my way out of it.

I do find, though, that changing your conscious thought patterns, as CBT teaches, only has limited ability to change your underlying beliefs and emotions.

Basically, CBT has been useful in improving my mental health, but on its own it hasn't nearly been enough. I do think it's worth learning, though. Even if what you learn seems obvious, it's about developing healthier mental habits.

We can leave aside the question of why the abject alienation of the individual that happens under capitalism necessitates an institutionalized system of professional listeners and counselors (in my more cynical moments I have called this "rent-a-friend").

All therapy, whatever system it uses, depends on the quality of the therapist.

This is what I've found as well. Some therapists don't converse with their clients, others intervene quite a bit. Some use particular techniques they like, but may not be the best practitioners of them. Because therapy is so personal, you need to find a practitioner who is self-aware as well as being at least professionally empathetic. It also helps if they aren't throroughly bourgeois in their outlook -- my therapeutic process does not need to include justifications of my politics.

I have done CBT, EMDR, talk therapy, and various combinations. The best therapist for me was one who used to work in the same field and then moved into psychology to assist her former coworkers. I didn't have to spend any time explaining the jargon or the acrynyms or the unhealthy attitudes of my coworkers -- she already had that as part of her history. From the beginning it didn't matter that much which techniques she used.

I have used CBT, and found it helpful, truthful, though hard to come to terms with. You might want to look at the variety of stress reduction techniques, as well as the challenging of false thinking.

CBT and other therapy stuff tends to have a liberal streak a mile wide. Individualistic and overly optimistic. Most commies/anarchists will naturally recoil from that. But as the saying goes, don't throw the baby out with the bathwater.

At times when exploring CBT or mindfulness, I would get angry and just want to dismiss the whole thing as garbage. But I resisted the temptation. Instead, I search for what makes sense to me, discard what I don't like. A lot of the time I edit or amend the advice to suit a more realistic, politically aware world-view.

I try to be a realist, but an optimistic skew on realism, rather than a pessimistic skew. Optimism and pessimism can become a self-fulfilling prophecy, to some extent. There are many other factors that I have no control over, but a realistic level of optimism will have a positive influence on my actions.

Sadly, we will most likely never live in the society we want, and thus never have anything close to the life we want. The next best thing is to live a life where we work hard to make that possible for future generations. And try to make as decent and happy a life for yourself as you can.

I wish you all the best in figuring that out... and do keep us posted on this thread with updates. :D

Scallywag

I've not brought up political things like that with my counsellor, I am not so sure that's a good idea, but it gets hard to avoid it.

I wish there were more commie consellors!

This is a very interesting thread, thanks to all for contributing. I thought I might add a bit from the other side of the chaise longue... I've studied a bit of CBT. I haven't had the opportunity to use it yet with any clients, so no experience in that regard but from a directly theoretical point of view there are plenty of downsides to it.

I don't want to get into a whole long spiel, but the neoliberal tsunami of the late '80s led to a shift in the way mental health care was delivered in most western countries. Efficacy (defined as 'value for money') became the order of the day and the newly-empowered layer of managers made it clear that all social support should be structured around 'evidence-based practise'. Methods that could not be clearly validated by empirical research, like psychoanalysis, lost ground to methods that could, like CBT.

From a researcher's point of view, CBT has a lot going for it; studies consistently show that it is particularly effective in the treatment of anxiety disorders. But it doesn't work for all clients, and it contains some philosophically questionable assumptions (for more on that, I recommend these two blog posts: 1, 2 -- sadly mental health researchers and practitioners do not study philosophy anywhere near as much as they should). The reason it's so ubiquitous is because how handy it is from a neoliberal POV -- it (usually) has a defined time-frame, its predefined outcomes are easily measurable, there's an endless backlog of studies and meta-analyses that show it gets results, it's fairly cheap, easy to grasp, you don't even need to pay a therapist to deliver it (as you mentioned, there's the workbooks, and there are even CBT websites and apps that can do it all remotely), etc etc. You put money in, you get a functioning human out.

There's also a background ideological bonus in the way it -- rightly or wrongly -- centres the patient as the main problem. In other words, it's not the external stimuli that make the anxious man anxious, it's the anxious man's cognitive patterns. And once you change the anxious man's cognitive patterns, the anxious man is no longer an anxious man. And I'm not calling that notion wrong! But you can see how it's so attractive for the neoliberal politician, or the manager of a clinic; you don't have to change a thing structurally, you just have to change the person. It's purely individualised. If work is making a person anxious, you don't have to change their shoddy working conditions, you just have to teach them to respond to those shoddy conditions without getting anxious.

Hopefully this made sense and I wasn't just rambling. There is a lot of critical literature about this, I know in the field of social work it's discussed mainly by people interested in 'critical social work', not sure what the equivalent might be for other fields. Unfortunately 90% of it is trapped behind paywalls, obscured by needless jargon, or seemingly written by crackpots, but it's there. I will try and find some readable open access stuff for you if you are interested.

I believe the root issue of most mental health issues is the fundamental alienation and trauma from abuse in our society. If you live in an actual community where people actually care about each other and are honest, you probably wouldn't really need therapy. However, the system teaches us not say or express what we really feel. Labor and life gets very alienating.

Therapy provides a way to help overcome at least some of the negative feelings from this. You can find a way to express all the ways you've fucked over and abused, and at least pretend you have some actual connection with another person. It doesn't solve the broader issues of society, but when you have live the system, it be useful. Protests and direct actions may also be useful in this regard to some extent.

This is a useful account of how the 'cognitive approach' to illness/disablement/unemployment functions as an attack on our conditions. (Towards the end gives the impression that it's all down to them nasty Tories, though the writer corrects this in the later comments..)

https://kittysjones.wordpress.com/2016/11/29/rogue-company-unum-had-a-profiteering-hand-in-the-governments-work-health-and-disability-green-paper/?fbclid=IwAR08jvfbmgu181tC0t-Kz5itU-Ez2-wCUcRsOaz8wBs7SKnU8i4BsIcidq0