Comments on
Is CBT Useful?

By Joe Kraynak

I’m taking an informal poll on our Facebook Page about the usefulness of cognitive behavioral therapy (CBT). Please …

15 Comments to
Is CBT Useful?

Before posting, please read our blog moderation guidelines. The comments below begin with the oldest comments first. Click on the last comments page to jump to the most recent comments.

  1. CBT is good in that it helps deal with the now. How do I deal with my behavior; how do I deal with people; how do I deal with what’s going on in my head? Some of these things it deals with okay. The problem is that it doesn’t deal with the past very well. If you are trying to get to the basis of why you act that way or why you repeat problems it doesn’t help you find the source and address it.
    If you have been abused this kind of therapy is partially good. It is not really something I would use on specific problems until someone has gotten to the basic reason why they do what they do. Whether it’s abuse, addictions or mood disorders each should be treated differently and CBT is a general patch. It should be used when people have worked on other difficult issues and learned how to deal with people in a group setting. It can help a support group but I doubt that it would be a strong enough reason for people to continue to go to a support group.
    People with dual diagnosis may become confused when trying to apply these terms and practices to their own lives. People who are paranoid will have a difficult time incorporating the process of these steps into their everyday schedule. If a person does not want help these lessons will do nothing for the sufferer of whatever disorder they have.
    Because CBT asks the person to look within themselves the person trying to apply the instructions needs to have a certain amount of stability before they can be relevant in that person’s life. Otherwise the lessons don’t stick and can be confusing as well as guilt inducing.

  2. It is THE most evidence-based therapy.

  3. I think of CBT as a glorified reality check. That said,a glorified reality check is a very useful thing. I have found CBT to be moderately helpful once my depression was somewhat under control with proper medication.

    I have, however, also found that my brain sometimes works in the reverse way as CBT. That is, my depressed mood spawns nasty thoughts. When the awful depression is brought under control, my thoughts become more reasonable and much less distorted. Given someone with a strong biological component to their depression, I think the premise behind CBT can be damaging in that the depressed person will blame themselves for being unable to think the right thoughts to make their depression go away.

    I think it’s best to use aspects of CBT when appropriate along with whatever other approaches a therapist finds useful for a particular client. CBT certainly has value, but nothing is one size fits all.

  4. I personally found CBT to be the most condescending, guilt-inducing, contradictory, and absolutely unhelpful therapy I have ever had the misfortune of having to be subjected to. The premise, from what I understand, is to “think your way out of your problems,” only worded in a more palatable way with therapy-speak. Of course, if I could think myself out of my bipolar, anxiety, eating disorder, etc. I probably would have done so by now.

    And Lord help you if you disagree with a CBT idea (like, say, thoughts => feelings => behavior). The design of CBT gives the therapist absolute authority and control. Thinking that leads to distress can always be called “irrational” and a lack of progress can always be accounted for by the patients “laziness,” (in therapist-speak, this would probably be called “motivation to change”). After all, there are always more worksheets to do.

    I know I have emotional problems but frankly I got pretty fed up with being told that MY thinking was irrational by therapists who live in a world where “anything is possible.” I would much rather be distressed about something that’s true than constantly deny reality. But that’s what CBT is: Think only pleasant thoughts, which will lead to pleasant feelings, which will lead to good behavior.

    Oh, and the fact that it’s “scientifically based” only gives the therapist more control over their patient. Because science shows that it works; if it’s not working for you, it’s because you’re doing it wrong.

    • You seem to be feeling angry.

      • Am I not allowed to feel anger towards something I perceived to be harmful? Or is anger a “bad” emotion to have?

      • “You seem to be feeling angry.”
        Wombats comment isn’t CBT, its Rogerian.

        more aptly:
        “I hear, that you are feeling angry”.

  5. Is CBT useful? Obviously it is. It’s been studied and shown to work for a lot of people.

    But given that, I have to agree with “A patient” (4:29 pm 12/10/12) that there are problems with it. CBT sets the patient up to constantly and eternally argue with himself. Every thought and perception must be examined, and the negative ones fought off by hurling more positive alternatives at them. It doesn’t matter how much truth there is to the positive alternatives … one has to cling to them without regard to facts.

    I can’t help but conclude that this is really no way to live. At best it causes the patient to expend a lot of mental energy, constantly arguing with himself internally. At worst it’s an invitation to delusion, because sometimes, one’s negative thoughts are reality-based and more positive alternatives are not. I ge that CBT can alleviate depression and other problems, but the price seems a bit high to pay for that. Moreover, I wonder how much of its success is more of a “band-aid” than true healing.

  6. Possibly good for the simple, absolutely insulting bunk for anyone with an ounce of self-reflection. It is, I think, helpful for the first days out of a hospital—after that, it’s like sitting in a room full of parrots.

  7. The key is YOU HAVE TO CONNECT & RESPECT your Therapist. I’ve had therapy when I was 27 years old. My therapist was probably only 12 years older, but I respected him and we clicked. I am almost 50 years old, I know what my problems are now but I am set in my ways, I take my meds and try my best to cope Desiree’s Way and there NO WAY I would receive therapy from a “Kid” and for me that would be anyone younger than me…PERIOD!….. Desiree Cart Dugas

  8. I’m actually surprised at all of the reported successes. It is helpful, of course, to learn to reflect and question oneself. But, quite frankly, I find my opinion leaning towards that of “the patient”, “DeeJay”, and “wmBlake”.

  9. I also found CBT to be extremely insulting. Bipolar patients are usually highly creative and intelligent, and CBT is so simple and obvious that it makes us feel completely misunderstood. And, it doesn’t work for me. Sure, I understand the logic of it and it works in the office, but when I’m anxious or paranoid or depressed or manic my mind is not logical enough to use what I’ve ‘learned’.

  10. I have bipolar disorder, am a psychologist of 20+ years and use CBT with my patients. If anyone feels insulted or that its not useful then it was probably poorly done by someone with not enough training or experience. The point of CBT is to help one discover more REALISTiC thoughts , not merely positive ones. And to sharpen one’s awareness of how thoughts and emotions interact in the context of environment and other thoughts/emotions. We can so often blame ourselves if we don’t see the whole picture, or conversely blame others or attribute all sorts of wild meanings to a situation. When I tell myself to look for the thought that ignites the emotion , I am wiser and better able to choose my response. Usually not in the middle of a bipolar temper or sadness but later on.

    It is never the “fault” of the patient it is a therapist’s inability to present the material and to be with the patient. Any therapist that makes you feel that way is not worth your time or money. Although you might try talking to them about their behavior before
    you leave. There are terrible things in life, but we can learn to work through them better if we understand how all the pieces fit together. We make decisions based on thoughts,informed by emotion– god knows I have made many major life decisions based on my bipolar moods and have truly had grace and my wits keep me from totally sinking.
    Further in to CBT you look at core beliefs, those beliefs that can undermine our best intentions and will. And one uses facts and evidence to examine old beliefs.
    And yes it is not complicated for smart people. Remember the bell-shaped curve! Although not easy to use seamlessly in life. But like all bipolar folk, I am so sensitive to being misunderstood, that it helps me when I remind myself that those thoughts might be exaggerated ones and then Listen more closely. And if I discover that my thought that the other person is controlling is an accurate reflection of reality…..I’ll probably tell them so and find myself a good therapist.
    Not to be snobby, but I always choose a psychologist or psychiatrist and with expertise in mood disorders and at least 10 yrs experience. Thanks for letting me add my 2 cents.

  11. I find that CBT only works for me when I’m not having an episode. I can’t CBT my way out of the chemical problems posed by hypomania or depression. All it does is make me feel bad that I am broken, because I can’t magically make the emotions go away with thoughts. There is no way for me to magically think my way out of an episode. Medication is the only thing that helps me out there.

    While I think CBT does help me a little bit, I think treating my PTSD was more helpful. Being able to remember traumatic events without reliving them has been the most helpful therapy technique of all. I have been able to stop the progression of events that lead to episodes by not feeling the trauma acutely anymore.

    CBT is a great tool, but is it the only tool, or even the best one? Probably not.

  12. The rules stands:
    What works for one person, may not work for the next.

    I found that all my hard work in five years of CBT could have been addressed in a good work-book or two.

    I did harbor some (irrational) resentment towards CBT for being a “waste of time”.

    The problem is none of the therapy work addressed my self-judgement, over-rationalizing, and over-thinking problems that triggered my BSD symptoms and Panic Episodes.

    I changed to Gestalt therapy and I did not use my insurance I paid for it. This allowed my Therapist and me to use Gestalt therapy with CBT, Rogerian and Existential therapy mixed in.
    The result has been nothing short of a success story.

    Interesting Note: Insurance companies at the time would only pay for CBT when for treating Bipolar Disorder.

    -B

Join the Conversation!

Before posting, please read our blog moderation guidelines.

Post a Comment:


(Required, will be published)

(Required, but will not be published)

(Optional)

Bipolar Beat


Subscribe to this Blog:
Feed

Bipolar
Disorder



Archives


Blogroll





Candida Fink, M.D. and Joe Kraynak are authors of
Bipolar Disorder for Dummies.


Best of the Web - Blog 2008

Subscribe to this Blog: Feed

Recent Comments
  • Summer Blues: I had chronic depression and anxiety all through perimenopause, about 10 years. I had tried just about...
  • mhemmen: That’s great dear! But it’s most likely because you are younger and your metabolism is still...
  • weirdling: Hello, I’m diagnosed with PTSD, MDD, BPD, and GID. I’ve known those with BPD, probably...
  • michelle: My doctor started me on Seroquel about a decade ago, used for chronic pain and the inability to sleep. Now,...
  • C.lo: I started depakote a day ago. Haven’t really noticed anything. Iam very concerned because supposely these...
Subscribe to Our Weekly Newsletter

Find a Therapist
Enter ZIP or postal code



Users Online: 12240
Join Us Now!