Posted by Peter S. on November 23, 2002, at 23:09:52
In reply to Re: Burns NOT a med-basher » wcfrench, posted by mattdds on November 23, 2002, at 12:10:13
Hey Matt and CharlieI've used cognitive psychology for years. I've also gone to a cognitive therapist for a number of years. What I've found is that the techniques Burns describes are extremely useful in dealing with mild depression as well as anxiety. A major result of depression is distorted thinking- the cognitive approach directly challenges these thoughts. I think it is much more effective than going to an insight oriented or other kind of therapist for depression. Of course for some people this may not be true.
The problem with this approach is that I don't think it has much validity or use with more severe depression. I've done tons of cognitive exercises (writing down all my distortions and challenging them) and have had very little results. It's like water off a duck's back.
The idea that cognitive therapy is the answer to dealing with depression is very far off the mark. It's true David Burns leaves room for meds, but I still get the feeling that he believes if you try hard enough to do the exercises then you can beat any kind of depression. I completely disagree.
Peter
> Hey Charlie,
>
> This is an interesting exchange. I appreciate your comments on it. I have actually done a lot of thinking about this subject.
>
> The message that I am getting from Burns when I read his work is a bit more subtle than I think you may have interpreted. I am afraid you may have missed his point.
>
> I understood that he, in fact, **does** believe there is genetic susceptibility for depression / anxiety / mania, etc. He is especially convinced that this is the case in schizophrenia and mania, for which he strongly encourages neuroleptics and mood-stabilizers as part of the treatment.
>
> But wait! Just because something is “biologically based”, why does it logically follow that there must be some drug treatment involved to treat it? Keep in mind this is not an anti-med position; in fact Burns used antidepressants in roughly 50% of his patients (although he had better luck clinically with MAOI’s, and fared poorly with SSRI’s). It just means that there are other ways of “rewiring” your brain. For example, blood phobias are very much inherited, and “biological”, as you put it. But people who get exposure to blood eventually can overcome this extreme fear. The treatment of choice for this is not “cranking up the serotonin” with meds, but merely getting more exposure to the feared stimulus.
>
> Burns used the analogy of a computer to illustrate what may be going on in depression and anxiety. The brain is more of an electrical system than a chemical one. The neurotransmitters are essentially there to complete circuits, as in a computer. But perhaps the problem is more the “software” than the “hardware”, so to speak. I believe this is the case, and feel there is little, if any evidence of any neural pathology (at least the obvious traditional pathology) in depression. We can “rewire” our brains through experience. For example, there was a study done at UCLA where one group got CBT and the other got fluvoxamine for OCD. They did PET scans and fMRI’s for the responders of both groups at the outcome. Guess what? The changes in glucose metabolism in the orbitofrontal cortex (the part thought to be involved in OCD) were *identical*, suggesting that CBT causes actual physical changes in the brain! So, the point being, yes there may be a biological anomaly; but that changing the way you think about things can change your brain.
>
> You see, if thinking is a biological phenomenon, with neural counterparts, why could we not use thinking as a way to (directly) access the problem?
>
> Does any of this make sense? Sorry so rambly, but this is an interesting subject to me!
>
> Take care,
>
> Matt
>
poster:Peter S.
thread:128568
URL: http://www.dr-bob.org/babble/20021122/msgs/129000.html