> I think it's dangerous for severely depressed people to suggest that merely changing your thoughts will help you.
CBT is much more sophisticated than that, as you know, if practiced fully and with guidance. The goal is to discover and change core beliefs.
Top-down paradigm:
- Cognitive distortions
- Intermediate beliefs
- Core beliefs
CBT helped me and did not make things worse. Perhaps I am an exception. I doubt it though. I watched a great many depressed people profit from CBT when I was a patient at a partial hospitalization program.
In my way of thinking, CBT is not a replacement for other forms of "talk-therapy". Unfortunately, very little work of any sort can be accomplished when someone is severely depressed. Maybe your "band-aid" metaphor is appropriate in these cases. When my depression is untreated and at its most severe, my mind is frightenlingly inactive and simply does not function well enough to operate at levels so deep. I think CBT might help people who are severely depressed precisely because it does not need such sophistication of thought in order to be productive. Maybe we are talking about two different types of depression.
> Telling a person who already believes that she's deeply damaged
and thus always wrong and unable to trust herself that her problems are because she is "faulty" in her thinking is not *wrong* per se; it's simply unhelpful because it exacerbates her deeper issues.
How exactly does telling someone that their core issues can be addressed exacerbate deeper issues? My CBT facilitators never called our thinking as being wrong so much as distorted by depression. It was not our fault. It sounds to me like the approach that you were subject to was unnecessarily harsh and counterproductive. I like Aaron Beck's methods more than those of Albert Ellis.
> Telling her to fix her faulty thinking puts her in an extremely unhelpful, endless, crazy-making struggle against herself.
This is not how I experience CBT. I was never made crazy. It never seemed like a struggle so much as a new habit to exercise. I have never been told that a lack of success was a personal failure. Just trying is a success.
DBT sounds good to me.
- Scott
![[collapse]](http://www.dr-bob.org/images/babble/hide.gif)
this signature | Show by default | Change to hide (next time)Some see things as they are and ask why.
I dream of things that never were and ask why not.
- George Bernard Shaw