Posted by mattdds on November 10, 2003, at 21:02:49
In reply to Re: CBT'ing myself! » mattdds, posted by ace on November 9, 2003, at 22:58:03
Hey Ace,
>>Matt- you didn't want to continue our discussion on CBT?
I hope I didn't imply that, I love to discuss the topic. I just thought the thread had run its course.
I did learn a long time ago that trying to convince someone to your way of thinking is fruitless and winds up actually polarizing the other person to their way. So if the discussion you had in mind entails trying to convince you that it works (or vice versa), I'd rather not discuss it.
I really appreciate you having "faith" that CBT actually did work for me (and many others, as shown by a mountain of scientific evidence), even though you don't believe it works. It's nice to have someone believe you when you say you're suffering (and when you get better with a treatment). Thanks.
>>1. I personally find it hard to see how CBT works as I do not agree with it's main tenets.
I don't *know* how it works either. I'm quite sure it *does work* though. And again, you'd have to have a pretty elaborate argument to say that it doesn't. This is not a disputed therapy, the vast majority of credible scientists say it does indeed work, even for severe depression.
On that same vein, scientists have no clue (okay, they have *some* clues, albeit very few) about how antidepressants work. But the fact is, clinically, they work for many people. Do you *know*, or for that fact need to know how Nardil works?
I would have a hard time believing that your only problem was serotonin, dopamine, and norepinephrine deficiency (all in a vacuum), and the treatment worked simply by restoring these levels. Sound like a Zoloft commercial?
But the fact is, all we know about Nardil is that it raises levels of cerain neurotransmitters. To me, this is not a very intricate understanding. My feeling is that anyone who is still buying into the monoamine hypothesis of depression needs to do a bit more review of the recent literature.
But who cares why? Nardil quite obviously works for you! That is what clinical research shows - efficacy, that's it!
I could make some *hypotheses* as to how CBT works. To me it makes perfect sense that an animal's (human's) feelings / behaviors would correspond to the way they interpret the world. It all begins with our sensory organs, filters through to the cortex (where we make "conscious" decisions, and where beliefs and thoughts occur). From there, after the "threat" has been perceived is when the emotional and fear neurocircuitry is activated.
It is downstream from the cortex that all the "biological" treatments lie. But I believe that the emotional neurocircuitry does not get out of sync in a vacuum. Wouldn't it make sense that someone with continuous threat-related thoughts would feel continuously anxious? To me, CBT is trying to convince our cortex and the archaic "downstream" neurocircuitry that we are not being chased by a wild animal (to use anxiety as an example).
Don't get me wrong, I have no doubt that neurolochemical changes occur after this onslaught of threat-related thinking and beliefs, and involves actual biological changes. But I'm not convinced this all happens randomly or in a vacuum. I feel with *only* "biological" treatments, we are treating it too far downstream.
This is not to say that meds aren't helpful, they certainly are, and in many cases, restore an individual to complete function. So I don't care how we get there...whatever works!
I'm no neuroscientist, but this makes sense to me. I remember reading a theory in my neuroscience book that emotion and behavior arise directly from "lower-level" processing areas in the brain, but *only* after a threat has been assessed in the neocortex. So what doesn't make sense about this? This seems to work very well with CBT theory.
I don't believe feelings are random and unconnected to thoughts, beliefs and perceptions...this would not make sense biologically, and such animals would not likely have survived millions of years of evolution. What purpose random feelings and behaviors serve in early periods of evolution? The cortex perceives threat, and *then* the fear and emotional circuitry is activated. I believe depression and anxiety are products of tangled webs of cortical processing that is amenable to restructuring with CBT. People suffer because they are constantly (and inadverdantly) eliciting the fight or flight response, and this causes actual physical changes to the brain.
This is just my crazy, juvenile understanding, and obviously only a hypothesis, but to me it makes sense.
>>I hope this clears the air, and I hope you have not taken offense to my comments.
No offense taken, dude. The air smells fine here to me (besides the New York pollution).
>>We might just have to agree to disagree, as they say!
I'm completely fine with that. But why magnify this one disagreement? In general, I think we agree much more than we disagree, right? Even to me, an avid supporter, there is much more to life than CBT.
Take care,
Matt
poster:mattdds
thread:277907
URL: http://www.dr-bob.org/babble/psycho/20031030/msgs/278358.html