![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 91. Go back in thread:
Posted by Larry Hoover on June 2, 2003, at 9:20:24
In reply to Re: Found Psychological Babble - p.s. memory » Larry Hoover, posted by Squiggles on June 2, 2003, at 8:14:40
> Larry,
>
> Just one more thing, i forgot to add in my
> previous reply to you; i do believe there
> are ways of altering the effects of PTSD on
> behaviour, but i don't know how (at least
> one) practical this is.
>
>
> - actual topical brain surgery of memory
>
>
> The other is simple -- remove the offending
> stimulus from the person's environment.
>
>
> SquigglesYour reply raises issues around locus of control. One way of looking at it is by placing reactivity and proactivity on a continuum. Or, consider whether you believe the choices you make affect your environment, or whether the environment determines your experience.
One common social construct is the belief that someone can "push your buttons". That it's the other person's fault (the button pusher) if that happens, showing disrespect, manipulation, yadda yadda.
But whose buttons are they? How did they get there? Why do they work so well?
And, why do you let them continue to exist? Why do you leave them exposed for anybody to push? And, how many buttons do you have that you yourself push?
Desensitization from trauma-related stimuli is an extinguishing event. You can end the "button-pushing drama", once and for all. Avoiding the stimulus doesn't accomplish that, because life is full of stimuli, and one day, you're going to meet it again.
Psychosurgery is an option, but hardly one with long-term benefit.
With reference to the 30-year passage of time issue.....
Unexamined issues, the skeletons in your closet, remain suspended in time. They don't go away. They don't change. They just wait. If you never examine them, they remain. If it takes thirty years, so what? It's irrelevant.
Lar
Posted by Squiggles on June 2, 2003, at 9:45:55
In reply to Re: Found Psychological Babble - p.s. memory » Squiggles, posted by Larry Hoover on June 2, 2003, at 9:20:24
Larry,
The fact that you have succeed with CBT, means
that you were able to. I don't know what kind
of trauma you have suffered - whether one or many,
but you are one of the people who have been able
to turn cognitive states around.You must understand, that not all people have
the same ability. Take a look at some of the
War vets - they never get over what they went
through - they need drugs, they need assistance
outside of their own resources. That's because
some people don't have the emotional or mental
resources - they may be burned out.As for control, again, take a look at domestic
incidents of violence and abuse (no, i am not
putting myself here). These women need to be
removed from abusive situations and the law is
what will help in these circumstances, not CBT.So, basically everyone is different with different
strengths and weaknesses. In the worst cases,
i do believe that drugs, and removal of the
hurtful stimulus help the most. I think that
CBT is a long-term, analytic, and didactic solution
to something that has already faded in memory.Squiggles
Posted by Larry Hoover on June 2, 2003, at 9:56:15
In reply to CBT and metacognition » Larry Hoover, posted by mattdds on June 2, 2003, at 1:55:30
> Larry,
>> As I'm sure you can deduce, metacognition is the awareness of your own cognition.
I was unaware of this author, but I totally grock the concept. (Grock, from Heinlein, meaning understand in absolute completeness)
> Wells emphasizes the importance of developing a "metacognitive mode" of processing, in which we become passive observers of our negative thoughts and or symptoms. In this mode, thoughts themselves become just like any other neutral event in the universe, rather than absolute truths. He suggests attentional training and mindfulness meditation to get into this type of mode.
I would expand the concept of metacognition to include positive thoughts as well. Moreover, the attributes positive and negative have no place in metacognition.
Judgmental language, anything that is suggestive of emotive impact, reduces the metacognitive state, IMHO.
You can practice achieving nonjudgment in day-to-day self-talk. For example, if you try something, and it fails, you could say to yourself, "I screwed up", or "I am a screw-up", but the more nonjudmental approach reflects your experience, as in, "That didn't go the way I had hoped." You see, it's the non-realization of an expectation that is the real issue.....becoming emotionally attached to an externality.
I like to summarize non-judgment as selecting descriptive language.
> Once you get into this mode of thinking - this metacognitive mode - it frees up mental resources. It allows you to step back, and be able to see more than one schema, or way of seeing things. It also, according to Wells, allows information that is likely to disconfirm existing destructive beliefs to sink in. Is this sounding like secularized Buddhism yet? To me this is great stuff!Absolutely, according to my own experience. And when you do select a schema, it comes with a peaceful certainty that you've fairly and appropriately accomodated all the factors that entered into your awareness during deliberations (including recognition that, as a human being, there are limits to your awareness).
> He also goes on to talk about rumination, in relation to depression. He led a study which showed that rumination was positively correlated with increased depth and duration of depression. So the idea is to reduce rumination. He also showed that attention training activities can help to reduce rumination, as can mindfulness meditation training.
It all responds to decision-making. Yup.
> The amazing thing is how few therapists are aware of cutting edge things like this. I mean the gap between the scientist and the clinician is HUGE! (Most) clinicians are still practicing CBT of the dark ages. Even worse, some practitioners advertise as CBTers but really are doing some nondirective eclectic mess.Maybe I got really lucky. Or maybe Canadian therapists grock this, but I've gotten ideas like this from many therapists, or at least, the tools to achieve it, whether or not it was an overt goal of therapy.
One such tool was the development of what was called a "narrative dialogue". One way to picture that is to consider a large boardroom table, around which sit all the voices in your head, and you're the chairperson. Everybody's got different voices in their head; when we're ambivalent about something, we're acknowledging more than one voice. There's the voice of societal expectations. There's the voice repeating things your mother said. There's your own "inner critic". There's the voice of your spiritual self. There's the strict logical voice. And so on. By picturing yourself as the chairperson, you're fostering metacognition of the schemas presented by each voice. And, as chairperson, you're not bound by any one schema; you can create a synthesis of schemas.
> I wonder how much better the response rate would be if people were doing REAL CBT? Am I making any sense here?
>
> Take care,
>
> MattYa, you're making sense, if I enter a metacognitive state and bypass the excitement. Heh.
Lar
P.S. Not meaning to blow my own horn, but I help a lot of people in real life. People in crisis call on me all the time, because I can help them sort out the various components of their cognition.
Posted by mattdds on June 2, 2003, at 9:58:43
In reply to Re: CBT and metacognition » mattdds, posted by Dinah on June 2, 2003, at 8:52:17
Dinah,
What I am referring to is not "dissociation", though I can see how you might have thought I meant that, since you seem to be very preoccupied with your dissociative tendencies.
Nor am I talking about detaching yourself from trauma as a form of coping - that would be denial.
For me, this has been helpful, but haven't been able to apply it at "all levels of my being".
You seem to be saying that CBT merely creates other forms of psychopathology, am I correct? I have never seen any evidence behind what you are saying. Much to the contrary, CBT is being used for severe depression and panic attacks.
I don't get into this idea of having to rummage through all my old traumatic experiences and somehow, through reliving them, attempt to get rid of it. This seems unnecessarily painful and rarely helps, besides the cathartic nature of it. I don't believe you can get rid of it. So why not make peace with it? That's the difference between CBT and nondirective or psychoanalytic therapy. In CBT you are trying to "work your way around it", forming new neural pathways and focusing on them. There is good evidence behind this approach. Once fear circuits have been imprinted in the amygdala, they cannot be erased. The best you can do is work at a cortical level to form inhibitory pathways that quell that fear. This is what neuroscientists think is happening.
Another thing, I am not Buddhist, but I am quite sure the state you described (panic attacks, dissociation from reality) is NOT what Buddha had in mind. I mean, he didn't base a whole religion on denial, so I think your therapist had some misconceptions about Buddhism.
When I passively observe my thoughts, they sometimes become funny to me, and I laught at them. I feel less depersonalized, if anything! I take my intrusive thoughts less seriously and treat them as nothing particularly important, just like any other event in the universe. I can't do this all the time, but when I am able to pull it off, it greatly enhances CBT.Also, every time I post about CBT on here, you seem to have a tendency to throw discreet little jabs at me, as if you are bothered by me even mentioning it. Are you bothered by something I'm saying, or with me? Maybe I'm misreading you but I sensed some sarcasm and disbelief in that this has helped me. I've gotten this vibe before from you. I'm a bit put off by this, and perhaps you could explain why?
Regards,
Matt
Posted by mattdds on June 2, 2003, at 10:10:20
In reply to Re: Found Psychological Babble - p.s. memory » Larry Hoover, posted by Squiggles on June 2, 2003, at 9:45:55
>>As for control, again, take a look at domestic
incidents of violence and abuse (no, i am not
putting myself here). These women need to be
removed from abusive situations and the law is
what will help in these circumstances, not CBT.Of course they do! Nobody has the capacity to cope with this much stress on a daily basis. But this seems to be kind of a "straw man" argument, that is detracting from the real issue (which is, whether *most* depressed people have the "cognitive capacity", as you put it, for CBT to work for them).
Most people with depression don't have these terrible ongoing traumatic events. But if someone does, NOBODY (even Buddha himself) would tell that person "ah, it's all in your head, it's just the thoughts about it, not the event, keep getting beaten by your husband and go read some Feeling Good!".
How would you feel about them getting CBT *after* being removed from the traumatic situation?
regards,
Matt
Posted by Larry Hoover on June 2, 2003, at 10:11:40
In reply to Re: CBT and metacognition » mattdds, posted by Dinah on June 2, 2003, at 8:52:17
> But it was all a false self that was so wonderfully detached. And my panic attacks were a way of my body telling me that. So if you can truly reach the state you were talking about, of reaching the metacognitive mode you were speaking of, perhaps you would feel a great reduction in distress. But if you are only able to achieve that at a rational level, if you only *think* you've reached that state, it is in my own experience an invitation to just a different type of psychopathology.
The key is in your own words. Denial of any part of your existence is not metacognitive.
Metacognition is not blocking of any sort. It is non-judmental acceptance of every bit of yourself (in its ultimate expression). That's what you strive towards.
Put in another way, metacognition is the adjustment of your self-perception such that it accurately reflects your reality. This may sound bizarre, but I think the process itself changes you. Addiction, for example, depends on denial to even exist.
The reduction in distress arises because there is no effort to deceive yourself about anything. No exaggerating of this quality, or trivializing of that one.
Lar
Posted by Squiggles on June 2, 2003, at 10:18:50
In reply to Re: Found Psychological Babble - p.s. memory » Squiggles, posted by mattdds on June 2, 2003, at 10:10:20
I believe that a person who is being beaten
by a stick, physical or psychological, even
a dog for that matter, will feel much better
and will recover when that stick is removed.
I think that you are putting the onus on the
victim here, when the CBT should really be
applied on the person causing the depression.
Bullies may need CBT more than the bullied.Squiggles
Posted by mattdds on June 2, 2003, at 10:39:10
In reply to Re: CBT and metacognition » Dinah, posted by Larry Hoover on June 2, 2003, at 10:11:40
Larry,
Thanks. You just managed to say what I *meant* to say 10 times more articulately and in fewer words.
I was thinking more about this and metacognition is better yet the antithesis of denial. You are patiently and non-judgementally listening to *all* voices in your head, and non-judgementally feeling your symptoms. Denial would be *not* accepting something as a part of you and trying to run from it (perhaps through dissociation, or fragmentation of consciousness?)
Thanks,
Matt
Posted by Larry Hoover on June 2, 2003, at 10:42:46
In reply to Re: Found Psychological Babble - p.s. memory » Larry Hoover, posted by Squiggles on June 2, 2003, at 9:45:55
> Larry,
>
> The fact that you have succeed with CBT, means
> that you were able to. I don't know what kind
> of trauma you have suffered - whether one or many,
> but you are one of the people who have been able
> to turn cognitive states around.
>
> You must understand, that not all people have
> the same ability.It's a matter of training and support, not ability.
>Take a look at some of the
> War vets - they never get over what they went
> through - they need drugs, they need assistance
> outside of their own resources. That's because
> some people don't have the emotional or mental
> resources - they may be burned out.That's not the reason at all. I have corresponded with many vets. They weren't provided with the supports required to foster success. For twenty years, the only support offered many Vietnam vets was drugs, if they could even get that. They came home to a society that vilified them. One component of CBT is the empathetic attention provided by the therapist. There is no substitute for that.
The lawsuit just launched against the Canadian Armed Forces with respect to PTSD arises from the institutional trivialization of the affected parties, and the absence of therapy. The problem isn't the veterans.> As for control, again, take a look at domestic
> incidents of violence and abuse (no, i am not
> putting myself here). These women need to be
> removed from abusive situations and the law is
> what will help in these circumstances, not CBT.That is so simplistic a viewpoint. Get them out of there, and all will be well? The threat of imminent harm must certainly be addressed, but what has that got to do with the aftermath?
> So, basically everyone is different with different
> strengths and weaknesses. In the worst cases,
> i do believe that drugs, and removal of the
> hurtful stimulus help the most.In the acute phase, it's a start.
> I think that
> CBT is a long-term, analytic, and didactic solution
> to something that has already faded in memory.
>
> SquigglesIf it has faded in memory, there's nothing to treat.
You have done no more than create a circular argument. Petitio principii, writ large.
Lar
Posted by mattdds on June 2, 2003, at 10:49:41
In reply to Re: Found Psychological Babble - p.s. memory » mattdds, posted by Squiggles on June 2, 2003, at 10:18:50
>>I believe that a person who is being beaten
by a stick, physical or psychological, even
a dog for that matter, will feel much better
and will recover when that stick is removed.
I think that you are putting the onus on the
victim here, when the CBT should really be
applied on the person causing the depression.
Bullies may need CBT more than the bulliedI just agreed with what you said above: people in traumatic events *do* indeed need to be taken out of the event. Where did I say it should be otherwise?
You say I am putting the "onus" on the person who was victimized. I don't quite understand what you mean. You seem to be saying that CBT is some sort of punishment, and that the victim doesn't deserve it. CBT is intended to help victims, last time I checked.
So what you are saying is that if someone is raped, we should do the CBT on the person who did the raping? But what about the victim? Do we just give him/her medications and totally avoid the CBT? Or what do we do? You tell me.
I agree with you, however, that the angry oppressor could benefit from CBT. But I think that he/she is much less likely to accept it. Forcing CBT on people never works, they have to seek the help. Anger *feels* too good to want to overcome it. I am not saying that CBT can't help anger, but that people are less likely to search treatment because anger feels empowering, whereas, e.g. depression is painful.
Thanks,
Matt
Posted by Dinah on June 2, 2003, at 10:59:36
In reply to Re: CBT and metacognition, posted by mattdds on June 2, 2003, at 9:58:43
I think you misunderstand. I don't disbelieve CBT worked for you. And I'm not "jabbing" anything. I'm happy it worked for you. Check out the CBT grand rounds though. Even the outcome studies show that CBT works better with some personality types than others.
I merely think there is a danger in CBT of blaming the patient if they don't improve enough. If they don't get better, they must not be working hard enough at it. Pull yourself up by your bootstraps. Change your actions and you'll change your feelings. Those are the messages I get from CBT.
CBT frankly makes me feel very bad about myself when applied in its purest form.
But for those it works for, great! More power to them, and thank heavens for different treatment modalities for different people. For most everyone, facets or ideas from CBT can be helpful.
And as I said before, I am not throwing jabs at you, I am not being sarcastic. We hold differing views on a form of therapy, and I attempt to express my viewpoints in discourse with you. If you see anything personally directed to you in what I say, it is certainly not my intention. Perhaps you are mistaking "jabs" and "sarcasm" with simple disagreement. I am by nature neither sarcastic nor belligerant. If in any way I failed in my attempt to discourse in a respectful and civil manner, I apologize.
P.S. My therapist was reacting to the way I presented myself at the time. He honestly thought I was incapable of certain things that we value in Western society, but where the lack thereof are considered virtues under the Buddhist ideology. I doubt he would say those things about me now.
Posted by Dinah on June 2, 2003, at 11:20:19
In reply to Re: CBT and metacognition » Dinah, posted by Larry Hoover on June 2, 2003, at 10:11:40
I was merely remarking on my own experience. Mind you, I didn't have formal CBT therapy at the time.
What happened was this. In my preteens/early teens I basically fell apart. All at once I became the picked on kid at school, we adopted my brother, and various and sundry other stresses. I developed an all consuming phobia/OCD obsession with people vomiting. I became almost agoraphobic. I behaved very badly (acted out). I went to a psychiatrist for a year, and was on thorazine for that time. One day I decided I didn't want to be that way any more.
I didn't have any access to CBT or CBT literature. I was only thirteen or fourteen. But on my own I came up with many things that I later recognized from CBT. And I did them very well. I became functional again. As far as I or anyone else knew, I was just fine.
When I went into therapy twenty years later for a recurrance of my OCD symptoms under the new stressers of marriage, my therapist was very CBT oriented. But he discovered that it just didn't work with me. Because I could believe everything he said with every fiber of my being. I could do the homework. I could say what I was supposed to say, and believe it too. I couldn't possibly believe it more. But it didn't reach deeply enough. I had an intellectual understanding and belief in what he said. I had lived it for twenty years. But I simply could not stretch it deep enough.
In fact, with some OCD self help books based on CBT principles, I pretty much conquered my OCD. Or at least got it under control enough that it was no longer a problem for me. I can sing my obsessions. I can laugh at them. They go away. The panic attacks pretty much stopped. But guess what? My OCD had served a purpose. Without the OCD, other symptoms emerged. My mood regulation abilities destabilized. I went from a relatively high functioning person with OCD to a not well functioning person with my OCD under control.
CBT, with me, had its limitations.
I'm not denying its usefulness. I'm just saying that with some people it works better than with others.
I like CBT, I prefer DBT. But I just think it needs to be seen as a tool, not a cure-all.
(P.S. If I had it all to do over again, I'd take back the OCD and panic attacks, and never have tried to overcome them. I don't know what purpose they served, but whoo-boy, it must have been an important one.)
Posted by mattdds on June 2, 2003, at 11:29:39
In reply to Re: CBT and metacognition » mattdds, posted by Dinah on June 2, 2003, at 10:59:36
Dinah,
My apologies for misinterpreting your comments. I have my own insecurities that sometimes become quite apparent. You see, had I been in metacognitive mode, I might have seen other ways of interpreting what you said <wink>.
I will be the first to admit that CBT works better for some than for others. And you're absolutely right in that it is extremely dangerous to "blame" the patient. But this is not the impression I get from CBT. Perhaps from some misguided CBT therapists, but not CBT in general.
For example, one of the "cognitive distortions" is, in fact, blame! David Burns does a very good job of dispelling the myth of blame (even for treatment failure). Blame is just an extreme oversimplification of a phenomenon that had too many variables for us to see, so we attempt to find a scapegoat. In depression, the scapegoat is oneself. In anger, another person.
You see, you interpret CBT as "blaming" you or "faulting" you. Perhaps you had a therapist that "blamed" you for not getting better. This is unfortunate. I agree that this is extremely misguided, and counterproductive. There have been studies that have shown that therapeutic empathy strongly predicts whether patients will remain in treatment (and subsequently get better)
On the other hand, if I cannot take at least some responsibility for my own recovery, than even the best therapist in the world has no chance of helping me. We need to move past this myth of fault and blame, and work on real problems. Blame (and the guilty feelings that follow) is just another delusion in depression's vast repertoire.
I see CBT as holding me personally responsible for my own state of affairs, but not in a "blaming" or "faulting" way. Again, there is a subtle but definite distinction between "blaming" and "holding responsible". Being held responsible for my own recovery is, to me, empowering! I am no longer the helpless victim, but the master of my destiny.
Best,
Matt
Posted by Dinah on June 2, 2003, at 11:39:31
In reply to Re: CBT and metacognition » Dinah, posted by mattdds on June 2, 2003, at 11:29:39
> I see CBT as holding me personally responsible for my own state of affairs, but not in a "blaming" or "faulting" way. Again, there is a subtle but definite distinction between "blaming" and "holding responsible". Being held responsible for my own recovery is, to me, empowering! I am no longer the helpless victim, but the master of my destiny.
>
Hi Matt. I'm afraid that that subtle distinction is one of those ones that my mind is not nuanced enough to make. And believe me, there are many. My therapist goes around and around with me sometimes to get me to understand distinctions between things that to me are the same. I don't really get the distinction between holding someone responsible and in some way blaming them for not living up to those responsibilities.The feelings of blame I get came not from my therapist but from the literature. Perhaps if my mind were capable of more subtle distinctions, it wouldn't be a problem for me, but it is. My therapist was flexible enough to back off from the strict CBT approach that is his initial response to anxiety disorders and move to a modality that was more useful to me. He still incorporates CBT concepts. He just doesn't rely on them exclusively.
Isn't that also the main reason for DBT? Marsha Linehan found that CBT didn't work for her target population, in part because of a high dropout rate. So she incorporated other concepts into her DBT so that it would better suit that type of patient.
I always see that as a mark of good therapy - flexibility.
Posted by Larry Hoover on June 2, 2003, at 11:54:12
In reply to Re: CBT and metacognition » Dinah, posted by mattdds on June 2, 2003, at 11:29:39
> Dinah,
>
> My apologies for misinterpreting your comments. I have my own insecurities that sometimes become quite apparent. You see, had I been in metacognitive mode, I might have seen other ways of interpreting what you said <wink>.I'm glad you recognized that. One of the outcomes of metacognition is flexibility. Same facts, different conclusion. Not getting stuck on the first cognition that comes to mind.
> For example, one of the "cognitive distortions" is, in fact, blame!
Blame is nothing more than giving the past a second chance (or more) to hurt you.
>Being held responsible for my own recovery is, to me, empowering! I am no longer the helpless victim, but the master of my destiny.
>
> Best,
>
> MattThe way I would put it is: "Here I am. Now, where do I go from here."
The past can serve as an anchor, or a solid footing for a move into the future.
The past can be informative (by remaining descriptive about it).
If you've suppressed the emotive content surrounding an experience, then releasing that through catharsis can be a liberating experience. If you've ever carried something heavy for too long, you'll know what I mean. Putting it down feels really good. Finally finding a bathroom after a long search for one, is another example.
However, ruminating over situations which cannot possibly change (history is immutable), only serves to reinjure over and over again. Rumination stops at the point of feeling. You never get to the resolution phase. It's a decision, to not let go.
Not trying to convince anyone of anything.
Lar
Posted by Larry Hoover on June 2, 2003, at 12:01:44
In reply to Re: CBT and metacognition » Larry Hoover, posted by Dinah on June 2, 2003, at 11:20:19
> I was merely remarking on my own experience.
I'm sorry. I wasn't trying to convince you of anything. I was trying to show how understanding denial is a key component of successful CBT.
Denial is like holding your finger on a weighscale. You distort the measurement. If you cannot accept that you are even doing that, you most certainly will never come to understand why you have chosen to cope that way.
Lar
Posted by Dinah on June 2, 2003, at 12:14:30
In reply to Re: CBT and metacognition » Dinah, posted by Larry Hoover on June 2, 2003, at 12:01:44
So not trying to convince someone of something is metacognition, eh? :) I always just thought of it as common sense. For the most part I've never found anyone to say "Oh, of course! You're right! Why didn't I see that before?" lol. I always figure you can state your point of view, but not expect anything to come of it. Or as I always like to say "What I do (or say I guess) is what I do. What other people do (or say) is what they do."
Acceptance? (see, I did listen to my therapist)
Posted by Larry Hoover on June 2, 2003, at 12:48:05
In reply to Re: CBT and metacognition, posted by Dinah on June 2, 2003, at 11:39:31
> Hi Matt. I'm afraid that that subtle distinction is one of those ones that my mind is not nuanced enough to make. And believe me, there are many. My therapist goes around and around with me sometimes to get me to understand distinctions between things that to me are the same. I don't really get the distinction between holding someone responsible and in some way blaming them for not living up to those responsibilities.Really excellent issue to examine....
Here's my slant.
Holding someone responsible implies that there are duties or obligations arising from a decision, and that these are implicitly part of the decision. The individual is "expected", I guess, to take that on, regardless of outcome. I would say the responsibility is "built in", a priori. Like criminal law.
Blaming is reactive in nature, flowing from others (or self), based on outcomes. In this case, the responsibility is "added on", post hoc. Like moral indignation.
I'm not suggesting that these are mutually exclusive. Far from that, as both can reasonably arise from the same situation.
Here's an essay on the subject, if you're interested:
http://plato.stanford.edu/entries/moral-responsibility/Lar
Posted by Squiggles on June 2, 2003, at 14:59:02
In reply to Re: responsibility and blame » Dinah, posted by Larry Hoover on June 2, 2003, at 12:48:05
This is turning into a thick subject;
I imagine that many days, maybe months,
maybe years are spent on analysis with
a therapist. Perhaps it helps some people
to cope by learning ways of behaving that
did not know before meeting the therapist.In my case, there would be a number of
obstacles i think why this kind of therapy
is not for me:1. I don't believe that someone with
a psych. degree knows more than i do - i have
two university degrees and almost finished
the doctorate by a course. I'm not bragging --
just saying that i think i have the rational
capability to analyze problems - my problems
are not mine, but other people's.2. My doctor does not believe i need a therapist.
He believes i need drugs.3. My doctor, even if he did believe in
CBT, is not able or willing to take me off
my drugs.4. I have lived most of my life with the
problems and habits i have inherited. I do
not have enough time left now to restructure
my life.5. I know what i want.
6. I believe that i am fortunate to have the
life i have, problem-filled as it may be in
the light of the misery about 95% of the human
race lives in. In a way, i do not want the
yuppy lifestyle, which i think CBT is part of.Squiggles
Posted by mattdds on June 2, 2003, at 20:03:27
In reply to Re: responsibility and blame » Dinah, posted by Larry Hoover on June 2, 2003, at 12:48:05
Larry did a good job with the blame / responsibility thing.
Here's my take, which is very close. I am going to try to make some definitions.
Responsibility - A sense of awareness of one's potential influence on an outcome. This sense of awareness realizes and accepts the implicit limitations of being human. It also encompasses an awareness of other mitigating factors that are involved in the outcome.
Blame - An awareness that gives excessive, and arbitrarily selective attention to the influence one had on a *negative* outcome. It fails to recognize that there were other mitigating factors involved in the undesirable result.
Does this help?
All the best!
Matt
Posted by mattdds on June 2, 2003, at 20:21:21
In reply to Re: responsibility and blame » Larry Hoover, posted by Squiggles on June 2, 2003, at 14:59:02
> i do not want the
yuppy lifestyle, which i think CBT is part of.What on earth are you talking about? This is a sentence, and appears to make sense, but on closer examination is just word salad! How did you make the connection between "yuppy-ism" and "CBT"? I don't see it. All you've done is create a worthless ad-hominem argument. And you seem to be reduced to labeling people!
Also, your argument goes something like this:
A. Yuppies are undesirable people.
B. All CBT'ers are yuppies
C. CBT'ers are undesirable peopleCould you kindly tell me what yuppies are and why they are so undesirable? You seem to take pride that you are not one of "them", and it gives you some sort of moral superiority.
Are all CBT'ers yuppies? Am I a yuppie, since I was helped by CBT?
I feel like this discussion could be really productive. And I'm having a lot of fun. Let's try to stay reasonable, and lay off the labeling.
Thanks,
Matt
Posted by Dr. Bob on June 2, 2003, at 20:36:22
In reply to Re: responsibility and blame » Squiggles, posted by mattdds on June 2, 2003, at 20:21:21
> > i do not want the
> > yuppy lifestyle, which i think CBT is part of.
>
> This ... on closer examination is just word salad! ... All you've done is create a worthless ad-hominem argument. And you seem to be reduced to labeling people!Different points of view are fine, but please don't post anything that could lead others to feel accused or put down, thanks.
> I feel like this discussion could be really productive... Let's try to stay reasonable, and lay off the labeling.
Exactly! :-)
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
Posted by Squiggles on June 2, 2003, at 20:47:28
In reply to Re: responsibility and blame » Squiggles, posted by mattdds on June 2, 2003, at 20:21:21
I mean that the therapy style which is
in vogue now, and suggests an appeal
to the rational (hence cognitive) part
of man, is part of an image of modern man.
The image of man who, through his cogitative
abilities is able to work out his emotional
problems. The image of man who, through
assisted analysis of his habits and the
process through which he has acquired them,
will be able to change himself through his
own bootstraps.It's rehashed Freud, and badly cooked at
that -- as Freud understood that emotional
problems, when not part of psychosis or
biological disorders, were problems of the
irrational part of man. The irrational part
of man, meaning his needs, his drives, his
fears, do not respond to reason. They respond
to compassion, love, and sympathy.Cognitive behaviour therapy is good for
those who do not need therapy at all, but
simply a good shoulder to cry on or a good
friend to speak to. This is an old fashioned
view. It is not a yuppy view, as defined by
say GQ magazine or shrill empowerment-hungry
radio announcers.As for a syllogism, well i did not think of
it that way, but if i were to put my point
in premises and conclusion, it might look like
this:A. CBT is a yuppie philosophy in psychological treatment.
B. Squiggles does not like the yuppie philosophy.
- Therefore, Squiggles does not like CBT.or
If CBT is a yuppie trend and Squiggles
does not like yuppie trends, then Squiggles
does not like CBT."YUPPIE" is an acronym for "young urban professional"
and perhaps if you are in Britain it is not a common
phrase there. It is basically what happened to
hippies when they became capitalistic and also
were referred to as the ME-generation in the 80s
when ambition, self-determination and economic
control became fashionable again.Sorry, about the labeling; i hope i did not
cause offense. I am speaking for myself and
generally. I suppose what i want to stress
is that in mental illnesses, compassion and
kindness are far more important than talk
therapy; and this is particularly important
when the psychological problem deals with
affective disorders. I suppose i agree with
Hume (the Scottish philosopher), "reason is
the slave of the passions".Squiggles
Posted by Squiggles on June 2, 2003, at 20:51:42
In reply to Re: please be civil » mattdds, posted by Dr. Bob on June 2, 2003, at 20:36:22
I'm not sure whom you are reprimanding
here Dr. Bob, me or Mattdds; but judging
by the past posts, i think you mean me-- *again*,
LOL.OK - i really am not aware of causing offense
at all - infact i thought i was receiving it.But i will try to change my ways - maybe this
is a lesson in cognitive behaviour therapy.Squiggles
Posted by mattdds on June 2, 2003, at 21:56:02
In reply to Re: responsibility and blame » mattdds, posted by Squiggles on June 2, 2003, at 20:47:28
First off, I didn't intend to make you feel put down. Getting my first PBC from Dr. Bob was kind of a downer, I really do try to behave. I just get a bit emotional about this stuff.
>>I mean that the therapy style which is
in vogue now, and suggests an appeal
to the rational (hence cognitive) part
of man, is part of an image of modern man.
The image of man who, through his cogitative
abilities is able to work out his emotional
problems. The image of man who, through
assisted analysis of his habits and the
process through which he has acquired them,
will be able to change himself through his
own bootstrapsSo the main problem is that it is in style? It doesn't seem very popular to me. I feel nerdy and cheesey talking about it to anyone but my wife. Even here, a mental health support board, I get the feeling that everyone thinks it's hokey and that pharmaceuticals are much sexier.
>It's rehashed Freud, and badly cooked at
thatCBT is the antithesis of Freud. Have you read anything at all by Aaron Beck, who is kind of CBT's grand-daddy? Practically the first 10 years of his career were spent debunking the whole Frued thing.
>>Cognitive behaviour therapy is good for
those who do not need therapy at all, but
simply a good shoulder to cry on or a good
friend to speak to. This is an old fashioned
view. It is not a yuppy view, as defined by
say GQ magazine or shrill empowerment-hungry
radio announcers.I cried on my mothers shoulders for two weeks straight when I was in my second year of dental school. All the psychiatrists at my school had thrown their hands up in the air, wondering what to do. I cried on the shoulder of my wife all year, literally.
It was only after the therapy that I began to improve, and my therapist was anything but a "shoulder to cry on"; he was caring, yet stern and insisted that I should continue on fighting.
>>It is not a yuppy view, as defined by
say GQ magazine or shrill empowerment-hungry
radio announcers.Wait, is this a typo? I thought you just said it *was* a "yuppy" movement.
>>"YUPPIE" is an acronym for "young urban professional"
and perhaps if you are in Britain it is not a common
phrase there.I am aware of what the acronym (and label) stands for, as well as the history behind it. But I was asking more about the connotation, which seemed overtly negative to you. For instance, I am young (just over 25), live in New York City (urban), and will shortly be considered a professional when I graduate from dental school. So by your definition, I am a yuppie. But are these three criteria the ones that make yuppie-ism so terribly bad? I don't ever read GQ magazine and I dress like a slob! And I don't really listen to the "shrill empowerment-hungry radio announcers", whoever they are. So am I a yuppie? Why are you so put off by people that fit these three criteria?
>>I suppose i agree with Hume (the Scottish philosopher), "reason is the slave of the passions".
So do I. But I don't think this issue is totally black-or-white, (almost) nothing is. At times I feel my reasoning is largely driven by emotion. Other times I feel the opposite. This is not out of tune with CBT. CBT is not "thought control", it is just heightened awareness of thinking. CBT actually discourages suppression of thoughts, or attempts at thought control. You are encouraged to be a passive observer of thoughts. Thought intrusions are almost completely emotion dependent, without a doubt. But where we go with these intrusions is what CBT emphasizes. Do we continue to ride the negative pattern out? Or do we choose a way of looking at things that is either more accurate or beneficial?
Lastly, I am absolutely 100% certain that I will not persuade you to my way of thinking. A part of me wants to, my competetive side (the one that got the best of me when I got the PBC from Dr. Bob). But deep down, I know the futility of arguing with someone; it only strengthens their preconceived notions (even mine were strengthened, and I am totally aware I have them too).
See, I wanted this to be a positive discussion, one that would enlighten all of us. I much would have preferred a discussion about *doing* CBT, and the actual dynamics of it. Instead I / we set it up to be a combative, one-upmanship about our opinion on CBT.
Is anyone interested in actually talking about the dynamics of it or techniques, or research, or how it is supposed to work? This is what I wanted. And hope that we can get there.
Out of breath,
Matt
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