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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by capricorn on November 4, 2006, at 17:42:30
http://www.timesonline.co.uk/article/0,,8123-2434776,00.html
Posted by Jost on November 4, 2006, at 19:24:24
In reply to Junk medicine:cognitive behavioural therapy, posted by capricorn on November 4, 2006, at 17:42:30
The article seems a little agenda-driven, although maybe CBT has less effectiveness than it might seem.
If problems recur, it's a significant flaw-- but on the other hand, symptom relief or abatement seems a valid goal. Whether it's better than other forms of therapy-- or only briefer, and more goal-oriented (lesser unhappiness or greater-meaningfulness as a goal is not only hard to assess-- but hard to understand at all--) I couldn't say.
And if symptoms recur, it might be that more therapy would strengthen the result, so that over time, the person might really find significant relief.
One statement from the article really undermines its effect for me-- It doesn't help one's position to make comments that seem to be creating a straw man in what you're criticizing. As in this:
"To take the simplest example, if you believe nobody loves you then CBT therapists believe they need only to produce evidence that one person does love you for you to be proved wrong and for your behaviour to change."
Maybe there are CBTs who would do that-- but that summary seriously demeans the approach of CBT-- it's not as simplistic as all that.
Jost
Posted by Racer on November 4, 2006, at 19:54:40
In reply to Re: Junk medicine:cognitive behavioural therapy, posted by Jost on November 4, 2006, at 19:24:24
CBT is popular for studies, because it's easy to standardize and it's short term, so you can measure results quickly. And it does seem to work -- short term. ALL the studies I've read -- sorry, no links -- have said that there's typically relapse within 12 to 24 months.
And the relapses can be bad. There's a local eating disorders treatment program that does CBT, and the bulimics who come out of it are b/p free when they do. And about six months later, when they finally made it to the peer support group I used to go to, they felt as though they were totally at fault, as though there was something so wrong with them that they could never be OK, etc. They were very down on themselves about their failure. (And it just isn't a good choice for anorexia.)
Anyway, I think there is a place for CBT techniques. I just don't think they're all that helpful for most people as the ONLY form of therapy.
And the good news in that article is that the NHS is going to be offering therapy, as well as drugs.
Posted by Jost on November 4, 2006, at 20:56:28
In reply to Re: Junk medicine:cognitive behavioural therapy » Jost, posted by Racer on November 4, 2006, at 19:54:40
What I like about CBT is that it's an attempt to confront issues about how to work with certain insurmountable obstacles. It's not the specifics, but the focus on change, or actual thinking about change seems right-- overly technical or "organized" but right.
Maybe it's a fad right now. It's not that CBT offers a deep answer to the question of change, but it's raised the question (not only CBT, but because it has a cogent method, it raises the question somehwat more pointedly than general critics).
Long-term therapy is crucial and the subject of somewhat unfair comparisons-- because while costly and time-consuming , it's the best there is so far-- -
For example, in CBT, the relationship between the T and the P is omitted-- at least theoretically-- and that's a huge theoretical problem. And it doesn't address deeper causes or the hold of destructive patterns. But, if the goals are minimal, and a bit flattened, or extremely incomplete-- and even subject to misuse--it's not as simplistic as the article suggested. I mean, the article would be more believable if it at least acknowledged that CBT isn't that reductionistic-- even if it is somewhat reductionistic compared to other treatments. (Hey, isn't reductionistic a word? I've got enough problems without a spell-checker telling me that I've misspelled it, or it isn't a word???)
It's more the potential theoretical challenge it poses to traditional psychotherapy that I like. It does seem like a step in one right direction.
Jost
Posted by SatinDoll on November 4, 2006, at 21:33:57
In reply to Re: Junk medicine:cognitive behavioural therapy, posted by Jost on November 4, 2006, at 20:56:28
For what I am learning is that most T's don't do just one kind of therapy. They use some of the best from all of types to help different kinds of people.
I belive looking at things so black and white really is a disavantage to people who want to do CBT therapy, , in other words it is putting negative ideas torwards a type of therapy which is most used today, so it is like putting a negative spin on therapy itself.For my own example, my T is mostly cognitive, but I have been in therapy for almost 2 years, our relationship is a common topic, we do look into the past, heck that is what EMDR is for to look back at the tramatic memory no matter when it happened. So according to a lot of people defination of cognitive, my therapy doesn't seem fit that model, but it does. Plus I doubt I am an exception.
So just because one T is taught a certain kind of therapy, doesn't mean that they don't know the others, and may use other models of therapy, if they don't, well they probably aren't the greatest T anyways. Just my thoughts about it.
Posted by Declan on November 5, 2006, at 0:25:11
In reply to Re: Junk medicine:cognitive behavioural therapy, posted by Jost on November 4, 2006, at 19:24:24
Like psychoanalysis, Buddhism, Sufism, the mystical traditions. Who dreamed this stuff up anyway? The best part of it is mindfulness, isn't it?
I found CBT so offputting. Mainly aesthetically, I'm such a snob.
Posted by capricorn on November 5, 2006, at 7:09:33
In reply to Let's stick with traditional things, posted by Declan on November 5, 2006, at 0:25:11
I have never had CBT but it's quite heavily championed/pushed/given the hard sell at my mental health centre .
Judging from replies i've read from people who have had it,it's not quite the universal panacea that the CBT disciples make it out to be.
It has to be said the psychiatric profession can be big on overselling things. For example the atypicals were touted as being so much better than the first generation antipsychotics
but more and more research is questioning the hyperbole that has surrounded the atypicals.Undoubtedly CBT works for some.I've read posts by some who swear by it. However, as with the the atypicals, overselling results in what actual merits there are being to some degree hidden by the failure to do what's written on the package.
For those who buy into the hype, as it can be so easy to do when desperate and vulnerable, the failure to meet expectations can result in disillusionment with the psychiatric process itself.
See also http://tinyurl.com/ykrwt3
Posted by Meri-Tuuli on November 6, 2006, at 11:57:55
In reply to Re: Let's stick with traditional things, posted by capricorn on November 5, 2006, at 7:09:33
Well to be fair Oliver James is bit of quack himself.
And also, us Brits will happily gobble up *any* therapy that the NHS is to offer. Often there are waiting times in excess of a year. I was offered a pathetic 6 counselling sessions. What can you do with just six? And note, they are counselling sessions, and not therapy sessions. Sigh. I suppose this is all free so thats bonus.
Its just the way the article is written so black and white. And also The Times probably has bit of an anti-Blairite stance, it is, after all, owned by Rupert Murdoch.
So its basically good that the government are getting some CBT into the system. Sure it might not work long-term, but at least its better than nothing and its free. Its a start anyway! People in the US tend to forget that therapy isn't so common in Europe or accepted.
Yeah I agree Declan we all need more spirituality in our lives.
M
Posted by zazenducky on November 7, 2006, at 13:27:17
In reply to Let's stick with traditional things, posted by Declan on November 5, 2006, at 0:25:11
> Like psychoanalysis, Buddhism, Sufism, the mystical traditions. Who dreamed this stuff up anyway? The best part of it is mindfulness, isn't it?
From the New York times
--------------------------------------------------------------------------------November 7, 2006
A Neuroscientific Look at Speaking in Tongues
By BENEDICT CAREY
The passionate, sometimes rhythmic, language-like patter that pours forth from religious people who “speak in tongues” reflects a state of mental possession, many of them say. Now they have some neuroscience to back them up.Researchers at the University of Pennsylvania took brain images of five women while they spoke in tongues and found that their frontal lobes — the thinking, willful part of the brain through which people control what they do — were relatively quiet, as were the language centers. The regions involved in maintaining self-consciousness were active. The women were not in blind trances, and it was unclear which region was driving the behavior.
The images, appearing in the current issue of the journal Psychiatry Research: Neuroimaging, pinpoint the most active areas of the brain. The images are the first of their kind taken during this spoken religious practice, which has roots in the Old and New Testaments and in charismatic churches established in the United States around the turn of the 19th century. The women in the study were healthy, active churchgoers.
“The amazing thing was how the images supported people’s interpretation of what was happening,” said Dr. Andrew B. Newberg, leader of the study team, which included Donna Morgan, Nancy Wintering and Mark Waldman. “The way they describe it, and what they believe, is that God is talking through them,” he said.
Dr. Newberg is also a co-author of “Why We Believe What We Believe.”
In the study, the researchers used imaging techniques to track changes in blood flow in each woman’s brain in two conditions, once as she sang a gospel song and again while speaking in tongues. By comparing the patterns created by these two emotional, devotional activities, the researchers could pinpoint blood-flow peaks and valleys unique to speaking in tongues.
Ms. Morgan, a co-author of the study, was also a research subject. She is a born-again Christian who says she considers the ability to speak in tongues a gift. “You’re aware of your surroundings,” she said. “You’re not really out of control. But you have no control over what’s happening. You’re just flowing. You’re in a realm of peace and comfort, and it’s a fantastic feeling.”
Contrary to what may be a common perception, studies suggest that people who speak in tongues rarely suffer from mental problems. A recent study of nearly 1,000 evangelical Christians in England found that those who engaged in the practice were more emotionally stable than those who did not. Researchers have identified at least two forms of the practice, one ecstatic and frenzied, the other subdued and nearly silent.
The new findings contrasted sharply with images taken of other spiritually inspired mental states like meditation, which is often a highly focused mental exercise, activating the frontal lobes.
The scans also showed a dip in the activity of a region called the left caudate. “The findings from the frontal lobes are very clear, and make sense, but the caudate is usually active when you have positive affect, pleasure, positive emotions,” said Dr. James A. Coan, a psychologist at the University of Virginia. “So it’s not so clear what that finding says” about speaking in tongues.
The caudate area is also involved in motor and emotional control, Dr. Newberg said, so it may be that practitioners, while mindful of their circumstances, nonetheless cede some control over their bodies and emotions.
> I found CBT so offputting. Mainly aesthetically, I'm such a snob.
Posted by zazenducky on November 7, 2006, at 19:49:42
In reply to Re: Junk medicine:cognitive behavioural therapy » Jost, posted by Racer on November 4, 2006, at 19:54:40
No current medications effectively treat the eating disorder anorexia nervosa. But some forms of behavioral therapy may help prevent relapse and provide other limited benefits, says a study released Monday by the U.S. Agency for Healthcare Research and Quality (AHRQ).
Researchers reviewed scientific literature published since 1980 and concluded that cognitive behavioral therapy (CBT) helped prevent relapse in adult anorexic patients once their weight had been restored to normal. There wasn't enough evidence to determine whether CBT was effective during the acute phase of the disorder, before restoration of normal weight.http://www.drdean.healthcentral.com/newsdetail/408/1508110.html
Posted by zazenducky on November 7, 2006, at 20:24:14
In reply to CBT helps prevent relapse in adult anorexics, posted by zazenducky on November 7, 2006, at 19:49:42
http://www.medscape.com/viewarticle/464618
Nov. 18, 2003 — Cognitive behavior therapy (CBT) is more effective than nutritional counseling in improving outcomes in the treatment of adult anorexia nervosa and preventing relapse, according to the results of a randomized trial published in the November issue of the American Journal of Psychiatry.
"We believe this to be the first empirical documentation of therapeutic efficacy for any posthospitalization treatment for adult anorexia," write Kathleen M. Pike, PhD, and colleagues from the Columbia University College of Physicians and Surgeons in New York City.
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