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Is CBT Just a Load of B?

3K views 41 replies 12 participants last post by  socially inept 
#1 ·
A Clinical Psychologist's blog entry shares an article that shows cognitive disputing techniques are unnecessary for treatment because behavior therapy or even meds are more effective in countering automatic thinking! If this is the case, then just using either exposure therapy alone or exposure therapy with drug treatment should suffice! And by exposure therapy, they probably mean behavioral experiments.

In fact, I encountered about two or three sources showing that exposure therapy is effective enough to treat SAD. This isn't because of habituation but of being able to challenge your automatic thoughts through changing your behavior. As for myself, I'm only going to use Behavioral Experiments and Lexapro to transform my SAD into mere shyness!

Edit: I would like to apologize to the early posters of this thread for my misleading op. Obviously, I should have been more clearer.
 
#2 ·
A Clinical Psychologist's blog entry shares an article that shows cognitive techniques are unnecessary for treatment because behavior therapy or even meds are more effective in countering automatic thinking! If this is the case, then just using either exposure therapy alone or exposure therapy with drug treatment should suffice!

In fact, I encountered about two or three sources showing that exposure therapy (aka in vivo desensitization) is effective enough to treat SAD. As for myself, I'm only going to use Exposure Therapy and Lexapro to transform my SAD into mere shyness!
did you not say yourself on your blog that there is no point changing behaviour (i.e exposure) without using cbt techniques like precicting what will happen and then finding out what realy happens and using that to alter uor thinking and beleifs ?
 
#5 ·
im not a fan of meds. as soon as u stop taking them your thinking returns to it origionally anxious state
the root of the socially anxious persons thinking is the subconcious mind. if you want to alter thinking patterns then the place to do it is the subconcious mind. medication does not change things in the subconcious all it does is mask the problem

alsowhy stick chemicals in your system and live with all of these sde effects when its not necesary ?

at the nd of the day to overcome sa you need 2 things 1) a change in thnking 2) a change in behaviour

now wether changing behaviour automatically changes thinking is a debateable issue. if it does then obviously ther would be no need for cbt cos all oyu'd need to do is change behaviour to beat SA

from personal experience ive done some exposure without the thinking and it didnt work but everyone is different, im not saying it wouldnt work for someone else
 
#15 ·
so basically, you have to change the automatic thought during the behavioral experiment, instead of in a nice closed off room with a therapist and you and the therapist are like:
"so we've identified the negative thought"
"yep, Ive now stopped thinking it"
"now if only you could stop it out there in a real situation"
"yep, that would be nice"
"yepperooo"
"yep indeedee"
"............."
".........."
"so....shouldnt we go out and try this in a real situation?"
"no, i dont leave this room...but at least your well trained to not be anxious when in this room"
"ok......but i dont live my life in this room"
"oh look at that! our times up, gimme my $160 bucks and get the *** out!"


so your better off doing your own cbt yourself during the behavioral experiment
 
#17 ·
so basically, you have to change the automatic thought during the behavioral experiment, instead of in a nice closed off room with a therapist and you and the therapist are like:
"so we've identified the negative thought"
"yep, Ive now stopped thinking it"
"now if only you could stop it out there in a real situation"
"yep, that would be nice"
"yepperooo"
"yep indeedee"
"............."
".........."
"so....shouldnt we go out and try this in a real situation?"
"no, i dont leave this room...but at least your well trained to not be anxious when in this room"
"ok......but i dont live my life in this room"
"oh look at that! our times up, gimme my $160 bucks and get the *** out!"

so your better off doing your own cbt yourself during the behavioral experiment
Hahah, I found that dialogue funny!

Let me be clear because I'm concern that you might have misinterpreted it though I'm beginning to think you got it right. Probably an equally or even more effective way of countering your automatic thoughts is by trying out a new behavior that test it (behavioral experiment).

For instance, Dr. Richards (famous for his Overcoming Social Anxiety: Step by Step tape series) believed that when he went to the supermarket everyone scrutinized him. This would lead me to look down on the floor, avoiding people's eye contact. Dr. Richards then made a behavioral experiment (either consciously or intuitively) where he would look at the people at the supermarket to see if his automatic thought is true. Of course, no one looked at him at all thus dispelling his belief.
 
#18 ·
CBT is definitely NOT for the birds. It helps us put our thoughts into perspective. It's like we go out and prove a lot of our thinking is wrong.
 
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#19 ·
It depends on the person. Personally I don't think exposure behaviour is the only important thing. I did that for two years and I only got worse. In fact most people with SA are constantly exposed to social situations and yet their anxiety lingers for years or for their whole life. It's really a condition most people live with.
I think you're following the old habituation method when in fact, you need a more behavioral experiment. Yes, they expose themselves but they didn't identified their unrealistic beliefs nor try to challenge them with a new behavior. Social Anxiety Disorder is not only consisted of avoidance.

As for this psych blog - don't get over excited over one article. You really need to have 50 - 60 large scale studies all giving evidence that the cognitive component of cbt is a waste of time before you can conclude it's a waste of time.
Actually, I've read from two other sources that exposure therapy alone was enough. It wasn't this article alone. Plus, it isn't so much CBT itself that needs to get rid of, but more of the cognitive disputing techniques themselves.
 
#20 ·
Nah cbt isn't totally worthless it's just not very effective if it's the only thing you use, it's more of an aid to be coupled with other techniques. I think it's the first step into getting the courage to try exposure too as if you have negative thoughts you think you'll fail before you even try.

I also think people shouldn't dismiss medication outright, that "all or nothing" thinking a lot of has is definately apparent in this thread either you are for using drugs the rest of your life or none at all. There needs to be a happy medium where you use the drugs as a crutch until the other techniques begin to work and you start getting better then you can stop them.

Some people might need to be on drugs for life but it depends on the severity of what you have and the decision should be entirely left to a professional.
 
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#28 ·
2 Depeche eyes.

First of all, I'm not judging you as stupid or retarded. That's probably your SA speaking not me. On the contrary I think you are one of the more intelligent people here because you take an interest therapeutic techniques for SA and the evidence base for them. 2nd, I don't mean to be rude but i think you keep misinterpreting that...why can't you just take other opinions on board instead of getting defensive?
Misinterpreting what?

I actually study psychology at uni. And I know what cbt / habituation / exposure etc is. And I know what kind of empirical research must be sought before one therapy is deemed better than another officially; a meta-analysis. Citing books as sources is not the best source of info, because it is far more likely to be coloured by the biases of the authors, to be based on only one study /no studies, or to be out of date.
I'm fully aware there isn't enough evidence that cognitive disputing techniques are aren't quite effective. Still, I believe it is most likely that cognitive disputing techniques aren't necessary.
 
#29 ·
To LaRibbon:

Alright let me be frank here. I'm irritated about your question about why I keep misinterpreting you. It irritates me because I interpret what you said that I should just act rational and realistic when I'm a fallible human being who like everyone else makes mistakes. You pretty much answered your own question on why I misinterpret you: I have SAD.

But it angers me because you seem to be saying that I absolutely shouldn't be making such a stupid mistake like misinterpreting when you are aware that people have automatic thoughts. So of course, many times I prefer to be honest with people on how I feel and my thoughts rather than falsely appearing calm and rational. Sorry but I prefer to be honest than to put a false front.

I don't think I said that my interpretations are absolutely true. I'm aware that I misinterpret others. As you know, you can simply say that my interpretation is false and that would be ok.
 
#36 ·
ACT is much like how you say Behaviorial or Exposure is better than CT. Look into Acceptance and Commitment Therapy. This is where it says it is better than Cognitive alone because they know it only goes so far, disputing alone may not give emotional relief or touch the emotions.

If you got a smart demon you are dealing with, then yes, deal with it on a physical doing way in some kind of way. Because you could be arguing with a nasty thing that wins on some emotional level though you know it sounds wrong.
 
#38 ·
ACT is much like how you say Behaviorial or Exposure is better than CT. Look into Acceptance and Commitment Therapy. This is where it says it is better than Cognitive alone because they know it only goes so far, disputing alone may not give emotional relief or touch the emotions.

If you got a smart demon you are dealing with, then yes, deal with it on a physical doing way in some kind of way. Because you could be arguing with a nasty thing that wins on some emotional level though you know it sounds wrong.
Oh yeah, I heard about it! It seems like a very good form of therapy actually and shows a lot of promise! Can you tell me what it is exactly?
 
#41 ·
When I first bought this book, I had a bad experience with it and I put it aside. To sum it up, I was reading the sections in the beginning on how CBT doesn't work well and I turned off my mind accidently and the next day I had problems where I was being harrassed from within. I heard things actually. Then I realized it was that I was not disputing my thoughts. I must of said something to myself the day before about not disputing my thoughts and took it seriously and I think I was malnourished. As soon as I remembered my shift in thinking and started to lightly dispute my thoughts and said no that's not true, the horrible problems stopped. I drink protein regularly now but I believe that CBT is good rational thinking that goes along with ACT. I'm going to read the book again without fear.
 
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