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Shortcomings of cognitive behavioral therapy and remedies to them

posted by Joshua on September 9, 2011 in Blog, Evolutionary Psychology, Nature
2 responses

[This post is part of a series on The Model — my model for the human emotional system designed for use in leadership, self-awareness, and general purpose professional and personal development — which I find the most effective and valuable foundation for understanding yourself and others and improving your life. If you don’t see a Table of Contents to the left, click here to view the series, where you’ll get more value than reading just this post.]

Yesterday we looked at cognitive behavioral therapy. Today we’ll consider some of its shortcomings and why those shortcomings excite me about my Model.

Shortcoming 1: Cognitive Behavioral Therapy doesn’t motivate its model

I believe the therapy will help best to the extent people understand why and how it works. If the underlying model works, I support using it whether the therapist or patient understands why, but it will work more effectively the more they understand how and why.

I haven’t taken formal training in cbt so I may have missed something, but I’ve never seen the motivation for its model. I believe explaining its origin will help therapist and patient alike.

Remedy 1: explain the model

My explanation motivates the Model. I recommend starting here. Give the patient a reason for the Model so they don’t have to memorize it or wonder where it came from.

Shortcoming 2: Cognitive Behavioral Therapists don’t apply cbt to healthy people

Healthy people want to improve their lives, not just unhealthy people. Just because you’re happy sometimes or partly happy doesn’t mean you don’t, can’t, or shouldn’t want more happiness. If you ask me, everyone should improve their lives. The U.S. Declaration of Independence ranks the pursuit of happiness along with life itself. We all want resilience from unhappiness and unrewarding emotions.

Cognitive behavioral therapists apply their model to unhealthy people, ignoring healthy people who want more happiness, rewarding emotion, leadership skills, resilience to their opposites, and more.

This shortcoming applies to its practice, not necessarily the underlying theory. Let’s look at some sources on cbt for where they apply it.

Wikipedia mentions applying it to

a variety of problems, including mood, anxiety, personality, eating, substance abuse, and psychotic disorders”, “a number of mental health difficulties, including post-traumatic stress disorder, OCD, bulimia nervosa, and clinical depression“, anxiety disorders, mood disorders, insomnia, severe mental disorders, stuttering, and complex trauma

I like the idea of helping people with these problems, but what about healthy people?

Beck’s page mentions applying it to

psychiatric disorders such as

  • depression,
  • the full range of anxiety disorders,
  • eating disorders,
  • substance abuse,
  • personality disorders,
  • and (along with medication) bipolar disorder and schizophrenia;

medical disorders with a psychological component, including

  • several conditions involving chronic or acute pain,
  • chronic fatigue syndrome,
  • pre-menstrual syndrome,
  • colitis,
  • sleep disorders,
  • obesity,
  • Gulf War syndrome, and
  • somatoform disorders;

and psychological problems such as

  • anger,
  • relationship difficulties, and
  • compulsive gambling…Draft

CBT is also used to address

  • stress,
  • low self-esteem,
  • grief and loss,
  • work-related problems and
  • problems associated with aging.

Again, what about healthy people? Don’t we want to help them (us)?

Another Beck page gives a more comprehensive list of “treatable conditions.” Scour the list. See if it helps someone who doesn’t have a disease or mental problem.

What about healthy people?

Remedy 2

As positive psychologists who noted that for the half century clinical psychology “has been consumed by a single topic only – mental illness” applied their science to increasing wellness and resilience, I believe we should do the same with cbt and not restrict its application to unhealthy people.

It turns out I was doing that before I’d heard of cbt at all. I recommend doing the same. Use the techniques to improve your life. Just because a psychologist somewhere studied a technique somewhere doesn’t mean you can’t use your common sense to derive techniques on your own that work. Yours may be similar to theirs, but don’t let their white lab coats let you think you need their training to improve your life or that because their techniques resemble theirs that they imply you’re unhealthy.

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2 responses on “Shortcomings of cognitive behavioral therapy and remedies to them

  1. Pingback: The Model: summary | Joshua Spodek

  2. Pingback: Cognitive behavioral therapy and its problems | Joshua Spodek

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