One of the things that drives me crazier than usual is this notion that anxiety is in overwhelming proportion amenable to rational thought on the part of the person suffering from the anxiety disorder. It’s a persistent idea. It’s also wrong.
Cognitive behavioral therapy: What they don’t tell you, why you should find out
Large segments of society and government sit in the somewhat jaded but still pro-positive thinking/CBT camp. (CBT essentially being the idea that rational interventions can identify and mitigate harmful cognitive feedback loops.)
The problem? This has increasingly led to the use of CBT as a catch-all for people with mental health issues with the expectation that it will make them well and do it darn quickly.
CBT seems like a tailored, streamlined mental health treatment that should work sufficiently well for most. Plus insurance companies love it. The underlying premise is, however, not so much brain-centered as it is economically and emotionally motivated.
I’m the last person to suggest either of those motivations are inherently bad. They’re not. But when it comes to things like treating anxiety and depression, emotional and economic efficiency shouldn’t be top of the list. Making them so endangers lives but nobody wants to think about that much, ‘k.
Brains require more than brief, ‘rational’ interventions. If you don’t believe me, please watch this amusing and informative TED talk by a cognitive neuroscientist:
After you’ve watched that. You did watch it? I know it’s long. Think about how many years we spend learning apparently simple skills like:
- How to relate to each other;
- How not to freak out and think the world is ending when someone leaves;
- How to answer questions in our own lives whilst feeling confident about that and possibly creating our own small miracles of nature in the process.
How to tell your mental illness really does exist
Suppose one day, in your 20s, or when you pop out one of those small miracles of nature, a whole bunch of those skills get wiped out. Without warning, or preparation. “And there’s no manual”, as Ruby Wax would say.
You didn’t have a stroke but in terms of your ability to function mental illness can have similar effects. A stroke might be easier; Nobody would tell you to “perk up”.
In any event, you’ve crashed and now you get to pick up the pieces. Most people do not know how to do this. Again, no guidebook. Maybe they keep quiet, until it turns into ‘I seem to be in the hospital. Er, maybe there’s really something wrong?’. It’s about that time someone offers 6 to 8 sessions of CBT with a side of medication.
CBT is not the magic bullet of mental health recovery
What isn’t often mentioned is that to work well, and not remain simply a semi-functional bandaid that comes off when wet, CBT needs continual reinforcement over the long-term. That 6-8 therapy sessions with some dude you’ve never seen before but to whom you’re supposed to reveal your innermost thoughts, no matter how terrible they may seem, probably won’t fix mental illness.
Regardless of efficacy or efficiency the government, my neighbor, my family have no right to tell me that 6-8 sessions should be quite sufficient to undo the damage. It’s unlikely I’ll begin to understand the magnitude of what I’ve lost in 6-8 sessions, let alone fix anything. Can I pick up a few helpful tools? Sure but it’s still the equivalent of shopping at the 7-Eleven for all your mental health needs.