Re: Notes: abusive parents, suicidal ideation

Date: 2017-02-15 05:16 am (UTC)
siderea: (Default)
From: [personal profile] siderea
What you're describing in this case are not cognitive distortions.

One of the things I despise about the CBT cultural hegemony our host decries is how it has resulted in this crude, bastardized form of Cognitive Therapy becoming the jargon that lay people use. It's as bad as, back in the Freudian days, everyone calling everything a "complex".

When somebody has an unlikely and extreme emotional reaction to something apparently relatively benign, and it is remedied by realizing that the reaction is actually perfectly reasonable given some specific, unobvious circumstance (present and true or past and remembered), that form of clinical intervention is called insight.

Insight based therapies are ones predicated on the idea that understanding one's self results in the remission of symptoms. The classic example of an insight based therapy is Freudian psychanalysis; there are others. I gather Gestalt is similar. I'm a Rogerian, and played at a high enough level that becomes an insight based therapy too.

Historically, CBT snobs have made much of their contempt for insight and insight based therapies. CBT was held out as the opposite of insight-based therapies, and, indeed, did not require insight. Insight requires time-consuming investigation of each case; insight-based treatment is always bespoke, customized to the patient. Insight requires intense listening and attention to a patient over a long time, getting to know them deeply.

CBT was sold as the BigMac of therapies: eight sessions, out of a standardized workbook, and you're cured. Or you're resistent to treatment and it's all your fault you're ill. CBT partisans bragged that they didn't need to "waste" huge amounts of time listening to patients to figure out what was wrong with them. CBT already knows all the answers, and they have "Evidence" to prove it.

Of course, that's rarely how CBT is practiced in the wild, today. Turns out insight – and spending time listening to the patient – aren't optional in psychotherapy.
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