Wednesday, December 7, 2022

Comments by Kent Shultz

Showing 1 of 1 comments.

  • “CBT requires that a client enjoy a certain amount of socioeconomic privilege and financial stability in order to actually be effective.”

    This is a good point that I hadn’t really considered before. If your life really *is* horrible, you’re poor, you have no education, no family/friends, no future prospects, then how will it go when you attempt to challenge your negative thinking? In interrogating your thoughts (“I’m a loser, my future is hopeless” etc), what if you find good evidence for their truthfulness? Of course it’s *possible* to overcome one’s circumstances and change the course of one’s future for the better, but when the deck is stacked against you, it does seem CBT techniques will be an exercise in frustration.

    I come from a privileged background, and I’ve tried CBT. Yet I never found it useful. My depression had nothing to do with hopeless circumstances; I always had a good chance at a bright future. So CBT should have been able to help me defuse my distorted thinking, right? Well, anyone who’s ever been depressed knows that depressed thinking doesn’t really respond to reason and logic. I just couldn’t use my higher mind, my cortex, to neutralize something that was coloring my entire consciousness all day every day. Even if my thoughts were distorted, I wasn’t able to see that while inhabited by despair. While in despair, you are not lucid, you cannot see clearly. It’s a cloudy state of mind.

    I found Acceptance and Commitment Therapy (ACT), a third-wave CBT, more useful. It uses mindfulness to step back from your thoughts and get space away from them, rather than fighting and engaging with them as CBT would have you do. So much of mental illness–depression, anxiety, OCD–has to do with excessive thinking, rumination. It seems to me that CBT techniques involve more rumination. On the other hand, ACT is about recognizing that you’re thinking excessively, detaching from that, and allowing the thoughts to just be there and pass away on their own time, without you feeding them. You’re not analyzing them, you’re accepting them–not their truthfulness, but their presence. And I think that can be useful for anyone, regardless of their real circumstances.

    What do you all think about that?

    (I am not a therapist, just speaking as a therapy client.)