Cognitive Behavioural Therapy Isn’t The Answer

The Daily Mail has an interesting article today about the pro and cons of Cognitive Behavioural Therapy (CBT)

CBT is a short-term psychological treatment based on the idea that negative thinking and behaviour can trigger problems such as depression or panic attacks.

During treatment, the therapist helps you identify these negative thoughts – and encourages you to work out a way of looking at things more positively. CBT is used to help with a wide range of mental health and physical conditions, including phobias, anger, relationship problems, sleep problems and eating disorders.

The process was developed by the American psychiatrist Aaron Beck in the Sixties. He believed that our emotions and moods were influenced by our patterns of thinking.

But rather than focusing on past events in your life such as your childhood – as most of the older psychotherapies do – CBT focuses on the here and now.

Fearing the growing recession will cause a depression epidemic, the Government recently announced funding for hundreds more therapists trained in CBT. This is on top of the 10,000 new therapists promised two years ago.

The Mail article features psychologist Oliver James who argues that this is a waste of money as CBT doesn’t work, while psychotherapist Derek Draper argues that it really does transform lives.

James argues that CBT is nothing but personal spin, so it is slightly ironic that the case for the defence is the ex-labour spin doctor Draper.

In the past I have had treatment for depression brought on my death of my father due to cancer and intolerable pressure at work. As well as being prescribed anti-depressants I also had sessions with a therapist, these sessions were in my opinion a waste of our time as she insisted on dwelling on my negative thoughts, poor self esteem and personal relationships rather than the real reason I was depressed which was crippling grief and an unsympathetic employer. The pills and being signed off work were what helped me recover and not the ridiculous hand-wringing navel gazing weeping sessions.

I now know the therapist was using CBT, It was a short course of sessions and involved filling in before and after questionnaires and I agree with James assertions.

If given no treatment, most people with depression drift in and out of it. After 18 months, those given CBT have no better mental health than ones who have been untreated.

Yet the claims that the Government has made for this method have been dishonest. CBT’s inefficacy becomes explicable once you understand just how shallow a form of psychiatric spin-doctoring it is.

The patient is taught a story to tell themselves, a relentlessly positive one. If the therapist is skilled, the patient persuades themselves and others that they are feeling good.

When tested, they often regurgitate the positive story, literally placing ticks in the right boxes of the questionnaires used by researchers to evaluate their mental state.

CBT does have some short-term effect: while undergoing it, people admit to fewer and less intense symptoms. But a few months after the therapy, their negativity forces itself to the surface and they cease telling the positive story.

Re-tested, they no longer tick the right boxes. The initial gains measured in CBT patients are often a simple parroting of what they have been taught, rather than expressing their real state.

Interestingly James backs up his arguments with scientific studies and reports, while Draper who is a proponent of CBT just argues that it works for some people. James acknowledges that fact but his argument is that it doesn’t work for sufficient numbers to warrant the investment and the money should be made on different treatments with a higher success rate even suggesting Cognitive Analytic Therapy, or the Hoffman Process.

Whilst driving home last week I caught the back end of an discussion about CBT on the BBC Radio4 PM program, where Oliver James was being interviewed. He made a coherent and strong argument and I found myself agreeing completely with everything he said.

Unfortunately it is now unavailable online but there are plenty of comment on the PM and iPM Blogs.

Just a note, Don’t do a Google image search for CBT without a the safe filter on, will make your eyes water!

Games are killing your children!

Change4Life, the government’s flag-ship £75m pound nanny-state ‘health’ campaign to tackle obesity may have just made a costly mistake.

Their latest print advert (above) has angered the UK games industry. The advert created by the Department of Health in conjunction with Cancer Research, The British Heart Foundation and Diabetes UK, shows a small boy slumped on a sofa holding what appears to be a PlayStation controller – above him is the headline, “Risk an early death, just do nothing”.

Condemnation has been universal throughout the industry. Richard Wilson, CEO of Tiga, the trade association representing the business and commercial interests of games software developers in the UK and Europe, is quoted saying

“This advert is absurd and insulting in equal measure. To imply that playing a video game leads to a premature rendezvous with the Grim Reaper is a non-sequitur of colossal proportions. Alcohol and drug abuse, smoking, obesity and involvement in violent crime are forms of behaviour that risk an early death.

“In contrast, many video games are mentally stimulating, potentially educational and social and some involve physical exercise. ‘Brain Training’, ‘Wii Fit’ games or ‘Civilisation’, ‘Singstar’ and ‘Buzz’ are cases in point.

“This advert is offensive to the 30,000 people who work in the UK’s video games industry, particularly the 10,000 who work in games development. Game developers are typically intelligent, very qualified and creative individuals who work to produce high quality games for people’s entertainment. They are not in the business of driving people to an early grave.

“With nearly a quarter of men and women and almost a fifth of 2 to 5 year olds in England obese we clearly need to encourage a more active lifestyle and healthy diet. It should be possible to achieve this objective without misrepresenting a creative industry of 30,000 people.”

Sony are considering whether to sue for the unauthorised use of their controller, James Binns, publishing director at Future, makes an interesting point:

“There is no arguing that the campaign’s underlying message about premature death is incredibly important – but the government would never risk the wrath of showing a child sitting still reading a book to illustrate their point.”


Picture by Nick Brickett

It could easily be argued that books and TV are much more sedentary, but demonising books was never going to go down well with the ad’s target audience of concerned parents. It would also have not gone down well with a famous Labour donor who amazed a fortune out of immobilising children for hours on end, year after year, with her stories of wizards!

The UK games development industry is a world leader, often cited as an example of Britain at it’s best, but like many industries is now suffering from foreign competition during the current economic downturn. It has asked for state help and has received little support and for the government to now demonise it as the bogeyman intent on harming children might just be enough to convince companies that their future lies elsewhere.

The Guardian blog article sums it up nicely.

But to many it feels like, once again, games are the soft target, the acceptable scapegoat for hand-wringing middle-aged policy makers unwilling and unable to engage with game culture in any productive way. It’s such a lazy cliche and such a convenient get-out clause for a society that’s been happy to slowly erode the freedoms of children, turning the education process into a joyless conveyor belt of examination and testing, while outside the playing fields are sold off to property developers.

Childhood obesity is a complex and devastating problem. It needs to be addressed, but it needs to be addressed properly. Giving parents a bogeyman to point at and blame is not the answer, is it?

Dog Owners More Likely To Share Germs With Pets By Not Washing Hands Than By Sleeping With Dog

sleeping dogs
As I share a home with three dogs at the moment it is reassuring to read about this piece of research on the ScienceDaily website

(2009-01-30) — Dog owners who sleep with their pet or permit licks on the face are in good company. Surveys show that more than half of owners bond with their pets in these ways. Research done by a veterinarian found that these dog owners are no more likely to share the same strains of E. coli bacteria with their pets than are other dog owners.

It reminds me of a story told by a dog-trainer acquaintance a few years ago, she regularly informed people that she shared her bed with her two ‘large’ dogs. When someone expressed their abject horror at such a “disgusting and unhygienic arrangement” she replied “I don’t see what the problem is I’ve sleep with dirtier men!” – the complainant was apparently utterly lost for words!

Oh and the picture above is not me or the wife!