[0xcde4c3db]

> The most researched approach - CBT

While it's true that CBT is the most researched, virtually all of that research is on overall observed efficacy (and there are concerns that the efficacy that has been observed, especially in the earliest studies, is inflated by allegiance effects). That kind of research doesn't provide the tools to say anything about the validity of CBT's underlying conceptual/theoretical model, especially considering that CBT doesn't consistently outperform other modalities with radically different underlying models.

[antonkar]

One of the most proven things we have to manage depression and anger among others things (I regularly check the most recent meta analysis and CBT is always one of the top treatments by efficacy). What other psychological approach you consider more effective to manage depression?

The writer of the article based it on the book by Karla McLaren M.Ed., as her Amazon page describes her “an award-winning author, social science researcher, and pioneering educator whose empathic approach to emotions revalues even the most “negative” emotions, and opens startling new pathways into the depths of the soul.” When was the last time scientists discussed souls?

Here is her articles, make your own conclusions: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Karl...

Compare them with Beck’s articles: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=aaro...

[0xcde4c3db]

I'm not saying that there's anything more effective (for the conditions for which CBT is commonly studied and recommended; much like any other "school" one might name, a handful of true believers are out there suggesting that it would cure conditions such as obesity and ADHD if only we could raise sufficient awareness and belief), I'm saying that:

1) The margin of CBT's superiority in robust studies (AFAICT, most published psychotherapy studies are of sufficiently poor quality that if you cited a similar one for a medical intervention, you'd be accused of being an industry shill) is likely sufficiently small as to be of little practical importance [1], and there are credible reasons to suspect that even that small apparent superiority might be an illusion caused by biases among both individual researchers and institutions [2].

2) Even if we did have robust evidence that CBT works substantially better than other modalities as a treatment, that wouldn't represent a validation of its underlying theoretical model per se; it would just suggest that any model telling us to take blatantly opposite material actions is unlikely to be valid. Consider the scenario of an isolated, highly religious society encountering leprosy. Probably the most effective intervention would be for a religious leader to tell the people that it's a punishment from the gods and sufferers must be shunned. That would work, but it would work because leprosy is caused by a pathogen spread through close contact, and the intervention provides a strong incentive to avoid close contact, not because that society's gods actually exist and care who people hang out with. That's arguably an extreme example, and my point is not to suggest that belief in CBT is akin to religion (indeed, one could reasonably argue that CBT is the flavor of psychotherapy least guilty of stumbling into a religious mode of thought), only that just-so stories are all too easy to spin.

[1] https://pubmed.ncbi.nlm.nih.gov/36640411/

[2] https://www.frontiersin.org/articles/10.3389/fpsyt.2018.0015...

[antonkar]

Good, I especially like your first cited meta analysis: “CBT appears to be as effective as pharmacotherapies at the short term, but more effective at the longer term” (I have nothing against the meds). I view it this way: modern CBT is actually vacuuming all the working approaches. CBT is something that you can use anywhere - it’s mostly a tool to notice and rewrite your unhelpful thoughts. The goal of the best approach is to eventually have no crutches - no need to have a permanent psychologist if you become one for yourself. Group therapies or approaches that are hard to use individually cannot give you that. I found CBT to be very easy to learn from their main book. Some people rave about meditation - I think they’ll eventually learn the basics of thought-rewriting from CBT and will rave about it even more)

[roguecoder]

"One of the top treatments by efficacy" doesn't even slightly imply that its theory of the world is more correct than those other top treatments.

Even being effective doesn't mean its stated rationale is correct. Acupuncture absolutely treats numerous conditions, but that doesn't mean meridians are real.

I'm glad you found a modality that works for you. But in general, it doesn't routinely out-perform other interventions. It is more popular than the other effective modalities because it easier to administer and sell to insurance companies, but that doesn't make it more correct.

[antonkar]

Yes, I never said that CBT is completely correct in every regard. I was just shocked to see an articles based on a book that mentions souls on Hacker News. CBT is actually researched and quite effective unlike the book of former chakra practitioner Karla McLaren. We cannot change emotions directly, we can only change our thoughts and it will change our emotions. I recommend reading Beck directly in addition to counseling, it really helps. Sadly some psychologists are not great. Wish you the best!

[roguecoder]

Ah, I see the confusion: this book isn't about changing our emotions. It is about learning from them.

There are aspects of CBT that are essentially gaslighting ourselves, ignoring the information we could get from our emotional responses in favor of becoming more socially acceptable. It is part of why it is contraindicated in cases of cPTSD.

This book is about a very different goal. It is about what can be learned from our built-in sensors, rather than how we silence their alerts.

[maleldil]

> There are aspects of CBT that are essentially gaslighting ourselves

Could you be more specific? I'm another patient undergoing CBT, and I've found it overall helpful in managing BPD. I'm curious what you mean by this.

[antonkar]

I don’t think you need to worry. Beck was literally writing down all his thoughts down for many months and analyzing them and that way he came up with the idea of CBT in the first place. It’s results oriented but when you reach your goals you can continue changing even the most inconsequential thoughts and emotions. No gaslighting involved. Quite the opposite)