[rocketbop]

I share your concern about using an app to deal with a psychological problem, but I think a counterpoint to your concern about this app being one-size-fits-all is Cognitive Behavioural Therapy. The central premise of CBT is that it doesn't really matter what the roots of the behaviour a patient wants to change are. Reprogramming our behaviours is enough.

This is really the opposite of the old Freudian ideas that a therapist must get to the root of the problem (which might have been in childhood) before progress can be made on the neurosis.

Perhaps the author here is approaching social anxiety from the CBT perspective.

[jon-wood]

> I think a counterpoint to your concern about this app being one-size-fits-all is Cognitive Behavioural Therapy

CBT is absolutely a one-size-fits-all solution though, and in my opinion quite harmful in many ways. The core premise of CBT is more or less "it's all in your head". I'm sure for some people it is, but for many (myself included when I tried it), it is absolutely not all something I could just handwave away with positive thinking.

CBT comes down to just sucking it up and accepting your place in life, when for many people it's that very place in life that is destroying their mental health and the right thing to do isn't to suck it up, it's to make concrete changes to their life and get out of that situation. However, CBT is cheap to provide, so is the darling of health systems the world over. Just do some colouring in while thinking about how great life is really folks, the world burning around you is keeping you warm.

[jodrellblank]

I've listened to dozens of hours of Dr David Burns' Feeling Good Podcast[1] about CBT, he's in his late 70s and was one of the pioneers of it. I tend to come away thinking of it as a panacea and have to remind myself that diseases are complex and multifactorial and treatments won't work for everyone ...

Then you say "The core premise of CBT is more or less "it's all in your head" [...] it is absolutely not all something I could just handwave away with positive thinking." which is insultingly misrepresenting it, like grandpa disparaging everyone who works on computers in any capacity because "playing computer games all day isn't a real job".

It's nothing to do with handwaving things away, it's not positive thinking, it's not "just" any one trivial idea, and it doesn't come down to sucking anything up or accepting 'your place' (unless that means a terminal disease diagnosis, perhaps). It's as involved, interesting as debugging software - debugging how and why your thoughts generate your feelings - and you don't debug software by handwaving the bugs away or accepting that you will be stuck with broken software forever. There's counter-examples to your claim through the podcast: people who have been helped to get jobs or promotions, to be more effective or less stressed at work, to improve and rebuild their relationships with partners, friends, estranged parents. There's no colouring-in involved and Dr Burns is constantly banging the drum that patients must be tested at the start and end of every session to self-report their feelings in different areas to make sure they are improving because it's too common over the industry for patients to 'suddenly' leave after weeks and weeks of treatment saying "this hasn't helped me at all!" but when it's working well, patients will self-report significant improvements in very few sessions, and if they aren't, change something.

[1] https://feelinggood.com/ - podcast menu, at the top.

[afro88]

It's a one size fits all approach sure, but only for cases where it's your thinking that is causing the negative state you're in. A state that has left you helpless or otherwise unable to help yourself get out of it.

CBT is about establishing new constructive thought patterns that break that cycle.

Condescending those that need this kind of tool to improve their mental health is unnecessary.

You might not have been in that kind of state (thoughts spiraling deeper and deeper into self loathing and depression for example), and it genuinely was just external circumstances that you needed to change.

[jon-wood]

Apologies, my intent wasn’t to have a go at people who CBT genuinely helps, I’m sure it’s very effective in many cases otherwise it wouldn’t be such a big thing. I’m projecting my general frustration at the world onto it to an excessive degree.

[basisword]

You seem dramatically misinformed about CBT. I can understand if you had a bad experience with it. I think the psychologist you work with matters a great deal as do their tools/approaches. But your description of it is inaccurate and I thought worth noting lest you scare anyone away from something which could help them.

[tolarewaju3]

Bingo.

It's a mix of exposure therapy and CBT. I understand that people are concerned over the simplified approach. But like most things (therapy included), if it's not simple enough to understand, it doesn't get used.

Many Social Anxiety therapists first go will be exposure therapy -- gradually exposing their clients to fears until they don't feel it as much. We employ a version of this in Roadmap. The levels start out small and then gradually introduce larger steps at the player's pace.

CBT - This practice comes in two parts: identifying the underlying thoughts / beliefs of the anxiety. And then forming skills / behaviors to tackle that.

Social Anxiety is focused on our future failures in front of people. In Roadmap, that central belief is uprooted when we capture your wins and replay them to you over and over.

Instead of focusing on future failures & being discouraged, we rewire the mind to appreciate past wins & build confidence.