Book Review: CBT: The Cognitive Behavioural Tsunami

Andy

Andy

Retired committee member
Author and psychotherapist, Dr. Farhad Dalal, recently published a book that critiques the philosophical and scientific bases of Cognitive Behavioral Therapy (CBT). Frequently upheld as an alternative to psychiatric drugs, CBT, according to Dalal’s investigation, is derived from the same flawed scientific and philosophical understandings that is less concerned with the origins of one’s distress, and more apt to reduce suffering to medicalized explanations and institutional treatments.

The book, titled “CBT: The Cognitive Behavioural Tsunami” examines the influences of managerialism, politics, and the corrupt science that endorses particular views and responses to human distress. The book’s introduction features the following statement:

“The rise of CBT has been fostered by neoliberalism and the phenomenon of New Public Management. The book not only critiques the science, psychology and philosophy of CBT, but also challenges the managerialist mentality and its hyper-rational understanding of ‘efficiency’, both of which are commonplace in organizational life today.”

“The book suggests that these are perverse forms of thought, which have been institutionalized by NICE and IAPT and used by them to generate narratives of CBT’s prowess. It claims that CBT is an exercise in symptom reduction which vastly exaggerates the degree to which symptoms are reduced, the durability of the improvement, as well as the numbers of people it helps.”
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https://www.madinamerica.com/2019/02/new-book-deconstructs-ideology-of-cognitive-therapy/
 
Under the Youtube video there is some biographical information and an outline of the talk.

Farhad Dalal is a psychotherapist and Group Analyst in private practice in Devon. He also works with organizations. He was Associate Fellow at the University of Hertfordshire's Business School. Currently, he is Visiting Professor at the PhD School, Open University of Holland.
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Estherbot said:
At the end of the article, there is a link to a talk given by the author Dr. Farhad Dalal in 2015 (it's not given a hyperlink on the Mad in America site).



It's 46 minutes long.

Disclaimer: I've not watched it!
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I've watched it several times and think it's brilliant. I've also watched some of the other videos from the same Limbus conference called Challenging the Cognitive Behavioural Therapies. The one by Patrick Pietroni apparently focusses on the NHS. I haven't watched that one.
http://www.limbus.org.uk/cbt/videos.html
 
Watched most of it. I want to visit the CBT and Mindfulness-Based CBT studies in pain reduction to learn how to dissect them.

I am somewhat fearful of the intersect of CBT and MB-CBT for pain reduction for sufferers taking opiods for pain (such as myself).

Thanks for this!
 
shak8 said:
Watched most of it. I want to visit the CBT and Mindfulness-Based CBT studies in pain reduction to learn how to dissect them.

I am somewhat fearful of the intersect of CBT and MB-CBT for pain reduction for sufferers taking opiods for pain (such as myself).

Thanks for this!
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You might be interested in this. It's a science program on (Aus) ABC tv. This episode follows a university experiment and is from a couple of days ago. One of the participants who is followed is a heavy user of painkillers, including morphine. She was very skeptical at first but found mindfulness helped and was able to reduce them. The conclusions are the usual: more studies are needed.

https://www.abc.net.au/catalyst/stories/4949516.htm

I hope it's available in other countries.
 
In my experience things like mindfulness will only help with certain types and levels of pain. If the type of pain isn't suitable, or the level is too high, or a combination of both, then trying to control it with such techniques has a rebound effect once control is lost, and the pain becomes overwhelming.

Just my experience, others may differ.
 
I can and have (yesterday in 13 degree C induced pain) cheerleaded myself through some tough pain moments.
"Don't focus on it."
"You'll be home soon and can get heat to the area, rest, take meds."

I would submit that every pain patient already employs CBT cheerleading to herself. Sure, there are people who are over medicated with opioids, as well as those under-medicated.

I am firm in my self-knowledge that only meds work to put the pain away so I am not plagued by it front and center during say, two-three hours.
I used a judicious and safe small dose of methadone, tizanidine (muscle relaxant) and if needed, a very small dose of a benzo, clonazepam.

This is clinical, self-knowledge.

I'll will read the Australian article with the hopes I don't have to pick off the logic.
 
I perused the transcript of the Australian video. It's the same rubbish: you can train your brain to stop feeling pain. that the brain is plastic therefore you can change pain.

Again, show me proof that this works. My pain has been the same annoying, life-changing deal since 1998. Just like ME, it's here to stay.

I don't have a lot of psychological suffering or complexity around it. I have made my peace with it. I just don't want ineffective treatments rammed down my throat, nor efficacious meds withheld from me. I take the equivalent of two codeines a day.

the hoopla about Mindfulness based CBT is all about trendy and cost-saving.
 
@shak8 I'm probably in a similar situation to you regarding pain but mindfulness and CBT are not things I would bother with either.

In the experiment not everyone found it useful and those who did had varying degrees of relief. You get less of an impression watching the whole thing that it is cut and dried; it is quite non-committal actually. The people who were helped only had varying degrees of improvement but they were very happy to have any and intended to continue to see if they improved more with time. As Farhad Dalal says, whatever works.
 
Found this today, see pages 49-51.
Veterans Administration (USA) Therapists' Manual of CBT for Chronic Pain.

https://www.va.gov/PAINMANAGEMENT/docs/CBT-CP_Therapist_Manual.pdf

Sure, there are people who need some nudges to help themselves.
BUT, pages 49-51, the same old crap take by non-pain sufferers: if you only change your beliefs, increase your activity, do pleasant activities, focus on social interactions, stop worrying. YEAH RIGHT. Try that at a pain level of 8-10 and see how much you do.

And oh, it's the Venn of chronic pain/emotions/thoughts/withdrawal.

What I see is a bunch of not so bright Ph.D's in psychology walking around with clipboards, ticking off meaningless categories during research.

And I thought I might read something useful...always hoping...always in vain.
 
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