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To those of us who actually know what CBT is and people who have benefited from it, all you have proven is that you haven’t a clue.
And that is my “happy thought”
Wow Popa…Ok I’m back because of your foolish comment. Saying depression causes there to be less serotonin (or whichever chemical neurotransmitter is involved; they’re not positive it’s always serotonin) is like saying that having a cut on your arm is CAUSED by feeling pain. Depression consists of the symptoms AFTER there is a biological chemical imbalance. Again in layman’s terms – if your brain is chock full of the chemicals that make you feel happy, you probably will not be feeling depressed because…oh right – you feel happy! Think of anesthesia – they can be doing a surgery with local anesthesia (laughing gas or whatever) where you’re wide awake for the surgery and they can be cutting a part of your body open, but you will feel happy (sort of) and on another planet – because they give you the chemical that can alter what your brain feels. Saying that depression causes a chemical imbalance in your brain makes absolutely no sense, whatsoever. Again, that’s like saying feeling pain causes a cut to appear on your arm, instead of the obvious reverse.
CBT is not foolproof, and PBA knows everything, though he likes to be provocative sometimes.
rebyidd23 – you are perfectly right. CBT is not fool proof. But unfortunately when it comes to mental illness, nothing is foolproof – even medications can have negative side effects. CBT HAS been shown scientifically to help many, many people with a variety of psychological disorders.
“If I get angry, don’t you think that releases different neurotransmitters in my brain? So am I angry because of the neurotransmitters, or because I stubbed my toe?”
Popa raises a good question, which is one of causality. How can we know which variable causes which. Or maybe there is a third element at work influencing both.
Correlation is not causation. So what can we do to eliminate causality? We run an experiment. One with random assignment and a control group.
So in our case, how do we find out if low serotonin causes depression or the other way? We would randomly assign participants of the experiments into two groups. One would receive and SSRI, and the other would get a placebo. Then we rank the participant’s level of depression (using the Beck depression inventory or an equivalent test). If the experimental group shows a better improvement in symptoms than the control group, we can say that high serotonin reuptake can be a cause of depression. It’s as simple as that.
And I must ask. What is “real therapy”?
Read your post again. It didn’t make any sense, and proved my point.
What you are saying is precisely the point. If you cut your arm, the nerves send signals which cause neurotransmitters to be released which result you feeling pain. Similarly, if someone has inflicted emotional “cuts” on you, then it causes neurotransmitters to be released which make you feel emotional pain.
And the same way you would never think of ignoring the cut on your arm and blaming the pain on neurotransmitters, you shouldn’t do that with emotional cuts either.
I never sawyou should ignore anything. CBT is about rationalizing these feelings and emotions.
Correlation is not causation. So what can we do to eliminate causality? We run an experiment. One with random assignment and a control group.
So in our case, how do we find out if low serotonin causes depression or the other way? We would randomly assign participants of the experiments into two groups. One would receive and SSRI, and the other would get a placebo. Then we rank the participant’s level of depression (using the Beck depression inventory or an equivalent test). If the experimental group shows a better improvement in symptoms than the control group, we can say that high serotonin reuptake can be a cause of depression. It’s as simple as that.
Sorry, try again. All you are showing with your experiment is that they are correlated. But I’m saying that the depression triggers are what cause the lack of serotinin. So it doesn’t prove anything to that. It doesn’t show which way the causation is.
It’s like saying that headaches are caused by a lack of tylenol because tylenol helps them.
Popa, what if we took a whole bunch of normal people and lowered the seratonin level of half of them, and see if they become depressed?
So what? Of course they would be sad.
What if you took a bunch of normal tired people and gave half of them caffeine. Would that finally prove to the deniers that lack of caffeine causes tiredness?
Ok, so here’s how Popa thinks emotions work. And this is what I’m saying:
Let’s start with simple emotion. Your dog dies and you are sad. So you have a stimulus of dog dying. Then your brain picks up that this is something that should make you sad. So your brain tells your body to release chemicals that make you feel that sadness, and you feel sad. Dog died—>felt sad.
Now, if someone would have scanned your brain while you were sad, they would have seen all those sad chemicals swirling around. But if they asked why you were sad, they would have known that it was because your dog died.
Suppose some jerk leaves davening early when you wanted to and now you can’t leave because you are the minyan. Your brain tells your body to release the angry chemicals, and it does, and it results in you feeling angry. If someone scanned your brain, they would see angry chemicals, but you are angry because of the jerk.
If you bang your elbow, your brain tells you body to do whatever it does that makes you feel pain. And someone could scan your brain and see those nerve endings firing, and maybe think that nerve endings firing caused your elbow to hurt. But you know it was your banging your elbow.
So studies which show that depressed people have less serotonin are just restating the obvious: that the brain works through chemical transmitters. But they don’t show anything about what causes those chemicals to be released or not released.
Now, so we’ve established that when dog dies, you feel sad because your brain releases sad chemicals (or withdrawn happy chemicals, either way). How about when you feel sad all the time? So your brain obviously has released the sad chemicals–but why has it? It’s probably a good idea to wonder what it could be about your life that your brain thinks you are experiencing constant sad stimuli. Maybe you are constantly anxious about things–that might be a good reason to be sad. And then you should ask why you’re anxious. Maybe your a perfectionist and nothing is ever good enough, so it makes sense to be anxious. In which case you should ask where that perfectionism came from. Maybe it was your parents who made you think you were a failure for being a normal imperfect kid.
Imagine you went to the doctor and said, “it hurts”, and he just prescribed a painkiller without asking why it hurts or trying to figure it out. Would you go back to that doctor? Well, why not? He did solve the symptom you came complaining about. Never mind the blood dripping from your elbow.
Popa I did not prove your point, I proved mine. First, before you feel any effect, there has to be some sort of biological change that will trigger the nerves and therefore make you feel something. First the cut, which is biological and physical, then the pain follows. Likewise with depression, first there would likely be a biological imbalance, and then the effect follows – the symptoms of depression. I also hope you do realize while we are talking about this that clinical depression is very different from simply feeling down about something happening. Clinical depression must go on for a certain amount of time and there are various other things that are looked for. That is why not everyone will become depressed. Some people may have a genetic predisposition to it, again indicating a biological cause.
As to your headache comment – what do you think causes headaches? It’s not lack of tylenol, but it is most certainly some sort of chemical, biological change that occurs. The following is quoted from a September 2013 updated article from medicalnewstoday.com:
“Experts today believe that a change in certain brain chemicals may be the main factors that contribute to tension headaches. These chemicals are the ones that help nerves communicate, such as serotonin, endorphins, and several others. We are not sure why the levels of these chemicals change. We suspect that the fluctuations activate pain pathways to the brain and probably undermine our ability to suppress pain.”
I think I have figured out your problem Popa, and it is something many people don’t know, which is that everything that we feel, all sensation, eventually leads back to the spinal chord and up to the brain, and the brain is ALL PHYSICAL. It is hard to imagine that everything that we feel every day is actually the result of chemicals passing messages back and forth, but it is true. If you can understand that, then I don’t think you would have much of a problem anymore. Again, there are no mysterious “boogie” forces going around our brain. It is all electro-chemical, biological, and therefore PHYSICAL.
And here you go Popa, this is from the same website. I’m not sure how you can keep arguing against this unless you’re either just trying to annoy people (and also prevent someone from getting a treatment that is proven to help) or if you just truly are incapable if comprehending this, in which case you’re off the hook because I can’t blame someone for their level of intelligence given to them by Hashem. But anyway:
“A study published in Archives of Psychiatry found that MRI (magnetic resonance imaging) scans showed patients with clinical depression had less brain volume in several regions, including the frontal lobe, basal ganglia and hippocampus. They also found that after treatment the hippocampus returned to normal size.
The Stanford School of Medicine says that genes do play a role in causing depression. By studying cases of major depression among identical twins (whose genes are 100% identical) and non-identical twins (whose genes are 50% identical) they found that heritability is a major contributory factor in the risk of developing depression.
An article in Harvard Health Publications explains that depression is not caused simply by the level of one chemical being too low and another too high. Rather, several different chemicals are involved, working both within and outside nerve cells. There are ‘Millions, even billions, of chemical reactions that make up the dynamic system that is responsible for your mood, perceptions, and how you experience life.’
An awful experience can trigger a depressive illness. For example, the loss of a family member, a difficult relationship, physical sexual abuse.”
In other words – depression certainly has physical causes.
Ezactly. And it all starts with a stimulus.
So you need to figure out what the stimulus is.
Well, yes there is always a stimulus. There is also a stimulus to catching any disease – going where the various germs are. And just like the stimulus for any other disease causes (we’re at those words again) BIOLOGICAL and PHYSICAL changes in the body – bacterial or viral cells and organisms to wreak havoc, So too do the stimuli for depression cause (here we go) BIOLOGICAL and PHYSICAL changes through chemical imbalance. But it’s impossible to eliminate the stimuli that cause depression, the same way we can’t really completely prevent ourselves from getting sick. You generally can’t prevent the loss of a family member, or physical or sexual abuse from happening, can you? The stimuli that cause depression – various incidents that can cause grief, will not be eliminated from life, although we’d all love to avoid them. They are part of life. But not everyone gets depression either. Certain people can be biologically more likely to get it. So you treat depression with things that work – therapy or drugs (often both).
Perhaps that stimuli are maladaptive behaviors and thoughts.
It’s funny watching you argue Against established scientific fact. But it’s also kind of sad.
But it’s impossible to eliminate the stimuli that cause depression, the same way we can’t really completely prevent ourselves from getting sick. You generally can’t prevent the loss of a family member, or physical or sexual abuse from happening, can you? The stimuli that cause depression – various incidents that can cause grief, will not be eliminated from life, although we’d all love to avoid them. They are part of life.
Good, so we agree.
Now the question for you is: if you agree that depression might be caused by outside stimuli, isn’t it worth trying to see if you can treat the cause?
Say it was caused by sexual abuse. Isn’t it worth seeing if you can find a healthy way to address the issue emotionally?
Does your regular doctor always just prescribe painkillers to mask symptoms?
CBT does find healthy ways to address the cause. I currently work in the child and family trauma clinic at my university, with a professor who has published numerous articles on PTSD. I can tell you unequivocally that the best way to treat PTSD, which can result from abuse and various other traumatic incidents is the combination of CBT with Exposure therapy (which is really basically a form of behavioral therapy). It is empirical. It is proven to work way more often than not. What do you propose is the best way to go about it? Obviously I would love to treat the causes too and get rid of all molestation and death and grief and traumatic events and…do you see? it’s not very practical to say that. People will be traumatized or depressed and we have methods that are proven to work, that the victims themselves say have helped them. I also think you may be confusing psychologists and psychiatrists. Psychiatrists are medical doctors and really just prescribe pills – for depression, anxiety, etc… Those pills just treat symptoms and often have negative side effects. Psychologists, who use CBT, teach clients how to confront their fears, traumas, and depressive thoughts. That is not just treating symptoms. Anyway, what do you propose?
Lemme ask you something.
Go back to the dog dying sadness. Do you think it might help in that case for someone to talk with you about it? It does, right?
So might there not be some things you could think about and talk about to reverse the damage done by a long term emotional trauma also?
There is something very wrong about just giving up without even trying to fix something.
Also, just realize please how far out of the mainstream you already are by acknowledging that there are outside stimuli that cause mental illness. Most pseudo-psychologists today will tell you it is just purely genetic.
So once you’ve joined my kefira team, why not wonder if there are also outside stimuli that can help after the fact. Maybe ask your professor why he’s never researched that?
Why is everyone giving this guy so much attention? He’s clearly out to get a rise out of you. He’s arguing with complete ignorance as is obvious to anyone following this “debate.” Your words are just giving him more to write about.
PBA-you really gotta be careful. Though I don’t recommend it, some people asking these questions really might rely on The CR people to be honest. So you gotta be careful.
Though-a note to all you users out there-this is NOT the place to go to get your info. Some people know what they’re about, but ?? of them are just having fun.
Well PBA, you did it. You got me to write too. So I gotta grant you that-you are good at getting a rise out of people.
But sometimes when people are depressed, it’s like they die a little every day. So an artificial solution is used to keep them going until the problem can actually be solved in a real way.
Sorry, there are times when I’m just trying to get a rise out of people, and I’d usually admit to it after 75 posts. But this isn’t one of those times.
I truly do hope that people listen to me, or at least consider what I’m saying. It might change your life.
How about everyone try therapy and see if they like it? Sorry, I can’t sponsor it, though.
Popa I have yet to find the psychologist who says that mental illness is purely genetic. In fact, i have never heard of that before…genetics can often play a part. But there can be many other factors as well…not everyone who become mentally ill has family members who are also mentally ill.
I don’t think anyone was ever arguing that depression or other mental illness can not be stimulated by various outside incidents that occur in life. But what we are saying is that those outside incidents spark biological physical change that result in the symptoms of mental illness. Which is why CBT is perfect – It’s cognitive and behavioral. Behavioral therapy treats symptoms such as anxiety while cognitive therapy helps to cut to the core and show the client why their maladaptive thoughts or behaviors are precisely that – maladaptive. And it helps them recognize when the thoughts come and how to avoid their painful results.
I really think you don’t quite understand what exactly CBT is. Or at least you didn’t when you made your ridiculous statement that it’s “narishkeit” and that there are no studies proving it’s efficacy. Maybe now you do. I grow tired of this. My final word is that it is really wrong to discourage someone from getting a treatment that can vastly improve their life. I know the coffee room. I don’t post often, but I know you like to get your kicks by getting a rise out of people. But if you take a deep breath and step back and look at what you are doing, I think, maybe, you can see that you were wrong to just throw out such general, ignorant statements.
Perfect. I’ll also leave a final word.
My final word is that it is wrong to encourage people to pursue treatments such as CBT which are narishkeit and which I understand very well and am well read on.
And I stand by that 100%.
My final word,
It is wrong to discourage people from pursuing a clinically and statistically validated treatment such as CBT, which I understand very well and am well read on.
And I stand by that 100%.
It is improper, perhaps immoral to provide such advice here, unless one wishes to reveal their identity and credentials.
Meanwhile, if I question whether CBT or any other treatment approach is appropriate for me, I will ask an expert in the field and take direction from them.
And I stand by that 100%.
popa,
You are over your head. Stop digging.
It is improper, perhaps immoral to provide such advice here, unless one wishes to reveal their identity and credentials.
Fascinating. And why is that?
Meanwhile, if I question whether CBT or any other treatment approach is appropriate for me, I will ask an expert in the field and take direction from them.
And depending on the random expert you ask, you will do different things? The experts don’t agree.
Why, is CBT used in epidemiology also? My what a wonder therapy it must be.
I continue to be amazed by PBA’s attitude (and some others, too). The mental health field has not been snake oil for many, many years. Yet, it is correct to note that it has been dominated by theory, with various efforts invested in proving things scientifically. Psychology remains a “soft” science, with a limited amount of the concepts proven beyond a shadow of doubt. But it is a science, and anything can be subjected to research to prove or disprove it. I will not entertain debate on the validity of scientific method.
The average mental health clinician is equipped with training that included background if not supervised experience in various therapeutic approaches. Traditional Freudian psychoanalysis still exists today, but has been basically abandoned by most of the mainstream clinicians. Still, most will accept many of the premises of psychoanalytic theory, even though they are not recognized as being relevant to applied psychology. Other therapies also abound. Most clinicians do what they were trained to do, many gaining additional skills through additional training after their degree and formally supervised work.
CBT is one of those approaches that has been subjected to massive research, and the reports of its efficacy cannot be justifiably dismissed. Having noted that, not every clinician is adept at it, and not every case is best treated with it. Often, elements of CBT are included in a therapy plan, and this is done because there are judgment calls by the clinician to use another approach as the main intervention. Still, efforts to dismiss it are simply irresponsible. It remains true that it is not the cure-all for every condition or for every client.
I will repeat my earlier assertion. When I want to seek an eitzah about therapy, I will pose my questions to trained experts in the field, not someone in the checkout line in Shoprite or Pathmark, nor someone on the internet whose credentials are unknown.
Now maybe that is not the answer you want to hear, but I will not be dishonest and lie to you to please your agenda.
CBT has done wonderful things for me. Every penny I spent was well worth it! It is not the only form of therapy that I have tried, and I have found CBT to be extremely effective in teaching me how to take control of specific thought and behavior patterns, and i only had to go a few times! Once u have a handle on whatever thoughts and feelings you are dealing with, and you still feel that you want to get to the root of the problem, regular talk therapy can help you more with that… talk therapy/psychoanalysis on its own was not as effective for me while I was still dealing with the anxieties… Once the emotions were manageable, i was able to start digging deeper to understand them…
I also know other people that have tried CBT and found it extremely helpful.
and btw, regardless of what form of therapy you choose, you have to make sure that u have a good patient-therapist relationship
I will repeat my earlier assertion. When I want to seek an eitzah about therapy, I will pose my questions to trained experts in the field, not someone in the checkout line in Shoprite or Pathmark, nor someone on the internet whose credentials are unknown.
And I’ll still wonder how that is a good strategy, since it subjects you to the randomness of the opinion of which expert you consult. If you consult an expert that agrees with you, you’ll do CBT, while if you consult an expert who agrees with me you’ll do psychotherapy.
Why settle for random?
Didn’t you promise two posts ago that it was your final word?
I’m just curious, BTW, can someone do psychotherapy and CBT? If I get headaches, I may want to reduce the stress which induced them, and/or make sure I get enough sleep to avoid them, but meanwhile, I’ll still take Tylenol.
Or, is like being tired; I can address the cause and take a nap, or address the symptom and drink a large strong coffee, but I can’t do both.
Yes, the same way someone can do medication and psychotherapy.
Ok, then I guess it’s not narishkeit, it just shouldn’t replace psychotherapy.
That might be reasonable.
CBT is a form of psychotherapy
Let’s not bicker over definitions. We’ll just say that CBT shouldn’t replace other classic forms of psychotherapy.
Daas Yochid, that’s exactly what I wrote about in my earlier post… I have done both CBT and regular talk therapy and found them to be extremely effective together
Of course you should consult and be evaluated by a Profesional for your individual case, to determine what approach to pursue. With that said,
I have personal anecdotal support that this therapy works.A few years ago I was suffering immensely from post traumatic stress disorder, I received CBT from a psychotherapist for about 8 months( a 30 min appointment every other week, with a lot of homework in between) The Therapy improved my situation immensely, Although I am still minorly suffering from the trauma, It is very manageable at this point of my life, and I am grateful I received this therapy.
However,this therapy is not like a magic pill! Therefore, it takes time and a lot of self work.(and of course Siyata Deshmaya).
PBA:
Come now. If the subject was a particular “novel” approach in surgery, a new form of chiropractic manipulation, or a newly developed medication, would you make the same broad brush statements? I would hope not. To argue that one must use CBT for everything, or even that it is the only method to treat specific conditions would be foolish. Knowing many therapists from the full spectrum of mental health professionals, I have yet to meet anyone that believes that one single approach is the only one of choice. When any of us commenters here were arguing against your dismissal of CBT as “narishkeit”, some of us countered your pronouncement as rubbish. But, sorry to bust your bubble, no one reputable considers it the only method around. It has a great track record, and many therapists use elements of it in much or all of their work. Neither extreme is rational. And I repeat my position – I will ask professionals before looking to anonymous internet sites or bloggers for advice.
What’s in a name, maybe. I don’t know anything about this, I was just trying to clarify popa’s position here.
Just to clarify yours, if you could only do one, would you do CBT or psychotherapy?
that’s actually a really great question… I think I would choose CBT. here’s why: while talk therapy/psychoanalysis is wonderfully clarifying, gives me the chance to express myself understand why I feel the way that I feel, etc… it can drag on and on and it’s a very slow, gradual healing process that can begin to feel draining (and expensive!). And though there are times during CBT that I wish I could talk more about my thoughts on my feelings, each time I walked out of my CBT therapist’s office, I felt like I had the tools to face the world, face myself, and felt less burdened by my anxieties! I felt strengthened after each session of CBT rather than exhausted from delving so deep inside my thoughts and feelings…
CBT is fast and provides relief! I still use the techniques my therapist taught me years ago… it really had a positive impact on my life! bH
Nothing like a quick fix. Who wants to spend time and energy actually dealing with emotions, when you can just repress them!
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