anythingcouldhappen:

cureforbedbugs:

I was so upset the other day when K-punk wrote a shitty article about how “cognitive therapy doesn’t work because CAPITALISM,” and I didn’t respond to it then, and won’t now, or link to it, because fuck him, and whatever, y’all ignored it for the most part. It’s the only process I’ve experienced that actually works like a medical intervention, in which patient knowledge and behavior outside of the office actively contribute to the process. You finish treatment, you leave, you come back as needed or in a year for a check-up. It’s not the kind of thing where you go in once a week, spill your guts, and are left wondering where it’s all going until you move or miss enough sessions to have lapsed. It would be nice to have that practice established early, too, expected of all parents and children whether or not they think there’s something “wrong” with them (and, obviously, for health care to support that line of thinking).

Usually I’m down with Mark Fisher (k-punk), but he doesn’t know what he’s talking about regarding cognitive therapy. I loathe self-help, pop-psychology culture too! I hate the kind of self-sufficient society people like Margaret Thatcher and Mitt Romney idealize! But when something works, you know, in practice, it kind of behooves you to take a step back and question some of your theoretical assumptions. This is classic baby-with-the-bathwater stuff.

I’m sure there are numbers somewhere, but what I know is how much cognitive therapy helped me when I was introduced to it in my early 20s while suffering from a severe bout of depression. My depression is a clear-cut case of brain chemistry gone wrong (as opposed to situational depression, although bad situations exacerbate it), so antidepressants have been enormously beneficial too. But cognitive therapy helped me rewire my own brain so that I don’t automatically turn objectively neutral situations into negative ones and negative ones into fiascoes. I’ll never be completely “cured,” but I can recognize when I’m blowing something totally out of proportion (e.g. someone frowned at me, he obviously doesn’t like me, nobody likes me, I’m an unlikeable person, the world would be a better place without me, etc.). It’s not that having such feelings is wrong, per se, but that they make you miserable. The goal is to stop making yourself miserable. And the beauty of cognitive therapy is that it’s simple, inexpensive (yes), useful to people with different kinds of mental health issues and effective even when applied selectively. You don’t have to swallow a belief system or overhaul your personality, you just need to understand that while you can’t control many things in this world, you can control how you feel about and act on them.

Well, OK, I’ll talk about it a little bit. [EDIT: article is here] I think that what seems to be the impetus for the critique — even if it’s a mischaracterization of the subject — is actually worth thinking about: “What if people really are perceiving you negatively beyond your control because of this that or the other characteristic, as a facet of institutionalized racism etc.?” [EDIT: Or, to speak to Fisher’s point, “what if your poor living conditions can’t be changed for reasons beyond your control” — though I have lots of problems with the general line of logic here, that “strategies can help you with depression and anxiety” must somehow mutate into a convenient rightwing ideology of the self being responsible for all well-being.]

And of course, the answer is: “cognitive therapy has zero to say about this, because it even though it has a lot to do with anxiety and depression, it doesn’t have a lot to do with anything beyond strategies for dealing with the acute everyday manifestations of anxiety and depression” Just as heart surgery has zero to say about the ethics of fast food advertising, available diet, etc. etc. etc.

What K-punk seems to be conflating is a kind of individualist self-help mentality with the actual body of evidence around cognitive therapy (which is “self-help” to the same extent that being mindful of any other health consideration is “self-help” — if your strategies are delusionally affirmational, you’re not doing cognitive therapy, you’re being delusional. And, in fact, delusions of affirmational grandeur are often symptoms of low self-esteem). It would be like blaming actual neuroscience for the pop bullshit versions of neuroscience that are extrapolated from the limited things neuroscience can do to absurd realms that it doesn’t actually speak to.

But if you want to attack the pop-bullshit versions of theory — and hey, why not, the world would probably be a better place with fewer Jonah Lehrers in it — the way to do that would be to name and shame those pop-bullshit versions, not to throw out an entire field on the basis of its charlatans. And if it’s charlatans all the way down, well, you’d better be prepared to actually go all the way down.