A (very) critical "review" of CBT: individual psychotherapy

Now, to say at least something nice about the CBT-program which I did: The psychotherapists were nice, kind and, I think, understanding. However, in the time I was there I had four different therapists and that’s not because I didn’t get along with one or the other, but because they have contracts which suck as well: Their contract ran out, so they switched to a different position. 

Therefore I obviously couldn’t really discuss anything with them in depth, due to the time constraints. However, that wasn’t too bad, because I wouldn’t have known what to discuss anyways. I told them about the struggle with my PhD, but I feel like twitter is the better place to discuss that, because the details are of course difficult to understand for people who don’t work in research.

So, it was nice that they were sympathetic and at least pretended to understand how I was feeling, but I’m not sure that did anything to help me with depression, though I do think it possibly made staying at the hospital (which is not the nicest place to be) a bit easier. But then, on the other hand, they try to figure out why you are depressed, i.e. which live events made you depressed. Maybe I’m just not good at arriving at hypotheses (regarding that) in which I feel some sense of certainty (though of course you fundamentally can’t know), but I don’t know why this happened to me. My working environment might be a candidate (for a cause) but I really don’t know, I liked my work and I liked what I was doing (mostly), I feel it would be unfair to blame that entirely. 

But then, psychologist come up with their own hypothesis, like maybe your parents avoided and ignored you as a child. Of course they state it as a hypothesis, not a fact. They barely know you, let only your parents, so how could they? But still, a hypothesis that is spoken out is something you think about, is it true, is it not true, how can I know whether it’s true or not, I only have my memories and not the ones of other children and no one did an experiment on my family (well, I hope ;)) to figure out if I was treated worse than other children. So how could I possibly know? And, I dunno, but I think this can be the side-effect of psychotherapy: That you search for a cause, because there has to be one (hasn’t there?) and start to reinterpret (normal or maybe not so normal) events in the light of that hypothesis. (Depression certainly can help with that…). And I just don’t know if much is gained with that; if I’d think of my parents as bad parents (I don’t!) how would that help me (other than avoiding the awkward moments when I’ve to explain that I don’t know how it happened)?

A (very) critical "review" of CBT: music therapy

Even though the psychotherapy program I did for depression was called "cognitive behavioral" it had some elements which I’d classify as psychodynamic, namely the "art-therapy" and the "music-therapy". Luckily I got rid of both of them pretty fast.

In the art therapy we had to do stuff like drawing our feelings. Surely you can make up a visual metaphor for everything, but to me it didn’t make a lot of sense, nor did I want to provoke the therapist with blank papers. The music-therapy however was a lot stranger than that, it didn’t have really anything to do with music, even though that’s what it was called. Well, to be fair, I could have played an instrument, the therapist had asked if I wanted, but I didn’t want. So she thought up her own therapy for me, which consisted of figuring out how many parts you (I) have and naming them. Since I told her, that I am, fortunately or not, only one person, who – as everyone else – of course has different personality traits or aspects but no different parts, she did the work for me and defined and named different parts. I don’t remember all of them, but one was the self and a supposed other one was a waiting person. She wrote these "parts" on individual pieces of paper and asked me to lay them down on the floor. So I did; I placed the stack of papers on the floor. Of course my stupid part didn’t get *how* she wanted the pieces to be laid down; I had to put them besides each other, kind of like a mind map. But even when I did that, it wasn’t right. The therapist didn’t feel that I’d placed them the right distances apart, so she asked me to step on one piece of paper while she stood on another and asked me if that was a comfortable distance. It was not, I don’t like standing face to face with another person, without any distance. But I’m sure this didn’t have to do anything with the pieces of paper on the floor. So I told her about my suspicions about cause and effect here. And that’s how I got rid of that therapy :).

To be honest it is quite mysterious to me why the health insurances even pays for a therapy like that. They don’t if you are not inpatient, but if you are in a psychiatry they pay for all kind of stuff. However, there were other patients (though not many!) who said that it helped them. But then, if it’s not evidence based (and it isn’t by the insurances own criteria; otherwise they had to pay it on an outpatient basis as well), you don’t know what else might have helped them….