Posted by mattdds on June 2, 2003, at 11:29:39
In reply to Re: CBT and metacognition » mattdds, posted by Dinah on June 2, 2003, at 10:59:36
Dinah,
My apologies for misinterpreting your comments. I have my own insecurities that sometimes become quite apparent. You see, had I been in metacognitive mode, I might have seen other ways of interpreting what you said <wink>.
I will be the first to admit that CBT works better for some than for others. And you're absolutely right in that it is extremely dangerous to "blame" the patient. But this is not the impression I get from CBT. Perhaps from some misguided CBT therapists, but not CBT in general.
For example, one of the "cognitive distortions" is, in fact, blame! David Burns does a very good job of dispelling the myth of blame (even for treatment failure). Blame is just an extreme oversimplification of a phenomenon that had too many variables for us to see, so we attempt to find a scapegoat. In depression, the scapegoat is oneself. In anger, another person.
You see, you interpret CBT as "blaming" you or "faulting" you. Perhaps you had a therapist that "blamed" you for not getting better. This is unfortunate. I agree that this is extremely misguided, and counterproductive. There have been studies that have shown that therapeutic empathy strongly predicts whether patients will remain in treatment (and subsequently get better)
On the other hand, if I cannot take at least some responsibility for my own recovery, than even the best therapist in the world has no chance of helping me. We need to move past this myth of fault and blame, and work on real problems. Blame (and the guilty feelings that follow) is just another delusion in depression's vast repertoire.
I see CBT as holding me personally responsible for my own state of affairs, but not in a "blaming" or "faulting" way. Again, there is a subtle but definite distinction between "blaming" and "holding responsible". Being held responsible for my own recovery is, to me, empowering! I am no longer the helpless victim, but the master of my destiny.
Best,
Matt
poster:mattdds
thread:230572
URL: http://www.dr-bob.org/babble/psycho/20030529/msgs/230792.html