I’ve been thinking a lot about why there is so much aversion to speaking about behavioral health. Why is there a stigma associated with a problem that so many people face? I believe that the best explanation is that people just don’t understand it. We believe that since we can’t measure someones depression or anxiety with a number or a lab test, then it must not be something of consequence. We also have been conditioned that feelings are a sign of weakness.
Recently, however, there has been a movement away from this traditional view of mental health. I, for one, have noticed an uprising of groups on social media platforms that are tackling these issues head on. Folks are starting to recognize that feelings are a normal part of the human psyche. It’s how we deal with these emotions that lead to either strength or weakness.
This brings me to my topic of Cognitive Behavioral Therapy (CBT). Whatever the stigma that is associated with mental health in general, multiply that by about 10 fold and that’s the stigma associated with Psychotherapy. I want to talk a little bit about what we think CBT is and how that it’s stigma is dramaticized into something it is not. Then I want to talk about what it is and how it can help people suffering from behavioral disorders.
What Do we think of?
If your are like me and came of age in the late 80s, you may well remember the film “Bill and Ted’s Excellent Adventure.” Two dopes who are on the verge of failing a high school history course are sent on a course through time in a phone-booth/time machine hybrid to collect various important historical figures to give their impression of modern day San Dimas, California. (Their only chance to pass History was to get an A + on their final project, which was to get historical figures take on modern day San Dimas) A real gripping piece of American Cinema. Despite it’s ridiculous premise, the film is quite entertaining and at least provides an introduction to the identities of some pretty significant figures in world history.
One of these figures is Sigmund Freud (pronounced “Frood” by the title characters). They come upon Freud in 1901 Vienna, Austria. They capture him by having Billy the Kid throw a lasso and bringing him into the phone booth and away they go through the circuits of time. Well they bring Freud back to modern day California, and after a brief run-in with the police, they make it to their final presentation. During that presentation, Ted lays down and Freud performs psychoanalysis on him. We are given the impression that Freud has dug into Ted’s brain solo and made him feel feelings that he’s never felt before.
I really think this is what most folks see when picturing what they think behavioral therapy looks like. You sit down, tell your therapist all of your problems, and then they tell you some hallmark event in your life that has triggered you to act the way you do.
What CBT is Really
The type of therapy that Freud was performing on Ted is an actual form of psychotherapy. It’s called psychoanalysis. It was popularized by Freud and then continued by students of his teaching. But this intense, deep analysis has fallen out of practive in favor of the more documented, evidence based Cognitive Behavioral Therapy (CBT).
CBT is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.
In CBT, the psychologist and the patient work together in sessions to develop a plan to combat the issue that the patient is having. It is not like psychoanalysis where the practitioner comes up with a solution on his/her own and the patient is to adhere. Psychoanalysis is much more involved usually taking 2-3 sessions per week for up to several years. CBT is a much more integrated approach. There is much more emphasis on the patient to become their own therapist. Through exercises in the session as well as “homework” exercises outside of sessions, patients/clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions and behavior. It also is beneficial because it focuses on what it is going on presently in a patient’s life, instead of focusing what happened in the past. I find this particularly helpful because we can always change our present, whereas we can never change our past.
In our world, CBT is shown to be both the most evidence based and practical approach to combatting mental health disorders. It’s an integrative care approach to helping the patient/client become more self sufficient in their care. The problem we are running into is the lack of clinicians in relation to the population. This is especially true in rural areas and farm country. The majority of clinicians are located in metropolitan areas. Farmers and other folks in rural communities have a lack of access to these areas. We also see a problem with third party insurers paying for such therapy. So, in short, the two biggest obstacles to better implementation of CBT is accessibility and affordability.
So what can we do. We can begin to normalize our the access to CBT. I’ve had my own experience with CBT that I will talk about in another post. But I will tell you that I believe that CBT was the crucial first step to me dealing with my own issues. I learned methods that helped me cope along my own journey with battling my own demons. I believe if we talk to more people who have underwent CBT, we would be able to further see more specific benefits.
If you are willing and feel comfortable, please leave a comment regarding your own thoughts on CBT. If you have experience with this treatment, please share your story. I appreciate you taking time to read this today and hope it shed some light on what CBT is and how it can be effective. My hope is for CBT to be as normal as going to the doctor for a sinus infection. Please subscribe to my blog and share with those who you may know.