Cognitve Therapy-Why It Does Not Work In Every Psychological Condition



Posted: Wednesday, November 02, 2005

by Pradeep K Chadha
Dr Pradeep K Chadha

A lady was once referred for treatment for emotional distress. This distress had resulted from unpleasant memories of having undergone sexual abuse. In her case cognitive therapy had been unhelpful, Her own opinion was that cognitive therapy did not address the anger and fear that she was feeling strongly .

There are many approaches in therapy that are available for anyone who wants this service. Cognitive Behaviour Therapy (CBT)is the most well known, because it is the most researched form of therapy. CBT is the product of the West, where people are encouraged to think and discouraged to feel emotions. CBT is based on the premise that our thinking can change our feelings.

This is not always true. When people undergo abuse or torture, no amount of thinking is going to sort out the feeling of rage that underlies such experiences. The rage that one feels about such experiences overwhelms the thinking ability of an individual and the person still ends up acting out the emotion. In all such cases CBT fails to get any results. Yet because it has been written about widely, mental health practitioners erroneously believe that it is the only suitable form of therapy in almost all forms of psychological conditions.

A middle aged man, enraged by an ex-employee’s deception wanted to harm the ex-employee physically. Overwhelmed by anger, he felt that the only way the person would realize how they felt was by conferring physical pain. No amount of reason or logic was useful. According to him, ‘action had to be taken’. The best solution in this case was to reduce the anger by releasing it. When it was done in a few minutes, he thanked me for helping him out of the situation. The perception had changed. The thoughts were non-aggressive. Needless to say, he did not act out the rage.

When our inner drives are strong, they overwhelm our thinking. At such times reason or logic is governed by the drives. Anger is one such emotion. When it takes the form of rage, the person may lash out physically. The solution does not lie in reasoning with the person, but to help the person reduce the drive. In other situations when the anger is in the form of annoyance, reason can still be used to ‘distract’ the person away from the issue. But the feeling stays. To distinguish between times when behaviour can be changed by thinking and when it cannot be changed by thinking requires wisdom.

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Top-level comments on this article: (4 total)
» left by Leeland Durst
from E Wenatchee Wa
6 years 15 days ago.
I am doing research on cognitive therapy and I found your article to be so interesting that I read the whole thing. I think that music therapy can help to open up a person to learn from cognitive therapy.
» left by econdude
4 years 285 days ago.
As a doctor (assumedly in psychology) you know more about the brain than I do, but my thought was that a thought registers through the emotional part of the brain first and we have 'feelings' about a thought before we consciously 'think' about it. So how would cognitive behavioral therapy do anything to help with negative emotions? CBT does help - it helps your therapist with his or her down payment on the $500,000 dream house they're building.
» left by Leeland Durst from Ellensburg Wa 3 years 125 days ago.
Cognition treatment helps to stop a person from overreacting by mentally preparing that person before the situation happens. The release of anger should happen through the mental release of the emotion not the physical. Lee
» left by Lee
from net
3 years 125 days ago.

Interesting that people are so quick to negate rational thinking.

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