Cognitive Behavior Therapy

On Fridays, the federal government has me attending a group therapy program. My notes from these sessions are to be found under “group session notes” or by reviewing the Supervised Release archives link (look at the right hand side of your screen).

My new PO has been keen to know how my “treatment” is going. 

I decided to (finally) check into what kind of therapy it is I am in the middle of, and that led me to the National Library of Medicine's entry for Cognitive Behavior Therapy. 

Now, my takeaways from reading that entry.

In the 1960s, Aaron Beck developed cognitive behavior therapy (CBT) or cognitive therapy. Since then, it has been extensively researched and found to be effective in a large number of outcome studies for some psychiatric disorders, including depression, anxiety disorders, eating disorders, substance abuse, and personality disorders. It also has been demonstrated to be effective as an adjunctive treatment to medication for serious mental disorders such as bipolar disorder and schizophrenia. CBT has been adapted and studied for children, adolescents, adults, couples, and families. Its efficacy also has been established in the treatment of non-psychiatric disorders such as irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, insomnia, migraines, and other chronic pain conditions. (footnotes omitted)

Back in 2010, I was diagnosed as having severe depression. This blog is a chronicle of my dealing with my depression. 

The following is the curriculum of the group meetings, so I am correct connecting with this article:

Cognitive Distortions

Errors in logic are quite prevalent in patients with psychological disorders. They lead individuals to erroneous conclusions. Below are some cognitive distortions that are commonly seen in individuals with psychopathology:

• Dichotomous thinking: Things are seen regarding two mutually exclusive categories with no shades of gray in between.
• Overgeneralization: Taking isolated cases and using them to make wide generalizations.
• Selective abstraction: Focusing exclusively on certain, usually negative or upsetting, aspects of something while ignoring the rest.
• Disqualifying the positive: Positive experiences that conflict with the individual’s negative views are discounted.
• Mind reading: Assuming the thoughts and intentions of others.
• Fortune telling: Predicting how things will turn out before they happen.
• Minimization: Positive characteristics or experiences are treated as real but insignificant.
• Catastrophizing: Focusing on the worst possible outcome, however unlikely, or thinking that a situation is unbearable or impossible when it is just uncomfortable.
• Emotional reasoning: Making decisions and arguments based on how you feel rather than objective reality.
• “Should” statements: Concentrating on what you think “should” or “ought to be” rather than the actual situation you are faced with or having rigid rules which you always apply no matter the circumstances.
• Personalization, blame, or attribution: Assuming you are completely or directly responsible for a negative outcome. When applied to others consistently, the blame is the distortion.

But this article raises problems for me.

Underlying beliefs shape the perception and interpretation of events. Belief systems or schemas take shape as we go through life experiences. They are defined as templates or rules for information processing that underlie the most superficial layer of automatic thoughts. Beliefs are understood at two levels in CBT:

Core Beliefs

• The central ideas about self and the world
• The most fundamental level of belief
• They are global, rigid, and overgeneralized

Examples of dysfunctional core beliefs: 

• “I am unlovable”
• “I am inadequate”
• “The world is a hostile and dangerous place” 

I emphasize that sentence because I do think that way. If it were otherwise, there would be no murders or wars. Genocide would be in our dictionaries. We would not have plagues or hurricanes or blizzards. Nor would we have governments or natural selection. The former means to ameliorate the world's dangers (see John Locke and Thomas Hobbes if this idea is alien to you.) Without a dangerous world, there is no need for adaptation, therefore no evolution.

Moving on.

Cognitive behavior therapy is a structured, didactic, and goal-oriented form of therapy. The approach is hands-on and practical wherein the therapist and patient work in a collaborative manner with the goal of modifying patterns of thinking and behavior to bring about a beneficial change in the patient's mood and way of living his/her life....

The Friday meetings are structured - the person leading them rattles off the concepts.

Didatic? Obviously.

Goal-oriented? No one has told me what the goal is for me.  It seems to me that the goal is to persist in lecturing the same material until one is released from probation or three years, whichever takes longer.

Following upon goals:

Most psychotherapists who practice CBT personalize and customize the therapy to the specific needs of each patient. 

This is a group meeting, there is no sign of customization. There is nothing done to apply the ideas expounded to anyone's specific experience, let alone needs. 

And nothing like this has been done:

The first step is an assessment of the patient and the initiation of developing an individualized conceptualization of him/her. The conceptualization based on the CBT model is built from session to session and is shared with the patient at an appropriate time later in therapy. The approach to therapy is explained very early at the start of the therapy. The problems patient would like to work on in therapy, and goals for therapy are decided in the first or second session collaboratively. The prioritized problems are worked on first.

 So, I am being treated for depression as part of a sex offender management program? Or is it the SOMS as treatment for my depression? 

I have no idea, other than this is your tax dollars at work.

sch