Training in 'concrete thinking' can be self-help treatment for depression | Hacker News Reader

Training in 'concrete thinking' can be self-help treatment for depression

sciencedaily.com

104 points6ren26 comments

I hope this isn't a stupid question, but how is this significantly different from Cognitive Behavioral Therapy? My understanding of CBT is that through guided training you are able to take the automatic negative thoughts you have and through introspection realize that they're not as devastating as you may think they are, and over time and with practice you turn the automatic negative thoughts into more realistic and optimistic thoughts.

EDIT: This is not to imply that this technique is bad; on the contrary I'm very fascinated by the topic, and just want to make sure I understand it.

I agree. It seems exactly like CBT to me. I have a pretty bad anxiety and Obsessive disorder myself and have been in therapy and actively practicing CBT and this article kind of confused me because it seemed so similar.

CBT isn't a technique in itself, it's more of a general strategy. This seems to be a particular CBT technique.

I am working on an App (web and phone-based) that aims to encourage this sort of change in thinking with a focus on depression. If you, or someone you know, are interested in being a Beta tester drop me an email - me@alexmuir.com - it's a couple of months off being ready for testing.

I'm curious to know if you're worried about lawsuits at all.

There are plenty of "mood chart" apps, which are used with self-guided Cognitive Behaviour Therapy. There are self-guided apps, websites, and books for CBT too.

Why would lawsuits be a problem?

Not really. If the company is successful enough to be worth suing then brilliant. If the app does any harm to people (pretty unlikely I think) then a lawsuit will be the least of my worries.

Alex, I wouldn't be worried of the app harming someone so much as someone hurting themselves and their family blaming it on you or your app in a search for a cause of their loved one's suicide.

Add in a lawyer who smells a case, and you could wind up in legal trouble quickly without actually harming anyone. Don't give up on it, just shield yourself appropriately.

As far as waiting until you are successful to do this, there's really no way for you to tell what mental state a purchaser of your app is in, and however unlikely it may be, a tragic scenario similar to what I described above could happen to one of your first users. I think in your case it would be wise to protect yourself now instead of waiting.

Speaking as someone who once felt the same way, and has been paying lawyers the equivalent of a mortgage payment for the last three years, do yourself a favor and look in to insurance. At least some basic form will give you something to throw at a plaintiff should the day arrive. Attorneys working on contingency are incredibly difficult to convince that your start-up has no assets, and they seem happy to drag the suit out until you do.

As a person who used this technique on himself to get out of depression, I can attest that it does in fact work. Anecdotal evidence be damned!

Takes a lot of will power though and does not work every single time since it's the mental equivalent to solving the halting problem.

This new research looks very much like Martin Seligman's theory of learned helplessness developed 25 years ago.

His book 'Learned Optimism' is good.

Learned Optimism really helped me:

https://github.com/raganwald/homoiconic/blob/master/2009-05-...

Interesting, I'm going to check this book out now, thanks.

Your comments regarding the community were dead on. The ad hominem and personal nature of so much, well, I hesitate to even call it criticism since it's really just thinly veiled hate, has got to stop. It's absolutely a recipe for creating unhappiness, for making people feel bad, and for turning off potential contributors.

"A third received their usual treatment from their GP, plus CNT"

"This is the first demonstration that just targeting thinking style can be an effective means of tackling depression. " (emphasis mine)

While I don't doubt it can be effective, this study is only the first step towards CNT being anything resembling a silver bullet.

Anyone have a link to the actual paper?

http://journals.cambridge.org/abstract_S0033291711002480

Interesting to find a study that shows how changing your thinking may reduce depression. Coming from the other side (happiness research) in a study from 2006, Sonjy Lyubomirsky et al showed, that talking or writing analytically about negative events positively affected the overall happiness of the participants even several weeks after the event.

http://www.faculty.ucr.edu/~sonja/papers/LSD2006.pdf http://www.faculty.ucr.edu/~sonja/papers.html

Can someone clarify what 'concrete thinking' actually is?

The opposite of abstract thinking. Only thinking about specific, real things that actually exist and you have to deal with, rather than constantly thinking in hypotheticals etc. It involves confronting the definite, physical, "embodied" aspects of problematic experiences, rather than thinking too abstractly about the causes and effects.

From the paper:

"In CNT, the training exercises involved patients’ identifying a recent mildly to moderately upsetting difficulty and working through standardized steps to facilitate concrete thinking: (i) using mental imagery to focus on sensory details during the difficult event, noticing what is specific about the event and the context in which it occurs; (ii) noticing the process and sequence by which the difficult event unfolds (‘How did it happen?’), including warning signs and actions that may have influenced its outcome; (iii) focusing on how to move forward by specifying the particular steps and behaviours to do next (Watkins, 2009; Watkins et al. 2009)."

Seeking advice from HN members:

My spouse is under depression and has such symptoms. Yet, I do not think I'll be able to convince her of undergoing such training. She refuses to believe she is under depression, which is due to an ego issue from being a meditation practitioner / counselor herself. Yet she has exactly the symptoms described -- over-generalization of any small negative thing to ultimately falling into an infinite loop about all the problems she has and shouting at me or my kid for several hours straight. This happens about twice a week.

Could I be doing something that can help? Thanks for any advice.

Apologies if this does not belong to the HN forum.

Depression is caused by many things, but exercise helps most people suffering from mild to moderate depression. I would try asking her if she'd help you keep up your new jogging/workout regimen by doing it with you. If she's already fairly active, I would try improving her nutrition. This explains it better: http://www.hypoglycemia.asn.au/articles/depression_disorder....

During a very difficult time in my life, a friend of mine would interrupt my pity parties by listing some of the good things in my life (or insisting that I do so) and then telling me "now smile" and telling me what a lovely smile I had. It did me a lot of good in terms of both helping me get through a very difficult time in my life and also breaking a bad habit/preventing me from getting mired in something bad.

My oldest son used to do stuff like this as a child -- get wrapped around the axle about what a bad child he was because I crabbed at him for not doing his chores or something. He was maybe 14 when we were in the car one day and heard a news blurb about a teenager (14 to 16 years old) being tried as an adult for murder in a bank robbery case. I turned to him and said "Killed anyone here lately? Robbed any banks? How bad are you really?" And then talked about, yeah, I really need you to do your chores and I will crab at you when they don't get done because it's actually important to our quality of life, but if your mom bitching at you about not taking out the trash is your biggest problem, then life is really not that bad. This incident was a watershed moment and he never went back to being so very prone to wallowing in self pity and giving himself such a hard time.

So it is possible to do this for someone else even if they don't want to do it for themselves. You have to be gentle and have good timing and not wear out your welcome (ie don't simply sound like a nag, which is not a positive experience). But judicious use of such interventions can make a permanent positive difference.

Best of luck, whatever the answer turns out to be.

I wonder how his would work with people on the Autism Spectrum? One issue they have is with not handling abstract thinking yet they are quite prone to depression.

So, basically, stoicism.

And Zen. A common solution to a common problem. Therefore plausible it will work.

Yeah. I wonder how the results would be if they were told it was "Zen" or "Stoicism" or some type of set philosophy, ya know? Maybe people would attach to it stronger like people attach to religion.

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