Comment by G5ANDY | Hacker News Reader

Comment by G5ANDY | Hacker News Reader

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Unfortunately, as it is practiced, this IS what CBT ends up being a good deal of the time. CBT has an implicit, and sometimes explicit, mechanistic view of human nature. This can come off as extremely judgmental to vulnerable and intelligent clients. Other approaches, like Motivational Interviewing, adopt a neutral stance that offers the potential for clients to actually explore their feelings instead of just getting rid of them.

http://en.wikipedia.org/wiki/Motivational_interviewing

Edit: re-reading my comment, I think I am coming off too hard on CBT. There are real reasons why clients can come out of CBT thinking the therapist is trying to find what is twisted with them or having them fill out pointless booklets - this does not completely undercut what CBT is about. There is good working going on to combine CBT with Motivational Interviewing to improve treatment of depression and suicidality.

http://www.selfdeterminationtheory.org/SDT/documents/2011_Br...

i am doing CBT (not often though, busy travelling work schedule). I suffer from bipolar I, and while the medication was the one thing that just completely changed my life, CBT is there to help me to:

- figure out my mood. this is about keeping checklists on how long i sleep, how i feel, if i took my medication, if i ate correctly. this sounds terribly stupid, but it is very hard for me to even understand what i am feeling. seeing a little graph that tells me "you have been sleeping 16 hours a day for the last 2 weeks, and now you are barely able to sleep for 3 hours, something is going on" is very helpful.

- figure out what i need to do when certain patterns have been recognized. this is for example upping up on sports, being careful about diet, going out to see people when i'm in the down phase. and conversely cutting down on sports, going out, meditation (which makes me way too energetic and stimulated), stimulants when being too far up.

- figuring out my own personal triggers and signs for depression. this is starting to come along, and these are kind of "personal" things. if i want a new tatoo, or learn a new skill or programming language, i should be careful because this is what usually accompanies mania.

it also involves meeting with other people with the same illness, and just for a few hours every year feeling that you are not the only one in that mess.

an interesting thing about the mood graphs is suddenly realizing that a lot of these mood swings actually come out of the blue, or are more related to seasonal effects. it is my brain tricking me into finding causes and patterns and reasons. i don't want to commit suicide because nobody loves me, it's more i think nobody loves me because i am depressed because i haven't gone out for 2 weeks and missed out on my medication 3 days in a row. or because it is december.

i find CBT (at least with the practictioner i have) to be a very no-bullshit pragmatic approach to handling the psychological side of the illness.

but seriously (and in a way, thank god i have bipolar), medication works extremely well, and the one i take (lamictal) has almost no side effect.

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