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Is cognitive-behavioral therapy really all that good for schizophrenia?
I am being deliberately provocative with my title. What prompted today’s post is an article about careers for the coming decade. Cognitive-behavioral therapist is one of them, the reasons given below.
The Mental Health Parity Act requires that mental health now be covered as fully as physical health, but many insurers will cover only cognitive-behavioral therapy because it’s both shorter and, on average, more efficacious than traditional psychotherapy. Learn more: Association for Behavioral and Cognitive Therapies.
My blog is USA-centric, even though I don’t live there, for the reasons that the USA tends to drive the way the world sees things, for better or for worse. Is it throwing the baby out with the bath water by favoring CBT over other kinds of psychotherapy when it comes to schizophrenia? Schizophrenia is not garden-variety depression. It’s not about coping with a dead-end job or having your wife leave you or your dog die. Schizophrenia is the larger than life mother of all existential blow-outs. People who come under its influence deserve the best psychotherapy from the most skillful therapists, which may not be cognitive-behavioral therapy and probably isn’t in most cases. I don’t want to rain on CBTs parade. I just think that schizophrenia is more complex than what CBT can deliver.
Here’s another viewpoint about this from Psychminded.co.uk. … there are radical approaches in psychotherapy that are especially vulnerable to state regulation, approaches that really do provide the space to speak freely. Some approaches like ‘cognitive behavioural therapy’ are unfortunately compatible with state regulation because there is an assumption in them that there is a correct and incorrect way of thinking about the world.
People experiencing a crisis of schizophrenia do not think about the world conventionally, and I wonder really how effective CBT is in helping them grapple with their myths and heroic struggles. CBT may be cost effective for governments, but will it really up to the job of helping people in severe existential angst get on in a conventional world?
Getting there sooner rather than later
Another reason why I like the book, The Alcoholism and Addiction Cure by Chris Prentiss is because he maintains that if you want to get to the bottom of your problems, the multiple therapy approach is best and it works faster. Many people can go for years seeing the same therapist and never become well or else not well enough. This may be because they are undergoing the wrong therapy or perhaps because they do not have a good rapport with the therapist.
Since the goal for everyone should be to resolve their problems as quickly as possible, people should be free to pick and choose their therapy and their therapist, and use several different therapy approaches. People should be free to choose but in reality they are not, as I have found trying to ask Chris’s doctors for the use of other therapies while he was under their care. Just because psychiatry is slowly opening the door to acknowledging the value of Cognitive Behavioral Therapy for schizophrenia doesn’t mean that CBT should be the only therapy employed. CBT may not work for you.
Cognitive Behavioral Therapy can be slow going, so I have introduced Chris to Family Constellation Therapy, sound therapy including the Tomatis Method, and Emotional Freedom Technique. I am of the strong opinion that schizophrenia needs to be solved at the intuitive level. You literally have to become a different emotional being inside your body in order for your sense of self to develop.