And the little bears growl to each other, “He’s mine,
As soon as he’s silly and steps on a line.”
A.A. Milne’s poem is about the childhood superstition that you must never step on the lines between paving stones or something bad will happen to you. It was first published in his 1924 book of poems, When We Were Very Young. Milne is now best known as the creator of the “Bear of Very Little Brain”, Winnie-the-Pooh.
The entire poem, Lines and Squares is quoted by Judith L. Rapoport in her book Obsessive-compulsive disorder in children and adolescents, in an informative passage (which you can read online) about superstition and ritual, and their relationship to obsessive-compulsive disorder (OCD).
Her conclusion is that these rituals and OCD are quite distinct (p. 307):
Rituals in normal children enhance their socializing process, help them master anxiety, and advance their development. In contrast, obsessive-compulsive rituals are incapacitating and painful, promoting social isolation and regressive behavior.
Rituals and superstitions are also harmless in adults, by the way, if they enhance or at least do not interfere with everyday life.
In a searing denunciation of phoney CBT, “You Own Your Own Feelings” or the Limits of CBT DeeDee Ramona describes her anger at incompetent therapists who thought they were practising CBT when they were only playing games of blame-the-victim with their patients.
The technique is to lecture patients about how their feelings are their own choice, creating a make-believe world in which feelings carry no meaning and can be adopted or discarded at will. So if the patient is troubled by certain feelings, all the patient has to do is unfeel them, and that’s that. What’s the problem? If the patient refuses to unfeel the bad feelings, then the patient must be wilfully refusing to get better.
They were telling me that it was entirely a matter of choice if I chose to be upset about, among other things, severe physical abuse and sexual type abuse dished out to me by a schoolteacher, constant emotional and physical abuse in the home til I was about 16, a string of abusive boyfriends etc etc etc.
I chose to let these things bother me, evidently. If I chose differently, which of course I could, since I owned my feelings, I would no longer have these things bothering me. Nice little logical extension of CBT and solution to all my trauma-related problems in one, natch.
But not all CBT is like that, she later points out:
CBT is great for me. It’s wonderful in dealing with fear of heights, or thoughts that people in the street are looking at me, or worries about the standard of my work. It’s made a big difference to my quality of life. I last used the skills last night, when I was getting weird phobic thoughts about a DIY project I’ve been working on. I did a written exercise and rid my mind of those nasty thoughts.
Commentators generally agreed. For example, Lorna:
It’s a useful tool. But when you know your feelings are based on XYZ irrational thoughts and the feelings are going “phlllbt, don’t care!”, you’ve exhausted it… And when you’ve used it up but there’s things it cannot fix, and you’re being told you aren’t getting any better because you’re not doing it hard enough, it’s a little discouraging.
Then Jessa got nearer to the truth:
I have a friend who recently had a manic episode. Throughout it, she was CBTing her thoughts all the time. Why am I angry at this guy? Why am I angry at his mom? The CBT itself is what put her feelings in a bottle. CBT told her to assume her anger was pathological, and examine it away, which prolonged her problems because her anger really was appropriate.
The kind of techniques that Jessa described as “CBTing her thoughts” are nothing more than superstitious behaviours that you adopt in a childish way to make you feel safe. They are no better than being careful not to walk on the lines between paving stones. They don’t really do anything except throw you back to a childish and ineffective way of interacting with the world. So if you started out with problems, after learning to “CBT your thoughts” you have even more problems.
That’s the easy part to understand. The next part is more subtle: The technique inflicted on DeeDee is also a throwback to a childish and ineffective way of interacting with the world.
The two techniques are essentially the same. They both rely on superstition. It’s just that the “own your own feelings” superstition does not give its victims any ritual to observe, making it difficult to believe in, while the “CBTing your thoughts” superstition does give you rituals, making it easy to believe in.
Both of these techniques are harmful because they ask intelligent adult patients to behave like superstitious children. Victims of these techniques are trapped by a combination of their original illness and the phoney cure, unless they work out what is happening to them.
Being subjected to “CBT” of this kind is a little like joining a cult. You are told crazy things, and you are pressurized into to believing in them, denying the reality of your own experience and your sense of self. Ritual and superstition are used to reinforce the cult’s power over you…except it’s not really a cult — no one is in charge, no one is getting anything out of it — it’s just a kind of cult-like non-therapy.
A related article by Martin Robbins at The Lay Scientist complains about lack of ‘regulation’ for practitioners who offer all the various treatments, including psychological treatments, for medical conditions: Drowning in Alphabet Soup: The Wider Battle for Health Regulation
In particular it makes no sense at all that alternative “medicine” is not subjected to the same rigorous regulation as normal medical practice.
Martin describes hiself as having a common theme in his career — “understanding complex systems”, but his article makes me think that simple ideas about regulation in medical treatment are a little beyond his grasp.
One such simple idea that anyone working in this area needs to understand is: ‘regulation’ gives credibility to the practitioners who are ‘regulated’. The therapists who mistreated DeeDee were very likely regulated. Being part of an establishment profession is what gave them the authority to do what they did. One of the major problems with ‘regulation’ is that it validates and protects practitioners who routinely harm their patients or do them little good.
Another simple idea that you need to get used to is: ‘regulation’ is not the same as protection for the public. Professionals who do actual harm are subject to the law like anyone else. Thinking that being ‘regulated’ in addition to being subject to the law will prevent mistakes, poor training, and criminal behaviour, is just make-believe.
And a third simple idea that many people just don’t get is: secret committees of civil servants are unaccountable. If there is any point at all in ‘regulation’, government is the worst possible candidate for doing it, because government is least likely to do it effectively. Even if those responsible for any lack of effectiveness are found out they cannot either be named or sacked if they are part of government.
The notion that professionals should undergo some kind of ritual affirmation by a higher authority (and the more remote and mysterious the higher authority, the better) and that the world is somehow a better place because of it, is just another childish superstition.
The opposite of all this, the idea that it is good to be just exactly who you are, without using techniques and beliefs and rituals to try to be something else, is very old. It occurs in the Tao Te Ching, as a concept called in Chinese p’u (which is pronounced like Pooh but with the ‘ooh’ sound much much shorter).
P’u is usually translated as ‘uncarved block’ expressing simplicity, although the Chinese character for it represents a tree and a thicket, suggesting something in its natural place, something that has not been uprooted and worked on:
P’u is illustrated by Winnie-the-Pooh’s approach to life. Milne’s other characters, Owl, Tigger, and the others, get themselves into muddles but Pooh gets out of muddles by being simply Pooh.
That’s the goal of CBT, too, to allow you to discard superstition and ritual and just be exactly who you are, to live your life like a tree in a thicket, in your natural place in the world.
The things that get in the way of that and cause mental illness cannot be countered by superstition and ritual. And the phoney therapists who peddle superstition and ritual cannot be countered by superstitious belief in secret committees of civil servants and their rituals.