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Archive for the ‘For therapists’ Category

In Fear of coffee I mentioned the renowned American CBT therapist, Christine Padesky. One of the recurring themes in her work has been to counter the notion that CBT is just about providing helpless patients with techniques for solving their problems, by emphasizing that patients always come to therapy with capabilities and strengths of their very own.

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Parents never really understand, do they? They just go about their business. But anything could happen. It’s as if they don’t realize how important they are. And then, later, it’s as if they don’t realize how unimportant they are.
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Arriving late at night, exhausted after a long journey, you find your hotel room smells of vomit and is crawling with cockroaches. In the morning you check out early and complain, but the concierge only shrugs and gives you a customer satisfaction questionnaire. Ticking boxes to questions like, “Was your room number easy to read?” and “Did the bath have a plughole?” you realize you have been forced to give the hotel a 95% satisfaction rating, squeezing your complaints on to the one line allowed for “Other remarks” at the bottom.

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If you’re a therapist, how much of yourself do you invest in a session with a patient who’s hard to reach?

If you’re a patient, how much effort does your therapist make to understand what it’s like to be you?

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A recent research study that asked CBT therapists to reflect on their own thoughts illustrates unwittingly how poor some CBT training has become.

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Sometimes I can only point.

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It seems strange to think that we are all hurtling through space on this big chunk of rock we call Earth. It’s OK when immersed in a science fiction story and disbelief is suspended, but for real? Weird.

Yet it’s the accepted view of things. Scientists tell us that it is so.

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Far away to the North, in Lapland, some say, Santa’s elves are elving away making Christmas presents ready for good little girls and boys. What would be on a mental health Christmas list, I wonder? Immediate response to every psychiatric crisis? Coordinated team treatment without any referrals or waiting lists? Effective home treatment that keeps people off medication and out of hospital? Perhaps, if you’ve been very, very good…

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At the edge of a state of mental illness, there is a boundary with normality. But where are the edges? These days we see one of the edges of mental illness becoming clearer, and another one becoming fuzzier. Strangely, the clear one is easier to lose sight of than the fuzzy one.

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One of the most important organizing principles of a person’s life, traditionally, was felt to be a clear sense of values — ideas to believe in and to be devoted to, a set of ideals more important than an individual life, which therefore could be relied upon as a way for an individual to make choices. This notion of values comes perilously close to the notion in CBT of beliefs, which have the potential to go wrong occasionally and lead an individual astray into a state of emotional disorder.

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