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Thread: My Problems with Psychology (Or Rather 'Self-Help')

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    Default My Problems with Psychology (Or Rather 'Self-Help')

    I had big problems with psychology as a field - or so I thought - until I stepped into the self-help section of my local bookstore. When I arrived there I realized: "Man, what I'm confusing with psychology is really self-help!"

    This now requires a definition: what is 'self-help?'

    Think of self-help as Tony Robbins-esque stuff that is supposed to 'fix' your problems, but only does so by pandering to your sentiments through positive thinking.

    I believe that there is a movement in psychology, such that instead of trying to fix one's problems using a practical approach, one has to change their behaviour through these self-help methods and techniques. What is the result? If you have a real problem, something like 'changing yourself before you change the problem' is simply not going to work... And this is the problem to me. I have noticed a lot of people in psychology have turned towards self-help instead of actually trying to fix one's problems. (I have also noticed this in certain places with spirituality.) To me, the results are shocking.

    However, when I study 'real' psychology that has some practical value, the feeling is different: "Maybe this actually can help someone..."

    Therefore, I would like your insight into this situation... Is psychology doomed with a 'self-help' approach... I would like to hear your insights...

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    A lot of self-help is useless garbage. The idea that you can change behavior by starting at changing your thoughts is not.

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    the problem is that it causes more overthinking, which is usually the initial source of the neurosis.

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    Last time I was in a physical bookstore their self help section was separate from psychology.

    CBT has a proven track record if you want to help yourself.

    Just about anyone can do a self help book. On amazon.com there are so many for 99 cents that I wondered how they made money. I like reading book reviews and it turns out they usually point to a website to sell you more information that was conveniently left out of the book. I have never been into self help type books. My sister frequently gifts them to family members. I have a stack I have never read from her. She seems to get something from them. She really dislikes Tony Robbins.

    What are the key elements of CBT?

    CBT ultimately aims to teach patients to be their own therapist, by helping them to understand their current ways of thinking and behaving, and by equipping them with the tools to change their maladaptive cognitive and behavioural patterns. The key elements of CBT may be grouped into those that help foster an environment of collaborative empiricism and those that support the structured, problem-orientated focus of CBT.

    Collaborative empiricism (Wright, 2006) is based upon the establishment of a collaborative therapeutic relationship in which the therapist and patient work together as a team to identify maladaptive cognitions and behaviour, test their validity, and make revisions if needed. A principal goal of this collaborative process is to help patients effectively define problems and gain skills in managing these problems. CBT also relies on the non-specific elements of the therapeutic relationship, such as rapport, genuineness, understanding and empathy. Initially, to aid the collaborative relationship, the therapist explains the rationale of the cognitive behavioural model and illustrates the description using examples from the patient’s own experience.

    The focus of CBT is problem-oriented, with an emphasis on the present. Unlike some of the other talking treatments, it focuses on ‘here and now’ problems and difficulties. Instead of focusing on the causes of distress or symptoms in the past, it looks for ways to improve a patient’s current state of mind. CBT involves mutually agreed goal setting. Goals should be ‘SMART’, i.e. specific, measurable, achievable, realistic and time-limited. For example, a goal for a patient with obsessive compulsive disorder may be to reduce the time spent washing their hands from 5 hours per day to 1 hour per day by the end of 3 weeks of therapy. The therapist helps the patient to prioritise goals by breaking down a problem and creating a hierarchy of smaller goals to achieve.

    CBT sessions are structured to increase the efficiency of treatment, improve learning and focus therapeutic efforts on specific problems and potential solutions. Sessions begin with an agenda-setting process in which the therapist assists the patient in selecting items which can lead to productive therapeutic work in that particular session. Furthermore, homework assignments are used to extend the patient’s efforts beyond the confines of the treatment session and to reinforce learning of CBT concepts.

    CBT is a structured and time-limited treatment. For non-comorbid anxiety or depression, a course of CBT typically lasts 5–20 sessions. If axis II disorders are present, which are personality disorders or intellectual disabilities, treatment may need to be extended due to the lifelong, pervasive pattern of these disorders and slower change that has been observed with CBT.

    What techniques are used in CBT?

    CBT aims to change how a person thinks (‘cognitive’) and what they do (‘behaviour’). CBT therefore uses both cognitive and behavioural techniques. The specific interventions chosen depend on the individual’s formulation.

    Cognitive techniques

    A key cognitive concept in CBT is ‘guided discovery’ (Padesky, 1993). This is a therapeutic stance which involves trying to understand the patient’s view of things and help them expand their thinking to become aware of their underlying assumptions, and discover alternative perspectives and solutions for themselves. An aspect of guided discovery is Socratic questioning, which is a method of questioning based on the way in which Socrates (c. 400 BC) helped his students to reach a conclusion without directly telling them. Padesky (1993) explained that Socratic questions should draw the patient’s attention to something outside of their current focus. Therapists use questions to probe a patient’s assumptions, question the reasons and evidence for their beliefs, highlight other perspectives and probe implications. For example, ‘What else could we assume?’, ‘What do you think causes …?’, ‘What alternative ways of looking at this are there?’ and ‘Why is … important?’. Guided discovery is central to the interventions aimed at each level of cognition.

    To target maladaptive core beliefs, the patient can be asked to keep a positive data log (Padesky, 1994), in which the patient keeps a daily log of all observations that are consistent with a new, more adaptive schema (e.g. ‘I am useful to people’). Core beliefs are the least accessible level of cognition and so are tackled later in therapy than dysfunctional assumptions and negative automatic thoughts.

    To target dysfunctional assumptions, the patient can be asked to provide evidence that supports/does not support their assumptions. The mixed evidence can help remould the rules to make them more ‘elastic’ and accurate.

    Thought records are used to make a patient aware of their NATs, distinguish thoughts from facts, and see how they impact upon their mood. They encourage the consideration of alternative thoughts and the resulting change in emotion. These are used to challenge NATs. Filling out a seven-column thought record (Greenberger and Padesky, 1995) involves detailing the situation, mood, the NAT, evidence for this NAT, evidence against this NAT, the development of an alternative rational response, and a rerating of mood.

    Behavioural techniques

    Activity scheduling and graded task assignment aim to enhance functioning and systematically increase pleasurable or productive experiences. Activity scheduling is used to plan each day in advance. The therapist and patient work to reduce the mass of tasks to a manageable list, which removes the need for repeated decision making. The graded task assignments create manageable steps to help overcome procrastination and anxiety-provoking situations. These techniques involve obtaining a baseline of activities during a day or week, rating activities on the degree of mastery and/or pleasure, and then collaboratively designing changes that will reactivate the patient, stimulate a greater sense of enjoyment in life, or change patterns of isolation or procrastination. These techniques help patients re-establish daily routines, increase pleasurable activities and deal with problems and difficult issues by increasing problem solving.

    Behavioural experiments are mainly used with anxiety-based mental health disorders. The technique allows a person to test out their catastrophic predictions (e.g. ‘If I leave the house, something terrible will happen’). Concurrently, behavioural experiments also help patients to learn to tolerate anxiety. The patient makes a prediction before completing a task (e.g. walking to the shop) and then records whether that prediction came true. Over time, the patient will thereby be re-evaluating their catastrophic thoughts, by developing helpful evidence against their predictions. The therapist works with the client to develop hierarchical tasks, starting from lowest anxiety-provoking task going up to high anxiety-provoking tasks.

    Behavioural experiments are also used to help patients gather evidence against the use of ‘safety behaviours’ (Salkovskis, 1996), which are avoidance and escape behaviours. Within the cognitive model, safety behaviours reinforce anxiety as they make disconfirmation of dysfunctional assumptions and negative automatic beliefs impossible. For example, if a patient avoids going on public transport because they believe something terrible will happen, they will believe that avoiding public transport ‘saves’ them from this perceived threat. A behavioural experiment would allow the patient to gather evidence to discount the predictions that something terrible will happen and that the safety behaviour of avoidance is necessary to remain safe.

    Progressive relaxation training and breathing exercises may be used to reduce levels of autonomic arousal related to anxiety. These techniques may be used to help manage panic attacks or other symptoms of anxiety disorders.


    https://journals.sagepub.com/doi/ful...55738012471029
    CBT is arguably the most widely studied form of psychotherapy. We identified 269 meta-analytic reviews that examined CBT for a variety of problems, including substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The vast majority of studies (84%) was published after 2004, which was the last year of coverage of the review by Butler and colleagues (2006), making the present study the most comprehensive and contemporary review of meta-analytic studies of CBT to date.

    For the treatment of addiction and substance use disorder, the effect sizes of CBT ranged from small to medium, depending on the type of the substance of abuse. CBT was highly effective for treating cannabis and nicotine dependence, but less effective for treating opioid and alcohol dependence. For treating schizophrenia and other psychotic disorders, the empirical literature suggested appreciable efficacy of CBT particularly for positive symptoms and secondary outcomes in the psychotic disorders, but lesser efficacy than other treatments (e.g. family intervention or psychopharmacology) for chronic symptoms or relapse prevention.

    The meta-analytic literature on the efficacy of CBT for depression and dysthymia was mixed with some studies suggesting strong evidence and others reporting weak support. Some authors have suggested that the strong effects in some studies may be an overestimation due to a publication bias (Cuijpers, et al., 2010). Similarly, the efficacy of CBT for bipolar disorder was small to medium in the short-term in comparison to treatment as usual. However, there was limited evidence for the superiority of CBT alone over pharmacological approaches; for the treatment of depressive symptoms in bipolar disorder, the use of CBT was well supported. However, the long-term superiority compared to other treatments is still uncertain.

    The efficacy of CBT for anxiety disorders was consistently strong, despite some notable heterogeneity in the specific anxiety pathology, comparison conditions, follow-up data, and severity level. Large effect sizes were reported for the treatment of obsessive compulsive disorder, and at least medium effect sizes for social anxiety disorder, panic disorder, and post-traumatic stress disorder. Medium to large CBT treatment effects were reported for somatoform disorders, such as hypochondriasis and body dysmorphic disorder. However, more studies using larger trials and greater sample sizes are needed to draw more conclusive findings with regard to CBT’s relative efficacy in comparison to other active treatments.

    For the treatment of bulimia, CBT was considerably more effective than other forms of psychotherapies, but less is known for other eating disorders. Similarly, CBT demonstrated superior efficacy as compared to other interventions for treating insomnia when examining sleep quality, total sleep time, waking time, and sleep efficiency outcomes. However, although there were small effects of CBT for sleep problems among older adults (aged 60+), these effects may not be long lasting (Montgomery & Dennis, 2009).

    For personality disorders, there was some evidence for superior efficacy of CBT as compared to other psychosocial treatments for the personality disorders. However, the studies showed considerable variation in measurement methods, comorbid disorders, and demographic variables. CBT also produced medium to large effect sizes for treating anger and aggression (e.g., Saini, 2009), although a greater number of well-controlled studies are needed to more adequately parse out the specific efficacy of CBT compared to the psychosocial treatments for anger on the whole. Similarly, more studies are needed before any firm conclusions can be drawn about the efficacy of this treatment for criminal behaviors.

    As a stress management intervention, CBT was more effective that other treatments, such as organization-focused therapies. However, more research on the long-term effects of CBT for occupational stress is needed. Furthermore, there are open questions about the relative efficacy of CBT versus pharmacological approaches to stress management. Similarly, several common concerns recurred across meta-analytic examinations of CBT for chronic medical conditions, chronic fatigue and chronic pain, namely: (1) a scarcity of studies and small sample sizes; (2) poor methodological design of studies that are included in meta-analyses; and (3) grouping of CBT with a host of other psychotherapies (such as psychodynamic therapy, hypnotherapy, mindfulness, relaxation, and supportive counseling), which made it difficult to parse out whether there are any superior effects of CBT in the majority of medical conditions examined.

    There was preliminary evidence for CBT for treating distress related to pregnancy complications and female hormonal conditions. However, more research is needed due to a scarcity of follow-up data and low quality studies. This appeared to be a highly promising area for CBT given that the alternative – pharmacological treatments – can be associated with serious risks of adverse effects for pregnant women and breastfeeding mothers.

    In our review of meta-analyses, CBT tailored to children showed robust support for treating internalizing disorders, with benefits outweighing pharmacological approaches in mood and anxiety symptoms. The evidence was more mixed for externalizing disorders, chronic pain, or problems following abuse. Moreover, there remains a need for a greater number of high-quality trials in demographically diverse samples. Similarly, CBT was moderately efficacious for the treatment of emotional symptoms in the elderly, but no conclusions about long-term outcomes of CBT or combination therapies consisting of CBT, and medication could be made.

    Finally, our review identified 11 studies that compared response rates between CBT and other treatments or control conditions. In 7 of these reviews, CBT showed higher response rates than the comparison conditions, and in only one review (Leichsenring & Leibig, 2003), which was conducted by authors with a psychodynamic orientation, reported that CBT had lower response rates than comparison treatments.

    In sum, our review of meta-analytic studies examining the efficacy of CBT demonstrated that this treatment has been used for a wide range of psychological problems. In general, the evidence-base of CBT is very strong, and especially for treating anxiety disorders. However, despite the enormous literature base, there is still a clear need for high-quality studies examining the efficacy of CBT. Furthermore, the efficacy of CBT is questionable for some problems, which suggests that further improvements in CBT strategies are still needed. In addition, many of the meta-analytic studies included studies with small sample sizes or inadequate control groups. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on particular subgroups, such as ethnic minorities and low income samples.

    Despite these weaknesses in some areas, it is clear that the evidence-base of CBT is enormous. Given the high cost-effectiveness of the intervention, it is surprising that many countries, including many developed nations, have not yet adopted CBT as the first-line intervention for mental disorders. A notable exception is the Improving Access to Psychological Therapies initiative by the National Health Commissioning in the United Kingdom (Rachman & Wilson, 2008). We believe that it is time that others follow suit.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/

    “My typology is . . . not in any sense to stick labels on people at first sight. It is not a physiognomy and not an anthropological system, but a critical psychology dealing with the organization and delimitation of psychic processes that can be shown to be typical.”​ —C.G. Jung

     



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    DBT > CBT

    handssss down
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    Quote Originally Posted by fresh meat View Post
    DBT > CBT

    handssss down
    Oh I forgot about that. I had a friend with BPD who had DBT. Unfortunately for her it didn't work. I think BPD is hard to treat from what I remember. I don't know as much about it.

    Dialectical behavior therapy (DBT) is a comprehensive, evidence-based treatment for borderline personality disorder (BPD). The patient populations for which DBT has the most empirical support include parasuicidal women with borderline personality disorder (BPD), but there have been promising findings for patients with BPD and substance use disorders (SUDs), persons who meet criteria for binge-eating disorder, and depressed elderly patients. Although DBT has many similarities with other cognitive-behavioral approaches, several critical and unique elements must be in place for the treatment to constitute DBT. Some of these elements include (a) serving the five functions of treatment, (b) the biosocial theory and focusing on emotions in treatment, (c) a consistent dialectical philosophy, and (d) mindfulness and acceptance-oriented interventions.

    Keywords: dialectical behavior therapy, borderline personality disorder, suicide attempts, emotion, mindfulness
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/

    “My typology is . . . not in any sense to stick labels on people at first sight. It is not a physiognomy and not an anthropological system, but a critical psychology dealing with the organization and delimitation of psychic processes that can be shown to be typical.”​ —C.G. Jung

     



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    Quote Originally Posted by Aylen View Post
    Oh I forgot about that. I had a friend with BPD who had DBT. Unfortunately for her it didn't work. I think BPD is hard to treat from what I remember. I don't know as much about it.
    It’s good for impulse control. It didn’t work for me but that’s because I didn’t bother to implement any of the strategies we learned from it. I just liked sitting through the DBT groups a hell of a lot more than the CBT groups - I felt like we talked more in depth about our lives and it was rewarding. I think therapy in general is really Te oriented (Fi/Te axis), they present you with all these coping mechanisms you have to apply consistently. I think this is hard for Fe egos, for example, not that it’s easy for Fi egos but they seem more receptive to it.
    And I'm what you desire, like a siren in the night



    Quote Originally Posted by Starfall
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    Quote Originally Posted by jason_m View Post
    I had big problems with psychology as a field - or so I thought - until I stepped into the self-help section of my local bookstore. When I arrived there I realized: "Man, what I'm confusing with psychology is really self-help!"

    This now requires a definition: what is 'self-help?'

    Think of self-help as Tony Robbins-esque stuff that is supposed to 'fix' your problems, but only does so by pandering to your sentiments through positive thinking.

    I believe that there is a movement in psychology, such that instead of trying to fix one's problems using a practical approach, one has to change their behaviour through these self-help methods and techniques. What is the result? If you have a real problem, something like 'changing yourself before you change the problem' is simply not going to work... And this is the problem to me. I have noticed a lot of people in psychology have turned towards self-help instead of actually trying to fix one's problems. (I have also noticed this in certain places with spirituality.) To me, the results are shocking.

    However, when I study 'real' psychology that has some practical value, the feeling is different: "Maybe this actually can help someone..."

    Therefore, I would like your insight into this situation... Is psychology doomed with a 'self-help' approach... I would like to hear your insights...
    And what do you understand under "practical value" as opposed to self help which you imply has none?

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    Quote Originally Posted by Number 9 large View Post
    And what do you understand under "practical value" as opposed to self help which you imply has none?
    How about something like socionics or Holland's Code, whereby through understanding your personality, you can pinpoint the right career, relationships, etc... Another one I think makes sense are some of the other career placement services and placement tests on the web that also give practical advice. These services are a lot better than simply offering something that simply sounds good or 'feels good' without any tangible help..

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    Controversial opinion on what is essentially a psychology site but if you want true self improvement, not just learning how to handle your issues but truly erasing them from your mind, get yourself a copy of Dianetics. Speaking as one who has done CBT, medication (which almost killed me, turning my anxiety into solid depression, stay far away from it), and Dianetic therapy, Dianetics is the only thing that has given me results and is continuously doing so, along with stoic philosophy, especially the Enchiridion, which is superior to any and all self help books you may have encountered with the lessons of which actually having saved the life of a Vietnam POW. Just food for thought.

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    Self-help is for people that fail at helping themselves. By nature it's not supposed to work.

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    George Carlin said something a long time ago about how if you read psychological books about self help or see shrinks to give you 'self help' you don't need self help... you need help. LoL

    But I think from an American businessman PoV, it is perceived as 'weak' or something, to need any type of assistance from others.

    But... if you think about it, that's what is happening. If you have low self esteem or are depressed, and you want to read a book to make you feel better, you're accepting help from the author to do so. The author is trying to tell you that you are helping yourself by reading the book, but the author is actually really the one helping you. Or not. I mean of course what is really going on is that you are falling for a scam to make the author even richer and you even weaker under the guise that you yourself can alleviate your own insecurities by ... wasting even more of your resources on somebody else other than yourself. Therefore, 'Self-help' is more accurately known as 'Other-Scamming' but that is too honest for the world. xD


    There is no such thing as self-help- it's kind of an oxymoron. The very notion of 'help' is that it is inherently selfless. And that's okay. If you are taking care of yourself already you are 'helping your self' in a sense but why even call it that, you don't need help, because you are psychologically strong enough to take care of yourself. The 'self help' target group is written precisely for people who do not have that level of confidence. If they really could help themselves they wouldn't be duped into going to the Oprah/Byron Katie/Esther Hicks/Teal Swan self help meeting in the first place, right?

    (HAHA I WOULD LOVE TO BOSS FIGHT ALL FOUR OF THEM AT THE SAME TIME!)

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    The Lord helps those who help themselves, which is why after reading a self-help book, you're just as able to move mountains by praying as you were before. Hallelujah!


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    And yes, the point of therapy is to make people happy with how things are, which isn't completely useless or despicable, but it's almost always carried way overboard and just serves people with an agenda.

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    Quote Originally Posted by coeruleum View Post
    And yes, the point of therapy is to make people happy with how things are, which isn't completely useless or despicable, but it's almost always carried way overboard and just serves people with an agenda.
    Its better to focus on the things you can and wanna change, than on the things u might wanna change but cant.

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    Quote Originally Posted by Number 9 large View Post
    Its better to focus on the things you can and wanna change, than on the things u might wanna change but cant.
    However, it's useless to focus on things you don't want to change, which is why 90% of therapy is just destructive, like telling someone to drink coffee so they don't feel hungry when they're malnourished.

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    Quote Originally Posted by coeruleum View Post
    However, it's useless to focus on things you don't want to change, which is why 90% of therapy is just destructive, like telling someone to drink coffee so they don't feel hungry when they're malnourished.
    also that but i guess that was obvious

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    It's not obvious to most people. Most people aren't getting therapy for spider phobia, skin picking, marital issues, or something else where it's helpful and doesn't introduce much stigma.

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