Why Does Cognitive Therapy Not Work In Every
PsychologicalCondition?
A lady was once referred for treatment for emotional distress.
This distress had resulted from unpleasant memories of having
undergone sexual abuse. In her case cognitive therapy had been
unhelpful, Her own opinion was that cognitive therapy did not
address the anger and fear that she was feeling strongly .
There are many approaches in therapy that are available for
anyone who wants this service. Cognitive Behaviour Therapy
(CBT)is the most well known, because it is the most researched
form of therapy. CBT is the product of the West, where people
are encouraged to think and discouraged to feel emotions. CBT is
based on the premise that our thinking can change our feelings.
This is not always true. When people undergo abuse or torture,
no amount of thinking is going to sort out the feeling of rage
that underlies such experiences. The rage that one feels about
such experiences overwhelms the thinking ability of an
individual and the person still ends up acting out the emotion.
In all such cases CBT fails to get any results. Yet because it
has been written about widely, mental health practitioners
erroneously believe that it is the only suitable form of therapy
in almost all forms of psychological conditions.
A middle aged man, enraged by an ex-employee's deception wanted
to harm the ex-employee physically. Overwhelmed by anger, he
felt that the only way the person would realize how they felt
was by conferring physical pain. No amount of reason or logic
was useful. According to him, 'action had to be taken'. The best
solution in this case was to reduce the anger by releasing it.
When it was done in a few minutes, he thanked me for helping him
out of the situation. The perception had changed. The thoughts
were non-aggressive. Needless to say, he did not act out the
rage.
When our inner drives are strong, they overwhelm our thinking.
At such times reason or logic is governed by the drives. Anger
is one such emotion. When it takes the form of rage, the person
may lash out physically. The solution does not lie in reasoning
with the person, but to help the person reduce the drive. In
other situations when the anger is in the form of annoyance,
reason can still be used to 'distract' the person away from the
issue. But the feeling stays. To distinguish between times when
behaviour can be changed by thinking and when it cannot be
changed by thinking requires wisdom.