Oliver Burkeman’s article reminds me of a piece of work I did with Stella, a GP, when her therapy first started last year; it also helps me to understand why I am seeing more and more people paying for their own talking cure after a course of CBT. CBT is proven to be effective for certain conditions, for example obsessive / compulsive behaviours, so it works for some people suffering particular disorders. The point is that nothing, not even CBT, is THE solution for everyone everytime.
When Stella first came to see me, she disclosed that she had tried CBT but that despite being a model patient (her words) it had not worked for her. “I ended up still carrying my issues plus feeling like a fraud and failure because I was prescribing CBT when it had not worked for me. If I take something on I put 100% effort into it so on top of everything else I am wondering if it’s my fault CBT did not work for me.’
As a psychotherapist and counsellor I encourage patients to explore a variety of different practices and actively take a lead in resolving or coming-to-terms with whatever brings them to therapy in the first place. If I think that CBT is suitable for a patient I encourage and support them to get a referral from their GP.
Yet, more often than not our suffering involves relationships with other people and ourselves. So relational talking therapies which respects and embraces the whole person and not just their habitual thinking or compulsive behaviours may be helpful despite the fact they cannot be standardised.
Standardisation for the purpose of replication and cost management may fit a business model but a cost-effective agenda does not in itself relive human suffering. Research shows that it’s not the type / modality of therapy that aids recovery but rather the way their relationship with their therapist helps them to integrate and function in their lives.
Coming at mental health and wellbeing treatment from the point of cost — trying to find the cheapest, quickest process may cost us all a lot more than accepting that a more holistic approach which offers various methods, from talking therapist and CBT / DBT / EMDR through to psych-pharmaceuticals might, in the longer term be the easier more humane way.
Names and identifying features of patients have been changed to protect anonymity.