Hallmarks of a good therapist: Humility and Self-Doubt

Humility and self-doubt are hallmarks of a good therapist | Aeon Ideas – by Helene A Nissen-Lie – Feb 2020

‘The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.’

This phenomenon – observed in the 1930s by the English philosopher Bertrand Russell – has a technical name, the Dunning-Krüger effect. It refers to the tendency for the worst performers to overestimate their performance, whereas the top performers underestimate their own.

That’s because when you truly become an expert in a field, you’ve learned enough to see all the details and complexity and how much else is still unknown.

Quick fix of CBT doesn’t last

Why depth therapy is more enduring than a quick fix of CBT | Aeon Essays –  by Linda Michaels – Mar 2020

Ever since I learned about Cognitive Behavior Therapy years ago, I haven’t been able to believe it’s the solution to anything but immediate, superficial problems.

The grounding belief of Cognitive Behavior Therapy is that it’s our thinking that drives our feelings and that by changing what we think we can change what we feel. Oh, so clever, aren’t we?

But thinking and feeling are interdependent: how we feel affects how we think, which then affects how we feel, which then affects how we think, and so on and on. I find this disregard for the state of organic human feelings a fatal flaw; we are not such simplistic “computing machines”. 

Management of chronic pain in EDS – part 3

Management of chronic pain in EDS – Part 3 – Nov  2018

This post continues from the first part & second part, and delves into the varied options for management of pain.

3.2 Management

Most cases of chronic pain in EDS are a mix of nociceptive and NP. [Neuropathic Pain]

As symptoms vary based on the diseases phase and in individuals of EDS, broad recommendations in a patient with EDS or JHS include:  

Psychotherapy for Chronic Pain

Chronic pain treatment: Psychotherapy, not opioids, has been proven to work – Vox – By Brian Resnick @B_resnick brian@vox.com – Aug 16, 2018

When pain settled into Blair Golson’s hands, it didn’t let go.

What started off as light throbbing in one wrist 10 years ago quickly engulfed the other. The discomfort then spread, producing a pain much “like slapping your hands against a concrete wall,” he says. He was constantly stretching them, constantly shaking them, while looking for hot or cold surfaces to lay them on for relief.

But worse was the deep sense of catastrophe that accompanied the pain. Working in tech-related startups, he depended on his hands to type.  

Unwanted Events and Side Effects in CBT: the Study

Unwanted Events and Side Effects in Cognitive Behavior Therapy – Cognitive Therapy and Research – June 2018

Abstract

Side effects (SEs)are negative reactions to an appropriately delivered treatment, which must be discriminated from unwanted events (UEs) or consequences of inadequate treatment.

One hundred CBT therapists were interviewed for UEs and SEs in one of their current outpatients.

Therapists reported 372 UEs in 98 patients and SEs in 43 patients. 

Psychotherapy is not harmless: Side Effects of CBT

Psychotherapy is not harmless: on the side effects of CBT | Aeon Ideas | Christian Jarrett – Oct  2018

The structured nature of cognitive behavioural therapy (CBT) and its clearly defined principles (based on the links between thoughts, feelings and behaviours) make itrelatively easy to train practitioners, ensure standardised delivery and measure outcomes.

Being easy to learn, easy to standardize, and easy to measure nails the trifecta of cheap and widely scaleable medical treatment, making this quick and profitable therapy an instant hit among medical “providers” and insurance companies.

Consequently, CBT has revolutionised mental-health care, allowing psychologists to alchemise therapy from an art into a science.

What it has revolutionized is the impersonal standardization of medical mental healthcare.  

Side Effects of Psychotherapy

Here is What Clinicians Should Know About Side Effects of Psychotherapy – Dr Sanil Rege MBBS, MRCPsych, FRANZCP – July 24, 2017

In conditions such as depression and anxiety, the beneficial effects of psychotherapy are often comparable with evidence-based pharmacotherapy options in terms of symptom reduction and protection against relapse.

While discussion about side effects, risks and benefits are an important part of psychotropic medication prescribing, the same cannot be said for psychological treatments.

All pharmacological medications come with relevant or absolute contraindications, and yet the common assumption is that talking therapies are risk-free or come with little risk at all.  

Learning and Unlearning of Pain

Learning and Unlearning of Pain – free full-text article /PMC6027134/ – Biomedicines. 2018 Jun

This review provides an overview of learning mechanisms and memory aspects for the development of chronic pain.

Pain can be influenced in important ways by an individual’s personality, by family, and by the sociocultural environment in which they live. Therefore, learning mechanisms can explain why pain experience and pain behavior can increase or decrease.

Linking pain with positive consequences or removing negative consequences can contribute significantly to the chronification of pain.

If pain were linked with positive consequences, we wouldn’t mind having it, but I find it impossible to imagine how to link even moderate pain with anything positive.

Nora Volkow on Rx opioids, chronic pain and ‘hype’

Nora Volkow on prescription opioids, chronic pain and ‘hype’ – Opioid Watch – Nonprofit News from The Opioid Research Institute – July 2018

Research psychiatrist Nora Volkow, MD—the director of the National Institute on Drug Abuse for the past 15 years—is one of the world’s foremost authorities on addiction. Her pioneering work with brain imaging has changed society’s understanding of the phenomenon.

By showing how addictive drugs alter the brain’s chemistry, she helped prove that addiction was a chronic disease rather than a moral failing.

What follows is part 1 of a two-part interview, which was conducted by email. All links in her answers are to supporting references Volkow provided.  

CBT for Chronic Pain + Insomnia Needs More Research

CBT for Chronic Pain and Insomnia Needs More Research – by Angie Drakulich – April 2018

The Sleep/No Sleep Pain Cycle

Most are familiar with the vicious cycle of insomnia, depression, and increased pain.

Finding the right mix of CBT—including patient education, self-regulation, behavioral activation, and cognitive reframing—may help to break this circle.