therapy

During our ongoing vigorous discussions about whether it’s better to train as a clinical psychologist or as a mental health nurse, Bugsy made the following observation.

Plus don’t know about anyone else’s wards but where I work having Dr in front of your name means you are worth listening to, having RMN or BSc MSc after it tends not to pull the same punch - even if you say exactly the same thing.

Just a thought with regard to this. I’ve recently had my job title changed from “nurse” to “nurse therapist”. Suddenly, with this change of title, outside agencies (schools, social services etc) and families are more impressed by my opinions than before.

Interesting.

That famous stiff upper lip, it turns out, may well get you through the after-effects of shock much better than spilling your guts to a therapist.

The popular assumption is that talking about a terrifying experience, such as a terrorist attack or natural disaster, can be therapeutic and helpful.

But new evidence suggests “getting it off your chest” may not be the right thing to do.

Psychologists in the US used an online survey to test people’s responses to the September 11 2001 terrorist attacks on New York and Washington.

Those who chose to express their thoughts and feelings were compared with those who did not over a two-year period.

To their surprise, individuals who bottled up their feelings ended up better off. They suffered fewer negative mental and physical health symptoms than people who were willing to talk.

I’m always pleased to see another nail hammered into the therapy industry’s coffin.

Cognitive Therapy was first devolved by Ellis in the early 1950’s when it was called rational emotive therapy (REMT). It was developed as a reaction against the popular psychoanalytic methods in use at the time. Later developed independently by Aaron T Beck in the 1960’ Cognitive Therapy was further developed into its current form by incorporating elements of behavioural therapy and is now known as Cognitive behavioural therapy (CBT)

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Via Mandy Lifeboats Ahoy, I came across this audio lecture (7 minutes, 44 seconds) by psychoanalyst Janet Low, criticising evidence-based practice and cognitive-behaviour therapy.

I feel an urge to reply to Janet Low’s critique, and have my own little rant about psychoanalysis along the way.

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I noted from an ancient posting of Mental Nurse the suggestion of a posting something on “Insight”. I have not seen one yet within these pages and wasn’t sure in what direction Mental muight have been thinking of going but I thought I’d begin one anyhow (as I’ve had two recent dealings of suitable dispute to comment on).

Before you read on, I would note I tend to write in an academic style, not a ‘blog’ writing style. Sorry about that!

This opener looks at my own recent dealings into the “insight” of two distinctly different people.To clarify, my understanding of ‘insight’ isn’t “How well do they understand what I tell them about themselves and how to be better”; it’s more “How well do they know themselves and the effect they have on themselves.”
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These are the bedrock of mental health and well-being, argues Martin Seager over at Psychminded: -

It is relationships that make us, maintain us, hurt us and even break us. Relationship is perhaps the most important of several core and universal psychological needs that people have alongside their biological and social needs. This was one of the key conclusions of a national advisory group of distinguished psychological thinkers, clinicians, academics and writers that I convened at the personal request of the then secretary of state for health, Patricia Hewitt…

..psychological therapy outcome studies (see Norcross, 2002) also consistently conclude that relationship factors are the single most critical ingredient in effectiveness. But these factors get marginalised as non-specific as opposed to the specific technique or model. It was glaringly obvious to our group that this should be the other way around. In other words, it is technique that is non-specific, whereas the relationship factors are highly specific to the outcome.

Now, it seems to me that if the model or technique is of secondary importance, then surely it would make sense to forget about chucking money at talking therapies and instead employ many more people who are good at developing and maintaining empathic relationships based on trust, mutual respect and clear, honest communication. We used to call them nurses.

A big payout is on its way to Katrina Fairlie from NHS Tayside after therapy she was offered led to her accusing her father of rape: -

Katrina was undergoing recovered memory therapy in a psychiatric hospital in Perth when she made a series of allegations of sexual abuse by her father, former SNP deputy leader Jim Fairlie.

She later said those claims were completely untrue and a police investigation found there was no evidence of abuse

This wasn’t before her “memories” had ripped the family apart, however, and that is the basis of her claim.

Recovered memory “therapy” is now largely discredited and seems only to be available through various kooky organisations. But stories such as Katrina Fairlie’s are, I think, a useful reminder that talking therapies aren’t always the benign treatments they’re thought to be.

Alan Johnson is to make £170m available to increase the availability of CBT in the NHS.

The new money, which will be spent over the next four years, will treat 900,000 more people for depression and anxiety and provide an additional 3,600 trained therapists.

All GP practices will also have access to nondrug treatments.

Mr Johnson said: “More than one in six people suffer from mental health problems at any one time. For many people medication is a successful treatment but we know that psychological therapies work equally well. Today’s announcement shows the Government’s commitment to mental health.

“Improving access to psychological therapies will give people a real choice of treatment, helping to reduce dependence on medication.”

I have a problem with CBT: it’s just far too fashionable. And that instantly makes me want to find some reason to reject it.

I would rather £170m was released to provide - say - sheltered employment schemes for people with severe and enduring mental health problems. But what do others think? Am I just an unreasonably cynical old scrote who should get CBT himself for his faulty thinking patterns? Has anyone had experience of CBT, positive or negative? I’d like to hear about it.