…aaand breathe

I try hard not to read the Daily Mail because I end up getting far too shouty, and I know there is little point in commenting on something written therein, but I get angry with articles published that are misleading, one sided and downright irresponsible – especially when concerning mental health issues. And, when TV psychologist Oliver James writes an article entitled “Therapy on the NHS? What a crazy waste of £600 million!” I can’t help myself, even when I bear in mind that 1) Oliver James has recently had a book published and is therefore likely to want a load of publicity, and 2) this is the Daily Mail.
Dr James is an outspoken person at the best of times. He has made unethical and potentially damaging comments in the past – most notably about Peter Mandelson. Now, he turns his attention to the general public, poo-poohing CBT – one of the most successful treatments for mental health issues such as anxiety disorders, depression, PTSD, and others. He doesn’t merely question the efficacy of this treatment, and provide links to evidence – instead he dismisses CBT as a “crazy waste” of money. He supplies anecdotal ‘evidence’ to support this. He spouts ‘facts’ about relapsing after CBT without backing them up. He comes out with impressive sounding phrases like “research has shown” without going further to say who researched what and where the reader can learn more.
The validity of his claims are questionable, however more worrying is that these claims have been published in a widely read national newspaper, and basically say “having CBT? Don’t bother – you’ll be just as bad as ever in a couple of years…” According to biographies all over the internet, Dr James has had clinical experience, so he should know that the mind is a fragile thing when it is being assaulted by a mental health problem – in other words, the very minds that CBT can probably help. He should know that many people with depression and anxiety disorders frequently have a negative image of the future. CBT is hard work mentally, and I can’t help wondering how many people would give up if they read an article like this, written by a psychologist who has featured on “This Morning” and written successful self help books.
If Dr James is so against CBT, why not research it properly? Why not suggest possible solutions to the perceived problem? Dr James advocates Cognitive Analytic Therapy instead of CBT, yet studies have shown that in Generalised Anxiety Disorder, CBT was more effective. Dr James suggests that “where patients have been examined two years later, at least half of panicky ones have relapsed or sought further help.” yet makes no reference to the fact that CBT is an ongoing process – and techniques should be practiced long after the patient has stopped seeing their therapist. I personally would like to see research into how many people expect to be ‘cured’ (indeed James uses that word in the article) and go back to their normal lives. How many people didn’t really realise that they would need to practice CBT techniques to keep their symptoms at bay or help stem a relapse. But rather than suggesting that patient follow-up should improve, James dismisses the entire therapy.
He talks about CBT as though it’s as structured as a course of antibiotics. In fact, CBT is tailored to the individual. The principles are essentially the same, but because the problems that CBT can help are so diverse, obviously individual patients receive individual care. The three cases he refers to in the article do sound as though they are very disillusioned with their experience of CBT, but this could be for a myriad of reasons, not because CBT “doesn’t work”.
I really can’t understand why he has written the article in this way. It’s certainly not been written with the best interests of sufferers in mind. Why be so negative? What does he stand to gain from approaching it in this way? At the start of the article, he talks about how CBT is inexpensive, therefore would appeal to the government. Maybe it’s an incredibly round about way of saying the government isn’t spending enough money on Mental Health Services. If this is the case, I’m sure there are a million other ways of doing it without saying ‘CBT is a load of crap’.
I’d like to think that Daily Mail readers would have more sense than to take this somewhat vitriolic rant at face value, but I don’t know. When you factor in things like third party recanting, and the strange way in which these illnesses mess about with your emotions, you have a rather worrying mix. The media’s enormous reach has the power to cause much harm – just look at the MMR vaccine controversy.
I’m not writing this because of my own feelings on CBT. Having been ‘in the game’ for a while, I know better than to advocate one particular treatment over another. CBT seems to be working for me, others may find that it’s not for them. I personally think it is up to the individual and their therapist to come together with a plan for therapy that is most suitable for them, their problem, their personality and their lifestyle. If your therapist suggests CBT, have a go and be open minded. If they say something or suggest something you don’t feel happy with, tell them. Good communication with your therapist is paramount. Remember, even though it doesn’t work for some people, it does work for a hell of a lot of others. Have a look here for some success stories where CBT was used to help people with Social Anxiety Disorder. Hopefully, it will redress the balance.
Finally, please for the love of all that is sacred, can the media get their facts right about how much disability benefit is? £750 a month? I bloody wish…

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