…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…

5 thoughts on “…aaand breathe

  1. Roxy says:

    I have a confession to make, I’m a Daily Mail reader or, more accuratly, I’m a Daily Mail skimmer. I saw that headline but I tend to skip past the opinions of the columnists because more often than not they’re utter tripe. Unfortunatly too many Daily Mail readers will belive it, my friends mother is probably one of them. When I was visiting her I mentioned that my dad was ill, when she asked me what was wrong I told her he was suffering Post Traumatic Stress. She asked what his trauma was and I told her it’s from when he went to the Faulklands “but the Faulkland war was years ago, how can he still be traumatised by that?” My friend’s husband quickly changed the subject I’m pretty sure he could see me seething. Anyway just to let you know there are Daily Mail readers out there who realise columist opinions are just that…opinions

  2. dominocat says:

    Thanks, Roxy – it’s nice to know that there are still sensible people out there who read things like this in the Mail and realise it’s an utter pile of pap 🙂 The thing is, like you say, there are plenty of people that take it as gospel too…

  3. Mary says:

    The trouble with CBT is that it requires the patient to *want* to get better and to actually put some serious and long-term effort in (more effort than taking an antibiotic three times a day for two weeks).
    It works. But not for everyone.
    Oh, and as for the disability benefits, they want the highest figure they can get. So, if a person is ill enough to get absolute maximum-level long-term Incapacity Benefit with the maximum age addition, and they live alone so none of it is taken off because of partner’s earnings, and they have no savings so there’s no deductions for that either… that’s £380 a month. Living alone and being unable to work gets Housing Benefit, in my area that’s a maximum of about £230 a month for a single person under 25. Then add maybe £70 a month in as maximum Council Tax Benefit. Finally we’ll give them Low Rate Care Disability Living Allowance of £16.50 a week or about £70 a month. Ta-da, £750.
    And people think “£750! I could do with a spare £750 a month!” They forget it isn’t spare – most of it vanishes on rent (including any shortfall, how many people have rent of £230 a month or less?), council tax and bills, and the rest has to cover not just food and household expenses but also expenses invoked by the fact of your disability.

  4. Happystance says:

    Hi Dominocat,
    I was hopping mad about that piece by Oliver James(http://www.unltd.org.uk/blogs/tonyplant/283) so I’m glad that I’m not the only one. You said it far more eloquently, however.
    Best – Tony

  5. dominocat says:

    Mary – of course, they’re going to add up the highest rates of absolutely everything that we can claim, but conveniently forget that so many people are just on IB, which (even on the highest rate) amounts to a little over half what they’re quoting.
    Tony – thank you 🙂

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