14/11/2025
Throwing the CBT baby out with the bathwater.
Over the last few decades CBT, or Cognitive Behavioural Therapy, has been seen, by mental health professionals as the gold standard treatment for almost any kind of mental health struggles. You're anxious or depressed? A 6 week CBT course will solve everything.
Sadly so many of us have found this to be completely untrue.
Unfortunately this clinging to this one-size-fits-all philosophy has led to CBT being vilified amongst mental health sufferers and, to a larger extent it has been discarded.
This has been amplified by practitioners in this method applying it badly which has led to people, including me, feeling unheard and unseen. It's done more harm than good for some people.
But... ultimately, it's like any other tool in a toolbox. If you try to remove a screw with a lump hammer it's going to make a mess. But if you need to hit something fairly hard it's perfect for the job... and this is where taking the time to understand what CBT actually is is worth it.
I started using it around 10 years ago when, at the time, I was told I was being made redundant at some point in the future "but don't worry about it right now, it will be at least a year".
CBT didn't make the redundancy easier but it did make the journey to it more manageable.
I downloaded an app and it asks you to fill in a form, starting with what was going on and what your fears were. You then picked labels for the fears. Were you catastrophising, creating a future that hadn't happened yet, fearing what other people thought, etc. Then you created counter statements and asked what proof you had that these fears were going to come true. It all helped me through those months. Redundancy was horrific and a dark chapter of my life, but the time before it I learnt a lot.
When I developed OCD that led to crippling panic attacks it was utterly useless but this week it has helped me a great deal.
A few weeks ago my dentist surgery of 20+ years called to tell me that my dentist had retired and I would be seeing a new one. We made an appointment and the fateful day got closer. I hate the dentist, and it's always an hour I have to survive... and that was with someone I knew.
Out came the CBT tools.
Thoughts: What if they are horrible? What if my audio processing problems means we have communication struggles because of a non-local accent? What if they don't understand that they must tell me what they are going to do before they do it? How do I ask for a way to make them stop? I didn't even know if it was a man or a woman.
I heard these thoughts and countered them:
They're probably going to be younger and have more modern practices. You have zero proof there will be communication issues. Don't prejudge this situation, it's as likely to be fine as it is horrible...
And, you know, it worked. I got myself to the dentist, I was honest about how scared I was, communication was fine, even with him taking his mask off when he spoke so I could read his lips, he was kind and understanding. None of my fears came true.
CBT, when used as it was intended, is a fantastic tool, we just need to stop trying to solve everything with it.
