Posted by mattdds on November 3, 2003, at 11:51:03
In reply to Re: David D. Burns Quack MD » mattdds, posted by ace on November 3, 2003, at 1:24:29
Hey Ace,
I never meant to imply that you weren't entitled to your own opinion - I don't know where you might have interpreted that I said that. It's just that your claim that CBT is worthless and quackery is just not at all founded in anything *but* opinion. The science behind the efficacy is unequivocal.
Does this mean it's universally effective? Absolutely not, but this is true of any drug as well - yes even Nardil. Does this mean CBT is effective for Ace? Well...we know the answer to that question empirically.
>>I just feel [CBT] is more geared towards exogenous depression.
First off, the distinction between "exogenous" and "endogenous" depression is hazy at best, and an outdated relic at worst. Different people present with different symptoms. My understanding is that this idea represents pretty old-school thinking about depression. People used to diagnose "endogenous" depression by certain symptom subsets or inability to suppress cortisol with dexamethasone administration - but these methods are not even used anymore because they lack sensitivity / specificity.
It is generally agreed nowadays that *severity*, as measured by the Ham-D or BDI is the best measure we can have - calling a depression "endogenous" or "exogenous" is pure conjecture, IMO.
So if you are saying that CBT does not work in more severe depression, I'm sorry, but this is just absolutely incorrect. Here is but one study abstract - which was funded by none other than SKB (the manufacturer of Serzone) and the NIMH:
http://my.webmd.com/content/article/23/1663_53120
You're going to have a tough time arguing anything but that CBT is not effective for *Ace's* severe depression - despite the strength of your feelings / opinions. I mean, even the American Psychiatric Association has admitted that CBT is equally effective and has better long-term outcomes.
It would be much more honest and reasonable if you simply said, "CBT did not work for me".
>...I am just turned off by the CBT money making machine
I have no idea what you mean here. The CBT money making machine? Are you referring to Burns here? If so, forget Burns, and look to the overwhelming data supporting *generic* CBT. Can you explain that away with something besides "opinion"?
If you want to talk about strongly vested financial interest, I think we should first discuss big pharm. There is generally very little money to be made in CBT.
>>It certainly is a variant on the Vincent Peal positive thinking...
Umm, It *certainly* has nothing to do with Vincent Peal's work. You might want to re-read Burn's work a bit more thorougly. In the introduction, he actually says "this is not "The Power of Positive Thinking"". This represents a very oversimplified and inaccurate view of CBT. Peale's work blossomed into "positive affirmations", which don't work, but are not in any conceivable way, CBT. CBT, in fact, advises
*against* using affirmations. It concentrates on combatting *negative* rumination, as this is known through studies to initiate, perpetuate / prolong depressive episodes.You don't have to believe this, and again, you are entitled to your opinion, but studies certainly indicate that negative rumination perpetuates depression and increases the likelihood of relapse. CBT treats this rumination.
>>And people are free to believe what they want
I don't remember saying otherwise.
>>I'm just expressing my views
Again, you seem to think that I'm censoring you. I'm not. I just want some clarification and substantiation to what you are saying. Your arguments seem to contain a lot of name-calling (quack) and emotion, but perhaps a bit lacking in substantive evidence.
Again, you can say with 100% certainty, "CBT does not work for Ace". But when you say it's for "quacks", or that it's universally inferior to meds, you run into the problem of having to substantiate your claims with scientific evidence. I think you'll have a tough time doing that.
BTW, I don't know if you're aware, but I recently tried Parnate. It failed, and I also experienced a spontaneous hypertensive crisis. Does this mean I'm going to go on a crusade against Parnate? No. My own personal "experiment" does not have a large enough "n" to provide a meaningful evaluation of its overall efficacy and safety. So I'm not going to go out and incite people by saying "hey, Parnate is CRAP, look what happened when *I* tried it!". Parnate is very well studied, and a good treatment modality for around 66% to gain some relief. You catch my drift?
>>He did say this...and he called all psychiatrists 'liars' and used a cuss word to describe their research
Do you have a link to the transcript of where he said this? First off, Burns *is* a psychiatrist, and prescribed drugs to 50% of his patients (he's big on the MAOI's BTW - read his rave reviews of them in his book). So it would not make sense that he called all psychiatrists 'liars', as he lectures to psychiatrists. The dude graduated summa cum laude from Stanford medical school, did his residency at University of Pennsylvania, ran the lithium clinic at the VA in Philadelphia, did intense research on serotonin metabolism, and now is on the *psychiatric* faculty at Stanford. He originally wanted to do brain / pharm research, and was a leader in the field. But he got frustrated with his marginal results with using only drugs, so he teamed up with Aaron Beck to help develop CBT. This appears to be an exaggeration or gross misquotation. It just sounds completely out of character for Burns.
Take care ace,
Matt
poster:mattdds
thread:275048
URL: http://www.dr-bob.org/babble/psycho/20031030/msgs/276084.html