way back when i was in training as a psychiatric resident, cognitive-behavioral therapy (CBT) was virtually unheard of among psychiatrists. that's because psychiatrists are basically trained in the the psychoanalytic (freudian) tradition of psychotherapy. having taken up psychology as my pre-med course, i was well-aware of the weaknesses and limitations of the psychoanalytic approach and decided that i would never use it as stand-alone therapy. in my desire to offer more substantial help to my patients, i studied and learned how to do cognitive-behavioral therapy at the same time that i was training myself in psychoanalytic psychotherapy.
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here i am teaching cbt to psychotherapy students.
in my current clinical practice as a psychotherapist, i commonly employ cognitive-behavioral therapy on my clients with anxiety disorders (panic attacks), depression, obsessive-compulsive disorder (ocd), and addiction problems. cognitive-behavioral therapy teaches that "bad" thought patterns cause us to experience"bad" feelings and makes us engage in "bad" behaviors.
cbt however is not always the appropriate therapy to use. cbt may be the most popular and most-researched of the psychotherapies but this does not make it superior to other psychotherapies. for instance, a large long-term study by the national institute of mental health (nimh) rated medical treatment and interpersonal therapy to be more effective in the treatment of depression than cbt.
furthermore, cbt is the most-researched of the psychotherapy approaches NOT because it is most effective BUT ONLY BECAUSE it is the easiest to research on. why? because cbt is the most structured of the psychotherapy approaches and a cbt treatment protocol can easily be standardized (i.e., applied as a "de-kahon" approach). because it is a structured approach, you might not even need a cbt therapist to help you. buying yourself a self-help cbt workbook and religiously doing the exercises and assignments on a long-term daily basis will probably do you much better than merely consulting a cbt therapist for weekly sessions of one hour each.
in my long years (decades actually) of exposure to and practice of different psychotherapies, I personally and professionally consider gestalt therapy to be more effective than cbt. for one, gestalt therapy not only has a strong cognitive-behavioral component like cbt, but it also focuses on the physical, emotional, spiritual, energetic, relational (interpersonal), and ecological aspects of existence. it is therefore a more holistic approach than cbt. and secondly, gestalt therapy is not only about "fixing" your disorders; its higher goal is for the client to experience personal growth and have a more meaningful life. unlike cbt, gestalt therapy then is really about attaining your fullest potential as a human being. it is about becoming the person you were meant to be. but, enough of gestalt for now. going back to cbt...
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many people have the notion that cbt can take the place of anti-depressant or anti-anxiety medications and this simply is not true. in the midst of overwhelming emotions or symptoms, it is very difficult, even impossible, to apply cbt. do you think, for instance, that you'll still be able to apply your positive affirmations and positive self-talk when you're desperately gasping for air and physically feeling that your heart is going to explode from the pounding heartbeat of an intense panic attack? cbt can certainly be a helpful form of therapy for mild cases. my clinical experience (and the experience of many many patients) tell me however that psychiatric disorders (i.e., schizophrenia, major depression, GAD, SAD, panic disorder, OCD, etc.) have to be medically treated or managed first before cbt can be successfully applied.
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