The Myth of Mental Illness

[Jules]

Smudge, it's hardly a massive assumption that a friend of your choosing will have those qualities - it's part of what "friend" means. IF you have any suitable friends, then a therapist may not be necessary, if you don't (and are happy to shell out £70 per hour for the placebo effect + possibly some respect etc) then go to a therapist!

If you have neither the money nor any friends or family, then you're stuffed!

No, wait!

The NHS has provided a "therapy online" service:

http://www.guardian.co.uk/commentisf...heerfultherapy

Hmm... well you will certainly get some warmth from your computer, but I fear the placebo effect will be sadly diminished.

[smudge]

Smudge, it's hardly a massive assumption that a friend of your choosing will have those qualities - it's part of what "friend" means. IF you have any suitable friends, then a therapist may not be necessary, if you don't (and are happy to shell out £70 per hour for the placebo effect + possibly some respect etc) then go to a therapist!

If you have neither the money nor any friends or family, then you're stuffed!

It seems naive and unrealistic to assume that everyone's friends are of a certain standard of selfless, empathic, trustworthiness. Incorrect to assume that everyone has friends at all. I suspect this is particularly the case among many vulnerable people.

Still, I'm sure those lucky enough to call you a personal friend are delighted that you feel willing, able, and ready, to assist in any and all psychological or emotional difficulties they may have. Anorexia, depression, addiction, bereavement, self harm, suicidal thoughts, compulsive behavior, and who knows what else may come up! I admire your self confidence! I also wish your close friends the best of luck!

[Pebble]

But what about the null hypothesis? You seem to be suggesting that the efficacy of psychotherapy should be given the benefit of the doubt until it's been proven false. That isn't science!

In respect of CBT the null hypothesis has been rejected. The question is - whether this is a valid conclusion. Lutus asserts no, I say the evidence is not available to permit a conclusion.

If one had sufficient data to show that all one to one therapies delivered by degree level practitioners gave equivalent results, whereas less personalised therapies were distinctly less effective. Then the question arises, is this purely researcher bias, evidence for a real placebo effect, or actual evidence of efficacy by an unknown but shared underlying mechanism?

Given the inability to compare different psychological therapies in a completely double blind fashion, we may never be able to andwer this question fully.

[Jules]

I had a chat with my cousin (who is a Cognitive Behavioural Therapist) over the weekend, we didn't have time to discuss these issues in any depth but he is adamant that CBT is NOT a "talk" therapy, so it wouldn't even make sense to compare it with "talking to a sympathetic friend". He is working with some cutting edge techniques which involve meditation (called MBCT - Mindfulness Based Cognitive Therapy) which, although early days, seem to hold a lot of promise, particular for those suffering from depression.

http://news.bbc.co.uk/1/hi/7319043.stm

[smudge]

I had a chat with my cousin (who is a Cognitive Behavioural Therapist) over the weekend, we didn't have time to discuss these issues in any depth but he is adamant that CBT is NOT a "talk" therapy, so it wouldn't even make sense to compare it with "talking to a sympathetic friend". He is working with some cutting edge techniques which involve meditation (called MBCT - Mindfulness Based Cognitive Therapy) which, although early days, seem to hold a lot of promise, particular for those suffering from depression.

http://news.bbc.co.uk/1/hi/7319043.stm

It was only you that repeatedly made the comparison! Everyone else was countering your assertion that it was 'no better than talking to a friend'.

I have no great interest in debating the definition of 'taking therapy' with your cousin, but CBT seems to be generally considered within that description;


http://www.nhs.uk/Conditions/Counsel...therapies.aspx

http://www.mentalhealth.org.uk/infor...w-do-i-get-it/

http://www.psychotherapy.org.uk/diff...hotherapy.html


The meditation stuff sounds strange but interesting.

[Jules]

It was only you that repeatedly made the comparison! Everyone else was countering your assertion that it was 'no better than talking to a friend'.

Please don't misrepresent me; I didn't assert that psychotherapy was no better than talking to a friend, what I actually said was:

there is no evidence that any "talking therapy" has more benefit than any other, or simply talking with a friend

As Lutus says in his article, it MAY be the case that talking with a sympathetic friend is as effective, given the importance of the mutual expectation between client and therapist (the placebo) and other factors such as warmth and empathy. As pebble says, there is disagreement about how conclusive the evidence is, but even he admits that owing to difficulties in isolating the placebo effect, we may never be able to reach any firm conclusions.

Regarding the benefits of meditation, I found this (published 2007) -

http://www.ahrq.gov/clinic/tp/medittp.htm

Conclusion: Many uncertainties surround the practice of meditation. Scientific research on meditation practices does not appear to have a common theoretical perspective and is characterized by poor methodological quality. Firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence. Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results.

[smudge]

Please don't misrepresent me;

Well, I'll let others read the thread and make their own minds up.