Cognitive Behavior Therapy Isn't The Be-All And End-All Of Treating Anxiety
Cognitive Behavior Therapy (CBT) is a common, established, well-researched treatment for anxiety. If you struggle with your nerves you may have heard things like:
- "CBT is the Gold Standard for handling anxiety."
- "If you're seeing a therapist for your anxiety and they're not doing CBT with you they're a clueless hack who's wasting your time and money, and you should find someone else."
If you're trying to access mental health care your doctor may mechanically recommend CBT. Your insurance may only cover you for CBT sessions. Free treatment groups offered by the government or subsidized counseling agencies may only be CBT based. It can create the impression CBT is all there is.
If you've already tried CBT and it didn't feel like it worked, you may worry something's wrong with you. You've done this amazing therapy everyone can't stop gushing about and didn't see what the all the fuss was about. You might conclude you're a lost cause, your anxiety is extra-severe, you're just not cut out for counseling, and so on.
The fact is that while many people find CBT helpful, it isn't the be-all and end-all of anxiety treatment. Not everyone responds to it. Some clients give it an honest go, and it helps a bit, but not enough. It rubs other people the wrong way. They might chafe against its structured approach, or feel invalidated by its emphasis on logically disputing "irrational" thinking.
There are other talk therapy models that you may click with more and get better results from. A few examples:
- Therapy focused on processing the traumatic memories fueling your anxiety
- Therapy that does parts work / ego state work to get a better sense of what facets of your mind are driving your anxiety
- Psychodynamic therapy (no, it's not all totally outdated and obsolete)
- Body-based or somatic therapy
- Narrative therapy
- Expressive or art therapy
Of course, everyone's different, so I can't say which method will fit each individual, but there's plenty to choose from.
That's the main point I want to make. I want to validate anyone who's feeling iffy about CBT, but wonders if they're the one who's missing something or deluded. I'll clarify where I'm coming from a bit more.
What this article isn't saying
- I'm not anti-Cognitive Behavior Therapy - I'm not claiming CBT is worthless, overrated, a scam, doesn't deserve its current prominence in the mental health field, and so on. CBT can be really useful. There are concepts from it, like cognitive distortions, everyone should know. It's helped millions of people. It's helped me personally. This site has plenty of articles that explain CBT techniques. It's just not the only type of psychotherapy that can be lead to improvements.
- I'm not arguing people should always try other methods before CBT - In many cases it's sensible to start with CBT, since it still has decent odds of success, and move on if it isn't hitting the mark.
- I'm not trying to imply that everyone can only do one kind of counseling, and it's an all-or-nothing choice between CBT and something else - Of course people should draw from a mix of methods, take what works, and leave what doesn't.
- I'm not saying that just because CBT isn't the only game in town, that every alternative to it is automatically valid or equally as effective - When they're a good match for the client some types of treatment are on a similar level to CBT, but others really are useless, too inefficient, no better than a placebo, etc. I'm not arguing that if you didn't like CBT that some random crystal energy healer is just as likely to cure your agoraphobia.
- I'm not saying that every objection someone may have to CBT holds water - However, even if they dismiss it for misinformed reasons, it doesn't change the fact there are valid alternatives.
- I'm not saying that if CBT doesn't work for someone it's always the modality's fault - When they tried it they may have been ambivalent about changing and not motivated to do everything the therapy asked of them. Again, the point is that even if someone falsely blames CBT for not fixing them, when that wasn't the issue at all, there are still other things they could try.
To sum up, I don't hate CBT, but it's okay if it didn't do it for you. It doesn't mean you're untreatable. Take a look at the other options.