New Book Deconstructs Ideology of Cognitive Therapy

CBT forwards a hyper-rational perspective of human suffering that complements a managerialist culture of efficiency and institutionalization in the Western world.

Zenobia Morrill
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Author and psychotherapist, Dr. Farhad Dalal, recently published a book that critiques the philosophical and scientific bases of Cognitive Behavioral Therapy (CBT). Frequently upheld as an alternative to psychiatric drugs, CBT, according to Dalal’s investigation, is derived from the same flawed scientific and philosophical understandings that are less concerned with the origins of one’s distress, and more apt to reduce suffering to medicalized explanations and institutional treatments.

The book, titled CBT: The Cognitive Behavioural Tsunami, examines the influences of managerialism, politics, and the corrupt science that endorses particular views and responses to human distress. The book’s introduction features the following statement:

“The rise of CBT has been fostered by neoliberalism and the phenomenon of New Public Management. The book not only critiques the science, psychology and philosophy of CBT, but also challenges the managerialist mentality and its hyper-rational understanding of ‘efficiency’, both of which are commonplace in organizational life today.”

“The book suggests that these are perverse forms of thought, which have been institutionalized by NICE and IAPT and used by them to generate narratives of CBT’s prowess. It claims that CBT is an exercise in symptom reduction which vastly exaggerates the degree to which symptoms are reduced, the durability of the improvement, as well as the numbers of people it helps.”

Farhad Dalal works as a psychotherapist and group analyst in private practice. He is a training group analyst for the Institute of Group Analysis, London. Until recently, he was an Associate Fellow at the University of Hertfordshire’s Business School. He has published numerous papers on the subjects of psychoanalysis, group analysis, policy, organizations, and racism.

The central question tackled by Dalal is: “Is CBT all it claims to be?” In response to this, Dalal outlines several arguments that illustrate the falsities underlying CBT’s support. First, he argues that CBT has arisen out of an entrancement with hyper-rationality and a very confined notion of what is included under the umbrella of “science.” CBT’s attempt to understand human distress is modeled after the notion that everything must be precisely measurable in order to count, and further, that it must be documented to be legitimate.

“The activity of science is supposed to be the production of objective knowledge by rational means,” he writes. “The ‘means’ themselves are a mix of observation (empirical evidence) and logical argument. CBT claims to produce scientific knowledge in this way, and on this basis assert that its claims are rational, objective and value free. In short—that they speak the truth.”

In this way, CBT is presented in a way that denies cultural embeddedness. However, Dalal conveys the connection between this approach and a culture of efficiency that promotes neoliberal capitalism. Neoliberal institutions and structures promote efficiency through forms such as austerity measures that effectively result in greater levels of distress. However, human distress is then conceptualized as illness, through a CBT framework and, as such, the same cultural policies that contribute to distress are the ones that offer CBT as a solution.

Dalal expands upon his framing of CBT as hyper-rational:

“The watchword of hyper-rationality is ‘command and control’; its expectation is that we should be able to control everything: not only the world, not only the functioning of organizations, but our very beings.”

CBT’s grounding in a positivist scientific framework dictates the conditions by which CBT is studied and promoted, argues Dalal. He asserts that the CBT narrative is one that uncritically accepts the existence of “mental disorders” in the DSM. CBT as a treatment is studied and promoted alongside the reification of mental disorders. He elaborates:

“On this basis, treatments for mental disorders are tested under controlled conditions by scientists. This produces scientific evidence regarding whether or not the treatment actually works (the evidence base).”

Once this evidence is established and interpreted as convincing, institutional bodies that regulate treatment recommendations, such as the National Institute for Clinical and Health Care Excellence (NICE), develop manualized guidelines for disseminating similar treatments.

Dalal brings up a reason for concern however, with the seemingly unproblematic and linearity in the evidence and promotion of CBT. His main argument involves examining and questioning the ideological underpinnings of this process. He writes:

“Ideological readings edit out the twists and turns, as well as the complexities, contradictions and power struggles to make it appear that they were never there in the first place. The fact is, CBT’s narrative about itself is a political narrative that masquerades as a scientific one.”

Dalal’s book centers on unpacking this ideological reading. He discusses the influence of utilitarian philosophy on the popularizing of CBT, or what he refers to as the “CBT tsunami.” This involves an exploration of conventional understandings of happiness.

Further, he deconstructs the politics of identity formation. This refers to the ways in which the psy-disciplines (psychology, psychiatry, and psychotherapy) have wielded positivism to medicalize and individualize suffering. In doing so, they have accepted diagnostic framings of distress as individual disorders.

Dalal goes on to explain the genesis of cognitivism and its connection to neoliberal economics. He relays one example of this, describing the conceptualization of distress (framed as depression) as the inability to work. Governmental bodies fail to see the ways in which this “burden” is a result of austerity measures. The logical solution to this problem, when framed in this way is, according to Dalal:

“Treat the illness and they will get back to work.”

“On the back of this, new diagnostic categories have appeared in speeches and papers emanating from the Department for Work and Pensions (DWP), for example ‘psychological resistance to work’ and ‘entrenched worklessness.’ The DWP is offering lucrative contracts for providers of treatments for ‘mental illness’ of this kind.”

The link between cognitivism and neoliberal economics is played out in the “dispensing” of CBT as well, he contends. In this process, the task of examining the evidence and scientific base of treatments is one riddled with corruption and deceptiveness as a particular framework is forwarded without acknowledgment of its cultural-embeddedness nor its ideological framing.

Dalal takes the stance that the support for CBT is amplified by overgeneralizations, spinning, lying, and hacking all rooted within the objectification of subjectivity. Research is restricted and results are desire-driven.

“When stripped of jargon,” he writes, “CBT treatment amounts to little more than the injunction: think different, feel different.”

He goes on:

“These practices not only end up short-changing patients by significantly diluting the intensity and duration of treatments that they are entitled to, they also put practitioners under unbearable amounts of stress. But the art of managerialism is one of making it appear that none of these things are happening and that the institution is meeting all its goals and targets.”

In his conclusion, Dalal warns against the third wave of CBT which includes the promotion of Mindfulness-Based Cognitive Therapy (MBCBT). Although the evidence of this approach as an efficacious remedy for depression has been embraced by NICE and the IAPT, he points out that it is not the CBT success story that it may appear to be on first glance.

Rather, he looks closely into these studies to demonstrate the ways in which statistical spin and linguistic obfuscation create a story that matches a CBT narrative. Dalal concludes that CBT itself is a delusion, buttressed and sustained by surrounding managerialist beliefs, systems, and structures:

“The cognitivist delusion is exactly that: the delusion that modern humans are primarily cognitive, rational-decision-making beings. The delusion continues: thoughts precede emotions and are separable from them…Once corrected, once cognition matches reality, then the emotional life falls into line and the person is in recovery. This is readily achievable in anything between six and twenty sessions. Here endeth the delusion.”

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Videos of Dalal presenting on this issue:

 

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Dalal, F. (2018). CBT: The Cognitive Behavioural Tsunami: Managerialism, Politics and the Corruptions of Science.

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Zenobia Morrill
Zenobia Morrill
MIA Research News Team: Zenobia Morrill is a graduate of the dual master’s counseling psychology program at Columbia University. As a doctoral student and researcher at the University of Massachusetts in Boston, she seeks to understand the context informing psychology research and the underlying social factors that influence individual psychology. She is currently involved in projects examining the impact of structural violence.

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76 COMMENTS

  3. In a recent Australian survey, 62 per cent of doctors said the top reason for a patient’s visit was a psychological complaint. The response to this was either drugs or a referral for CBT and Australians are left wondering why aren’t people getting any better as prevalence and “diagnostic rates” have been increasing every year. As Lucy Johnstone once put it, if we don’t focus on the origin of people’s distress and suffering then we are merely mopping the floor with the faucet still running

    • What’s cool is we know the etiology of most of the “bipolar” is misdiagnoses of the adverse effects of the ADHD drugs and antidepressants.

      And we know that the etiology of likely most of the “schizophrenia” is the “schizophrenia” treatments, the antipsychotics/neuroleptics. Since the negative symptoms of “schizophrenia” are created via neuroleptic induced deficit syndrome and the positive symptoms are created via antipsychotic induced anticholinergic toxidrome.

      So what’s good is we do know the origin/etiology of the two most “serious” DSM disorders. Let’s hope the “mental health professionals” wake up to this reality some day. Since currently their DSM causes them to ignore and not “focus on the origin of people’s distress and suffering” leaving them “merely mopping the floor with the faucet still running.”

      One wonders how long our “mental health professionals” will continue behaving like such morons – 5 years and counting since their DSM was debunked as “invalid” by the head of the National Institute of Mental Health. Yet they’re still using the DSM, and the DSM alone, as their only “diagnostic” tool. How slow to learn can the “mental health professionals” be?

  4. Interesting (disclosure: I use CBT and its underlying research and evidence-base as the cornerstone of my psychological practice, albeit mostly in a ‘third-wave’ form – so the things the author is arguing against). There are some valid criticisms here, but there is a lot of what I’d call straw man arguments. For example:

    “The delusion continues: thoughts precede emotions and are separable from them…Once corrected, once cognition matches reality, then the emotional life falls into line and the person is in recovery. This is readily achievable in anything between six and twenty sessions. Here endeth the delusion.”

    Well this may be taught on some CBT training, but it was not on mine. In fact, in my training, we were specifically taught that behavioural change was generally necessary for stable cognitive and emotional change. Cognitive challenging, psycho-education and functional analysis is one way of helping a person engage/reengage in intrinsically valuable and rewarding behaviours in a way that will facilitate their recovery.

    I’m also not at all sure that (as argued in the youtube video) the ethos of ‘second wave’ CBT was ever ‘control’. CBT for phobias, OCD, trauma etc, implicitly, (if not explicitly in all teaching), requires the person to give up on their attempts to control their fear and thoughts. That is the only way out, to give up on unworkable attempts to control and try something else.

    The adoption of other approaches (from attachment and Eastern thought) can be used criticism, but I think the reality is better than that, in that CBT practitioners have acknowledged what is missing from their practice and attempted to correct their previous practice. I think we should welcome attempts to improve our work, and that requires seeing the flaws, and testing our assumptions. Otherwise we’d be stuck with the damaging and ego-driven over-interpretations, racism, misogyny, homophobia and ineffective practice (especially for issues such as seen in OCD) and such like that we started with.

    Now that said, CBT can be done extremely badly. It can:
    -place all the blame for suffering on the person
    -be used in collaboration with societal systems of control
    -collaborate with a persons’ unworkable desire to control thoughts, emotions and suffering when mindful acceptance of ‘uncontrollable’ internal experiences may be more effective
    -conspire with the idea that there is a ‘correct cognition’ that will make things better.

    We need to watch out for all of that.

    • Just wondering what this “evidence base” is that you are referring to. Is it the research trials during which people are selected based on fictitious disorders, these people considered to be a homogenous group that can be studied solely based on sharing a non-existent disorder, their individuality and the unique causes of their distress dismissed, a treatment applied according to a manual that has no bearing on how therapy is practised in real life, where all other variables that might impact on outcome are ignored and where researchers with vested interests delight at the statistical significance of pre and post treatment measures?

    • The whole article is pretty much strawman CBT is philosophical idealism, and this was a thinly disguised attack on philosophical materialism…the whole article was philosophically confused. Yes, CBT is NOT about control in the scientific realistic sense like we DO control things , we have airplanes and spaceships and automobiles, a hoarder could take control of their situation and clean up their house which would cure their depression, but CBT looks at this the other way around , idealistically, the depression causes the hoarding, mind makes matter. That is how CBT DOES try to control , matter makes mind instead of how it works in reality. Sure not EVERYTHING is under our control, but that doesn’t negate the things that are.

        • I have had that blog bookmarked in Google for quite some time. As a sufferer of OCD , this subject is very near to me. All to often CBT and other therapies tell the OCD patient to ; ” Accept the uncertainty” . I have zero problem accepting uncertainty . The problem with OCDers isn’t accepting uncertainty RATHER ACCEPTING CERTAINTY ITSELF is the problem . You CANNOT accept uncertainty WITHOUT accepting certainty , they go hand in hand like day and night . CBT misses this point ENTIRELY ! Being a Trotskyist and a student of dialectical materialism has helped me to understand this and finally move past much of my addictive behaviors . This paper is an essential read for sufferers of OCD : https://www.marxists.org/archive/novack/works/history/ch12.htm

          • With respect DBP, I found the article linked to be chillingy authoriatrian account of Marxism.

            It struck me as having a great deal in common with capitalism with its talk of controlling nature, of the ‘objectivity’ of science as an impartial arbiter of reality and as a kind of CEO defining and directing human ‘progress’.

            Like capitalism it conflated indviduality with individualism and conformity with collectivism, yet I can’t see how there could ever be any true connection, equality, respect and cooperation between people without a genuine freedom to explore and be a self through which to meet and be met by others and the rest of the external world.

            There also seemed to be no understanding of the flaws and limitations of humanity itself which doesn’t bode well for a blueprint for living well together.

            It seems ironic that on a site such as MIA, a version of socialism which disparages non-conformism would be promoted. I can certainly see psychiatry flourishing in this vision of a “brighter” future.

      • They won’t let you edit your comments here, I said : That is how CBT DOES try to control , matter makes mind instead of how it works in reality. Sure not EVERYTHING is under our control, but that doesn’t negate the things that are. IT SHOULD HAVE SAID : That is how CBT DOES try to control , MIND MAKES MATTER instead of how it works in reality. Sure not EVERYTHING is under our control, but that doesn’t negate the things that are. …. as CBT tries to control through MIND MAKES MATTER instead of HOW IT WORKS IN REALITY!!!! Correction noted.

        • Out – science IS objective Marxism is dialectical materialism and science is based on materialism and yes capitalism uses science , but we have to differentiate science and capitalism’s use of science as two different things. YOU are conflating science with capitalism, ignoring Marx’s embrace of it. Capitalism needs science, but the bourgeoisie found that they had to turn to religion to dope the masses because science would lead to progress , so it is only bourgeois science they embrace , mechanical materialism which regresses to philosophical idealism, but conflating science with capitalism you are embracing philosophical idealism , very bourgeois . As for the rest … to say that humankind is inherently flawed and limited has been disproved by history: we always overcome our difficulties , we have got past slavery , we have sent people to the moon, to say that our current limitations and flaws cannot be overcome just doesn’t jibe with science , evolution, and reality, your other arguments of accusing the paper of conflation are a strawman, Marxists DEFEND individuality WITHIN the collective, also a strawman that the paper disparages non-conformism : ….Like the existentialists, the socialist movement has made one of its chief aims and persistent concerns the defence and expansion of individuality… Also you strawman myself because I NEVER said psychiatry should not flourish, my argument is chiefly with CBT not, psychiatry in general. Your whole attack on this paper was a red herring designed to distract away from the REAL issue: CBT is philosophical idealism and is inadequate and existentialist, Marxism not. Do us all a favor, feign being a surprised Marxist elsewhere, your argument sides WITH existentialism thus WITH CBT!

          • CBT, like many techniques can provide some useful tools, but I don’t like it. I don’t even see it as logical.

            Thoughts don’t cause human suffering, imo, although they often reflect or express it, so thought control isn’t any kind of ‘answer’ as far as I’m concerned. I find the whole idea abhorrent and oppressive.

          • The idea is learning to control your OWN negative thoughts. Not letting someone else control them.

            Like Thomas Szazs I only support counseling sessions between consenting adults. If it doesn’t work for you or you don’t want it they shouldn’t force you to have CBT.

          • Absolutely! Cognitive therapy methods are, in my view, only ethical if the client identifies what thoughts (if any) they find troublesome and what kind of changes they would want to make. If the therapist has an agenda, the process is going to go south quickly, though many therapists don’t seem to notice when this happens, and mistake compliance for engagement.

      • Posting Guidelines
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        Mad In America serves as a community forum for those interested in rethinking psychiatric care. We aspire to make this space rich with a diversity of voices and experiences. Our ability to succeed in this goal requires your involvement and your protection. In this spirit, please…

        Honestly articulate your opinions and experiences. Your unique perspective is a welcome contribution to the issues discussed on the site.
        Keep comments civil.,,,,,,,,,,,,misrepresentations of oneself or others (including strawman arguments),

      • I was responding to Rachel777 when I said ” How do you let someone else control your thoughts” as in the logistics, HOW as in how can you do that …my point was YOU CAN’T !!!! It’s not an accusation that she let’s them OR YOU LET THEM. — STRAWMAN IN THE IMPLICATION.

  6. CBT can help in certain situations. But self blame should be avoided. Most people abused by psychiatry already blame themselves for everything. That’s why standard “mental health therapy” is ineffective.

    Tell them, “Hey you’re not a defective monster. Your brain is not broken. You can think for yourself and not believe everything the ‘sane’ folks tell you. They have no right to treat you like dirt just because they call themselves ‘normal’!”

    That would cure their depression in most cases. But it would make them leave the crazy house without walls. We can’t have that after all. 😛

    • In my experience, CBT is simply one of many potential techniques one can use depending on the person you’re working with and their needs and goals. To make it a “therapy school” has always seemed like a delusion and a deception to me. Why would someone restrict themselves to a particular technique and apply it to everyone? Different people have different needs. I’ve also seen/heard of CBT being used to blame the victim of abuse for not “thinking correct thoughts” instead of dealing with the traumatic experiences that led a person to the kind of beliefs they have.

      It seems like the movement was driven by ego and money-making. Starting from the assumption that someone’s thoughts are somehow “wrong,” and that these thoughts occur in a vacuum, having no relationship whatsoever to past or current experiences, is both idiotic and guaranteed to create bad effects. I’m glad someone is writing about this, but as usual, the facts will do little to nothing to disturb the professionals from their greed and egotism.

      • One of the best therapists I ever had–Kevin–told me he used a bunch of different methods and applied whichever fit the situation. He used CBT occasionally, but if the person was too down hearted he would try another technique.

        I used the book “Feeling Good” by David Burns. But it’s not the same as having it forced on you by an emotionally abusive “therapist” or shrink.

        • That was my philosophy – you do what works for the client, and if it doesn’t work, you stop doing it. Pretty simple, really, but it is based on the idea that the therapist actually gets to know and care about the client, and is able to empathize with the client’s suffering and understand how s/he thinks about things. In other words, human connection guides a helper toward things that work. In fact, a person in excellent communication with another can actually invent “techniques” on the spot, specific to that person. Eric Erickson said, “Therapy has to be reinvented with each client.” I believe he was right.

          • “…a person in excellent communication with another can actually invent ‘techniques’ on the spot, specific to that person. Eric Erickson said, ‘Therapy has to be reinvented with each client.’ I believe he was right.”

            Kudos, Steve, I agree wholeheartedly and I think this is vitally important. Healing is a present time endeavor which we *create* as we go. It is a moment by moment thread to follow by which we learn our process. This is appropriate to our uniqueness. In the moment is when we have the power to make a shift.

            For the clincians I’ve known, the problem is that if it’s not “in the book,” they are lost. If it doesn’t fit into a model, then it cannot exist. If this or that method doesn’t work, then you are either disordered or treatment resistant. This cannot work. It is why people do not heal. How can they when, in essence, they cannot be seen or heard and are only stereotyped and dehumanized?

          • You hit the nail. Compassion and empathy come first. Without them, “techniques” are worse than useless – they become a new form of abuse and oppression. And with them, “techniques” become of only secondary importance, as empathy will lead us down the right path toward knowing what best to do to help.

          • Let’s not forget “creative thinking.” Definitely vital in healing, and undoubtedly missing in the mh industry. That is the big huge void, I think.

  7. Hi Zenobia,
    I hope you are reading this.
    I gave a book to Robert Whitaker titled “Normality does Not Equal mental Health: The Need to Look Elsewhere for Standards of Good Psychological Health” Written by Dr. Steven James Bartlett. I sent this book to Robert about a year ago in hopes he -or someone he knows in MIA – would do a book review. Much of what Bartlett is arguing for ties in with Dr. Dalal’s many concerns. Ideally, I wish someone in MIA would do a 3 part video interview with Dr. Bartlett because his findings puts into question the whole of psychiatry as we know it. Anyway, I have an additional hardback copy that I’m willing to part with for anyone in MIA who will do a good book review. So if you are up for it, let me know where to send it.

  8. From it’s evolution from “behaviorism”, having trained in CBT {and “behaviorism}, I’ve always suspected CBT to be based on a fraudulent sales gimmick asserting high effectness when little if any effectiveness existed, especially noted when strong reactions to criticism of CBT have been verbalized. Years ago, when Pres. of the NYS Division of Public Sector psychologists I posted a copy of a paper of a study of thousands of Ss in Thought Field Therapy completed in South and Central America, for information only. The toxic reactions from those identifying themselves as CBT or “behaviorists” was incredibly overwhelming.

    In one major study of CBT I was professionally associated with as department chair but had nothing to do with the study, it was discovered by a staff psychologist who expressed concern to me as her supervisor, that the psychologist running the study faked the results. He was later dismissed. Thank you for your affirmation of my suspicions.

  9. I don’t think at all that CBT is as bad as this book claims it to be! This looks like his opinion only – he doesn’t provide any concrete evidence (at least I don’t see it in this article). After all, the main thing an individual experiencing mental issues need is hope, support and other interventions such as training in mind-calming activities. This is in contrast to psychiatric treatments where patients are given disempowering labels that increase stigma (along with psychiatric drugs that do more harm than good in the long-term).

    Also, as I see it, the mindfulness component is the most important component of CBT – perhaps this component should be greatly expanded for all CBT interventions. Mindfulness practices calm the mind, enable one to observe thoughts moment-by-moment and significantly reduce rumination, etc. (note that rumination is a large risk factor for mental health problems). Mindfulness practices also increase eudemonic wellbeing.

    • Exactly. This is why observing thoughts (whatever comes up), and becoming aware of various emotions, etc., that happen to arise in one’s mind makes so much sense. Practicing mindfulness is not about purposefully not thinking about something (what you are saying). Thoughts arise and pass moment by moment in a way that they have been conditioned, etc. Please take a look at the following article – you will then understand the profound theoretical underpinnings of mindfulness practices:

      Karunamuni, N., and Weerasekera, R. (2017). Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom. Current Psychology.

      • No, gaslighting, I understood perfectly. CBT and mindfulness etc. say that the cause of mental illness is ” rumination ” ” focusing on a problem ” i.e. THINKING about it , THINKING . Then it says the cure is ” mindfulness ” …somehow magically ” observing ” the thought(s) without ” ruminating ” i.e. THINKING ABOUT IT . So it DOES say the solution to mental illness is to stop ruminating i.e. TO STOP THINKING ABOUT IT . When in OBJECTIVE REALITY thoughts are caused by material objects and so mental illness is a result of those thoughts being unresolved because THE OBJECTIVE SITUATION is unresolved . The cure obviously is the resolution of the problem. CBT and mindfulness are assumptions of cynicism and narcissism that say your physical problems will never be resolved and that they affect you alone so you alone have the heavy burden of them . This goes against fundamental human solidarity and thus is very bourgeois , simplistic and oppressive .

        • It looks like you have no idea whatsoever regarding what mindfulness is!!! Mindfulness is never about stopping thinking or about not resolving objective situational issues one maybe facing in life – in fact it is just the opposite! I would suggest that you read Dr. Jon Kabat-Zinn’s book “Full Catastrophe Living” – it is a good place to start for someone like you who doesn’t seem to know the basics of mindfulness practices.

          It might also be useful for you to know that most of the time, people ruminate/worry about things that have not happened (and things that may never happen), or about things that have happened to them in the past etc (regrets). When practising mindfulness, one becomes aware of any thoughts and emotions and how they manifest moment by moment in one’s mind stream and this enables one to gradually cultivate self-knowledge and wisdom as well. Studies have also demonstrated that if one proliferates on a thought (it could be anger, depression, anxiety, etc.), these thoughts become more powerful whereas if you mindfully observe thoughts, they become less powerful.

          Additionally, so many studies have demonstrated that mindfulness interventions result in healthy structural and functional changes in the brain and also that improvements in patient’s psychological symptoms CORRELATE with structural changes that happen in the brain.

          I strongly suggest that you learn about these things before you argue in such a superficial manner. Dr. Jon Kabat’s book should be available in your local library – please read it.

          • “It looks like you have no idea what mindfulness therapy is.”

            Not sure the perky worker who forced us to hum and empty our brains for 2 hour sessions did either. Ugh! Torture. You had to be REALLY “medicated” to sit through one of those. Most just took naps.

            I referred to them as mindlessness exercises. Relaxed and dumb as possible is what mental health wants for all the clients. 😛 They love to force you to watch lots of TV too. They play it 16 hours per day in every psych ward I’ve visited.

            Of course forced therapy only “works” if inflicting pain is the end goal.

          • Hi Rachel: I agree that two hours is way too much meditation for a beginner, especially if it is introduced as simply “emptying the brain.” This is why mindfulness practices need to be taught by well-trained teachers who clearly understand the practice.

          • Hi Fiachra: Thanks. I have a passion for mindfulness practices and have studied them very carefully during the last ten years (both theory and practice). I have also personally benefited from them tremendously, and think others can benefit too if only they took time to understand them. Not sure what you mean by ‘official’ but I have a graduate degree in a health-related area. I also teach mindfulness (currently as a volunteer).

          • It looks like you have no idea whatsoever regarding what mindfulness is!!! Mindfulness is never about stopping thinking or about not resolving objective situational issues… ACTUALLY it IS about not resolving objective issues because if all you do is sit around and meditate and the philosophy behind that is the philosophically idealistic gaslighting attitude of: ” most of the time, people ruminate/worry about things that have not happened ” well that is philosophical idealism and meditation becomes an opiate because you have an attitude that thoughts don’t come from reality which is what you are saying when you say ” most of the time, people ruminate/worry about things that have not happened ” Which is the conclusion that since thoughts don’t , nothing is real , because if you say that most of the time you inevitably HAVE to say ALL of the time because if you can’t tell if one thing is real then you can’t tell if another is. And ” rumination ” means thinking about it , so stop gaslighting me. BTW I USED TO BELIEVE IN ALL THE CRAP YOU ARE TALKING ABOUT I HAVE OCD I USED TO MEDIATE , I also used to use drugs , alcohol , sex, porn,gurus, religion .. I was able to STOP all of those addictions when I became a dialectical materialist , so your statement ” It looks like you have no idea whatsoever regarding what mindfulness is!!! ” is an ASSUMPTION!!!! But that’s what philosophical idealists do, ASSUME, cause they don’t trust their 5 senses . .. of course you know what you do when you assume , right Nancy? No studies ( that you don’t link to ) have ever or CAN ever prove that mind makes matter… mechanical materialism… it is neo-Kantian some of the things you say… here is a refutation of that ….: https://www.marxists.org/archive/lenin/works/1908/mec/index.htm p.s. Nice assumption : ” superficial manner” … I actually had one CBT therapist who ENCOURAGED ME TO WATCH PORN!!! UNBELIEVABLE!!!!! same one who told me I couldn’t know about an obvious thing!!! The lady in this scene sums up the CBT philosophy : https://youtu.be/pbI6qTih2TI

          • The problem with mindfulness is that it has been abstracted from its spiritual roots in Buddhism and is now being used as a gimmick to deal with anxiety. Which it does help with, but it seems a shame (but typical) to remove the spiritual focus that provides a context for why one might meditate and what one might get out of such a practice over time. It should not be a means to escape the rigors of capitalism. It is a lot bigger than that.

          • Every time I hear about mindfulness I get this sick feeling in my stomach. I think it’s a mass effort to stop or curtail activism. I think it’s a farce. Yeah, it might feel helpful but it’s avoidant, really.

            If something sucks, face it head-on, figure out what sucks about it and if you can do something to make it not suck. Then, decide if it’s worth it. Sometimes it is not.

            Here is an example. My workplace screwed up and overhired. People are barely aware that this is the cause of us having very little work and very little pay. I personally am not making enough to live on and am going into the red. So this is what happened.

            I confronted them directly in an email and in a post on their social media. I posted both on our workers’ private Facebook page. Now, suddenly, as of today, people are following suit. They are speaking up!

            I asked them to be upfront with us and tell us what they plan to do with the huge number of surplus workers. I doubt they’ll get rid of us but they have to do something. As of today at last things are slightly improved.

            What was the alternative? Contemplate my navel? Talk to a therapist? Put a paper bag over my head?

            No! I spoke up right away. Nothing to do with coping except to tally up my budget and realize I can’t go on like this. All numbers, nothing that therapy or meditation can help with. I think we will see results!

          • Oh…I know! I’m sure there’s a pill for “pay cut.” Instant, right? I want a pill the pays me a hefty paycheck, please. You’d think these MH peddlers really had that, by the way they talk.

    • Mindfulness as taught in the mental health industry is NOT the mindfulness taught to beginning meditation students. This is a concept that’s been appropriated from the Buddhist community and bastardized into a system of shaming people for thinking too much about distressing things. In the psych community, mindfulness is taught with handouts, guided meditations, and is reduced down to the fragmented parts that psych researchers have decided are the most useful at stopping “rumination”.

      In a (Zen buddhist) meditation group, the atmosphere is so much different. The lights are dimmed, you take your shoes off and sit on the floor in a circle on a Zafu/zabuton, there are all sorts of rituals that you as the participant go through in an interactive way with the leader from the opening with the Tibetan singing bowl all the way to the close with the same. There’s a quiet respect. You learn to listen with an open heart when someone is speaking and you thank them for sharing. Every moment is an opportunity to relax and calm your entire mind and body. There’s a walking meditation component (my favorite part, especially being taught to match our breath to our walking rhythm and slow down our breathing), there’s the sharing afterward if any strong feelings arise. When participants cried while telling what feelings or memories they had experienced, it was treated as a sacred moment, touching some inner part of your psyche, not as a failure to properly clear your mind.

      In the community, meditating is treated as a way to get in touch with your environment and be interconnected with everything around you. In treatment, mindfulness is just another tool in the bag to shut people up and fix their unquiet minds. One is a way of life and the other is a means to an end treated as a tool. But we use tools to manipulate and force our environments into the shapes we want and that’s not how meditation works.

      I have been exposed to an extensive amount of mindfulness training in both treatment setting and in the community and there just is really no comparison. It’s truly a tragedy how mindfulness (without the spiritual and ritualistic components of zen Buddhist meditation) is taught to many patients with the goal being to feel better but not to become spiritually wiser and become connected with the universe and all of the living beings sharing this walk with you. Mindfulness as psych treatment is another bankrupt quick fix.

      I can only at this point but thank the gods I do think so much. A willingness to look at something over and over and over from every possible angle until you know it inside and out, that’s not ruminating, that’s a hallmark of the mind of a scientist, not a sick person.

      • I would add that in Buddhism, participation is always voluntary, and no one is “the authority” who can tell you that “you are doing it wrong.” It is understood that it is a practice that will unfold differently for each person, and that the person him/herself is the judge of what it all means. VERY different than the “mental health” version.

        • Yes it’s ridiculous to think that you can force someone to meditate.

          But I think also that I was getting at a greater point. There are other types of meditation that include the concept and teaching of mindfulness but the way they have become manualized for industrial application has removed the ritual and spiritual practice that I have felt is so closely intertwined with the results of mindfulness that Linehan drew from when she was designing DBT. And this is what I feel is so objectionable about the way it’s been bastardized for the mental health community.

          I have gone to many an Insight Meditation Meetup in my community and it is delivered in the same way that I experienced in clinical setting, though in theory, mindfulness is a critical component of insight meditation practice. So you’ll have an instructor at the front of the room speaking to a bunch of people in business wear who’d rushed to drive their from their important jobs, all sitting up in their chairs and paying attention, the glare of fluorescent lights overhead, some generic speaking from the leader, a guided meditation, and then you all pack up and go home. I went every week during the summer of 2016, never got the sense that there was a community of us with the kind of rapid turnover you might expect from a meetup group, and never feeling like I’d gotten any benefit from it.

          And I really did not get any benefit from it until I joined a zen Buddhist intro to meditation taught by someone who’d spent many years practicing with Thich Nhat Han himself at Plum Village in France. That was when I finally learned how to meditate for real and what it actually meant to simple observe thoughts without reacting to them emotionally. It was the very definition of a safe space. There really is no comparison between the way Buddhist monks and initiates meditate and these westernized versions.

          And it’s just my experience but I really feel that the focus on mindfulness alone is insufficient without genuine spiritual practice. It would be like going to Sunday school but skipping worship service and suggesting that people would reap the benefits of Christian spiritual practice out of that.

          It is the spiritual interconnectedness that Buddhist meditation practice develops in the practitioner that eventually produces the result of calming the mind and which the practitioner is then able to apply their newfound awareness to every day activities. The concept of ritual, whether you are washing the dishes, walking the dog, doing your taxes or dealing with a stressful situation, it is the ritual habits developed that contribute to the practitioners ability to relax and open the mind and practice mindfullness in everyday activities. Without this ritual, it is a tool. And I still believe that when you wield this as a tool (coping skill) instead of it being a personal practice of meditation with all of its rituals, that you’re unlikely to truly reap the long term benefits that the research on monks has shown to create in the brain, though you may certainly feel calmer immediately after a guided meditation and attempts to be more aware of one’s environment.

          • I agree completely. There is an entirety of Buddhist theory and beliefs that underlies the whole idea of why we meditate and what is to be gained from it. It is ironic that someone could think of scheduling a “mindfulness seminar” in the midst of an insane, “monkey-mind” world where real mindfulness would create nothing but horror as the person gained real awareness of what was going on!

            Psychiatry aims at removing any idea of spiritual existence and awareness in favor of worshiping the material world under the guide of corporate capitalism. Buddhism moves away from materialism to spiritual awareness of the meaninglessness of striving to control the material world. It is in some ways the essence of anticapitalism.

          • ferkane, I like what you said, and agree with many of your statements, especially when you said that a CBT therapist should not impose “correct” cognition. Or what they assume is correct.

            Here is where I cannot agree at all: “Well this may be taught on some CBT training, but it was not on mine. In fact, in my training, we were specifically taught that behavioural change was generally necessary for stable cognitive and emotional change.”

            Sadly, this is used on school children and it isn’t working. In fact, it’s totally missing the point. I am disgusted that school employees are now using behavior correction and they even think it’s helpful. I am terrified that as a school employee I’m going to have to praise kids for sitting quietly and be obedient. Ugh.

          • I have been told that running is a meditation, which I agree with. I do like running and usually when people push meditation on me I tell them I already run so PLEASE LEAVE ME ALONE!

            I like running because it is useful. I run on the treadmill, on a local running track, and on the street. If I am outdoors, I enjoy beautiful scenery. Indoors, I enjoy myself, too. It can be used as a form of transportation. Sweating is healthy for you and you earn your shower! Also, running strengthens your heart. Proven.

            No one pushed that on me. I decided myself. Maybe that is one reason I love it so much. That plus long ago when I went to brainwashing sessions, the therapist threatened me and said I couldn’t run. Now, it’s extra enjoyable to be free of her and defying her.

  12. Hi kindredspirit,

    I just read your comments. While I agree with some of what you have written, I disagree with several points.

    MBSR practices (as introduced by Dr. Jon Kabat-Zinn) is not about “shaming people for thinking too much about distressing things” (what you have written). If you carefully read the book of his I mentioned earlier, you will be able to clearly see this for yourself. Also don’t forget that Jon Kabat-Zinn studied under several Zen Buddhist monks (including the monk you mention: Thich Nhat Han) and this monk has fully endorsed his book (in fact he had written the preface to his book).

    You need to remember that there are many people who freeze at the mention of the word ‘religion’ or ‘spirituality’ (especially people who claim that they are “intelligent and scientific minded” and refer to spirituality as “new age mumbo-jumbo”). This is why Jon Kabat-Zinn decided to start MBSR without using any religious or ritualistic context (he explains this well in his book). This way, the Buddha’s universal and profound teachings are available to many people instead of just a handful – and many people have indeed entered spiritual lives after going through MBSR courses. You need to remember that although you like rituals, there are several people who would avoid them at all costs.

    In a recent talk by Jon Kabat-Zinn I listened to, he states that “the Buddha was not a ‘Buddhist’.” What the Buddha did was to analyze the mind in comprehensive detail (i.e., describe how the mind works), and present it to the world – in other words, people refer to teachings of the Buddha as a ‘religion’ only because the teachings are not easy to understand. The teachings are nothing but the ultimate “science of the consciousness.”

    By the way, MBSR courses (the 8-week course) teach many types of meditation, including walking meditation. Also, regarding your statement “over and over and over from every possible angle until you know it inside and out, that’s not ruminating, that’s a hallmark of the mind of a scientist, not a sick person” – you need to remember that there is a HUGE difference between rumination and analytical thinking. Rumination is about repetitive thinking and is not self-directed (the mind does it AUTOMATICALLY) and this is what becomes less with meditation training. I agree that analytical thinking is useful because that is what ultimately leads to wisdom.

    Also, as you state, stopping “rumination” is NOT the end goal of MBSR (but since this aspect is easy to measure, studies often assess this end goal). Here again, if you read the book, you will understand. Further, research has shown that people who go through the 8-week program demonstrate structural changes in their brains – these changes are not just limited to monks.

    • Hi Nancy,

      I think we’re talking past each other here. You have replied to ex patients discussion of mindfulness classes in mental health treatment settings as if your own community practice is being attacked and I’m confused.

      You’ve misinterpreted my statements on spirituality and ritual to indicate some kind of religious feeling or belief and I wonder if you know you’re talking to an atheist? I don’t need the lecture about how some people don’t like religion. Pffft!

      The fact remains that the way I experienced mindfulness taught in a mental health setting was not in any way useful to me. My experience wasn’t as egregious as Rachel’s but her experience is valid too.

      I am aware of Jon Kabat Zinn’s work on MBSR. Nothing I stated invalidated MBSR, since that isn’t what I have been exposed to in mental health settings which I still stand by calling it a bastardizarion of of the mindfulness that results from a personal meditative practice.

      (I realize that my comment above is nestled under yours. I wasn’t intending to appear to be replying to you. I was intending to be replying to the conversation and to back up what Rachel experienced. Sorry if it appeared I was directly replying to you.

      • Kindredspirit, I can’t agree more. I, too, was subjected to the fake Buddhism done by hospital clinicians and therapists. I hated it! We even had watered-down yoga. Ugh.

        I am actually triggered when anyone says to me, “Take a deep breath.” No, I will not! No one is going to tell me how to breathe! I’ve been breathing fine for 61 years now, and at 61 I can run four miles at least. Since when do I have breathing deficits? What is really funny is when the person saying that is a smoker. The only time I’ll do this is if a doctor is listening to my lungs with a stethoscope. I don’t even remember the last time that happened, either.

    • Thanks kindredspirit. So – I am assuming you are referring to negative aspects of how mindfulness is taught in mental health treatment settings (where the doctors assume ‘mindfulness’ to be just a tool in their bag), as opposed to MBSR 8-week training courses that were initiated by Dr. Jon Kabat-Zinn (where mindfulness is considered within its broader meaning). If that’s the case, I would agree with you. To address this issue, I suppose it is best for mental health providers to direct patients to do a full 8-week MBSR course (that explains and goes into details of mindfulness) instead of trying to teach/guide patients themselves using their superficial understanding of mindfulness.

      • Nancy99, a patient needs to decide for herself whether the concepts of mindfulness are useful. I do not agree that a therapist should impose these, but most do. I can’t tell you how many times I’ve been pushed to meditate, or blamed because I don’t meditate, that is, I CHOOSE not to.

        The concept of mindfulness is likely useful to some people, but it’s just not for me. I wish people would respect that.

  13. Typing a comment on the internet is taking control of the material world… hardly meaningless, hardly believing taking control of the material world is meaningless also to be anticapitalist is to be AGAINST private property, which Buddhism allows for, so what what political side does that put Buddhism on and what philosophical side does that put capitalism on ? Don’t get me wrong , there can definitely be Buddhists who believe in socialism, people who believe in both CBT and biopsychology , that are socialist too, but all of those things in and of themselves are about preserving the status quo, not change. Sitting in the lotus position does not remove what is causing trauma to our society.

  14. I was having a hard time getting through the comments, for some reason….

    Anyway, I am very glad this book came out. I just had a really negative experience with CBT. I purchased a self-help CBT book that focused on trauma. I couldn’t believe what I was reading. The book talked down to readers. It was so insulting I just had to put it down.

    Not only that, the so-called coping methods were just plain idiotic, or just so obvious it was common sense. Most reminded me so much of the “hospitals” that caused the trauma in the first place. Why on earth would I ever want to hold onto ice cubes? Oh please! I couldn’t read any further. What next? Stuffed animals?

    Finally, I confronted the real question: Why would I want to obliterate my emotions? What’s to “cope with” if I am coping just fine? I do not find certain emotions uncomfortable at all. The book totally missed the mark for me.

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