CBT Doesn't Work


Cognitive-behavior therapy will go the way of low-fat pudding.


Imagine you’re afraid of girls, too afraid to even think about asking one out. So you see a psychologist to figure out what could possibly make self-castration feel like the best option. Though he only talks to you about how there’s no rational reason to be afraid of girls, then he recommends you talk to more of them.

Imagine you’re a compulsive eater. Of course you’ve read every book on diet but it doesn’t help because of you cannot win against your inner urge. You see a psychologist to get to the bottom of the irrationality and she recommends you swap the cookie sleeve for broccoli.

Imagine your husband is going to leave you unless you learn to control your violent temper, a problem you’ve had since childhood. You see a psychologist to finally work through some of the latent pain and he recommends a breathing technique.

This kind of symptom-focused therapy, which has become known as cognitive-behavior therapy, is insulting. It’s even more insulting to graduate students because we’re forced to learn this intervention a mainframe could do.

To think we can solve our psychological issues by making a decision in the moment, is to not only be a robot but an outdated robot. In other words, a dumb nerd. These are the worst kind of nerds. The guy in high school who you wanted to beat up but he wasn’t even smart so you just felt bad for him. This is a high-conscientiousness and low-openness, the two marked personality traits of CBTs.

Even the idea behind CBT is self-refuting—if we change our psychology by making a decision in the moment, then there would be no such thing as a psychological disorder. That’s the point of psychology. The anxiety itself keeps us from asking out girls, the compulsion itself keeps us from changing our diet, the rage itself keeps us from an equable presence.

At the risk of sounding glib, CBT doesn’t work. The therapeutic technique that has been championed as the go-to scientific approach to therapy doesn’t work.

It gets a lot of funding, though. And insurance won’t cover therapy unless it’s CBT, so what happened?

What happened is the 1970s. Psychoanalysis was shown not to be reliable, given its—literally—subjective nature in that it’s practiced differently depending on the subject. To defend their field, psychologists scrambled to get a therapeutic practice together so they could get a piece of the NIH bloat that was occurring at this time.

The initial CBT studies were biased from the beginning because if this new, concrete-bound therapy wasn’t shown to work, then psychology may have gone the way of phrenology. Psychologists, because of the incentives, unconsciously became like race hustlers for their profession.

The initial CBT studies were only compared to psychoanalysis, which has been notoriously touchy when put under the lens of science.

In every study pitting CBT against an array of anxious or depressive disorders, simply going to group therapy works as well as going to group and CBT in combination. And it works better than going to CBT alone. Yet the idea behind group contradicts CBT. Instead of directed intervention at a specific thought and action, group simply lets the participants talk with little input from the psychologist. Sometimes no input from what I hear because, hey, insurance is paying for it so no one cares.

Yet it still works better than the more logical CBT because this is how psychology works. Our freedom of action and so change comes first from emotional literacy. The trick is understanding the syntax of emotions so we can learn the language.

The CBT hustle happened before with the high carb, low fat diet craze. Remember that? In the 90s and early aughts, when people though eating low-fat pudding and Snackwells was going to make them look like a Fight Club poster?

There was a health problem. Westerners were getting fat and dying and we needed a solution, any solution, so scientists latched on to the low-hanging fruit, the most intuitive answer: People were eating too much fat and cholesterol. Even the wrong answer looks better, in the short term, than no answer at all. Besides, the researcher gets paid either way. And we’re talking government grants from the NIH that engenders generational money. We thought we got rid of the rite of a king granting lordship with the founding of America but it’s only taken a different form.

Thus begets a vicious cycle: money pours into research, skews research, “evidence” makes us feel good, which demands more financial support. Not to mention the unseen catastrophe: our country’s PhD-level minds now spend their time proving a false idea correct to get more money instead of seeking out new solutions. It’s why symposiums resemble congressional gripe-fests about who gets what money as opposed to the Lyceum.

The solution is to understand why group works better than CBT. Why simply putting yourself in a room of people and listening makes it more natural for the incel to ask the girl out, the binger to put the food down, and the rager to mellow out.

We need an understanding of emotions, how they operate, how they affect us outside of our awareness. We need a structure to the emotions so we can work with them and not simply try to change them. And then we need a process through which we become more literate with emotions, and so reality.

To all the burgeoning psychologists out there, your professors are dinosaurs. It's on us to wake up the field out of its CBT slumber. Otherwise, we’re going to feel stupid when the most scientific therapy is debunked and the welfare runs dry—about as stupid as we feel when we remember all those Snackwells we ate.