RoR: Forum

Ed,

You are right that TFT isn't well accepted by the mainstream at all and I don't agree with the theory the TFT people put forth, but the effects are striking in certain limited areas. Imagine that someone had discovered some of the effects that aspirin had and then they created a theory to explain those effects. Say that theory was not unlike Eastern herbology or something. The effects are real and striking but I don't buy into the explained "why." That is where I stand with TFT. I've seen the results but don't have any respect for the theory.

One of my complaints about academic CBT (Cognitive Behavioral Therapy) is not that they have adopted an empirical approach for psychology, but that they threw out everything that isn't a product of a research study as NOT psychology. They don't look at the real world unless it's in a research project, and they don't look at underlying philosophy - they went too far and threw out parts of the baby with the bathwater. They also were so eager to rid themselves of the babble of hundreds of different schools of psychology that they decided to call all of what they said, every one of them, as either old or pop psychology. They exist in a world of self-made deafness to any voice outside of academia, and outside of any school but CBT.

The issues that the TFT technique works well on are those related to PTSD or phobias. The client is asked to imagine whatever is generating the feeling of panic or fear. Their job is to make it as real as they can in their minds and the therapist helps with suggestions, and guided imagery. The therapists taps when they have the fear as high as they can get it. It is more elaborate than that, but in a nutshell, that's it. Five to fifteen minutes.

My theory of why it works is very different from what others have proposed. It has to do with the mind storing traumatic memories - those used to trigger fight or flight responses - in a different way - some part of the memory is stored in areas of the brain stem (primitive area) and as a different kind of memory. Those memories get linked to sensory triggers that generate automatic (no conscious choice permitted) panic responses. The tapping while the client is maintaining the memory seems to erase that link to the panic feelings leaving it just a plain memory. Branden learned of it from a friend who tried to convince him of it's value, yet it took him years to try it because it sounded so hokey. When he did try it, the results were too obvious to ignore.

There are several other, related therapy techniques that are similar, (e.g., Rapid Eye Movement Desensitization). And the CBT people have some procedures for phobias, but they are just talking, and then 'getting back on the horse' type of thing (in stages) - and none are as effective.

There are other aspects of what is happening that might be at work making this so effective - like the technique of "proscribing the symptom" which gives a client an increased sense of control and disconnects a symptom from its natural environment, and cognitive desensitization that occurs just from bringing it out into the open and working on it, and the placebo effect, and others, but even added up together, they don't account for the effectiveness.

Post 241

Friday, January 2, 2009 - 7:24pm

Walter's post was accurate. That is similar to what I heard about Branden's introduction to TFT. Branden set some small tests of his own and then did what every practitioner does... Try the technique that seems best suited to symptoms and what is known of the client, and if it doesn't work, change techniques and try again.

Walter is right to point out that there are powerful affects at work that arise out of the client-therapist relationship. It is still much more of an art than it is a science. The difference between a good therapist and the average therapist is enormous. And I'd say that even a good therapist needs a minimum of 5 years of clinical work before they are very effective.

You can read everything Walter says about how empirically oriented the new CBT is. But what he doesn't mention is how awful some of the research is. In the end, bad research protocols, sloppy premises, and even dishonest data reports account for more of the hallowed results than anyone wants to admit. Psychology in academia has a lot of parallels with philosophy in academia.

Post 242

Friday, January 2, 2009 - 9:52pm

Steve is right to say that Nathaniel does not need to apologize to anyone for what he's written on psychology. Taken as a whole, his work is tremendous. However, there are lot of passages in The Psychology of Esteem on anxiety that bother me. Most of what he writes specifically about anxiety is in this book and given that it is old, that is certainly some mitigation, but even the title of Chapter 9 bothers me: Pathological Anxiety a Crisis of Self Esteem. Nathaniel does qualify this a statement about general anxiety rather than fears produces by specific causes or stressors.

Nathaniel's books are terrific for self-esteem improvement and there are very few people who don't need self-esteem improvement.

However, anxiety in many cases is a whole different thing. People differ in their response to stress, regardless of their self-esteem level. People with high self-esteem often have better coping mechanisms and manage crises better, but sometimes stressors are outside your control. My contention is that stress overload whether it is self-esteem induced or not, is a major cause of anxiety disorders. I think many people benefit from the use of benzodiazepines or serotonin reuptake inhibitors under supervision of their doctor or psychiatrist in addition to lifestyle modifications to alleviate these problems.

In any case, when talking about these phenomena, I like to know the specific brain structure and neurotransmitters involved. Recent advances indicate that anxiety involves the amygdala, the prefrontal cortex and the hippocampus. Psychotherapy can be effective, but largely in dealing with the problem from the standpoint of working memory as it is processed by the prefrontal cortex and hippocampus. However, anxiety also involves triggering the amygdala. Classic anti-anxiety medications work on the amygdala, specifically on GABA transmission.

Talk therapy works directly on the lateral prefrontal cortex(thought production) and Cognitive Behavioral Therapy works on the medial prefrontal cortex(working memory extinction). Steve certainly knows more than I do about these areas, so I'll yield to him on them. However, I see no reason why temporary use of relatively safe drugs such as Xanax shouldn't be used to aid in dealing with anxiety disorders.

In any case, doing the research on brain science is relatively accessible now, the chemistry and neuronal mechanics are not complicated, so I see no reason why professionals wouldn't want to learn about them. For anyone who wants to learn more, Joseph LeDoux has a website: http://www.cns.nyu.edu/CNFA

Jim

(Edited by James Heaps-Nelson on 1/03, 12:42am)

Post 243

Friday, January 2, 2009 - 11:52pm

Jim,

Excellent reply. I see four general sources of anxiety: Organic disorder, psychological trauma, low self-esteem, and, like you said, stress.

I always throw "organic disorder" in because we don't know enough to rule out organic causation for many disorders and we may find we are wrongly treating some disorders with talk therapy when it will only respond to medication.

I put psychological trauma separate from stress because its not only magnitudes of order greater, but it also has a different mechanism being invoked. Like PTSD, it comes about because of repression as a response to experiencing something horrific - something that sets ones sense of mortality to the forefront.

Low self-esteem would be the most common cause of anxiety, by my guess, and it is usually located in a general area. People are more likely to be anxious about capabilities or lovability - it gets triggered with even more specific repressed fears - like someone anxious of public speaking my have the subconscious fear, "They will find out I'm a fraud." And that could be from someone who has driven themselves to be a foremost expert in an area, but in a sense, the little boy in him is afraid, because of the way he reacted to his fathers harsh demands. Low self esteem won't cause the anxiety, but will lie under the immediate cause.

Self-esteem fluctuates but not greatly or very rapidly. We built up whatever our average amount is for a long time. But stress varies quite a bit. We change jobs or try something new. We move to a new stage of life or go through a health trauma. We break up with a loved one. We see what may be a economic depression looming on the horizon. Even the holidays tend to stress. Lots of people can't shake a feeling of sadness during the holidays.

My general approach for someone with moderate anxiety or depressed mood, was to start with talk therapy and see if that was enough - just for a short period. If the mood isn't changing, then evaluating to see if meds would be a good addition. If that worked and the mood is improving, experiment with stopping the talk therapy for a while and using just the med for a period. After a while drop the meds and see if all is well. A good talk therapist may never know if meds would help or not, but will know when it is time to shift to different techniques in talk therapy.

Psychology is working from the base - the philosophy of psychology - towards the theories, and then the techniques, and finally to arrive at an understanding right down to the physiology level. Biological psychiatry is working with the chemical pathways, the physical structure, and moving towards the understanding or normal and pathological functioning and to associate that with behaviors and disorders. Eventually they will reach, adjustments will be made, and it will be all one contiguous, coherent science of the brain and mind. But that day is way way off. Right now there is a very big gap between where one leaves off and the other begins.

Post 244

Saturday, January 3, 2009 - 12:49am

Steve:

There is something regarding psychologists that I have wondered about from time to time. With a detailed knowledge of the various types of psychological disorders, coupled with an understanding of various treatment approaches, do psychologists, in general, find that they can "talk to themselves" and with relative ease avoid or else solve most of their own issues relating to trauma, stress, anxiety, etc., or does it turn out to, more often, require an interactive partner to effectively use these tools. Just curious.

Regards,
--
Jeff

Post 245

Saturday, January 3, 2009 - 1:47am

Most of the people who become therapists start out having issues, at least some of which they couldn't or wouldn't resolve on their own. Not as a client, not with self-help aids. There are some who may have had someone close to them that was affected by a disorder and I have run into one - just one - person that went into the field with no personal connection what so ever to any kind of issue. (That seemed bewildering to me!)

The good therapists are the ones who managed to work through their issues. If not all of them, at least those in the area the client is dealing with. The bad therapists are mostly those that didn't.

For me, working with someone is far superior. I did all of my work with different therapists, but at the same time I explored all the various self-help techniques - I was my own study lab - but in conjunction with attended lectures.

I know that some people are more effective than other, or than I am, in focusing on desired changes, finding and persisting in techniques, and getting results. I don't think that knowing the various disorders is much of a help. Familiarity with techniques can help but it presumes that you work well in the self-help mode. Being a therapist helps strengthen some things that turn out to reduce stress - I'm less likely to have someone else's anxiety, sadness, anger or fear throw me off balance.

I think that the bottom line is that when I'm in psychologist mode, I'm focused on the other person in a special way that could never exist outside of the consulting room and that I couldn't do to myself.

What has been enormously helpful for me is the good therapy I've had. That has taught me more about catching bad patterns, spotting acts of consciousness that work against me, etc. And with most of my issues fairly well dealt with, I'm much less under the gun to deny, rationalize, project, evade, etc. There isn't that little inner part that feels angry or frightened and needs defending.

Post 246

Saturday, January 3, 2009 - 10:33am

Steve,

One of my complaints about academic CBT (Cognitive Behavioral Therapy) is not that they have adopted an empirical approach for psychology, but that they threw out everything that isn't a product of a research study as NOT psychology. They don't look at the real world unless it's in a research project, and they don't look at underlying philosophy ...

That's my complaint about ... and get ready for this haughty title ... "Evidenced-Based Medicine (EBM)".

Some post-modern, limey yahoo's got together, complimented each other on how smart they are, and then said that -- as a science -- that medicine should be based on ... "evidence." In their new and enlightened state of mind, they proceeded to create the Centre for Evidence Based Medicine (CEBM) where, in their new ivory tower, they could look at the "real" evidence. In this way, they thought, they could improve on the practice of medicine. They would make sure that every new advancement, every innovation, was first grounded in solid research performed with enlightened methods at robust institutions.

They ended up focusing on a few trees, blocking out most of the forest (from view) -- and, perhaps most importantly, blocking out the very idea of an integrated "forest" from the mind. They basically asked us all to think less about medical progress. They created an algorithm for medical approval -- a rule -- and everyone else had to simply tow the line. Useful innovations were entirely ignored. Promising theoretical connections were severed. We had a great, new lense to look through -- a looking glass -- and we were supposed to all get into line in order to get our sacred and reverent chance to look through that lense to see the enlightened truth of the matter (about medicine).

Did I mention I have a problem with EBM?

:-)

Ed

Post 247

Saturday, January 3, 2009 - 10:34am

Thanks Steve. That's interesting.

Post 248

Saturday, January 3, 2009 - 12:38pm

Well said, Ed. When they twist the empirical approach hard enough and put enough PC thinking in place, it will pretty near be faith-based. Instead of the scriptures we will have the approved journals of the holy academy. A kind of polytheism with a god or two per discipline, but democratically chosen by being the most cited author in those journals.

Thanks for the kind words, Jeff.

Post 249

Sunday, July 27, 2014 - 9:14am