Stumbled upon this article from the BBC News website, which shares the results of this study in The Lancet.

I was somewhat surprised to read that there hadn’t already been a definitive study (if this could be called definitive?) about the efficacy of CBT (cognitive-behavioral therapy).  It’s been around for a while now.

“Before this study, no evidence from large-scale randomised controlled trials was available for the effectiveness of augmentation of antidepressant medication with CBT as a next-step for patients whose depression has not responded to pharmacotherapy. Our study has provided robust evidence that CBT as an adjunct to usual care that includes antidepressants is an effective treatment, reducing depressive symptoms in this population.”

I’ve been in and out of “talk therapy” for well over a decade, though I’m not sure how much of it was CBT.  I honestly don’t know enough about the history and development of psychotherapy, or even what different forms of therapy are commonly in use these days.  All my therapists have been more or less the same, so I’m guessing it has all been CBT.  No Freudian psychoanalysis, anyway.

Details aside, I can honestly say it has been extremely helpful for me.  Obviously it hasn’t “cured me” — I don’t think what I’ve got can really be “cured” — but having someone to talk to about whatever’s going on in my life has helped me make important decisions, take myself more seriously (in a good way) and, most importantly, kept me working on myself.

The thing about medication, great a boon as it has been to me through the years, is that it doesn’t encourage active participation in the growth process.  For someone like me, who probably has something of a chemical imbalance but also a fair amount of non-genetic emotional/psychological dysfunction, staying actively involved in my own treatment is crucial.

That’s not to say that I think I would achieve the same results if I were to sit and talk to myself or journal or something for an hour once every few weeks.  That certainly helps too, but having an appointment, having to go, having someone with notes who looks back and says “last time you expressed such-and-such a feeling,” keeping far better track of things than I could even if I cared to, makes it feel more substantive, somehow.  I don’t want to say I spend my $60 copay JUST so I can feel my treatment is more “real,” but there is something to that.  Plus, if I’m financially liable I’m much more likely to keep with it (tell that to the running shoes I bought last month… but that’s a different story).  It’s far too easy to “not feel like” meditating or reading another chapter or just practicing a little awareness.  Which is why I haven’t really done much meditating the last few months… so maintaining contact with a therapist is important.  It keeps me present, keeps me from being able to ignore or pretend.

I guess that makes me one of the 46% of people (as reported in the study) who respond positively to CBT.  I wonder, with no small amount of sympathy, what the remaining 54% do?

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