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Wherever you look in the research literature, you will see research articles praising cognitive behavioral therapy (CBT). Despite the best efforts of the pharmaceutical industry, the academic researchers have managed to maintain enough independence to challenge the assumption that drugs are the best way of treating any disease or disorder. But it’s all very well for researchers to write articles. This is only useful information if the world changes a little. The are two key changes required. The first comes in the attitude of hospitals and the top physicians. The healthcare services industry is built on a for-profit model that makes the most efficient use of the smallest number of employees to deliver care to the maximum possible number of patients. Unfortunately, one-to-one therapy is an expensive way to use the time of any senior member of staff. Unless you create a new departmental empire for the senior staff to run, they will not support the move to provide CBT, and the hospital will refuse because it will not make enough money unless. . . The second change would have to come from the health insurance industry. The insurers have been hit by regularly increasing medical costs, all of which have been passed on to you as higher premiums. The insurers would have to adjust their payment strategies to prefer short-term therapy costs to long-term drug costs.

So what exactly is CBT? In a way the label is the answer. “Cognitive” = thinking. “Behavior” is easily defined. This is a short-term therapy designed to give you strategies for coping in your present circumstances, i.e. you focus on what you need to do “now”. You are encouraged to look for the cause and effect of what you think and how you act. This is not the same as classical psychological analysis which looks back in time for the deep-rooted causes of problems. This is a practical survival course. If you have a phobia, how do you overcome it? If you cannot go into a crowded room because of social anxiety disorder, what can be done? This makes it good for moderate anxiety states and it has proved a cheap way of helping people learn basic survival skills.

Like all emerging disciplines, it has been staking out its claim for leadership in the field of therapy and counseling. It has therefore made enemies. They accuse it of making exaggerated claims for its success rates. Quick fixes are just that, i.e. if you think of a car, a “fix” is often only good for a short time before full repairs have to be made. Nevertheless, CBT is rising to the top of the heap because it’s more positive. It reacts to situations rather than merely offering general advice as counseling. more…

When the sun is shining it’s easier to think everything is right with the world except, no matter what the weather, life is never straightforward. It can be a little like the training courses you see in the movies for rookies to go through. Whether training for the police force or the military, we have to be able to run when necessary, jump, and shoot the terrorists and not the good guys. For those who are good at it, this is both exciting and fun. There’s a satisfying challenge in getting through to the end with the maximum points scored. But for ordinary mortals, this can be a terrible trial. Bits of us wobble when we run and we have never been good at jumping. Most of the time it feels like the rest of the world is shooting at us. These feelings point to negativity in our lives. This makes it hard for us to enjoy the good things when they come along. When you feel more positive about yourself and your life, it’s easier to be happy.

The negativity can be both inside us and directed at us by strangers, colleagues and supposed friends alike. One of the first signs of internal tension is when we start to grumble. This is showing our unhappiness. More importantly, we may be taking the first steps to becoming our own worst critic. This is like turning off the light. A simple flick of the switch plunges us into darkness. Yet, so long as we have not moved, it’s easy to reach out again and turn the light back on. Easy in the sense of a physical action. But the mind does not always cooperate. It’s a bit like sailing one of these giant container ships or oil tankers. While they are under full power, they cross oceans fast, but they take forever to respond to the wheel and turn. Stopping them takes miles of sea. In the other direction, it takes enormous energy to get them to move from their moorings. That’s why you always see clusters of tugs towing them out of port. Without that outside help, these giants would never get started. That can be our lives. Some of us are not for turning. Some of us find it so hard to stop. Cognitive behavioral therapy can show people how to deal with negativity. It will always be a struggle, but it’s possible to sail ships around the world. It’s the same when it comes to dealing with negativity from others. If you learn coping strategies, you can respond more positively when people make suggestions or offer advice. Learn this is not necessarily hostile criticism. more…

The song originally carrying this title was sung seventy or so years ago in England as part of the propaganda to keep people’s spirit up after WWII started, but the version we’re interesting in comes from Eminem and starts with the line, “Some days I just wanna up and call it quits”. It’s a song about writer’s block where anxiety gets in the way of an author/songwriter trying to live up to previous glory. In the title, however, lurks an unexpected irony for even though you may feel you have hit a wall of bricks, running is actually good for you.

There’s new evidence emerging that physical exercise in general, and running in particular, is good for you. The idea was first seriously suggested about forty years ago when researchers observed that people who exercised regularly appeared less likely to become depressed than the couch potatoes. More importantly, the benefits appeared to stretch into the future with exercisers less likely to become depressed. But there was no longer term study to confirm this. The evidence was not scientifically convincing.

Ten years ago, a team at Duke University ran a formal trial, comparing one group of depressed people taking one of the standard antidepressants against a second group going through a program of aerobic exercise. To the embarrassment of the drug company, the exercise group had as good a level of improvement as those relying solely on a drug. This first trial has been repeated with comparisons being made against all the major drugs used in the treatment of anxiety disorders and depression. Without exception, the results of those exercising have been statistically the same as those taking medication. There is, however, a problem. All the exercise trials have been very short and have not involved many participants. To be credible, the trials must have significant numbers of people involved. Ideally, there should be more than one thousand. Without this, you cannot scale up the results and draw broad conclusions about how exercise would affect millions of adults. Nevertheless, there is a clear indication that exercise lifts mood and a suggestion it may have lasting effects. more…