Milestones in Alcoholism

[fabrisse]

Tonight my sister and I took Mom out for dinner. Sis and I hit this restaurant about once a week, and tonight, as usual, we ordered the Matzo ball soup. It was good.

Mom ordered a very dry martini on the rocks with extra olives. I quote: "That's my idea of dinner."

On a lighter note (sort of), I've seen a competent doctor who prescribed a book called "The Feeling Good Handbook." I bought it, but I'm a bit put off by the author's tone. Does anyone know more about it?

Comments

Re: My Experience: Excellent Book.

[siderea]

But you yourself are highly aware of that causality/correlation problem.

What causality/correlation problem? Since it's possible to have wholly affective depression without negative thoughts, there's can't be either causality or correlation assumed. Ta-da!

The difference between causality and correlation is only a problem if you're trying to argue for them.

It doesn't matter so long as the fix works. And I thought cognitive therapy was very empirically oriented.

Yes, that it is. Very empirically oriented.

Oh, go on, ask me what I think about their research.

Do you have evidence that CT doesn't work well?

I am increasing convinced that studies of the comparative efficacy of CBT smell funny.

I hesitate to comment further because I haven't looked into it as much as I like, but I have started becoming very, very suspicious.

For instance, did you know that the standard tool for measuring depression in research was designed, and is named after, the founder of Cognitive Therapy? The Beck Depression Inventory. I'm not real impressed with it: someone who has chronic depression without cognitive distortions is going to score as so minimally depressed that they'll be excluded from a study on depression!

There's other things which aren't problems, but add to the odor: CBT is, by it's structure and it's implicit nosology, both the easiest of all forms of therapy to build studies around; it is also incredibly attractive to insurers, so there's money to study it. That combination, that doing CBT research is the path of least resistance and there's lots of invested parties willing to pay for such studies, makes me leery for precisely the same reason drug efficacy research done by drug companies makes me leery.

There's more, but I'll stop here.

Because I thought there'd been lots of studies that show cognitive therapy to be as effective or better at relieving depression than drugs in the short term

There are now SSRIs which are effective in a single week, as opposed to the two-month ramp up with, e.g. Prozac. I don't know a talk therapy that can beat that land-speed record! But not everybody has the same response to SSRIs, the same as not everyone has the same response to CBT.

And as far as "effective or better", the current party line is that drugs+therapy beats any individual drug or therapy. Which, IMHO, makes a lot of sense, based on what we know of depression. But I haven't hit the papers myself to examine the quality of the research.

I'm certainly glad to hear the book worked for you! It makes me think more kindly on it.

Re: My Experience: Excellent Book.

[fabrisse.livejournal.com]

Thank you for taking the time for a detailed analysis.

Some of what you're saying fits with my general impression. But I'm at a point where I need something more than I have at the moment, and I don't dare do talk therapy because it might get reported to the company.
So. I'll give it a shot. If it doesn't help, I'm out $20. If it does, it's priceless.