Tag Archives: Cognitive behavioural therapy

Become a Cognitive Behavioural Therapist for £39? Pfffftttt….

Time Out London is currently offering this absolutely bloody ridiculous offer on their site: “93% off a Cognitive Behavioural Therapy Diploma”. Actually worth a “whopping £599” it’s currently available for the low, low price of £39!

Pretty amazing. Especially when it turns out that the course is being run by the NLP Centre of Excellence, and NLP as we all know, is a pile of incoherent and festering ordure. Also, a closer reading of the text reveals that the course is just a few e-books.

Cognitive Behavioural Therapy (CBT) is a serious set of therapeutic technologies, with a substantial evidence base, useful for treating several classes of mental health issues. It usually takes several years to become a CBT therapist – the most common route is to complete a clinical doctorate training program, and then do additional specialist training afterwards. In the UK, CBT therapists are registered with a professional body called the BABCP, and are required to undergo regular peer-supervision, and conduct their therapy sessions within the guidelines of the association.

Anyone who thinks they can become a CBT therapist by reading a couple of manuals from some NLP charlatans is in serious need of therapy themselves. I bet the e-books aren’t even about CBT; it’s probably the same old NLP twaddle warmed over again with a new title. This is an out-and-out scam, plain and simple.

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Further thoughts on EFT – Tapping as a safety behaviour?

CBT_Anxiety_TreatmentI’ve written before about the Emotional Freedom Technique and Tapping; a pretty ridiculous-looking form of therapy that involves tapping oneself on the face and body in order to stimulate the end-points of ‘energy meridians’. It’s clear that this is essentially bogus, for the blank and uncontroversial reason that such energy meridians in the body simply don’t exist.

However, it’s possible that people derive some benefit from tapping/EFT, even though the mechanism behind it is bunk. The internet is awash with people who claim to have had extremely positive experiences with all kinds of things, including reiki, homeopathy, acupuncture, any of the various kinds of energy healing, and a whole host of other new-age touchy-feely alternative-medicine approaches; all of which have been determined to be basically ineffective in controlled trials. The positive experiences that people have with these things can be fairly safely attributed to some combination of the placebo effect and regression-to-the-mean. Most likely the same is true for those who derive some benefit from EFT/tapping.

So far, so uncontroversial. In this view, tapping is basically harmless and the only people suffering from it are people who willingly pay money for bogus therapies. However, I want to make an alternative suggestion; in people who tap for issues related to anxiety, tapping might actually be harmful, because it might come to be a safety behaviour.

Safety behaviours are well-studied characteristics of anxiety disorders, and the Cognitive Behaviour Therapy (CBT) literature has many examples. This article explains them pretty well, but briefly, a safety behaviour is something that prevents engagement and exposure to the anxiety-provoking stimulus. For example, imagine someone who experiences panic attacks on trains, but  needs to take a train on their daily commute to work. One way of coping with this issue would be to simply get off the train at the next stop when the anxiety started to increase. A good CBT therapist doing exposure-therapy with this patient would instead recommend that they remain on the train and cope with their anxiety in other ways; this exposure to the feared situation, and the experience of being there and not having a panic attack (or having one, but then feeling the anxiety gradually decrease again) is the cornerstone of exposure therapy, and a very powerful weapon in the CBT therapists arsenal. In short then, safety behaviours are unhelpful in that they prevent exposure to the feared situation; they’re seductive, in that they reduce anxiety in the short term (by getting off the train, the situation is resolved and the panic attack doesn’t happen) but maintain, and perhaps even strengthen the association between a feared-situation and anxiety in the long-term. Some patients require many hours of therapy and exercises in order to reduce their safety behaviours, and this is generally a helpful process.

Tapping appears to be used a lot for anxiety relief, as this video (and many other videos/sites) suggests. My thought about tapping for anxiety then is, what if tapping becomes a safety behaviour? Tapping in an anxiety-provoking situation might serve to reduce the anxiety just because of simple distractibility. In fact it may be the spoken or sub-vocalised ‘scripts’ that accompany tapping that are more effective; something recognised by many previous authors. Unfortunately, this might have the effect of preventing the full exposure to a feared situation that is necessary to  learn that the fear will eventually reduce, and that the situation can be coped with. Just as for other safety behaviours, tapping might well be beneficial and highly reinforcing in the short-term (i.e. it reduces the anxiety) but harmful in the longer term. Some safety behaviours can be highly dysfunctional and, once entrenched, very difficult to eliminate.