I should note that Dr. Burns is refreshingly candid about the usefulness of antidepressant medications in treating some forms of depression. He also provides a good basic discussion of these drugs in one chapter. Most importantly, he is very careful to emphasize that anyone with severe and unremitting depression, with suicidal preoccupations, and/or with a history of mania should seek professional help and not just rely on this book.
My own experience has been that all of the talk therapy in the world won't help unless I'm feeling "well", and this wellness has only ever been achieved through many trials of psychotropic drugs. Ever since I have found a good medication combination I have found that I have become considerably more optimistic, patient, calm, and better able to withstand small daily crises. I know that it is different for many people, but for me CBT has only ever been effective for me NOW, when I am better able to recognize and address my thinking processes. I worry that Dr. Burns's book may lead some people to believe that they have complete control over their emotions, or that their depression is largely caused by their "negative affect". As a psychology major I know that one of the big conundrums surrounding CBT is whether the negative schemas shown by depressed patients are present before the illness onset, or whether it is depression itself, and the biological changes that go along with it, that leads to the negative schemas. I don't think that it can be concluded (yet) that the negative schemas precede the depression.
After studying FEELING GOOD, written by Dr. David D. Burns, M.D., I have learned how to change the way that I think about things. I have also found that I can change my basic values and beliefs. This, according to Dr Burns, is what Cognitive Therapy is about.
To be clear, I feel this is an excellent handbook for anyone with an interest in Cognitive Therapy. I strongly believe that a great number of people can find their life's situation improved by following the exercises prescribed by Dr Burns.
At the same time, I don't know that Cognitive Therapy is a cure for every person who suffers from Clinial Depression. Dr Burns acknowledges this sentiment, writing that it would be unreasonable to expect to improve or recover after reading FEELING GOOD. The research cited in this text clearly indicates that while many people who read FEELING GOOD improved, others needed the additional help of a mental health professional. As a responsible health professional, Dr Burns understands that there are also limits to which a self-directed therapy may apply, _Let's assume that you do NOT have a strong suicidal urge, hallucinations, or symptoms of mania_. he cautions.
For the rest of us who might be helped by a program of self-study in Cognitive Therapy, Dr. Burns provides a comprehensive tool. The first step is to diagnose my moods. A simple test is offered whose psychometric properties are discussed for the benefit of mental health professionals. This test is less important in determining a level of depression as it is in monitoring improvement. Periodic testing will reveal a change in the scores that will act as a positive reinforcement when improving, and will alert that a correction is required when declining.
Before engaging in the exercises, I feel that it is important to understand the principles of Cognitive Therapy as Dr Burns has described them. A first principle is that ALL moods are created by cognitions or thoughts. The second principle is that when I am feeling depressed, my thoughts are distorted, and my thinking process is dysfunctional. Finally, it is the negative thoughts that cause my emotional turmoil and these are ALWAYS containers of gross distortions. The implication is that my depression is probably not based on accurate perceptions of reality but is often the product of mental slippage. The degree to which these principles are accepted will determine the efficacy of Dr Burn's program.
Having taken the leap of faith required by Cognitive Therapy, the procedure is clearly articulated. The first step is to identify the cognitive distortion at work. It might be an overgeneralization, an unrealistic standard, a case of disqualifying the positive or another of the ten cognitive disorders provided by Dr Burns. The next step is to compose a rational response, an objective rebuttal. You won't need to create your own out of thin air because Dr Burns supplies a compendium of examples. Finally, a coping strategy designed to address the difficulty provides a path to relief. Although this brief overview does an injustice to the comprehensive tools presented in this handbook, it conveys the general idea that is common to nearly all of them.
Give it a shot! See if you don't end up feeling a little bit better. There is really not much to lose and perhaps, a great deal to be gained.
My interest is in spiritual matters. It is striking to me that the techniques presented by Dr Burns parallel many spiritual disciplines. In essence a choice is made as to where to apply my faith. Do I believe the circumstance, or my spiritual commitment? The techniques in this handbook have helped me to exercise my choice and strengthen my spiritual life.
PEACE