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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by jay on October 30, 2003, at 7:59:32
I found this excellent editorial on mentalhealth.com. This piece echoes my feelings, in that it still amazes me that I come across doctors who completely discount all of the excellent advances regarding meds and in particular the SRI's. They may not all work the best for everyone, but all of the half-truths, rumours, and so-called "evidence" based on here-say is far, far more dangerous than the truth. Considering there are millions who have been on SRI's for many years, leading excellent lives, I feel this more than proves my case.
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from http://www.mentalhealth.com/mag/p53-burn.html"30 Second Diagnosis and One-Day Cure" for Depression..
Phillip W. Long, M.D.
October 10, 1996Dr. David D. Burns, the author of Feeling Good, The New Mood Therapy, announced on October 6, 1996 that he had perfected a technique for a “30 Second Diagnosis and One-Day Cure” for depression.
Dr. Burns presented this technique during a workshop I attended in Vancouver, Canada entitled: “Secrets Of Successful Psychotherapy: A Two-Day State-of-the Art Training Program.” The on-site registration fee for this workshop was $399, and the accompanying course book (entitled Therapist's Toolkit) was available for an additional $214. In all, approximately one hundred therapists (physicians, psychologists, social workers, and nurses) attended.
The printed program for this workshop stated:
“Dr. David D. Burns, M.D., a Clinical Associate Professor in the Department of Psychiatry at the Stanford University, is one of the world's most highly regarded experts on cognitive therapy. His best-selling Feeling Good: The New Mood Therapy (1980) has sold over two million copies worldwide, and is the book most often recommended by both American and Canadian mental health professionals to their patients ... In this training workshop Dr. Burns will share the secrets he has gleaned from over 20,000 cognitive therapy sessions with a wide spectrum of patients.”
In his opening remarks, Dr. Burns stated that, in his twenty years of treating depressed patients with cognitive behavior therapy, he has had “only 10 patients relapse, and most fully recovered with only 1-2 additional sessions of cognitive behavioral therapy.”Dr. Burns stated that, earlier in his career at the University of Pennsylvania, he “used to average 17-20 sessions per patient” to cure their depression. Now at the Stanford University, Dr. Burns stated that “most of my depressed patients are cured in one day” using his “Five-Step Program,” a cognitive behavioral therapy which consists of three group sessions held in one day.
When questioned whether he felt there might be a biological basis to depression, Dr. Burns stated that “all psychiatrists are liars and their research is horseshit” concerning a biological basis to depression. Dr. Burns emphatically stated that “only our thoughts affect our moods.”
Dr. Burns presented a case of a “depressed woman with ovarian cancer.” Dr. Burns stated that this woman reported three main problems: “feeling guilty [100% rating] , feeling ashamed [100% rating], and feeling worthless [100% rating].” Dr. Burns' cognitive behavioral therapy for this woman consisted of having her write down her negative thoughts. For this patient, her negative thoughts were: “(1) I'm letting my family down [100% rating], and (2) they can't survive without me [100%].” In their first therapy session, Dr. Burns had this woman write a positive thought opposite each negative thought. Then Dr. Burns asked the patient to again rate the severity of her negative thoughts. Using this technique, Dr. Burns was pleased to report that, after only 20 minutes of cognitive behavioral therapy, this depressed woman rated her negative thoughts as being “only 10-20%.” Thus, Dr. Burns concluded that her depression was cured, and he “never needed to see the woman again for a follow-up session.”
Dr. Burns then reviewed case after case of similarly depressed patients that he had quickly cured with his cognitive behavioral therapy. After this, Dr. Burns taught the audience how, using his copyrighted checklist, they could diagnose depression “in 30 seconds.”
In all, this workshop was unlike anything I have ever witnessed in Canada.
Permit me now to editorialize. A recent World Health Organization report predicts that depression (suicide) will be the leading cause of disability and premature death in the industrial world in the next 25 years. Ten to fifteen percent of people suffering from severe depression (i.e., Major Depressive Disorder) commit suicide. Thus, it is remarkable that Dr. Burns states that he can cure depression in only one day with cognitive behavioral therapy and have virtually no treatment relapses.
This claim is a cruel hoax perpetrated on depressed patients suffering from this life-threatening disease.
In the twenty years that I have been a psychiatrist, I have learned how to diagnose when a fellow therapist is attempting to perpetrate a medical fraud. I would like to share my “diagnostic criteria for medical fraud” with you:
1. The perpetrator of the fraud claims miracle cures (e.g., curing depression in one day with virtually no risk of relapse).
2. The perpetrator of the fraud discounts all research contrary to his/her own as “horseshit,” and all of his/her detractors as “liars.”
3. The perpetrator of the fraud stands to make millions selling his/her fraudulent claims (e.g., by selling 2 million books, or by going on lucrative speaking tours).
4. The perpetrator of the fraud abandons his/her patients (e.g., treating a severely depressed patient for only one day, then deciding to do no further follow-up).
Posted by KellyD on October 30, 2003, at 9:28:14
In reply to Be *Very* Careful with Med/SSRI Bashing, posted by jay on October 30, 2003, at 7:59:32
Good editorial. I think we should be respectful of every indivdual's choice of what works for them. I also think that posters, in particular, new folks, need to be aware that these boards, and others like it, CAN give a somewhat jaded view of various meds and techniques for treatment. Sharing information is good. Sharing experiences is good. We are all unique and one man's poison is another's salvation. I think postings lean more to the negative aspects and rightly so, most people post when they are having problems and need help and advice. A number of posters have very strong feelings they wish to express. My observations are a bit off track of your post, but care is required when we give our opinions of what may be just the key for someone else's good treatment.
I do agree there is no "quick fix" to any emotional issue. Just too complex, there will never be a "one size fits all" and there is no ONE key that unlocks the mystery. That is true for most all illnesses of any type, in my opinion.
Posted by JonW on October 30, 2003, at 12:19:04
In reply to Be *Very* Careful with Med/SSRI Bashing, posted by jay on October 30, 2003, at 7:59:32
> When questioned whether he felt there might be a biological basis to depression, Dr. Burns stated that “all psychiatrists are liars and their research is horseshit” concerning a biological basis to depression. Dr. Burns emphatically stated that “only our thoughts affect our moods.”
I think Dr. Burns is awefully biased and may overstate the efficacy of his methods, but I am skeptical that he actually said "all psychiatrist are liars..." It is highly unlikely, to me, that a CBT therapist would make a statement with so many thinking errors in it. I think the point of this editorial is right on the money, though.
Jon :)
Posted by linkadge on October 30, 2003, at 13:27:52
In reply to Re: Be *Very* Careful with Med/SSRI Bashing » jay, posted by JonW on October 30, 2003, at 12:19:04
SSRI's are my only safe choice.
Linkadge
Posted by ace on October 30, 2003, at 16:19:08
In reply to Be *Very* Careful with Med/SSRI Bashing, posted by jay on October 30, 2003, at 7:59:32
> I found this excellent editorial on mentalhealth.com. This piece echoes my feelings, in that it still amazes me that I come across doctors who completely discount all of the excellent advances regarding meds and in particular the SRI's.
In fact, most love SSRIs. Dr. Burns is an anomoly.They may not all work the best for everyone, but all of the half-truths, rumours, and so-called "evidence" based on here-say is far, far more dangerous than the truth.
No one knows 'the truth' We can only make educated guesses (some better than others!)
Considering there are millions who have been on SRI's for many years, leading excellent lives, I feel this more than proves my case.
I havent heard great responses from SSRIs- a few yeah, but most a mediocre.
With regards to the Dr. Burns issue- I also find it very hard to believe he called all psychiatrists liars and used a cuss word in an interview. I have personally contacted Burns on several occassions- he seems very nice and down to earth. However, who knows what he is really like.I can say that I believe CBT, in the face of a biological depression, is a waste of time. i think it could be helpful for mild endogenous depression (that everyone has) but not for the truly ill.
I believe CBT, in the context of true organic disorders, can actually make things worse.
Thanks for posting this- this subject really interests me,
Ace.
Posted by ace on October 30, 2003, at 16:20:43
In reply to Re: Be *Very* Careful with Med/SSRI Bashing ?jay, posted by KellyD on October 30, 2003, at 9:28:14
> Good editorial. I think we should be respectful of every indivdual's choice of what works for them. I also think that posters, in particular, new folks, need to be aware that these boards, and others like it, CAN give a somewhat jaded view of various meds and techniques for treatment. Sharing information is good. Sharing experiences is good. We are all unique and one man's poison is another's salvation. I think postings lean more to the negative aspects and rightly so, most people post when they are having problems and need help and advice. A number of posters have very strong feelings they wish to express. My observations are a bit off track of your post, but care is required when we give our opinions of what may be just the key for someone else's good treatment.
> I do agree there is no "quick fix" to any emotional issue. Just too complex, there will never be a "one size fits all" and there is no ONE key that unlocks the mystery. That is true for most all illnesses of any type, in my opinion.Very well said. But Nardil sure comes close to being that 'key'!!!
Ace.
Posted by ace on October 30, 2003, at 16:22:45
In reply to Re: Be *Very* Careful with Med/SSRI Bashing ?jay, posted by JonW on October 30, 2003, at 12:19:04
> I think Dr. Burns is awefully biased and may overstate the efficacy of his methods, but I am skeptical that he actually said "all psychiatrist are liars..." It is highly unlikely, to me, that a CBT therapist would make a statement with so many thinking errors in it. I think the point of this editorial is right on the money, though.
>
> Jon :)I agree Jon...I can't imagine him saying such an 'all-or'nothing' statement and using 'emotional reasoning' like that. But that mental health page is preety thorough and scholarly- he must of I guess...
Ace.
Posted by KellyD on October 30, 2003, at 16:24:32
In reply to Re: Be *Very* Careful with Med/SSRI Bashing » KellyD, posted by ace on October 30, 2003, at 16:20:43
Posted by ace on October 30, 2003, at 16:39:52
In reply to ace, you know I'm happy for you! (nm), posted by KellyD on October 30, 2003, at 16:24:32
Posted by JonW on October 30, 2003, at 18:23:19
In reply to Re: Be *Very* Careful with Med/SSRI Bashing » jay, posted by ace on October 30, 2003, at 16:19:08
> I believe CBT, in the context of true organic disorders, can actually make things worse.
Hey Ace,
You know I have to disagree with you on this one, right? :) CBT (with moclobemide) has done for me what Nardil has done for you. CBT may not help everyone, but how could it make things worse? My own experience would suggest that endogenous depression needs medicine, but I don't understand how that translates into CBT being useless or harmful.
Jon :)
Posted by ace on October 30, 2003, at 20:35:38
In reply to Re: Be *Very* Careful with Med/SSRI Bashing ?ace, posted by JonW on October 30, 2003, at 18:23:19
> > I believe CBT, in the context of true organic disorders, can actually make things worse.
>
> Hey Ace,
>
> You know I have to disagree with you on this one, right? :) CBT (with moclobemide) has done for me what Nardil has done for you. CBT may not help everyone, but how could it make things worse?It made me worse. I believe organic disorders are anologous to a cut on the arm- if one itches at that cut it makes it worse. With CBT I feel one is itching at that 'cut' (OCD, depression etc)in the brain.
That was definately my experience of it. It made me a lot worse and frustrated ('cause it didn't work I got anxious/worried I was applying the techniques wrong). It made my OCD far worse.
I did it for a good two years and read 4 DD Burns books, Albert Ellis, all of those guys.
But I'm glad it works for you- I shouldn't havent generalized from my experience. I just find it real hard to see how it works.
My own experience would suggest that endogenous depression needs medicine, but I don't understand how that translates into CBT being useless or harmful.
>
> Jon :)
Whatever the case, I'm glad you are doing well,Ace.
Posted by JonW on October 30, 2003, at 23:24:00
In reply to Re: Be *Very* Careful with Med/SSRI Bashing » JonW, posted by ace on October 30, 2003, at 20:35:38
> It made me worse. I believe organic disorders are anologous to a cut on the arm- if one itches at that cut it makes it worse. With CBT I feel one is itching at that 'cut' (OCD, depression etc)in the brain.
Thanks for the reply, Ace! When I was seeing Dr. Liebowitz for meds, he said something similar to what you are saying. He told me it was critical that I be involved with CBT, but he made it very clear that I needed to be ready for it. He suggested that if someone is too depressed or too anxious, it can be like insult to injury.
> That was definately my experience of it. It made me a lot worse and frustrated ('cause it didn't work I got anxious/worried I was applying the techniques wrong). It made my OCD far worse.
>
> I did it for a good two years and read 4 DD Burns books, Albert Ellis, all of those guys.I read Burns, Ellis, and all those guys, too, before initially getting involved with CBT. That was years ago, and before getting involved with Liebowitz. I was very educated going into it, but inspite of that, it was never very helpful. It wasn't until I started the CBT program at Temple in Philly that my life began to change. I have been to some great CBT therapists, but they aren't even in the same league as the AACT at Temple. It is like night and day. It's a very targeted and intense program, and the result of a lot of research specific to social anxiety disorder. Their research defines how CBT is done for this disorder. Dr. Liebowitz is a big proponent of combining medication with CBT, and this has saved my life. But more specifically, the AACT at Temple has saved my life. The program at Temple and others like it are the Nardil of CBT, while the rest are no better than buspar -- no offense to anyone who loves buspar ;) Anyway, my point is that my own case and the research that's been done indicate CBT is a big gun. Unfortunately for you, it may have been no better than a water pistol... I wonder if you were ever involved in a comprehensive program, though. Sorry about the analogies tonight... I'm feeling a littly silly :)
Anyway, you are one of the luckiest "loonies" I know... Nardil has done wonders in your life, and without side-effects. More power to you, and by promoting CBT I certainly don't mean to promote it as a replacement for medication. I just think it deserves as much respect as medication, and the combination of the two can be life changing.
Jon :)
Posted by ace on November 3, 2003, at 21:04:37
In reply to Re: Be *Very* Careful with Med/SSRI Bashing ?JonW ?ace, posted by JonW on October 30, 2003, at 23:24:00
> > It made me worse. I believe organic disorders are anologous to a cut on the arm- if one itches at that cut it makes it worse. With CBT I feel one is itching at that 'cut' (OCD, depression etc)in the brain.
>
> Thanks for the reply, Ace!No worries bro!
When I was seeing Dr. Liebowitz for meds, he said something similar to what you are saying. He told me it was critical that I be involved with CBT, but he made it very clear that I needed to be ready for it. He suggested that if someone is too depressed or too anxious, it can be like insult to injury.
Yeah, that's my experience of it...made me a lot worse.
>
> > That was definately my experience of it. It made me a lot worse and frustrated ('cause it didn't work I got anxious/worried I was applying the techniques wrong). It made my OCD far worse.
> >
> > I did it for a good two years and read 4 DD Burns books, Albert Ellis, all of those guys.
>
> I read Burns, Ellis, and all those guys, too, before initially getting involved with CBT. That was years ago, and before getting involved with Liebowitz. I was very educated going into it, but inspite of that, it was never very helpful. It wasn't until I started the CBT program at Temple in Philly that my life began to change. I have been to some great CBT therapists, but they aren't even in the same league as the AACT at Temple. It is like night and day. It's a very targeted and intense program, and the result of a lot of research specific to social anxiety disorder. Their research defines how CBT is done for this disorder. Dr. Liebowitz is a big proponent of combining medication with CBT, and this has saved my life. But more specifically, the AACT at Temple has saved my life.Great to hear! So tell me, when you say it is day and night, do you mean you are constantly involved in CBT- like can you give me an example?
The program at Temple and others like it are the Nardil of CBT,How are they different?
while the rest are no better than buspar -- no offense to anyone who loves buspar ;) Anyway, my point is that my own case and the research that's been done indicate CBT is a big gun. Unfortunately for you, it may have been no better than a water pistol... I wonder if you were ever involved in a comprehensive program, though. Sorry about the analogies tonight... I'm feeling a littly silly :)
I just about always feel silly!!! No need to apologize!
>
> Anyway, you are one of the luckiest "loonies" I know... Nardil has done wonders in your life, and without side-effects. More power to you,Thanks man, I appreciate your support.
and by promoting CBT I certainly don't mean to promote it as a replacement for medication. I just think it deserves as much respect as medication, and the combination of the two can be life changing.
Yeah, it's great it works for some. I hope I have not offended too many people with my comments, but I always let 'em know that it's only my opinion. It's wonderful that people have different opinions I think- what a boring world if we were just clones!
Good luck to you, Jon! Look foward to hearing from you.
Ace.
>
> Jon :)
Posted by JonW on November 4, 2003, at 20:39:29
In reply to Re: For JonW!, posted by ace on November 3, 2003, at 21:04:37
> Great to hear! So tell me, when you say it is day and night, do you mean you are constantly involved in CBT- like can you give me an example?
I mean, other CBT therapists were well-intentioned but didn't bring the same know-how to the table as the AACT. Other CBT therapist I've seen never incorporated effective exposures into the sessions, for example.
> The program at Temple and others like it are the Nardil of CBT,
>
> How are they different?I would say the effective use of exposures, for one. The efficiency with which the AACT learns from what I say during my sessions is quite impressive as well. They seem to have this uncanny ability to figure out how to make it work for me. They are very good at identifying why things aren't working, and fixing it. They are very precise in everything they do. As far as the exposures go, they are quite elaborate. They involve the entire department at Temple (yes, lots of college girls <g>), and are as realistic as possible -- the people are not nice to you because you have social anxiety, etc. The advantage of the exposures is a chance to get real feedback, and afterwards ask the people involved questions specific to your automatic thoughts, etc. The impact of teasing it all out is amazing, at least for me. The real advantage this place has is that what they do is the result of research specific to CBT for social anxiety disorder, and not just the result of what someone thinks will work.
> Yeah, it's great it works for some. I hope I have not offended too many people with my comments, but I always let 'em know that it's only my opinion.
Aren't you "good ace" now? How could anyone be offended by "good ace"? :)
>It's wonderful that people have different opinions I think- what a boring world if we were just clones!
It's certainly a lot more fun this way!
Jon :)
This is the end of the thread.
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