By Chet Yarbrough
Written by: The Great Courses
Narration by: Professor Jason M. Satterfield
“Cognitive Behavioral Therapy” reminds one of “talking therapy” that dates back to the 19th century and became famous with the popularization of Freudian psychology at the turn of the century. Professor Jason M. Satterfield refines the principal of “talking therapy” by explaining that CBT adds a layer of scientific investigation and statistical analysis to the process. One can argue that the precursor to this therapy began when Socrates first questioned ill-informed fellow citizens for their thoughts about life and living.
Satterfield explains the process of Cognitive Behavioral Therapy in treating patients with anger management issues, depression, PTSD, and addiction. Though Satterfield does not discourage drug treatment for these maladies, he argues changing one’s behavior holds promise and measured success in curing rather than just treating symptoms of mental dysfunction.
Satterfield psychoanalyzes three patients in several lectures to explain how patients become part of a curative process that changes neurotic habits (developed over a life time) that are triggered by current events. Satterfield acknowledges CBT is no magic bullet for psychological imbalance but that it shows statistically significant improvement in some patient’s mental health. As noted by David Morris in “The Evil Hours” CBT does not work for all people.
Morris is an ex-Marine suffering from PTSD. His book explains that CBT made his Post Traumatic Stress Disorder more rather than less debilitating. Satterfield argues that discussion of a traumatic event with a patient allows the traumatized to re-image its impact on their psyche. In re-imaging trauma, Satterfield shows patients analyze past events differently and experience varying degrees of psychological relief. Morris, in contrast, suggests talking about the day he and his team were blown up by an IED only aggravated his symptoms. After listening to Satterfield, one wonders how much of Morris’s negative results are related to a particular therapist rather than the therapy’s effectiveness.
What makes Satterfield’s lectures interesting is his successful elicitation of patient’ participation in structuring their own treatment. There appears to be a buy-in by the patient that motivates changes in behavior. Satterfield explains how those changes in behavior must be measurable to provide feedback on the success or failure of the therapy. Fundamentally, Satterfield encourages patients to participate; i.e. to act and measure their actions against goals they establish in concert with their therapist. Satterfield measures a patient’s success based on baseline improvements in patient explanations of what does or doesn’t work for them. He begins with patient questionnaires to set a baseline for measured improvement.
Some interesting notes in Satterfield’s lectures are admonitions about the threats of addiction. He suggests alcohol, marijuana, and tobacco are threats for addiction at lower levels of use than one might expect. Having more than one glass or one beer at night, toking marijuana regularly, or smoking a cigarette a day are possible gateways to addiction. He argues behavior modification can reduce or eliminate their addictive potential. One of the suggested behavioral modifications is structured exercise, ranging from walking, rather than driving, while measuring the number of steps taken per day. Satterfield reinforces arguments for regular exercise and “fit bit” measurement of performance to change and encourage more healthful behavior.
Not too surprisingly, Satterfield believes meditation is a behavior that can be learned to improve one’s mental health. He notes that meditation has been proven to reduce anger and improve sleep habits. Those who meditate report statistical improvements in hours of sleep, reduced addictive substance use, and improved feelings of well-being, based on a scale of 1 to 10 or 1 to 100.
What seems clear to a listener of these lectures is that behavioral change is not easy but possible. Satterfield touches on different types of intelligence people have; i.e. particularly social and interpersonal intelligence.
He implies there are behavioral changes that can be learned through repetition to improve social and interpersonal intelligence. With those improvements, Satterfield argues mental health is improved.
CBT can help a psychologically troubled patient. However, one concludes from Satterfield’s lectures that a knowledgeable therapist is essential to success of the treatment. The therapist must be conversationally capable of getting a genuine buy-in by the patient. Without a patient’s personal motivation and participation, there seems little chance for Cognitive Behavioral Therapy success.