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Can Cognitive Behavioral Therapy Change Our Minds? - The New Yorker   

One thing that dismayed me about the panic attack was its accuracy: my life really did need a major course correction, which I had no idea how to effect. But I was also unsettled by what the attack said about my personality. Having grown up in a tumultuous family, with a mother beset by alcoholism, I had worked hard to master my feelings through homegrown strategies of self-regulation. I had, at various times, felt guilty, angry, paralyzed, worthless, incompetent, or ashamed, in ways that I knew made no sense, and over the years I’d figured out how to stop, or at least attenuate, those feelings. In many respects, overcoming my childhood was my life story; I took pride in not being “messed up.” Now it appeared that I was out of control after all.

I was far from the only troubled grad student. For reasons personal or professional, about half of my classmates seemed anxious, depressed, or otherwise at wit’s end. When I told one of them about my panic attack, she mentioned cognitive behavioral therapy, or C.B.T.—a rational kind of therapy, she explained, that focussed on influencing your emotions by inspecting and adjusting your thought patterns. I didn’t think that I needed to see a therapist, since panic attacks weren’t a regular part of my life. But I did read “Feeling Good: The New Mood Therapy,” a perennially popular self-help book about C.B.T., published in 1980 by David D. Burns, a psychiatrist at Stanford. Cognitive behavioral therapy, Burns wrote, was based on the idea that “your feelings result from the messages you give yourself.” This was an old and familiar notion (we are disturbed “not by things, but by the views we take of things,” the Greek philosopher Epictetus wrote), but C.B.T. systematized it through exercises designed to identify problematic emotions and trace them back to the thoughts that had authored them. “Your thoughts often have much more to do with how you feel than what is actually happening in your life,” Burns wrote. By confronting and adjusting those thoughts, he argued, you could change your mood and behavior.

I was skeptical about C.B.T.; I’d read “The Interpretation of Dreams” and “Civilization and Its Discontents,” and doubted that our irrational moods and feelings could be brought under such rational control. But, when I got to Burns’s list of “cognitive distortions”—bad mental habits that cause us to react inappropriately to life’s difficulties—I started to change my view. I recognized myself vividly in the list. I had certainly engaged in “all-or-nothing thinking”—assuming, for instance, that, after disappointing my parents in some way, I must be an altogether bad son. I had practiced “emotional reasoning,” in which a feeling is taken to be, in itself, “evidence for the truth”—a mental spiral that allows an inaccurate emotion to get a grip. (Feeling like an idiot, you might think, Only idiots feel this way.) I’d been particularly fond of “personalization”—the tendency to “assume responsibility for a negative event when there is no basis for doing so.” On some level, personalization had been the reigning condition of my teen-age years: emerging from a disorganized and confusing childhood, I had imagined that I’d created it.

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