CBT is freaking awful. The reason it took off is that a lot of studies showed a very strong effect pretty early on. But none of the meta analysis show efficacy in CBT long term, and even worse, many CBT practitioners are unskilled and not even using it properly.

However it's my opinion that CBT even if used exactly to gold standards is very unhealthy, overprescribed in a lot of situations it shouldn't be, and is based on some really faulty assumptions.

Number one, a lot of people with mental health issues have undergone trauma. CBT is completely useless in this case but yet gets overprescribed like everything else. The ABC model in CBT (Activating Event, Belief, Consequences) sounds like on the surface that it makes sense but it's a very very basic view of how the brain and body works. Here's how it's supposed to work. A) You see a spider. B) You think spiders are gross and scary and the scary could bite you. C) You are scared and run away. In reality, trauma and fear work at the speed of light through your sympathetic nervous system and hit your lizard brain before you are making any conscious thought whatsoever. Feelings like fear, disgust, and so forth are very primal and lizard brainy and it really doesn't do any good to dissect them with our Big Simian Brains. It just causes more problems because the solution is acceptance and understanding the nature of emotions.

100% agree by this statement by the pt: "CBT as a modality is based around gaslighting" That's exactly WHY it works so well and you see that great effect in the studies. Gaslighting works as a means to control people. For a while, until their world falls apart worse because you're programming yourself to tell you a different delusional reality, just in this case since it's "positive" it's supposed to be OK. News flash, if you can't get your basic needs met, you shouldn't be using CBT. Use all the CBT you want, it's not going to change the fact that you don't have enough to eat, you're about to be homeless, you're in an abusive relationship, and so on. In this case CBT was inappropriately prescribed to someone with chronic pain and trauma and big Psych is terrified to let this narrative out - that CBT is routinely used on people who don't have cognitive distortions. To get an idea of how ridiculously overprescibed this is, check out this video, where an actual MD with a vitamin deficiency was pressured by his sleep doctor to try CBT for his insomnia https://www.youtube.com/watch?v=d_qKA6KTvs8

Thankfully he knew, AS A DOCTOR, that the advice he was given was full of crap. But people who have already been marginalized, and are often women, people of color, and so on? God forbid we're questioning CBT and have valid reasoning behind it, that just means that you're resisting treatment and it's something further to put under the microscope.

If you push your problems down it makes it worse. The therapies we should be using should be about acceptance, distress tolerance, communication skills, and things like inner child work such as internal family systems therapy or somatic work. Things like DBT which have a mindfulness component, is about acceptance and dialectics - two things can be true rather than overanalyzing the crap out of everything, and IFS as well as EMDR and other body based work are evidence based to work against trauma as it exists biologically. CBT does not. Everyone has trauma from childhood and even if you don't have mental illness there are weird things around from that time which make you regress and feel bad about yourself. The key is working with that stuff and actually accepting those parts of yourself and loving them which CBT DOES NOT DO. It pushes things down.

Props to this author. We need more people speaking out against CBT. It causes people to give up on therapy and think it's a sham. This kind of disgusting behavior where the patient's experience is invalidated because god forbid that further puts cracks in the wall in the CBT model which we've invested so much in!