Top positive review
Limited, but still worthwhile
Reviewed in the United States on October 1, 2016
Dr. Satterfield strikes me as a smart and caring clinician, and I think his clinical vignettes in the course work well. He clearly put a lot of effort into this course, and I suspect that he gets good results as a therapist. I certainly benefitted from going through this course.
However, the course does have two key limitations.
First, the target audience for the course isn’t clear. Sometimes it seems to address individuals who want to help themselves, other times it seems to address clinicians and therapists who want to get a basic understanding of what Cognitive-Behavioral Therapy (CBT) is. Neither audience will get detailed guidance for its needs.
The second limitation is somewhat related to the first. CBT itself, while clearly helpful for many people and many problems, is based on a limited understanding of how the mind works (more precisely, the mind-body). In that sense, CBT can sometimes come across as a bit superficial and not all that different from generic ‘self-help’. If you expect this course to provide eureka insights, you may be disappointed.
But, again, I did benefit from this well-intentioned course, and I’m sure that many others will benefit from it as well, particularly individuals dealing with chronic stress, anxiety, depression, anger, sleep problems, pain, etc. which have reached levels which warrant attention (if these problems are severe, probably best to skip this course and immediately seek professional help).
Here are my notes from the course:
• CBT has roots in ancient philosophy, especially Stoic philosophy.
• CBT sets goals related to well-being, based on an understanding of what can and can’t be changed in terms of cognitions, behaviors, and emotions, and uses methods based on rationality and empirical data in order to achieve those goals. Quantitative assessments are helpful in gauging baseline starting points and progress towards goals. CBT is arguably more pragmatic than theoretical.
• CBT can be done with or without the help of a therapist, and can be combined with other methods. CBT can require considerable effort, can take time to show results, and may require ‘maintenance’ in order to sustain results. The results of CBT correspond to changes in brain images.
• CBT focuses on how particular events trigger automatic and dysfunctional thoughts, behaviors, emotions, and possibly also physiological responses in individuals, and then tries to modify those relationships between triggers and reactions; much of the emphasis is on changing ‘habits of mind’. Third-wave therapy, such as Acceptance and Commitment Therapy (ACT), differs from standard CBT by focusing on the process of cognition rather than the content of cognition.
• In general, CBT methods include being resilient, cognitively flexible reappraisal of situations (which may involve looking at the big picture, endowing our experiences with meaning, and viewing adversity as an opportunity to learn and grow), cognitively flexible reappraisal of our ability and resources for coping with situations, taking action to change situations (and accepting when situations can’t be changed), seeking help from others, distracting ourselves, cardiovascular exercise, and relaxation methods such deep slow breathing, guided imagery, and mindful meditation.
• ACT differs somewhat from standard CBT by emphasizing not ruminating and wrestling with seemingly unwanted thoughts, behaviors, emotions, and physiological responses – which may actually exacerbate them – and instead accepting them in a detached way while staying in the present moment (like observing clouds passing in the sky). Mindfulness, including mindful meditation, is a way to achieve this state of being.
• Stress is normal, but elevated chronic stress is abnormal and mentally and physically unhealthy. It can trigger or aggravate many other problems such as anxiety, depression, anger, pain, etc. Work is the biggest source of chronic stress for many people, and taking vacations is one of the best ways to recover from burnout.
• Anxiety disorders (phobias, panic, social anxiety, generalized anxiety, PTSD, etc.) are quite common. A specific CBT method which is often effective in treating anxiety disorders is exposure therapy, in which individuals expose themselves to situations which trigger anxiety until they eventually become desensitized to those situations. By contrast, avoidance of those situations can worsen the associated anxiety, and the anxiety can become generalized to a wider range of triggering situations.
• Depression is also quite common. It often spirals downward into increasingly negative thoughts, emotions, and inactivity. Fortunately, it usually remits on its own within one or two years, but it can recur, and each recurrence makes another one more likely. CBT methods aim to break the downward spiral and reverse it.
• Anger stems from feeling unjustly treated, and tends to pick up steam if not controlled. Specific CBT methods for managing anger including not taking things personally, not magnifying things out of proportion, distracting ourselves, and relaxation.
• Genetic predisposition accounts for about 30% of our health outcomes. That leaves about 70% open to other factors, and CBT methods can improve our health, including our ability to prevent and manage chronic diseases (which affect about half the US population).
• Sleep problems are very common, can be worsened by stress, anxiety, depression, etc., and this interaction can become a vicious cycle. Specific CBT methods for improving sleep include progressive muscular relaxation, guided or unguided imagery, and other relaxation methods. Medications can help with sleep, but the benefit may be limited because they may not restore good sleep architecture. CBT methods are generally more effective than medications for improving sleep.
• Chronic pain is fairly common, especially headaches, back pain, arthritis, and other musculoskeletal pain. Chronic pain and chronic stress can interact in a vicious cycle. Most CBT methods can help with chronic pain, and distraction and relaxation can be particularly helpful.
• In general, social relationships are essential, and online relationships aren’t a substitute for live relationships.
• Having an ‘attitude of gratitude’ has many benefits, including more positive overall emotions (people tend to be happiest in their twenties and sixties), better health, sounder sleep, less anxiety and depression, more kindness towards others, ability to think more broadly and creatively, and greater life satisfaction.