Luis I. De Amores Cabello 🐦

Here I'm going to explain the problem with treatment approaches that in some form endorse the idea that thoughts are meaningless or should be ignored (CBT, ACT, ERP). Let's say a patient has a thought of stabbing their newborn baby. It terrifies or disgusts them. They fear that this thought means they're going to actually harm their child, or they're going crazy and need to be locked up, or just that they're in fact a very bad person. We call it an "intrusive" thought because that's how it's experienced. Something "not me" is attacking "me". But where else could this thought be coming from except from "me"? But the patient doesn't really want to hurt their baby, so this thought is nonsensical and therefore meaningless, right? Or at least just ignore it, right? This is what CBT, ACT, and ERP tell us. And at first glance, this seems like a good way to think about it. In fact, some people are able to take a degree of comfort from the idea their thoughts are meaningless and they sometimes find their symptoms do lessen a bit: "Oh good, I'm actually not a bad or dangerous person." So what's so bad about this? If it helps, it helps, right? The problem is that the patient does continue to suffer in some form. Maybe the symptoms persist at a mild or moderate level. Maybe they come back later. Maybe they have intrusive thoughts about other things. Maybe they become depressed. Etc etc etc. Why do they continue to suffer? Because the thoughts actually do have meaning. Just because a thought isn't literally true, doesn't mean it's not symbolically true. Or carrying meaning in some form. Intrusive thoughts are parts of ourselves that we can't integrate into our conscious understanding of ourself, but it's still us and it comes back to haunt us in symbolic form and will continue to do so until we integrate it. So what could thoughts of harming a newborn baby mean? Here's a patient who maybe can't tolerate their own aggressive feelings towards people they also love. So no matter how much we present evidence that they'll not physically harm their child, this completely misses the mark of the true source of their suffering. We can't just treat the fever and ignore the underlying infection.

Hubo un tiempo que la derecha tenía a Vargas Llosa o Antonio Burgos. Hoy tienen a Juan del Val. No hay mucho más que decir.

Si no sufriste un balonazo de estos mojado, no has comprobado el verdadero dolor 🤕