A chapter in Jonah Lehrer's book, "How We Decide," along with a famous quote by David Hume, brought the title of this post to stark light.
Don't get me wrong. CBT is good to very good for mild, moderate and medium depressions. It's the bee's knees for panic attacks. In combination with densensitization therapy, it's very good for a lot of phobias.
But other neuroses, it might not help so much.
Lehrer talks about psychopathy in the latter portion of his book, and how psychopaths can read the emotions of others so well, but have no emotional connectivity to their own minds, so can rationalize, in a confabulating fashion, any decisions they may choose to take.
Autistic people, on the other hand, are just the reverse. They have an emotional life of their own, but simply cannot read other people's emotions.
Combine this with Hume's famous, and somewhat deliberately contrarian, observation that "reason is the slave of the passions," and you see CBT's shortcomings.
CBT says we can think our way through emotions.
Well, psychopaths can't. To the degree we can talk about a lesser version of them, and call that group "neuropaths" by analogy, they can't think their way through emotions very well. And, in a sense, autistic people can't think their way into emotions, if you will.
So, on counseling for emotional-based mental health issues where the emotions aren't irrational, or transcend the rational/irrational in some sense, being deeply rooted in the limbic brain (think PTSD), CBT really just can't cut the mustard.
Unfortunately, some CBT, or RBT (forgetting the "E") aficionados think it's almost a cure-all, or at the least, that it can do more than it can.
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