CBT: The Cognitive Behavioural Tsunami
Managerialism, Politics and the Corruptions of Science
Is CBT all it claims to be? The Cognitive Behavioural Tsunami: Managerialism, Politics, and the Corruptions of Science provides a powerful critique of CBT’s understanding of human suffering, as well as the apparent scientific basis underlying it. The book argues that CBT psychology has fetishized measurement to such a degree that it has come to believe that only the countable counts. It suggests that the so-called science of CBT is not just "bad science" but "corrupt science".
The rise of CBT has been fostered by neoliberalism and the phenomenon of New Public Management. The book not only critiques the science, psychology and philosophy of CBT, but also challenges the managerialist mentality and its hyper-rational understanding of "efficiency", both of which are commonplace in organizational life today. The book suggests that these are perverse forms of thought, which have been institutionalised by NICE and IAPT and used by them to generate narratives of CBT’s prowess. It claims that CBT is an exercise in symptom reduction which vastly exaggerates the degree to which symptoms are reduced, the durability of the improvement, as well as the numbers of people it helps.
Arguing that CBT is neither the cure nor the scientific treatment it claims to be, the book also serves as a broader cultural critique of the times we live in; a critique which draws on philosophy and politics, on economics and psychology, on sociology and history, and ultimately, on the idea of science itself. It will be of immense interest to psychotherapists, policymakers and those concerned about the excesses of managerialism.
Table of Contents
Ch. 1 Introduction: Hyper-rationality.
Part I – The Tsunami.
Ch. 2 The Tsunami Begins….
Ch. 3 The Merchants of Happiness.
Part II – Politics of Identity Formation.
Ch. 4 Master-Myths and Identity Formation.
Ch. 5 The ‘Psy' Wars.
Part III – Cognitivism.
Ch. 6 Homo Economicus.
Ch. 7 Managerialism.
Part IV – Dispensing CBT.
Ch. 8 NICE: naughty, but not nice.
Ch. 9 CBT Treatment.
Ch. 10 IAPT: Managerialism and the Privatization of ‘Mental Health’.
Part V - CBT Research.
Ch. 11 Good Science.
Ch. 12 The Corruptions of Science.
Ch. 13 Statistical Spin; Linguistic Obfuscation.
Ch 14. The Cognitivist Delusion. References
Farhad Dalal has been in independent practice as a group analyst and psychotherapist for over thirty years. He also works with organizations. His previous books have questioned received wisdom in a range of territories including psychotherapy (Taking the Group Seriously), racism (Race, Colour and the Processes of Racialization) and equal opportunities (Thought Paralysis – The Virtues of Discrimination).
"This book is breath-taking in its scope, perception and wit. It is critique at its most urgent and readable." --Professor Michael Traynor, Middlesex author of Nursing in Context: Policy, Politics, Profession
"Dalal gives us a devastatingly forensic critique of the weaknesses of CBT and the supposed ‘science’ that backs it up, and of the ruthless professional politics that have led its proponents to win the battle for the nation’s souls. His term ‘cognitivist delusion’ says it all. But in addition, as with his previous books, he lays bare the deeper intellectual and cultural histories that have conspiratorially allowed the ‘mental health professions’ to short-change citizens in the service of materialist capitalism and a society dominated by elites." --Professor Andrew Samuels, Department of Psychosocial and Psychoanalytic Studies, University Of Essex
"CBT is often presented as an alternative to psychiatric drugs for depression and other mental disorders. But in this erudite, thoughtful investigation of the "CBT Tsunami," Farhad Dalal details how it is built upon the same flawed foundation that gave us "safe and effective antidepressants": neoliberalism, the American Psychiatric Association’s Diagnostic and Statistical Manual, and bad science. A refreshing, and much needed, critique." --Robert Whittaker, Author of Mad In America
"This book is an analysis of the triumph of CBT as a method of ‘treating’ ‘depression’ but its argument also offers an urgent critique of the dysfunctions of our hyper-rational culture. By splitting nature from humankind, and then splitting emotion and ethics from reason in the latter, Dalal notes we have ended up with a perversion of Enlightenment values where the only things that count are the things that can be counted." --Paul Hoggett, Emeritus Professor of Social Policy and Chair of the Climate Psychology Alliance
"We live in alienating world where malignant individualism and rapacious neoliberal capitalism are destroying the belongingness and social cohesion that give our lives meaning, as well as degrading the planet we live on. In the therapy professions, these forces are thwarting relational ways of working, and replacing them with government-run machinery to provide industrialised therapy. This book is what we have all been waiting for: a robust, detailed and psychologically sophisticated critique of the frightening place where modern managerialism, regulation, compliance and performativity have taken us. It provides evidence that our narrow view of ‘evidence-based practice’ is not enough." --Rex Haigh, Consultant Psychiatrist in Medical Psychotherapy, Berkshire Healthcare NHS Foundation Trust
"This is an absolute masterpiece and should be read by anyone interested in anything to do with mental health or psychotherapy or economics or neoliberalism. Farhad has a wonderfully clear, engaging, intellectually rigorous, at times witty, style; but with a great talent for making complex phenomena easy to understand." --Sami Timimi, Director of Medical Education Lincolnshire Partnership Foundation NHS Trust
"This book could be the Apricity that is needed in these times: in a scholarly way it honours value-based ideas, and names those ideas that have been hijacked and corrupted. Watch out! It takes no hostages and introduces no heroes; it is a great read for those of us who appreciate challenging, perspicacious and compassionate analyses." --Professor Margie Callanan Programme Director of Clinical Psychology Doctorate, Salomons Centre for Applied Psychology
"Dalal’s book provides a vital contribution to our understanding of the politics and ethics of contemporary mental health treatment, and of the managerial and reductive pursuit of happiness which is a symptom of our times." --David Ferraro, President of the Lacan Circle of Melbourne & blogger Archives of a Divided Subject
"Under the sway of neoliberalism, the ‘happiness industry’ is in full flow and cognitive behaviour therapy is the technology of treatment for those who fall by the wayside. In this combative and passionate book, Farhad Dalal draws on his expertise in psychotherapy and critical thinking to reveal the corruptions of argument and evidence on which the dominance of CBT is based. The book is a much-needed and timely reminder of the dangers inhabiting simplistic responses to complex social and personal conditions." --Prof. Stephen Frosh Professor of Psychosocial Studies, Birbeck, University of London.
"With devastating irony and a poetic turn of phrase, this tightly argued yet wide ranging essay about politicised behaviourism in psychotherapy today is both highly instructive and entirely persuasive. ….. Farhad Dalal redeems the possibilities of Group Analysis from the corrosions and dilutions of neo-liberal economists and administrators. It is good to have him on our side!" --Earl Hopper, Ph.D., Mem.Inst.GA, CGP, DFAGPA. Psychoanalyst, group analyst and organisational consultant in private practice in London.
"Dalal lays bare a 'tragedy-in-progress' which will concern anyone for whom mental health or the direction of travel of twenty-first century healthcare is important." --Dr. Douglas Board; Coach and Organizational Consultant; MaslowsAttic
A powerful critique unpacking the rhetoric surrounding CBT. Both shocking and deeply convincing. --Oliver James, Clinical Psychologist - author of Affluenza
A powerful and courageous book chartering, among other things, the deep inefficiencies and failings of our IAPT-based CBT services. --James Davies, Reader in Social Anthropology & Mental Health University of Roehampton, author of Cracked: Why Psychiatry is Doing More Harm Than Good
"In this most timely contribution, Dalal forensically lays bare the limitations of CBT as a response to human distress and the grandiosity of many of its claims and shows how the systematic adoption of CBT causes injury to our image of ourselves. An invaluable resource for those wanting to understand and to stand against the absurdities of hyper-rationalism." --David Glyn, President, Group Analytic Society International
"Farhad Dalal shows how our current cultural fixation with hyper-rationality has led to CBT dominating the psychological therapies as part of our Neo-liberal post-truth era. This is a vitally important book if we are ever to relearn how to come to our senses." --Prof Del Loewenthal University of Roehampton, UK
"This is a seminal contribution…A brilliant tour de force that lays bare the working of power relations in obfuscating scientific methods and perpetuating falsehoods on important policy questions of our times. Lies appear to thrive not only through outright falsifications but also through orchestrations of selective disclosure, the currency of false promises, and misrepresentation of what constitutes efficacy and public good. Farhad Dalal masterfully takes us through the jungle overgrowth that institutionally militates against healthcare and human well-being." --Dr Ajeet N. Mathur, Indian Institute of Management
"This is a masterful analysis of the hidden forces, delusions and tyrannies which corrupt and toxify science. The book draws on scholarly research not only to interrogate CBT practice, it also articulates an ethical vision of what Good Science and its values ought to look like." --Prof. Charalambos Tsekeris, Academic Researcher (National Centre for Social Research, Greece) and Professor Extraordinary (Stellenbosch University, South Africa)
"A timely and crushing debunking of dominant mental health paradigms, opening up possibilities for a more humane approach to human suffering, rooted in rigorous socio-political analysis." --Graham Music, Author Nurturing Natures
"This is one hell of a book! Brilliantly written.
In his closely and passionately argued book, The Cognitive Behavioural Tsunami, Farhad Dalal issues a complex and thought-provoking challenge to the claims of Cognitive Behavioural Therapies as the pinnacle of effective psychotherapy. Implicit in his critique are such fundamental questions as: Do we have the right to suffer? Is human suffering a medical problem? Does personal happiness equate with mental health? Can one’s capacity to suffer reflect mental health rather than mental illness? What does it mean to "treat" suffering?
Dalal argues against the over valuing of hyper-rationality that has come to pervade models of contemporary psychotherapy. He outlines the corruption of science in the service of politics and profit. Though written primarily within the perspective of mental health services delivery in the United Kingdom, Dalal’s book mirrors the same economic and political forces seen in the United States in a once deeply personal field of human encounter, now increasingly defined, manualized, and controlled by government and market forces, insurance companies, and the pharmaceutical industry.
This book raises fundamental questions of the ethics and human essence of our psychotherapeutic endeavours that speak urgently to the future of psychotherapy." --William F. Cornell, Author of Somatic Experience in Psychoanalysis and Psychotherapy
"An important book for those worried about the clinical value of CBT. Dalal presents a rich and fundamental critique of CBT as well as the systems that support it. Dalal is an independent thinker who courageously challenges the DSM and the power politics of psycho-therapy." --Dr. Robi Friedman, Past President of the International Group Analytic Society.
"Farhad Dalal’s passionate and informative analysis of the questionable foundations of CBT, and of the professional and political contexts in which it has risen, is presented with his characteristic engaging directness. You do not have to agree with everything he says to be convinced of the importance of his powerfully-stated message: that the CBT behemoth, loaded high with good intentions and false hopes, should be halted." --Barry Richards Professor of Political Psychology Bournemouth University, UK
"Another brilliant book from Farhad Dalal! This time his target – well deserving the sue of heavy weaponry -- is Cognitive Behavioural Therapy, together with the idiocies of the Diagnostic Statistical Manual. Dalal demonstrates that they are symptoms of a much more general affliction of modern society: 'hyper-rationality' and the corruption of science." --Stephen Mennell, University College Dublin
"Farhad Dalal employs critical analysis with surgical precision to debunk the mythology surrounding and supporting the science of CBT.
The book will confront, inspire, provoke and enlighten any reader with an interest in how CBT has morphed from a treatment dealing with the fear of flying and spider phobia into a powerful political-scientific movement, which claims to cure almost all ‘mental disorders’ on an industrial scale." --Professor Stig Johannessen, Faculty of Health Sciences, Oslo Metropolitan University, Norway.
"Farhad Dalal’s book looks behind CBT’s moral and rationalistic justification for its dominance in the field of psychotherapy. Dalal succeeds in illuminating the dark politics that drive this process, exposing their self-serving actions for what they are. This eloquent and fascinating book exposes the reader to the cost we are paying for this therapeutic approach: the reduction and diminishment of the human subject and the silencing of other therapeutic alternatives." --Dr. Avi Berman, Tel Aviv University