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Ending the abusive use of psychotropics and psychotherapies

First, we highlight the fundamental and widely overlooked importance of the infernal triangle of cognitive dissonance at the level of psychic distress. This triangle is presented in the question 'What is cognitive dissonance?', which we invite you to read beforehand.
We will then briefly present the psychological mechanisms at work in two effective and sufficient psychotherapies in the general case.

Let us enumerate the different modes of action of the oppressing individual A on the victim B, within an infernal triangle of cognitive dissonance:

These three sources of oppression correspond to the expression of an individual's omnipotence at the social, physical, and intellectual levels respectively.
In the rest of this document, by extension, we will speak of the infernal triangle of cognitive dissonance whenever an aggressor A creates psychic suffering in a victim B, even in the absence of complacent individuals C.

When they exist, the deleterious effect of complacent individuals C on the victim B is absolutely not negligible. Indeed, to maintain the self-deception that preserves the alliance between the complacent C and the aggressor A, C needs to convince the victim B of the truth of this lie, thus creating confusion in B, which will manifest as existential distress, all the more easily as C is experienced and intellectually superior and B is young. C thereby becomes, by force of circumstances, an A using the third modality.

The #MeToo movement has allowed us to become aware of the extent of inappropriate sexual gestures. Moreover, whether regarding sexual assaults linked to the film industry or those perpetrated within the Catholic Church, society has become aware of the key role played by those who know and remain silent. We indeed have a triangle A aggressor, B victim, C complacent with A.
However, #MeToo concerns only sexual assaults, which, as we have just seen, are only a small part of the sources of oppression. Denial, namely the refusal to take into account a fact, is a far more general problem in our society. It causes the same type of disorders as sexual assaults when not denounced, namely the internalization of guilt in the victim and the loss of reference points linked to the action of complacent individuals, with all its harmful psychic consequences.

At the political level, the pressure to make the other accept a counter-truth or reproduce a behavior they judge inappropriate was particularly strong in communist countries where lies were almost absolute. At the domestic and professional levels, this problem is currently universal and represents probably nothing less than the main source of psychic distress evaded instead of being treated.

In the face of psychic suffering, one must proceed with method:

1. Is the cause organic?
The initial search for an organic cause is the foundation taught during psychiatric studies, and the justification for why psychiatrists are also physicians.

2. Are we facing an infernal triangle of cognitive dissonance (with or without the presence of individuals C)?
In this case, it is about identifying it, explicitly denouncing it at a minimum, and entering into struggle if possible. One could qualify the implementation of this step as nothing less than the greatest mental health project of the 21st century. Indeed, although this infernal triangle of cognitive dissonance is present everywhere, this step is today bypassed, especially regarding the exposure of complacent individuals C, to move directly to step 4 or 5.

3. Are we facing an abusive attempt at social normalization? For example, improving the decoding of facial expressions in mild autism. In this case, as in point 2, one must denounce and fight, not correct the victim's behavior.

4. Psychotropics artificially modify the chemistry of our brain.
The limit of psychotropics is that they reduce psychic distress without drying up its source, just as painkillers reduce physical distress without curing the disease. The problem of psychotropics, exactly like that of painkillers, is the side effects.

5. Psychotherapies often seek to act like psychotropics too much. They forget that the basic action should be that of step 2, namely bringing to light, denouncing, and combating the infernal triangles of cognitive dissonance. In doing so, they contribute to progressively locking the individual into a deleterious spiral of denial of reality and compensation, without facing the real problems at their source.

To conclude, let us return once again to the infernal triangle of cognitive dissonance, and study the effect of complacent C on victim B in a domestic context. C has an interest that victim B uses psychotropics or psychotherapies instead of exposing the infernal triangle of cognitive dissonance. He will therefore not hesitate to conspire for this. Indeed, if the triangle is identified and denounced, then C finds himself again facing his own cognitive dissonance, with an injunction to act that jeopardizes his relationship with A, something he lacks the courage to do. See the question 'What is an adult?'.
At the professional level, it is the same, but psychotherapies are administered by coaches, and psychotropics are requested by victims to 'hold on'.

Once this preamble is established that resorting to psychotherapy should not be a means to bypass the necessary struggle against injustice, we can present two serious psychotherapies.
To understand their mode of functioning, it is necessary beforehand to master the notion of splitting our psyche into two layers. These layers, presented in the article Should we listen to our emotions?, are on the one hand the cognitive-affective system, and on the other reason.

Cognitive-behavioral therapy (in English cognitive behavior therapy or CBT or simply CT)

Attention: cognitive therapies exist in multiple variants that are not equal. We refer here to the 'Cognitive behaviour therapy' method as formalized by Aaron T. Beck.

Its therapeutic principle is as follows: contemporary science has established that memory is not a reliable and stable recording system of the events we have lived through. In particular, every time we recall an event, it is re-recorded, reinforced, slightly modified, one could just as well say polluted as corrected, by our current state of mind and our knowledge acquired after that event. This mechanism was established during the numerous studies conducted to determine the reliability of witness testimonies, sometimes contradictory, in criminal cases.

The Beck method therefore consists in asking the patient to formulate the thoughts that come to them spontaneously (expression of what we have called the cognitive-affective system), and literally pass them through the filter of reason, so that they are re-recorded in a less intrusive form for the individual. Questioning these thoughts focuses mainly on the generalization in terms of content and time that the cognitive-affective system tends to perform. Generalization in terms of content can take the form of traumatic elements against which we were powerless that we generalize into an existential 'I am worthless'. Generalization in time consists in assuming that the same causes will always produce the same effects, thus that we will always be powerless if we have been powerless in the past against certain events. The Beck method essentially consists in fighting our tendency to essentialize things.

In Beck's cognitive-behavioral therapy, the therapist's art consists in part in breaking down the magma of negative thoughts into multiple small elements that can be challenged effectively one after the other, whereas confronting the whole at once would not produce results, and on the other hand in making the patient's reason work instead of trying to convince them.

At the beginning of the 21st century, CBT therapy tends to include elements of ACT therapy, particularly in the form of the importance given not only to the individual's negative thoughts, but also to positive elements such as their values and aspirations. Moreover, the cognitive triad brought to light by Beck (negative thoughts concerning oneself, the world, and the future) can be seen as a prototype of the axes split in ACT.

Acceptance and Commitment Therapy (in English, acceptance and commitment therapy or ACT)

If cognitive-behavioral therapy aims to use reason to literally clean the content of our thoughts stored at the level of our cognitive-affective system, the Acceptance and Commitment Therapy aims to limit the importance and credit we give to these thoughts. ACT is therefore relatively close to meditation methods, while being a more global system and freed from the beliefs of traditional spiritualities.

The ACT psychotherapy proposes to work on 6 axes:

1. Do not seek to block the rise of negative emotions.
This is the first counter-intuitive concept, particularly at a time when occupying one's mind, fixing attention on entertainment (Smartphone, Television, Radio, Book, etc.) has never been so easy. Overloading one's schedule produces the same result.
The practice of meditation is very ancient, although often associated with Buddha who is its most famous figure, but not the inventor. If it is so alien to us, it is probably because in the Judeo-Christian culture, it is largely replaced by prayer, which is only a withered form insofar as one directs one's thoughts towards God, and above all one seeks ultimate truth at the level of the cognitive-affective system, in opposition with point 2 below.

2. Do not consider that the emotions that rise are reality or the expression of what we are (defusion).
This is the second and last counter-intuitive concept. Our instinct dictates that what we feel strongly is what is most real and most intimately linked to our deep self. However, the emotions that our cognitive-affective system brings to the surface permanently, and even more strongly when the present situation vaguely resembles a past situation with a strong positive or negative emotional charge, are generally neither representative of current reality nor representative of what we are. These emotions are often just the product of our brain, whose mission is to find solutions to our problems, which gets stuck in a loop on problems for which it has not found a solution, or simply proceeds by superficial associations.

3. We are what we seek to become.
We are too inclined to represent ourselves as the fruit of our history (and especially the way we and others tell it), and act by simple reaction to the emotions that our cognitive-affective system brings to the surface, that is to say being turned towards the past. ACT invites us to realize that the person we are changes over time, to turn towards the future, and take the time to well represent the person we desire to become (and not simply the social position we wish to occupy), independent of our history, even if it remains often a driver. Transforming a past trauma or dissatisfaction into a source of motivation to act towards realizing an ideal is called sublimation. For it to operate, one must well define and keep at the forefront of our mind the ideal we wish to achieve, the person we wish to become.

4. Anchor in the here and now.
This axis corresponds to the Carpe diem concept of philosophy. One finds the same concept in Buddhism. The idea is twofold:
On the one hand, do not tell oneself that one will be happy ... later, when such and such a problem is solved. Anchoring in the here and now is a daily exercise consisting in seeking pleasure in the most banal gestures. The sun on one's skin, a kind word received, a tasty bite, etc.
On the other hand, be fully present in what one is doing, as opposed to letting one's mind wander under the effect of emotions (rumination) produced by the cognitive-affective system.

There is thus a potential contradiction between point 1 (allowing negative emotions to rise) and this point 4, insofar as focusing attention on what is happening here and now is also a way of blocking the rise of negative emotions. The appropriate way to resolve this contradiction is to dedicate specific moments to the emergence of emotions, such as meditation sessions. During these moments, one fixes attention on these emotions, without however considering them as real (point 2).
In other words, the emergence of emotions must be framed by reason, not endured.

5. Explicitly define the person we wish to become.
ACT therapy speaks of clarifying one's values, to better distinguish this from point 3 (clarifying the person we wish to become). This is somewhat risky because values are strongly subject to the progressive effects of cognitive dissonance.
In fact, ACT is only a technique. Its creators well understood that it must be based on content, which they associate with values, and they have the great wisdom not to try to define them, which would cause them to slip into ideology. In Greek philosophies, content corresponds to the representation of the world and morality.
This site is more ambitious than ACT, since like a Greek philosophy, it also defines the content. However, what prevents one from slipping into ideology is the result of two points:
Firstly, values are the product of the scientific observation of what constitutes our behavioral genetic heritage, and the minimum corrections required by culture (taking into account facts and solving problems to the detriment of the game of alliances) to limit social violence.
Secondly, the acceptability of each value stems from the coherence of the whole, whereas religious and political ideologies tend to present major inconsistencies, because their widespread success presupposes endorsing the game of alliances.
The first point was not accessible to Greek philosophies.

6. Translate all of this into action.
Here we find the final point of problem solving, namely the necessity to effectively move forward by representing and planning the next actions to take, as opposed to thinking that one will jump from who one is today to who one wishes to become in the end.
This concept appears once again in Buddhism, in the form of the saying 'The path is the goal', which invites us not to remain focused on the final objective (wisdom or enlightenment), but to concentrate our efforts on the next right actions to take.

The whole aims to establish what ACT calls mental flexibility, that is, in the face of adversity, the ability to reliably decide whether it is appropriate to persist or adapt, instead of remaining in doubt and worry. This is strongly connected to the second stage of problem solving (analysis).

Beyond psychotherapy

The two psychotherapies we have just briefly presented make it possible to avoid that one's future is too determined, and especially in a non-constructive way, by past traumas. They also have the advantage, under the general impulse given by the DSM manual, of being supported by effectiveness measurement studies as closely aligned as possible with the modern scientific method.

Furthermore, they constitute a complete system. Thus, ACT can be viewed in a very global way as Buddhism stripped of its beliefs (reincarnation, enlightenment, etc.), and CBT+ACT can be seen as psychoanalysis stripped of its beliefs (Oedipus complex, topographies, etc).

Finally, it is important not to forget to learn the following techniques in addition:

Mental self-defense techniques

As indicated in the question 'In what way are kindness and tolerance traps?', passively listening to another with kindness has the effect of engraving their discourse into our memory (our cognitive-affective system) through the force of repetition, without our full consent. This is a principle widely used in all social spheres, by politicians, and by advertisers.

Voici quelques techniques que l'on peut utiliser pour limiter cet effet pervers :

There are probably other techniques or variants that I do not master.

Deepen

The WHO proposes a simplified version of ACT psychotherapy, targeted at anxiety. This tool called Self-help plus (SH+) takes the form of either 5 audio courses, or a comic book Doing What Matters in Times of Stress. This comic book is available in many languages, with associated audio exercises.

↣ BD Faire ce qui compte en période de stress, et exercices audio

↣ SH tool in the form of 5 audio lessons

Caveat: The SH+ tool is based on a diluted vision of what a human is (notions of kindness and values).

The book Cognitive and Behavioral theories in Clinical Practice, by Nikolaos Kazantzis, Mark A. Reinecke and Arthur Freeman, presents an overview of available cognitive psychotherapies.

Chapter 2 (Beck's Cognitive Therapy) contains the verbatim of a therapeutic exchange aimed at reducing the generalization of memories associated with a negative emotion.
A more developed presentation of this type of psychotherapy (CBT and now CB-R) is proposed in the book Cognitive behaviour therapy - Basics and beyond - third edition, by Judith S. Beck, daughter of the founder Aaron T. Beck.

Chapter 5 (Acceptance and Commitment Therapy) presents a more complete method (ACT) for treating negative emotions of the cognitive-affective system. This method is based on 6 different techniques.
The book ACT with Anxiety by Richard Sears provides an accessible manual to apply these various techniques.
The book Acceptance and Commitment Therapy - the process and practice of mindful change by Steven C. Hayes, Kirk D. Strosahl and Kelly G. Wilson presents, in its first part, the model upon which ACT is based, and in its third part a more developed version of the 6 techniques that make up ACT therapy. However, the article Making sense of spirituality by Steven C. Hayes (1984) explains the origins of ACT more clearly.

See the question 'Why is politics important?' which mentions the danger of psychologism, which consists in interpreting all discomfort as a lack of adaptability on the part of the individual.