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Putting an end to the abusive use of psychotropic drugs and psychotherapies

We will first outline the fundamental and widely overlooked importance of the infernal triangle of cognitive dissonance in the context 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 psychic mechanisms at play in two effective and sufficient psychotherapies in the general case.

Let us enumerate the different modes of action of the oppressor 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 respectively at the social, physical, and intellectual levels.
In the rest of this document, by extension, we will refer to the infernal triangle of cognitive dissonance whenever an aggressor A creates psychic suffering in a victim B, even in the absence of complicit individuals C.

When they exist, the deleterious effect of complicit individuals C on the victim B is absolutely not negligible. Indeed, to maintain the self-deception that preserves the alliance between the complicit 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 superiorly intelligent, and B is young. C thereby becomes, by force of circumstance, an A using the third modality.

The #MeToo movement has allowed us to become aware of the extent of inappropriate sexual gestures. Furthermore, 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 say nothing. We have precisely a triangle: A aggressor, B victim, C complicit 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, that is to say the refusal to take a fact into account, is a much more general problem in our society. It provokes the same type of disturbances 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 complicit individuals, with all the harmful psychic consequences.

At the political level, the pressure to make another person accept a counter-truth or reproduce a behavior they deem inappropriate has been particularly strong in communist countries where the lie is almost absolute. At the domestic and professional levels, this problem is currently universal and represents nothing less than the main source of psychic distress that is sidestepped instead of being treated.

Faced with psychic suffering, one must proceed methodically:

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

2. Is there an infernal triangle of cognitive dissonance (with or without the presence of individuals C)?
In this case, it is a matter of identifying it, denouncing it at the very least explicitly, 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, particularly regarding the highlighting of complicit individuals C, to pass directly to step 4 or 5.

3. Is there an attempt at abusive social normalization? For example, improving the decoding of facial expressions in mild autistics. In this case, as in point 2, one must denounce and struggle, not straighten the victim's behavior.

4. Psychotropic drugs artificially modify the chemistry of our brain.
The limitation 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 with psychotropics, exactly like that of painkillers, is the side effects.

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

To conclude, let us return once again to the infernal triangle of cognitive dissonance and study the effect of complicit C on the victim B within the domestic framework. A C has an interest in the victim B using psychotropic drugs or psychotherapies rather than highlighting the infernal triangle of cognitive dissonance. They will therefore not hesitate to scheme for this purpose. Indeed, if the triangle is identified and denounced, then C finds themselves once again facing their own cognitive dissonance, with an injunction to action that puts their relationship with A in jeopardy, something they lack the courage to face. See the question 'What is an adult?'.
At the professional level, it is the same thing, but psychotherapies are administered by coaches, and psychotropics are requested by victims to 'hold on'.

Once this preamble is established that recourse to psychotherapy should not be a means of bypassing the necessary fight against injustice, we can present two serious psychotherapies.
To understand their mode of operation, it is necessary to first master the notion of the splitting of our psyche into two strata. These strata, 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 behaviour 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 experienced. In particular, every time we recall an event, it is re-recorded, reinforced, slightly modified; one could say just as much polluted as corrected, by our state of mind at the moment, and our knowledge acquired subsequently to that event. This mechanism was established during the numerous studies carried out to determine the reliability of sometimes contradictory witness testimonies in criminal cases.

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

In Beck's cognitive behavioral therapy, the art of the therapist consists partly in breaking down the magma of negative thoughts into multiple small elements that can be effectively challenged one after another, whereas confronting the whole at once would not produce results, and partly 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 accorded not only to the individual's negative thoughts, but also to positive elements such as their values and aspirations. Furthermore, the cognitive triad highlighted by Beck (negative thoughts concerning oneself, the world, and the future) can be seen as a prototype of the axis splitting of 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, 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 free of the beliefs of traditional spiritualities.

ACT psychotherapy proposes to work on 6 axes:

1. Do not seek to block the rising of negative emotions.
This is the first counter-intuitive concept, particularly at a time when occupying one's mind, focusing 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 widely foreign to us, it is probably because in the Judeo-Christian culture, it is largely replaced by prayer, which is only an atrophied form insofar as one directs one's thoughts towards God, and above all, one seeks the ultimate truth at the level of the cognitive-affective system, in opposition to point 2 below.

2. Do not consider that the emotions that rise are reality or the expression of what we are (defusion).
Il s'agit du second et dernier concept contre-intuitif. Notre instinct nous dicte que ce que nous ressentons fortement est ce qui est le plus réel et le plus intimement lié à notre moi profond. Or les émotions que notre système cognitivo-affectif fait remonter à la surface en permanence, et plus fortement encore quand la situation présente se rapproche vaguement d'une situation passée avec une forte charge affective positive ou négative, ne sont généralement ni représentatives de la réalité actuelle, ni représentatives de ce que nous sommes. Ces émotions ne sont bien souvent que le produit de notre cerveau, dont la mission est de trouver des solutions à nos problèmes, qui bug en boucle sur les problèmes pour lesquels il n'a pas trouvé de solution, ou procède simplement par associations superficielles.
De plus, ces émotions sont largement dictées par le discours général que nous portons et que les autres portent sur nous. Ce discours est la face négative de la puissance du langage, qui agit comme un filtre nous interdisant d'observer pragmatiquement la totalité des composantes du réel en cours. Nous nous trouvons ici à la source de la dissonance cognitive : l'histoire construite au moyen du langage passe au dessus, et cache le réel.

3. We are what we seek to become.
We are too prone to represent ourselves as the fruit of our history (and especially the way we and others tell it), and act simply by reacting to the emotions our cognitive-affective system brings up, that is, being turned towards the past. ACT invites us to become aware 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 in order to achieve an ideal is called sublimation. For it to operate, it is necessary to well define and keep in 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. We find the same concept in Buddhism. The idea is twofold:
On the one hand, do not say that we will be happy ... later, when such and such a problem is solved. Anchoring in the here and now is a daily exercise that consists of seeking pleasure in the most ordinary gestures. The sun on one's skin, a kind word received, a delicious 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.

Thus, there is a potential contradiction between point 1 (allowing negative emotions to rise) and this point 4, insofar as fixing one's 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 allowing emotions to rise, such as meditation sessions. During these moments, one fixes attention on these emotions, without considering them as real (point 2).
In other words, the rise of emotions must be framed by reason, and not endured.

5. Explicitly define the person we wish to become.
The 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, as values are highly subject to the progressive effects of cognitive dissonance.
In fact, ACT is merely a technique. Its creators understood well that it must be based on content, which they associate with values, and they possess the great wisdom of not seeking to define it, as that would cause them to slip into an ideology. In Greek philosophies, the 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 it from slipping into ideology is the result of two points:
Firstly, values are the product of the scientific observation of what our behavioral genetic heritage is, and of the minimum to be corrected by culture (considering 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 incoherences, because their widespread success presupposes endorsing the game of alliances.
The first point was not accessible to Greek philosophies.

6. Translate all this into action.
Here we find the last point of problem-solving, namely the necessity, in order to advance effectively, to represent and plan the next actions to be undertaken, as opposed to thinking that one will jump from what one is today to what one wishes to become in the end.
This concept appears again in Buddhism, in the form of the saying 'The path is the goal', which invites us not to remain focused on the final goal (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 capacity to reliably decide whether it is appropriate to persevere or to adapt, instead of remaining in doubt and anxiety. This is strongly connected to the second step of problem-solving (analysis).

Beyond psychotherapy

The two psychotherapies we have just briefly presented make it possible to avoid having one's future determined, and especially in a non-constructive manner, by past traumas. They also have the advantage, under the general impetus given by the DSM manual, of being supported by studies measuring their effectiveness as conforming as possible to the modern scientific method.

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

Finally, it is necessary 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 others with kindness has the effect of engraving their discourse in our memory (our cognitive-affective system) through the force of repetition, without our full knowledge. This is a principle widely used in all social spheres, by politicians, and by advertisers.

Here are some techniques that can be used to limit this perverse effect:

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

Deepen

The WHO proposes a simplified version of the ACT psychotherapy, targeted at anxiety. This tool named 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

Note: The SH+ tool relies 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 different 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 on which ACT is based, and in its third part a more developed version of the 6 techniques that make up the 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 of interpreting any discomfort as a lack of individual adaptability.