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CBT for Psychosis; keeping it real!

This rap I wrote and performed at a debate at a CBT (Cognitive Behavioural therapy) conference 2 years ago, which included psychologists Richard Bentall, Max Birchwood and Peter Kinderman.

I was asked to discuss the future of CBT for psychosis
Its spreading across the country like Mixamatosis…

But unfortunately it’s far too professional.
It uses clinical jargon making it so medical.
Clinical terminology has quite a negative effect you see
Words like Symptoms interventions relapse prevention and abnormality
Is the language of deficit and illness, it makes us want to feel less
and so we wait for the pills to work and give up responsibility.
Clinical language (pushes an ideology that) puts the therapist on a pedestal  and promotes passivity.
What we need is not language that smacks of technology
We want the language of experience that says it so respectfully.

Recently I met the mother of a son with paranoid thoughts
Scared of going into hospital, he ran away to not get caught
He was found in a disused building, dying of exposure.
“What would have helped the most?” I decided to ask his mother.
“To meet other people who were making a recovery”
If you’ve been in hospital, stories of hope are quite a discovery!
At a public meeting called Evolving Minds she made this observation
Here people are seen as people not carers, staff and patients.

I would like more cooperation between CBT and Self-help movements
But where CBT is thriving, Self-help groups are not started
Birmingham is a good example of this, perhaps we should ask Max Birchwood.
Why is it in a region that has focussed so much on services for psychosis
Hearing voices self help groups are as rare as reindeer with red noses?
Is it implicit in CBT to maintain the (expertise) ‘them and us’ divide
Or can it become more emancipatory? this is what we must decide.

In the final pages of Richard Bentall’s book ‘Madness Explained’
He suggests the way forward may have to be changed.
Liberation rather than cure could be the answer
Following in the footsteps of Marious Romme and Sandra Escher:

The International Hearing Voices Network is another trans global epidemic,
Where ‘experts by experience’ are seen as important as academics.
Yet at CBT events, professorial monologues still tend to dominate.
We need a different kind of dialogue that I think will stimulate
A broader type of thinking and a broader type of people
If that was the case then I’m sure that such conferences would be full
Of a diverse range of citizens
Who would be given the ammunitions
To really develop communities of healing hope and democracy.
As John Read has shown us we need to go to the roots
Of people’s suffering, if we don’t ever, we are in cahoots.
With the notion that psychosis is an arbitrary biological illness
When in fact it is a meaningful subconscious expression that can guide the way to wellness!

But while chemical cosh prescribing practice continues to promote suppression,
We should work with holistic therapies to help avoid the oppression
Of tardive dyskinesia, weight gain and akasthesia
The blocking of affection and empathy
Enthusiasm and creativity.
But with mindfulness, yoga and tai chi
People can naturally balance their energy
So CBT needs to think more openly
Acknowledge that there is no one right way to see
And that spiritual and emotional wisdom can sometimes be
More important than biomedicine and psychology.

Remember delusions are in the beholders eye
And thought manipulation is difficult to justify.
You must go very carefully
With techniques that push rationality.
Because it is only one world view
And the person on the receiving end may not thank you.

When we work with people’s voices
We should give them real choices.
One technique is to help the person communicate
With the voices that tend to dominate.
With voice dialogue using chairs we can open up a conversation
And the voice hearer and voices get some mediation.

So my last word is creativity holds the key
Listen to your heart as well as your head
And together we can demand more than just CBT!

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