To assuage a fear, it is necessary to modify the path of thought. This scientifically validated approach has a name: Cognitive Behavioral Therapy (CBT). A notion discussed in our "Neuroplanet" forum dedicated to the brain, on March 10 and 11 in Nice. In order to understand what it is, there is a famous example, that of the church bell that rings every time food is served to a dog. Over time, the animal understands that when the bell rings, it will be served food. A notion of repetition subsequently transposed to humans.
Indeed, thanks to CBT, it is possible to train patients to modify thoughts that are harmful to health. "Cognitive-behavioral therapy is a treatment of mental suffering based on assessment and validated by scientific studies", explains Marion, military doctor, chief medical officer. Better manage stress or social anxiety, fight certain eating disorders (anorexia, bulimia), get back to sleep, get rid of certain addictions (drugs, alcohol, cigarettes, etc.), eradicate phobias (crowds, school, animals, etc.), recovering from post-traumatic stress… so many problems to which CBT can provide a satisfactory answer.
“CBT can rely on different mechanisms. Mechanisms targeting learning aim to retrain the brain and teach it through conditioning or deconditioning, continues Marion. The exposure mechanism, which aims to decondition from traumatic fear, is used more in the case of post-traumatic stress disorder. In this case, the therapist gradually exposes the patient to the traumatic event he has experienced. A repeated exposure that leads to the deconstruction of fear. ". Initially, an interview with the patient determines the reason for the consultation, the origin of the disorder and allows the therapy best suited to the needs and history of each patient to be put in place. Unlike psychoanalysis, the therapist does not dwell on the unconscious, but is interested in the identifiable processes involved in the problematic behavior. In this way, he can put in place the learning of new behaviors and/or new cognitions that no longer lead to psychological suffering.
After a certain number of sessions, a mid-term review is carried out in order to adjust – if necessary – the practice. The practitioner's self-assessment is, moreover, permanent in the conduct of a CBT therapy. If for post-traumatic stress, support can be rapid (a few sessions), this therapy may require more sessions to fight against the comorbidities of this disease such as depression or addictions (drugs, alcohol, etc.).
If there is no contraindication to the implementation of cognitive behavioral therapy, the patient must be willing and involved in his care. "The implementation of a CBT always comes after a functional analysis in order to choose the right approach. It is a true therapeutic alliance. As with other therapies, you shouldn't choose your specialist lightly. The army doctor recommends relying on the sites of associations and learned societies, which bring together active and serious practitioners.
The establishment of a cognitive and behavioral therapy does not necessarily exclude taking medication. "The prescription of a drug can be joint depending on the patient's condition. For example, antidepressants help decrease the suffering of patients with post-traumatic stress disorder before starting exposure therapy. A way to make him more involved in his therapy. "Regarding reimbursement, Health Insurance recalls that serious anxiety disorders are included in the list of long-term conditions (ALD) covered at 100%. TCCs are better covered and some health insurance companies now offer reimbursement for part of the sessions.
CBT, Cure or Prevention? Obviously, it all depends on the pathology. “Cognitive behavioral therapy can be effective as part of primary prevention following trauma. It prevents the situation from developing into post-traumatic stress. For anxious patients, it can also help to work on ruminations to avoid the evolution towards a pathology of anxiety or depression. »
