A truly radical and critical conference

... held in the medieval grandeur of Dartington, with its Bohemian and Arts and Crafts roots, and Transition Town Totnes - an inspiration for anybody with a sustainable thought in their head.

This was the inaugural Limbus Critical Psychotherapy Conference, title 'Challenging the Cognitive Behavioural Psychotherapies: The Overselling of CBT's Evidence Base'. Official site here. There were six talks, with lots of large group plenary discussion time, good spaces for small group reflection around our tables - and a bar with decent beer in the evening!

Farhad Dalal opened the proceedings with a short impassioned plea for the values of being authentic and human.

The first session was Jonathan Shedler: What is the Evidence for Evidence-Based Therapies?

Jonathan Shedler

A lovely critique of the over-egging of the academic mountain of papers 'proving' the effectiveness of CBT.

Quotes:

• "the master narrative"
• "Evidence Based Therapy has become a brand and its apparel is all marketing, with a vast chasm between the buzz and the research "
• "the inverted pyramid of shame"

The next session was Goran Ahlin: Waiting for the tide to turn: Aspects of the rise and expected fall of CBT in Sweden.

Goran Ahlin

A decade-by-decade trip through fifty years of Scandinavian psychopolitics - though I'm not sure I'd be as optimistic as he was about the tide turning any time soon.

Quotes: 

• "New Public Management" (a rather chilling concept which ran through much of the weekend)
• Sweden was saved from the worst excesses of the post-1979 economic system
• "Fascistic state of mind" (from the discussion)
• 'Intolerance of any uncertainty" (ditto)

After lunch was Patrick Pietroni: Improving Access to Psychological Therapies: Where we were, where we are, and where we are going.

Patrick Pietroni

Turning IAPT into something meaningful - a vision of how an integrated primary-care based therapy system could deliver real therapy with much more benefit to everybody - rather than the superficial, transient, overcontrolled and often inaccessible system of Lord L and David C. And it has already started in Shropshire!

Quotes:

• "A different kind of space"
• "healthy human relationship systems"
• "social determinants of health"
• "Every MBA in DH should do an MBWA: management by walking about"

First up on Sunday was Oliver James of TV and book fame: Happiness, CBT and Apple Pie. Not to be confused with Jamie Oliver of course! 

Oliver James 

A gripping tale of intrigue and skulduggery as an elderly lord of the realm meets a sinister man-in-black psychologist - and try to make everybody happy. With solid genetic and social commentary.

Quotes:

• "Drivel"
• "La-la land"
• "Weasel words"
• "Happiness rubbish"
• 'Thrive' as a 'completely irritating' book

Next was Del Loewenthal: NICE Work if You Can Get It; Evidence and research cultural politically influences practices.

Del Loewenthal

This was a dense intellectual argument from deep in the academic world of non-positivism, and a scrupulous picking apart of the NICE machine

Quotes:

• "post exisitentialist"
• "relational psychoanalysis"
• "How dreadful it would be if psychotherapy became an agent of social control" (in discussion)

The formal presentations finished with Farhad Delal: Statistical Spin, Linguistic Obfuscation; The Art of Overselling the CBT Evidence Base.

Farhad Dalal

This was based on a close examination of a prominent CBT 'evidence' paper, and showing just how slippery both the numbers and words are - and how the impact it therefore has is a long way from the science in it.

Quotes:

• "3rd wave CBT" (about acceptance rather than control)
• Mischievously incudes words like 'Compassion-based'; 'Mindfulness-based'; 'Attachment-based' and 'Resilience-based'. 
• Parallels with Ben Goldacre and Bad Pharma
• "reduction" of risk of relapse does not equal prevention
• "CBT did iatrogenic harm" to those who had <3 depressive="" episodes="" li="" previous="">
• "MCBT (mindfulness-based CBT) is a perversion of an Eastern philosophical tradition." 

So, together with conversations setting up a SW event for the NHS campaign - and lunch with one of the key players in Transition Town Totnes - and scheming other cunning plans: a very stimulating and exciting weekend. I hope the 'Totnes / Limbus / Dartington Conference' becomes a regular fixture on the psychotherapy calendar.