Profitable cognitive behavior techniques employed by psychotherapists (psychologists) in Greece in order to extend indefinitely the length of therapy (Taken from A. Beck and distorted in a Greek style).

(renewed)

1. Spotting the negative thought (cognitive error), for instance, examining if the therapy followed is a cognitive behavior therapy or a charlatan therapy. Writing it down. In case such a spotting of the negative thought is not producing any results, the therapist asks the patient to discuss about negative thoughts related to obesity, even if the patient is not oversized at all.

2. Giving to the patient a page with a childish outline and drawings and explanation of the usual negative thoughts, which doesn’t make any sense at all, probably because the person who drafted it, was in a mental disarray. Discussing about the patients inability to understand what in the hell all these mean. The therapist is assuring the patient that 99% of his patient understand the meaning of the particular page and cooperating fully, writing down their negative thoughts. In addition the //Established Authority// uses them.

3. The therapist is proposing the patient to start reading books (bibliotherapy). However the recommended books describe a cognitive therapy which is totally different from the followed one at this time. The patient is understanding that he has a lot of negative thoughts. He is writing them down. He is presenting them to the therapist. The therapist feels embarrashed. (“I told you that with a difficulty I extract one single negative thought from my patients and you already brought me so many!”). The therapist forgets what he told about 99% understand at once and cooperating fully with the therapist analyzing their negative thoughts.

4. The therapist makes remarks to the patient about putting the negative thoughts in one column, while using other columns for the assumptions, intermediate core beliefs, reinforcing events, alternative suggestions, how he feels after his own suggestions. Spending a whole session on trying to explain to the patient the fact that the word “core” in core beliefs is translated into Greek with “nuclear”, “nuclear beliefs” and not core beliefs, as the ignorants believe. This is supported by two arguments. First it is translated in such a way in the Eginiteion Psychiatric Hospital, where disagreement is not favored (May be,as part of the decentralization program, the Eginiteion Psychiatric Hospital assuming the task of keeping and elaborating the Greek Language, replacing the Academy of Athens). The second is that it is translated in such a way in the Divry’s English-Greek dictionary, written by George Konstantopoulos from the village of Divry in the mountain Parnassos.

5. Without analyzing and elaborating the produced and stored negative thoughts, the therapist asks the patient to look for some more. The patient’s list is continually rejected by the therapist with the recommendation to make the columns more and more stylish.

6. Self disclosures of the therapist, so that the patient can grasp them and write them down as an exercise. He has to challenge his own thoughts, and write down how he feels about doing all the work himself. The therapist asks the patient no to take any more pictures with his digital camera because she has put cream in her face and is glistening.

7. At the request of the patient, discussion is being made about Judith Beck and her book “Cognitive Therapy, Basics and Beyond”, relating to the need for structuring the sessions, need for extracting some conclusions at the end of the session, bridging with the previous session, need for resuming at the end, realizing what the patient understood and what he didn’t, about the process followed in order to arrive to a negative thought, intermediate belief, core belief etc. After having completed approximately 65 hours of sessions the patient realized from the words of his therapist that all these are not absolute. (“Yes, there are some colleagues of mine that follow this strict procedure. However it is written (where?) the patient is tired out of this, and in fact all my patients have come begging me, imploring me to talk freely, because they can’t sand the structuring of the session. An as I am interested in their welfare, I don’t structure my sessions”). A therapist that respects himself never reads the following http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=332

8. Discussing about any other therapies that the patient is aware of and related to the cognitive and behavior therapy model, which might give the patient ideas that he is being cheated by his therapist.

9. Discovering that in the dossier kept by the therapist there are numerous negative thoughts given by the patient which have not been elaborated for months. The therapist can disarm the patient by saying “the structure and the time used during the therapy is your responsibility. You shouldn’t produce so many ideas during the session, Ha, ha ha, look how I smile like a “Spontaneous Child”!”

10. The patient could eventually contact thought email another cognitive behavior therapist, an ex cop, and receive the following answer: “In the cognitive behavior therapy there is always a structure, professionalism, and a clear timetable. The word “clear timetable” sounds like a bell in the patient’s mind. He contacts his therapist.

11. The therapist could eventually send an SMS message to the patient asking him not to ask for a “clear timetable”, because he has been diagnosed as “borderline” (the diagnosis is sent though SMS) and there is a lot, a lot of work be done. The differences between psychologists/therapists from psychiatrists/ therapists is that the psychologist have a low self esteem and a disguised mental handicap. In Greece the majority of the mental patients are women. The majority of psychologists/therapists are also women. That means that a mentally handicapped woman would make an option, either continue to be a mental patient for the rest of her life, or become a psychotherapist. With psychiatrists we see something different. They have clinical experience in clinics and hospitals, while the psychologists have little or nothing. The //Established Authority// offers them supervised sessions that end in a few months with the therapist saying “We have now concluded our therapy, Good-by!”)

12. The therapist, without following the method described by Judith Beck, for moving from negative thoughts, to intermediate beliefs and core beliefs, could eventually throw to the patient’s face whatever “nuclear” beliefs (what Americans call “core beliefs”) the patient should have (yes! Should have!) by virtue of the diagnosis of borderline personality disorder being already made. That means that in Greece first the therapist makes the diagnosis –usually at the bank when waiting for a bank loan- and afterwards looks for the “nuclear” beliefs that the patient was supposed to have. The diagnosis should be what the therapist has presented in her //Established Authority// as a difficult case, with imaginary behavior of her patients and has received with a general applause from the participants in the meeting. The patient is not entitled to disagree. If he objects the “nuclear” belief “the world is hostile and dangerous” he has to live with it. The therapist is never mistaken, especially if the patient’s objection can make the therapist loose his diploma from the //Established Authority//.

13. The patient could contact by email another therapist. She might answer “you should go back to your therapist and discuss again the issue with him. You shouldn’t break the relationship”. If you go to another one, the first thing to discuss in the disagreement with your previous therapist.

14. The patient could eventually visit another therapist (male) who is the boyfriend of the previous female therapist and one of the supervisors of the //Established Authority//. The established practice requires every cognitive therapist to contact every colleague of his or hers to find out whether the patient has escaped from them and seeks therapy elsewhere. When a patient escapes therapy, he is treated in a way resembling neutrality of foreign ships during a war blockade. They give description not only of his name, but also of his face, his height, weight, hair etc, so that they exclude that the escapee uses a false identity. The supervisor, after collecting the fees of two visits (2X70=140 Euros, or $ 100) could say to the patient:
THERAPIST (male): I can’t accept you for therapy because I shall be treating your wife in the same time.
PATIENT: No, my wife has told you that she doesn’t like to initiate therapy with you.
THERAPIST: But she might change her mind!
PATIENT: So you don’t accept me?
THERAPIST: You should go back to your previous therapist.
The therapist can disguise herself when rejects an escaped patient by saying “I noticed that you eat meat more than twice a week. I know a therapist that is suited for you. There is no point of discussing other problems. I don’t want to hear anymore. Go!” (Something similar happened to me!)

15. The reason for such a procedure followed is obvious: Solidarity is the key for the survival of the incompetent professionals. A therapist should never accept anybody who has undervalued the colleague’s opinion.

16. The therapist can accept the patient’s proposal for a cognitive behavior therapy through email. In the cost of one hour e-mail session the patient is charged for 40 minutes that are required for receiving the message and 40 more for sending the answer, because the therapist’s laptop is very slow and will be replaced later in May. The messages include material totally depleted of cognitive behavior material , for instance “ I should teach you how to remember names. For Mike Goof, you should remember Mikey and Gooffy.”

17. Judith Beck says in her book Cognitive therapy, Basics and beyond that “when there is a negative thought that is true –related to a fact –the therapist, instead of challenging the thought, should concentrate on how to help the patient solve the problem”. This is very embarrassing for the therapist because he or she has learned in the //Established Authority// only a photocopied textbook of 90 pages that includes all the cognitive therapy and no-one has ever heard of Judith Beck in his life. The usual symptoms treated by the cognitive therapist is “Oh my God I can’t wake up at 7,00 in the morning”, “I can’t stop eating”, “My boyfriend the supervisor doesn’t like me” etc. They are unable to deal with real human problems.

18. The therapist has the ultimate argument that present to the patient after completing about 70 hours of therapy: Since you are not pleased by my approach (nice word!) you should go to another therapist. Of course at the same time the therapist undermines all attempts of the escaped patient to be admitted to therapy by another therapist, as described above. If the patient asks the therapist for a recommendation the therapist might claim that she came to Greece after a lengthy stay in Madagascar for studies and doesn’t know any other therapist

19. Therapists should never feel bad when they are dealing with patient’s negative thoughts in such a way. By using the above procedure the patient shall forget the initial cause that brought him to therapy (it could be a sort of homeopathy treatment). When the patient ceases to feel indignant of his therapist, that means he is close to the end of therapy.

20. Generally speaking, the cognitive behavior therapist must be Spontaneous Child, free from any feeling of guilt, loved by his friends and colleagues, that would examine everything with a smile and would never keep bad thought in his/her mind.


In our next communication we shall deal with audio tapes containing therapist’s interventions during sessions dealing with:
How to commit yourself to therapy by paying the therapist a sum of money that will be refunded after therapy (“The Forfeit”) as the therapist says).
Questions made by the therapist in order to make sure that the patient is unable to pay the above amount of money as a guarantee (“Forfeit”).
Content of the therapist’s SMS messages showing that her two named colleagues –one of which is a supervisors- agree with the idea of depositing that sort of amount of money.
How to draft you therapist’s work to be presented to the //Established Authority// in order to get his degree.
Etc.