Over my life I have had several bouts of counselling therapy, with varying results. Just one set was based on the now widely used Cognitive Behaviour Therapy (CBT). I’m sure this would work well for many people, but it wasn’t a great success for me. Of course, now that I know at least some of my problems are neurological rather than psychological I have to expect that any psychotherapy will only take me so far.

In one sense, I do my own CBT in several ways: writing, cooperating with support services (both charities and social service provision), and listening to music. I’m not familiar with music therapy in general terms but I know music helps me when I feel lonely or depressed. What is more difficult is changing my habits that much, unless I gave up things like writing which help me anyway. Moreover, my depression bouts are often about the outside world – it’s my anxiety which tends to be more personal.

I was prompted to reflect on this by reading Stuart Schneiderman’s book Saving Face, and starting to work on a memoir of my own. I agree with Schneiderman that Freud neglected shame (rather than guilt) in his theories, but I have my worries about cognitive therapy being more effective if it works with shame and facing shame, as Schneiderman suggests. In view of the way shame prompts us to pursue status and conspicuous consumption, and the way women have been treated under its influence, I feel that might lead therapists into a Faustian bargain.

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